Ultrasound Requirements and the Battle Over Abortion
http://thedianerehmshow.org/shows/2012-02-22/ultrasound-requirements-and-battle-over-abortion
The Virginia legislature has approved a bill requiring women to undergo an ultrasound and 24-hour waiting period before having an abortion. Virginia's governor had expressed support for the bill but appeared to back off following protests. If signed into law, clinics would be required to ask women if they wanted to see the sonogram. Seven other states have some kind of ultrasound requirement. Supporters hope seeing an image of a fetus will make women change their mind about terminating their pregnancy. Critics say it's an effort to shame and harass women who have a legal right to an abortion. Ultrasounds and the abortion battle.
Guests
Carol Tobias
president, National Right to Life Committee.
Karen Tumulty
national political reporter, The Washington Post.
Nancy Keenan
president of NARAL, Pro-Choice America.
Comments
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Can you sue the state for the cost if it requires you to have a medical procedure deemed unnecessary by the medical professional?
Abortion industry? Thrive? Can you provide evidence?
Today's show was the best debate about abortion in America that I have ever heard. All the guests were respective to one another (and to the listeners) as well as rational in their discussion. This is the height of public radio -- I mean really -- I wish all journalism and news shows were this good. Thank you, thank you, thank you.
I have listen to your guest and I don’t think the person who is against the legislation articulated what the Virginia Bill is requiring. From my personal experience, my girlfriend at the time had her pregnancy terminated. The doctor did an ultrasound before the procedure and during the operation. However, the probe was a surface probe and not a trans-vaginal probe. There is a difference! This Virginia bill would require trans-vaginal probes to be used for greater resolution. Also, what opponents of the bill don’t like is that there is no way a woman can opt out of the type of ultrasound. That is going to far!
Diane,
I was disappointed that neither you, nor the representative from NARAL called the advocate for the Virginia bill on failing to answer the questions asked about transvaginal ultrasounds.
When the representative was expressly asked about her assertions about the routine use of transvaginal ultrasounds as part of an abortion, she repeatedly responded with statistics for all ultrasounds, the majority of which are NOT transvaginal.
From a medical perspective, if all of the information needed can be obtained by a transabdominal ultrasound (non-invasive) there is no need to perform a transvaginal one (p10 - http://www.arhp.org/uploadDocs/RH10_PRE_Abortion.pdf ). An ultrasound is not generally medically indicated for an abortion before 8 weeks gestation (p 7) and generally by 8 weeks gestation all of the medical information can be obtained by a transabdominal ultrasound (p 11).
In addition, when the pro-life representative responded to a caller who suggested that the representative had not had a transvaginal ultrasound, the representative had responded that she had had the procedure, "the ultrasound." I don't know whether she has had a transvaginal one or not, but given that she implied she had had a transvaginal one, in light of her deliberate blending of the two procedures (TVU and TAU) into one and, I would have liked to know, specifically, whether the representative had had a transvaginal ultrasound - not just (as she qualified it) an ultrasound.
NancyR
RE: the comments of the sonographer logged this morning (Akaka):
The transvaginal sonogram resembles the pelvic exam in only one important respect, and the sonographer’s comments to the contrary just underline the cavalier attitude of the Virginia policy under discussion.
I described my own transvaginal ultrasound at age 55 in an earlier post and won’t repeat that here. But I will add that I first had to drink 2 quarts of water, retain it for over an hour, wait in a waiting room for what seemed like an eternity in the presence of people who thought it was no big deal, endure the alternating infantilizations and indifference of the yawning technician, and put up with the external and internal indignities for nearly an hour with, finally, a bathroom break in the middle. And it was very expensive.
This is hardly the equivalent of a brief and familiar pelvic exam or pap smear by a doctor chosen, known, and trusted. The transvaginal sonogram was very uncomfortable, in every imaginable way, even with consent and without GOVERNMENT up in there prying about with the probe. It did not look like the sanitized picture this website has posted.
The details matter; this procedure ISN’T the same thing as mandating insurance coverage for birth control or anything else, and you don’t need to be “pro-choice” to see that. There is NO excuse for forcing it on anyone.
The one other thing I can say about this policy that hasn’t already been said is that it is good for business if you are a sonographer in the nanny state of Virginia. And it is exactly the “ho-hum, what’s the big deal” attitude of the sonographer I had, and the one who posted here this morning, that the Virginia legislature shares. And that is so very offensive.
If this policy passes, VA women should sue under the unreasonable search and seizure laws. If the Fourth Amendment doesn't cover this, what does it cover.
The use of ultrasound to coerce or manipulate a woman for any reason is an abuse of power and has no place in the medical setting. A transvaginal ultrasound prior to an elective abortion, however, provides essential information to the practitioner prior to the procedure that benefits the patient including (butnot limited to): how many weeks is the pregnancy (determines the type of procedure to be used), if the pregnancy is viable or not, and whether or not the pregnancy is intrauterine or ectopic ( a distinction that needs to be made prior to any procedure). The REAL problem here is whether or not medical practioners are forcing the patient to view the ultrasound image during the procedure, NOT the procedure itself. In the practice where I perform ultrasounds my strategy is to ask the patient how she wants me to handle it: if she want to view the image (most do not), whether or not she wants to have a friend or relative in the room with her, etc. Since I am performing this service for her I honor her wishes. For me this is a very simple model to employ. There have always been those who use the ultrasound image to manipulate a woman into feeling shame and to inspire guilt, and if the metaphor of rape is to be utilized in this context that is where it happens: psychologically. And, by the way, you don't have to have a govt mandate for a medical doctor to do an ultrasound before a termination--no good doctor would do it without knowing what they were getting into beforehand. According to what I have read about this "law" the practioner would have to ask the patient if she wants to view the image and, I'm assuming, honor her wishes if she said no. Sound familiar? A transvaginal scan is only an invasion of privacy if the patient is forced to view the image by someone exercising an abuse of power in the medical setting,which in my opinion is grounds for being relieved of their license to practice medicine.
In reply to ShyWoman:
Thank you, thank you, thank you! I totally forgot about how you have to drink all of that water beforehand. Quite honestly, it was such an awful experience that I've tried to forget it.
The point of the legislation is to punish, to control. Does this rise to the level of state supported torture? How much trauma does the state want to inflict on already traumatized rape victims? How much pain and discomfort does the state want to inflict on women who could, if they chose, have a chemically induced abortion? Barbaric legislation by the angry and vengeful. If they can't take away women's liberty (you know, the constitution) they want to make them suffer. I am SO glad we live in a 'Christian nation'.
Sorry that Shy Woman had such a difficult experience. But in all honesty most women I deal with (pregnant and non pregnant) who have transvaginal ultrasounds find it to be not such a big deal (and I have had numerous transabdominal and transvaginal ultrasounds my self, and it was not a big deal). I think it should be any one's right to refuse an exam, and I always say to this to any patient that is expressing anxiety or hesitance about the procedure, yet I also explain to patient that better detail is often obtained , as well things may be seen transvaginally that are not seen transabominally. (This includes pregnant and non pregnant patients. Again, it always a patients right to refuse an exam. My point is an ultrasound should be done (and yes sometimes transvaginal is necessary) prior to an abortion for medical reasons (dating and to r/o ectopic).
To Shy Woman, I do try to deal sensitively with patients who have excessive anxiety or hesitance about the procedure. It is important to maintain a calm and professional and sensitive manner at all times, explain the procedure, risks and benefits, and the patient always must give informed consent. I do not deal with preabortion patients, and have only commented that ultrasound is a medical indication prior to an abortion. I am not really offering my opinion about abortion.
I am not convinced that abortion is the solution for every unwanted pregnancy but I have never walked in the shoes of these women. Therefore I would like to propose a more pragmatic question to the debate - who pays for the abortion and how much do they cost?
Also, has anyone thought of about the legal and ethical issues these doctors who perform these procedures face? Maybe the ultrasound is not so much for the patient but to protect the doctors from performing an abortion and later being sued. I think that this is a way to insure that an abortion will be performed on a living fetus not a dead one. What if the patient has suffered a miscarriage and has not realized it thinking that she is still pregnant. It has happened just like women who do not know they are pregnant until they give birth. That way who ever pays for it - Medicare or private insurance or cash patients - will not be charged for a procedure that was not performed. Doing an abortion, I presume, has a different charge and co-pay than a cleaning out of a uterus of a foreign body.
Maybe we need to be a less emotional about this issue and move forward. Abortions have been around for centuries. Be grateful that at least young women are not dyeing because of badly performed abortions.
The trans -vaginal ultrasound is state sponsored rape. These politicians have indeed over stepped their bounds. How dare they. Inflicting their opinion into a medical procedures without a medical license. In the face of all the "get the government out of our lives" the trans-vaginal ultra sound is government sponsored rape. These politicians are impotent in matters of creating jobs,controlling the price of energy or controlling Wall St. Their fall back position is to push women around. It is truly despicable.
In 2011 I used my Bank of America credit card to help a friend of pay for an abortion. In the face of all the government help BOA has received I was happy to help a friend.
Lastly I had an abortion in 1979 I do not regret this decision.
Listening to some of the absurd comments made by Tobias was difficult. However, I was both surprised and disappointed to hear Diane Rehm also use words that were totally inappropriate. In asking a question related to abortion, Diane referred to "the mother". There is no "mother" here. Just as there is no "baby", nor is there a "child" when we are hypothetically discussing a zygote, an embryo, possibly a fetus. Think about it: Am I a mother because I carry eggs in my body? Am I suddenly a mother because I carry a fertilized egg in my body? And does that mean he is a father because he produces sperm? Or is he suddenly a father because he fertilized an egg? This is not merely semantics. It is a slippery slope - one that the anti-abortionists want you to follow.
From the moment of birth through the age of majority, parents are legally responsible for their children, keeping them alive and as healthy as possible. During that time, children have no rights, emancipation notwithstanding. Why would non-viable life have more rights than minor children?
It would be wonderful if every woman had access to perfect contraception. It would be wonderful if every pregnancy was hope fulfilled. Well, life isn't fair.
Non-viable, premature births often require expensive life-saving efforts (not exactly a natural approach) and often result in less than optimal outcomes. Yet, the parents are consulted and presented with difficult choices and decisions regarding life-saving efforts of premature babies. Why would the continuation (or discontinuation) of non-viable, UNBORN life be any different?
Well, it isn't, BECAUSE IT IS A PRIVATE MATTER AND DECISION.
Historically speaking, religions have literally grown membership in promoting large families by prohibiting contraception. Then, when resources, i.e. food, land, your-grass-is-greener-than-mine, become scarce because there are so many mouths to feed, people begin taking it from others out of need or greed. Battles and wars are fought, effectively reducing population, and the whole cycle begins again. (Think global warming.)
Clearly, contraception is the answer to many of life's problems. When that fails, whether it's a 1st pregnancy or the 11th or 12th, it remains a PRIVATE MATTER. The reasons are PRIVATE.
Government, butt out.
One need not be a feminist to recognize when her rights are are risk.
EXACTLY!
I listened to this discussion this morning, and was struck by the "outrage" activists expressed at "politicians coming between doctors and patients" and "the government forcing medical procedures" on women. Frankly, if that's how you feel, conservatives against the government takeover of our health care system and abortion proponents should be fighting Obamacare from the same side, the argument is the same. Adding coverage to the thirty or so million without coverage in this country doesn't equate to the head of Health and Human Services dictating insurance coverage or treatments to the remaining three hundred million.
Arguing against sonograms when 85% of abortion providers already perform them and currently offer them to 14 of the remaining 15% of their patients is rather indefensible. What you're asking is for women to be assisted in avoiding the reality of what they are doing, especially when doctors are performing sonograms to make sure all the severed limbs or head of a fetus has been removed before declaring the procedure a success. While I'm pro-choice, I still consider fetuses to be living humans, and believe abortion is a tragedy rather than just a bunch of cells. A young lady was
expelled from school today for borrowing an asthma inhaler. Others have been
severely disciplined for having an aspirin in their pocket, yet some of your
guests believe minor girls should be free to abort the life of a baby without
informing their parents. In Great Britain, some school girls had abortions
actually facilitated by their schools, and without the knowledge of their parents.
There needs to be some middle ground in this discussion. Really, should a twelve year old child really be allowed to abort a fetus without counseling and parental involvement? Can there really be an intelligent discussion of the issue with militants who think that's a legitimate case of patient privacy?
Shy, abortion providers already perform sonograms on 85% of their patients, they have to to make sure one, that the procedure is legal, and two, to be sure they retrieve all the body parts of the fetus they dismember. The outrage against sonograms is a false one. Your outrage against a bureaucrat getting involved in medical decisions is legitimate, and shared by conservatives who want nothing to do with the head of the HHS dictating insurance coverage, pricing, and choice of medical procedures to doctors. Bottom line, how can you be for the intrusion of Obamacare into the dr/patient relationship and against it for abortion providers?
Shy, abortion providers already perform sonograms on 85% of their patients, they have to to make sure one, that the procedure is legal, and two, to be sure they retrieve all the body parts of the fetus they dismember. The outrage against sonograms is a false one. Your outrage against a bureaucrat getting involved in medical decisions is legitimate, and shared by conservatives who want nothing to do with the head of the HHS dictating insurance coverage, pricing, and choice of medical procedures to doctors. Bottom line, how can you be for the intrusion of Obamacare into the dr/patient relationship and against it for abortion providers?
As the parent of drug exposed children adopted from the foster care system, I'm curious if you believe abortion/sterilization of all those "addicts" is appropriate government policy? After all, if the government is paying for the medical coverage, and sterilization is now supposed to be provided for free (how an insurer can be forced to pay for services without payment is another constitutional issue) isn't the next step for some government bureaucrat to force women to get abortions or sterilization? The logic being all the money the state will save covering mental health issues or criminal justice system costs? As in Europe, do we adopt a cost benefit model that actuarially determines when it's no longer cost effective to provide elder care? Government involvement in medical care issues creates a huge number of ethical dilemmas as well as questions of just how free are we when we give up the right to make our own life and death decisions.
The ultrasound requirement is just one more attempt to bully women into submission. Right to Life seeks to achieve its goals by tearing women down, telling them they don't know what's best for them and they need someone else to tell them what they should do.
Right to Life is production oriented - make babies, make babies, make babies. Why is there greater focus on life before birth than with the deaths after birth in wars? No woman ever shed more tears over loss of a pregnancy than does the mother who mourns for a son or daughter she loved for twenty something years and lost in some far away war.
If an employer objects to birth control coverage in an empoyee's insurance, that employee should look for another place to work. That employer is not interested in competence and productivity, and the company or institution will suffer as a result. Look for an employer who respects you and values your work.
The Catholic bishops complain about being forced to offer employee insurance plans that would pay for female contraceptives, the use of which goes against their beliefs. The bishops should have the ability to hire the people who they want to as long as tax money is not involved. This means that Catholic institutions need to be self-sufficient, stand alone, not sharing in any federal programs. The insurance controversy is showing us even more the wisdom in the separation of church and state.
However one might feel, we need to be aware that this birth control controversy is not really only about what God says and about the sanctity of life. It is also about fallible human beings with very human agendas. Let us not be bullied.
I'm a day late getting a chance to hear this show, online. Haven't read any others commentors rants or raves. Half through the show and have to say:
1. A Females reproductive health care, including the right to an abortion, is a Basic Civil Right and a right to privacy between the female and doctor. -- That's if the high and mighty Republican Hypocritical party truly believes in the 13th and 14th Amendments.
2. The men of Congress, particularly one paRty, continually perpetuate women as thoughtless second class citizens. This was illustrated brilliantly by the refusal to let any women sit, testify or participate on the recent Congressional panel.
3. Nancy Keenan, you rocked! this conversation by reframing the rights of women and their rights to privacy. Karen Tumulty excellent job explaining things and keeping the peace. Carol Tobias you lost your argument at minute 21 when you said: "we are trying to tell women 'that we know best' ... . and N.K. you put a nail in it with your following comment. C.T., you lost the argument again at minute 25 when you began psychoanalyzing all women; and Bam, N.K., great comeback again.
Ok, I read the first three comments;
BillH yours doesn't stand up. your opening statement "I don't care" followed by a statement of freedom and right to privacy, but then you go on clearly expressing a conservative opinion. "the radical left" made he chuckle and think of the bible thumping (read separation of Church and State) pandering hypocritical Republican congressmen. And the flocks ranting mantra of: government stay out of our lives yet constantly strive to restrict the rights of others who don't agree or follow their narrow right "theology". And you finish with a whopper of a sentence illustrating hypocrite, especially using the word 'crusade'
-- Zoomama1 - Your comment was spot on, great.
These laws are insulting and degrading to women. While thinking part of the population is pulling the cart of human progress, religious people keep sitting on the brakes with their fingers in their ears saying "lalala".
Ain't those "Pat Robertson Virginia Gentlemen" wonderful. I just wish they were as rare as they want abortions to be. "I say, "Abort all Virginia Gentlemen of the Republican Class" Abort this mission. Remember, these people are being led by the man who urged the local Christians to pray that a Hurricane miss our area and head to New Jersey instead. These Christians and the Catholics only real interest is to protect their real estate and holding, and they manipulate people by keeping them harassed, uneducated, and making sure they misunderstand any issue that would affect their estates. Off with their head, or at least, head count. Let them be put in the Stocks in Williamsburg. They all think they built this country, and all our soldiers died, and continue to die for what Pat Robertson believes. And he does believe. He is Privaledged to Know what God wants for him and for you. As do his minions in the Virginia legislature, and in the Governor's office.
Next up will be George Allen and his foolishness. Watch out world. Do we need this locker room attitude posing as a world class citizen. I think not. Save Virginia from itself, please, all you citizens of the Heartland. Keep this hunting and hasselling the poor class out of our lives, and off the world stage. There are serious issues that must be attended to. Keeping people otherwise distracted and exhausted is the task of all skalliwags and carpetbaggers. And, yes, we grow our own in the Old Dominion.