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When Texas Tells You to Have a Sonogram

Photonics.com
Mar 2012
Mar. 20, 2012 — Transvaginal ultrasound doesn’t often show up on the comics and editorial pages, as it did in a Doonesbury storyline that ran all of last week. But then, transvaginal ultrasound isn’t often wielded as a political tool demanding satire.

The storyline concerns a Texas law that went into effect in February. According to the law, a woman seeking an abortion must undergo a sonogram at least 24 hours before the abortion is performed. The doctor then must provide, “in a manner understandable to a layperson, a verbal explanation of the results of the sonogram images, including a medical description of the dimensions of the embryo or fetus, the presence of cardiac activity, and the presence of external members and internal organs.” He or she must also play audio of the heartbeat.

(The law allows for a few exceptions: pregnancies that resulted from sexual assault, incest or other violations of law, for example.)

Not surprisingly, this raised the ire of activists and others concerned about reproductive rights. “Texas women deserve much better than this,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement. “Women’s fundamental reproductive rights, and the First Amendment rights of their doctors, are now being violated on a daily basis.” In a New York Times column by Nicholas Kristof, Dr. Curtis Boyd, a Texas physician who provides abortions, was described the law as “state-sanctioned abuse [that] borders on a definition of rape.”

Gary B. Trudeau picked up on the latter theme in the Doonesbury series last week. The strips follow a woman who goes to a medical center to receive an abortion and is told she must first undergo a transvaginal ultrasound. When she protests that she doesn’t want a transvaginal ultrasound, the doctor explains that the male Republications who run Texas have determined that any abortion-seeker in her first trimester must be examined with a “10-inch shaming wand.” He continues: “By the authority vested in me by the GOP base, I thee rape.”

Pointed commentary, to say the least, but commentary that needs to be made. In the Kristof column, Dr. Boyd notes that the law goes beyond the bounds of what he feels is medically appropriate, and of what he would necessarily advise when a woman comes to him seeking an abortion. “Many states describe rape as putting any object into an orifice against a person’s will,” he said. ‘Well, that’s what this is. A woman is coerced to do this, just as I’m coerced.”

Defenders of the law will tell you it’s simply a matter of informed consent, of providing a woman with medically relevant information needed to make a decision about having an abortion, but such arguments are disingenuous. Already, doctors will order sonograms before abortions if they deem them medically necessary. And in any event, few have made any attempt to mask the ideological intent of the law.

“Today’s ruling is a victory for all who stand in defense of life,” Rick Perry said in January when a Court of Appeals overturned a temporary order against enforcing the law. Perry, the governor of Texas who was campaigning for president when he made the comments, signed the law in early 2011. “Every life lost to abortion is a tragedy,” he added.

In an op-ed that appeared in The Des Moines Register this past Saturday, Elizabeth Graham, director of Texas Right to Life in Houston, wrote: “Trudeau and the abortion industry cringe at the thought of the fledgling heartbeat made audible during the sonogram. If the tiny flicker touches her mother, she just might continue her pregnancy.”

Individuals will of course have their own opinions and beliefs about abortion. I respect that, as anyone should. The imaging community as a whole, though, should be concerned any time imaging technology is used to further a political or any other agenda. Medical researchers and practitioners will decide what information patients need to make decisions — and especially when procedures need to be performed — based on understandings of what is medically relevant and necessary. Allowing anything else is irresponsible and a dangerous precedent to set.


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