Vaginal Ultrasound Required for Abortion in Texas

I generally try to be cordial, but it is hard to find cordial words with which to begin discussing this. I speak, of course, about Texas’ mandatory ultrasound law, which forces doctors to give, and women to undergo, an invasive ultrasound and a lecture before a female patient may receive an abortion. Previously, U.S. District Judge Sam Sparks had ruled that parts of the law may be unconstitutional, and had blocked it from being enforced. Today, a three-judge panel on the 5th U.S. Circuit Court of Appeals overturned that order.

Now, sometimes transvaginal ultrasounds are called for, like when a pregnant woman has unexplained pelvic pain. Indeed, there are some situations where a doctor’s failure to do a transvaginal ultrasound could conceivably constitute medical malpractice, unless—pay attention here—the patient (who has been told of the risks and the diagnosis, and who has the capacity to make her own medical decisions) acts against medical advice and leaves. Yes, that is what’s known as informed consent and informed refusal. More on those in a moment.

But first back to women genuinely needing transvaginal ultrasounds: those situations involve what we in the give-a-hoot-about-women community call “medical reasons.” See, in real medicine, it’s the medical community who makes the professional standards and protocols whereby its members know which treatments are indicated and which aren’t and under what conditions. And do you know what is not a medical reason? Well, for example: A third party’s non-medical conclusion that some female patients are quite likely to be exceedingly stupid and culpably callous in their medical decision making. In fact, the sentiment, I think some ladies are really stupid and dirty and immoral but they might just improve if I forced them to get an ultrasound and a lecture, has nothing whatsoever to do with medicine. (Except, perhaps, in the sense that some psychiatric counseling might help such a person get over their preoccupations with preemptively addressing the moral failings of strangers.) 

No, arguably, the closest medical cognate is a situation in which a patient lacks—can you guess?—the capacity to consent to or refuse treatment. Which is, of course, the rationale here. The idea is that someone seeking an abortion can’t possibly have considered the matter as thoroughly as she needs to, by virtue of having sought out an abortion in the first place. Therefore, she has to have treatment imposed by threat: either submit to a transvaginal ultrasound you may or may not want, or else lose your legal right to an abortion. 

One of the most infuriating aspects of this law (and believe me, it’s a crowded field) is that its proponents dress it up as “informed consent,” when it precisely undoes informed consent. Undergoing a transvaginal ultrasound is not the same as being informed of your diagnosis and the medical risks of a treatment or procedure. A transvaginal ultrasound is a procedure (duh!)—one usually used to diagnose potential problems with a pregnancy in the presence of certain symptoms. Except in Texas, where it’s also used to treat the malady of not being as opposed to abortion as some people wish you would be. Which is different from the way things typically work. Ordinarily, in this country, adults have the right to refuse a medical procedure without it thereby cutting off their access to other, basically unrelated, legal medical procedures. If you think that it ought to work differently in this case, then two possible explanations present themselves:

1) Perhaps you think that women who seek out abortions are not really, as a class, legal adults, by virtue of their having sought out a legal procedure that you don’t think should be a legal procedure;

2) Perhaps you are too busy to read this because you are hard at work on a letter to your elected representative demanding that any man seeking a Viagra prescription should be required by law to undergo a vasoscopy first. (You know, just to make sure he has all the information he needs to make this most important and personal of decisions. After all, how can his libido-addled man-brain POSSIBLY have considered everything he needs to know until he’s seen it for himself? You know how men are. Wait, what? No, I’m sure it’s totally constitutional.)

And by the way: have any of the laws’ supporters considered that sometimes pregnancies come about as a result of rape and/or sexual abuse, and that some of those pregnant women seek abortions, and that it just might be especially re-traumatizing to a rape survivor to be vaginally penetrated against her will? Or did they just overlook it? If not, well, wow, sounds like they might not have all the facts. By their logic, I would have to at this point suggest that they be forced by law to watch very graphic footage of rapes so they could understand the implications of their decision, before they are allowed to go on being judges. But I wouldn’t do that, because that would be cruel and ignorant

Ah, but Rick Perry called it a victory for life. “Every life lost to abortion is a tragedy,” he said, “and this important sonogram legislation ensures that every Texas woman seeking an abortion has all the facts about the life she is carrying, and understands the devastating impact of such a life-ending decision.” Yes, it is important to try and understand devastating impacts, isn’t it?

sarah.morice.brubaker@ptstulsa.edu'

Sarah Morice-Brubaker is an assistant professor of theology at Phillips Theological Seminary in Tulsa, OK. In addition to writing for RD, she’s also written for The Christian Century, Dialogic Magazine, and Faith and Leadership. She has a chapter in the forthcoming edited volume from Ashgate, Placing Nature on the Borders of Religion, Philosophy, and Ethics.