Anti-Choice Ultrasound Laws Don’t Change Abortion Rates, But Continue Getting Tougher

Last last week, the New York Times published an article about the growing wave of U.S. state anti-abortion laws that center on ultrasounds. Specifically, the state laws in question usually either require that ultrasounds be performed prior to an abortion or that the woman (or person of a different gender seeking an abortion, though they are never discussed in such articles) be offered the opportunity to view the images when an ultrasound is performed. Sometimes the laws do both.

The article contains quite a few interesting tidbits, namely about how these laws have impacted — or more accurately, have failed to impact — personal decisions about abortion.

In one of the few studies of the issue — there have been none in the United States — two abortion clinics in British Columbia found that 73 percent of patients wanted to see an image if offered the chance. Eighty-four percent of the 254 women who viewed sonograms said it did not make the experience more difficult, and none reversed her decision.

That generally has also been the case in Alabama, which enacted its law, the first of its kind in the United States, in 2002.

“About half of women opt to view them,” said Diane Derzis, who owns the Birmingham clinic. “And I’ve never had one patient get off the table because she saw what her fetus looks like.”

In some instances, the ultrasounds have affected women in ways not intended by anti-abortion strategists. Because human features may barely be detectable during much of the first trimester, when 9 of 10 abortions are performed, some women find viewing the images reassuring.

“It just looked like a little egg, and I couldn’t see arms or legs or a face,” said Tiesha, 27, who chose to view her 8-week-old embryo before aborting it at the Birmingham clinic. “It was really the picture of the ultrasound that made me feel it was O.K.”

It really doesn’t surprise me that anti-choice legislation isn’t doing what it was promised to do. Without a prior emotional attachment to the fetus, first trimester ultrasounds aren’t particularly impressive. Embryos and fetuses at that stage of gestation don’t look human, and when anti-choice propaganda regularly revolves around pretending that images of stillborn or miscarried full or almost full term babies are what abortion looks like, of course seeing nothing more than a little blip can be a huge relief.

I also don’t think that it’s a bad thing to offer a patient a chance to view an ultrasound when one is performed. First of all, clearly lots of women want to view the images. Secondly, medical personnel often have a way of making us feel as though we are disconnected from our own bodies, through failure to explain procedures and treat us as though we are mentally present during them. Including patients by showing them the ultrasound may, for many, have a reassuring and calming effect that makes them feel less objectified, and as though they are being treated as people rather than specimens.

Where I have a problem is not with setting a standard that patients should usually be presented with the opportunity to access information about their own bodies, but with the requirement by law regardless of circumstances. What I have a problem with is the lack of empathy that forces the hands of medical personnel in very difficult situations and has the potential to emotionally devastate someone seeking an abortion. What I have a problem with is the state interference with professional opinion about when medical procedures are actually necessary, and professional opinion about the most caring way to respond to a person who is very sure about the decision to have an abortion but nonetheless quite distressed by it.

What I have a problem with is purposely failing to give patients any choice in the matter about whether to view images and where to draw the line in their own emotional involvement in medical procedures:

Late last month, Oklahoma went a step further. Overriding a veto by Gov. Brad Henry, a Democrat, the Republican-controlled Legislature enacted a law mandating that women be presented with an ultrasound image and with a detailed oral description of the embryo or fetus.

A state judge quickly stayed the requirement pending a July hearing in a suit filed by two abortion providers. But the measure has prompted outrage among abortion rights advocates and raised questions about the impact of ultrasound laws.

As I said before, it comes as little to no shock that many patients choose to view ultrasound images when presented with the option, that most did not regret it, and that exceedingly few actually changed their minds. But reviewing those numbers in context with the new, even more extreme Oklahoma law does force me to reconsider my previous view about the purpose of such legislation.

Previously, a large concern I held about such legislation is that it infantalizes women.[1. As women are falsely usually understood to be the only people who need abortions, they are not the only ones impacted by such laws but are the ones intended to bear the impact.] Legislators always tout such bills as necessary to reduce the number of abortions — suggesting that women simply don’t understand what abortions are before climbing up on the table to actually receive one, and upon seeing an ultrasound will realize the grave, naive, and murderous error of their ways. Further, I reasoned, such legislation cements in the public mind that women are too childish and ill informed to understand the nature of their own bodies, and must have very basic matters, such as the fact that abortion ends pregnancy, very carefully explained to them. I knew that such laws were always highly unlikely to change the minds of those seeking abortions, but was outraged and offended that anti-choicers actually believed that they might do just that and remained oblivious or indifferent to any harm that they might cause.

I’ve now come to believe that while the rest may also be true, the harm is actually a really big part of the point.

Oklahoma’s new law exempts women who need an abortion for emergency medical reasons. But it does not allow exceptions for victims of rape or incest.

During the six days the law was in effect, all of the patients at the Reproductive Services abortion clinic in Tulsa averted their eyes from the ultrasound screen, said Linda S. Meek, the clinic’s director. But they could not avoid hearing descriptions of fetal length and heart activity, she said. Many left in tears, but none changed course.

“It’s very intrusive, and very cruel,” Ms. Meek said.

As I’ve stated before, while anti-choicers’ tactics may be cruel, extreme, and sometimes even dangerous, they’re rarely foolish. They almost always have a point, even if that point isn’t immediately apparent. It indeed seems ludicrous that they would stand outside of clinics with bullhorns and giant posters, expecting abortion patients to suddenly decide to reject the procedure. But it makes a lot more sense when you consider that they’re not so much trying to change minds as introduce as much guilt as is possible into minds that have already been made up.[2. As well, of course, as terrify workers and patients alike.]

For all their success, I believe that it’s absolutely dangerous to discount the objectives and strategies of the anti-choice movement. I don’t believe for a second that they haven’t seen these same numbers. I also believe that if their real goal was to actually reduce the number of abortions, they would have changed course.[3. Perhaps by promoting contraception and comprehensive sex education?] And so it seems that their real goal instead is to punish those have abortions as much as they can for as long as abortion is still available.

For “opening their legs.” For “being whores.” For “killing their babies.” For being such failed women. For being poor and still having sex. For being raped. For thinking that their bodies are their own. For exercising rights that anti-choicers don’t believe women deserve. For thinking that their own lives and health have value. For all of that, anti-choicers believe that those who have abortions need to be punished as much as they can possibly get the state to punish them.

After all, while most patients don’t regret viewing the images they’re offered, some do — some is good, as some have then apparently been appropriately “punished.” But when such high numbers feel ambivalent or even relieved upon viewing the images, giving them an option and simply showing pictures isn’t good enough, anymore. After all presenting choices is the “problem” to begin with. Further punishment is needed — and that means forcibly heard, lengthy, biased descriptions about what exactly it is that these sluts — who may have been raped, but probably deserved it, after all — are supposedly killing.

The Oklahoma law is indeed about anti-choice legislators pushing boundaries and seeing what exactly they can get away with. But it’s also about pretty directly about kicking the misogyny up a notch, and saying “they may still technically have rights, but that doesn’t mean we can’t make them suffer because of it.”