I recently saw a patient in the office for amenorrhea, severe left-sided pelvic pain, and a positive home pregnancy test. I ordered blood work and a stat ultrasound to rule out ectopic pregnancy. When I mentioned the ultrasound, the patient balked and confided that she was uncertain whether she wanted to continue the pregnancy.
My patient felt that an ultrasound would just complicate an already painful decision to terminate the pregnancy. I explained to her that while I understood her apprehension, given her clinical presentation, we needed to ensure this was not a tubal pregnancy and move forward with the ultrasound.
Under normal circumstances in New Jersey, this patient would not have needed an ultrasound to confirm her pregnancy, especially if she was considering an abortion. Unfortunately, not all women have this choice.
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On February 28, 2012, the Virginia Senate passed a bill that will require all women seeking an abortion to undergo ultrasound prior to the procedure. Many other states including Pennsylvania and Mississippi are currently working on similar bills. Seven states already require ultrasound and clinicians to provide a description of the image of the fetus.
The Virginia bill initially required a transvaginal ultrasound be performed, but was revised to transabdominal ultrasound with the option for a transvaginal probe, after widespread public opposition and cries that the legislation was equivalent to “state rape” by prochoice and women’s advocacy groups.
Virginia Republicans maintain that transvaginal imaging is the most technologically advanced ultrasound method for early pregnancy and would enhance the informed consent requirement prior to pregnancy termination.
Many others believe these laws are an attempt to degrade and humiliate women seeking abortion — thinly disguised, government-enforced roadblocks to a legal procedure. For a group of politicians who claim to want less government intervention and involvement, Republicans advocating these bills seem intent on micromanaging women’s health care and the way providers practice medicine.
First trimester ultrasounds are not part of routine prenatal care. Many insurance companies will not cover first trimester ultrasound without a medical indication, such as vaginal bleeding or severe pelvic pain. So why are politicians now requiring this expensive procedure for a woman who plans to terminate her pregnancy?
Despite what some prolife advocates may think, the decision to terminate a pregnancy is never an easy one. Prochoice does not mean proabortion. Prochoice means supporting a woman’s legal choices regarding pregnancy and her body. Requiring unnecessary ultrasounds add to the pain women experience when making an already difficult decision, but will most likely not change the decision once it has been made.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
