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Ultrasounds Are Cool. That Doesn’t Mean Abortion Patients Should Be Forced To Have Them.

CREDIT: SHUTTERSTOCK
CREDIT: SHUTTERSTOCK

Presumptive GOP presidential candidate Scott Walker is making headlines this week for defending a Wisconsin law that requires abortion patients to undergo a mandatory ultrasound before their procedure. Walker approved the law in 2013.

The vast majority of the media coverage has focused on the fact that, in a recent interview with conservative radio host Dana Loesch, Walker called ultrasound technology “cool” — pointing out that ultrasounds allow people carrying wanted pregnancies to see an image of their unborn child.

“I find people all the time who’ll get out their iPhone and show me a picture of their grandkids’ ultrasound and how excited they are, so that’s a lovely thing. I think about my sons are 19 and 20, you know we still have their first ultrasound picture. It’s just a cool thing out there,” Walker said.

Right-wing outlets like the Washington Examiner and the Daily Caller have criticized the recent coverage, arguing that reporters are taking Walker’s “cool” adjective out of context and piecing together his quote to make it appear as though he praised mandatory ultrasounds. Perhaps to address that criticism, some story headlines have since been edited — Politico’s headline, for instance, used to read “Scott Walker on mandatory ultrasounds: ‘It’s just a cool thing out there’” and now reads, “Scott Walker defends mandatory ultrasounds.”

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To be sure, it’s a narrow distinction. But the push-back to the media’s coverage of Walker’s comments illuminates that fact that ultrasounds — a routine medical technology that’s typically an important tool at a doctor’s disposal — have become somewhat misconstrued by people on both sides of the contentious abortion debate.

There’s nothing inherently nefarious about ultrasounds, which doctors administer at least twice throughout the course of a pregnancy that’s being carried to term. At a very basic level, Walker isn’t wrong: For proud parents who are excited to welcome a child into the world, ultrasounds are cool. It’s the first chance they get to see their unborn child, and it’s how they can find out the gender if they want to know that information. Many people do save the images. So-called “keepsake ultrasounds,” which allow parents to take home their 3-D fetal portraits and keep them in a scrapbook, have become so popular that the FDA has started warning patients against having too many ultrasounds for purely sentimental reasons.

The difference, obviously, is that those pregnant people actually want to be pregnant. The women who are choosing to end their pregnancies because they can’t bring a child into world for emotional or financial reasons, on the other hand, probably don’t want to send their parents a photo of their ultrasound so they can keep it on their iPhone. In that context, it becomes clear that Walker’s comments about how much everyone loves ultrasound technology are implying that every pregnancy is a wanted pregnancy — which is demonstrably false, and disenfranchises the one in three American women who decide that abortion is the right choice for them.

However, even when it comes to abortion patients, ultrasound procedures are more complicated and nuanced than the political debate makes them out to be.

Ultrasounds are often a routine part of medical care before an abortion, since they can help pinpoint the gestational age of the fetus. And some patients do want to look at the image. According to one 2014 study that examined more than 15,500 medical records, abortion patients opted to view their ultrasound image 42.5 percent of the time when they were given the option. For some women, it’s a helpful experience that can confirm their decision to end the pregnancy.

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Medical professionals sometimes grow frustrated with pro-choice political rhetoric that casts ultrasounds as something that’s automatically in direct opposition to women’s reproductive health and rights. Writing in RH Reality Check back in 2013, Tracy Weitz, the director of Advancing New Standards in Reproductive Health (ANSIRH) — which conducts rigorous research in the field of abortion care — pointed out that ultrasounds are a useful medical tool, and abortion patients shouldn’t enter their doctors’ offices being terrified of them.

In reality, forced ultrasound laws are concerning from a slightly more complex angle. The real problem arises when state lawmakers reach into the exam room to make decisions about ultrasounds that remove agency from patients and doctors themselves.

Laws mandating ultrasounds — which are very popular on the state level — interfere with the doctor-patient relationship by dictating medical professionals’ behavior. To make matters worse, many of these laws include specific provisions designed to shame women who have chosen to end a pregnancy. Some stipulate that the doctor must describe the image in detail to the patient, even if she chooses to avert her eyes. Particularity radical versions of these laws require doctors to deliver state-mandated information about abortion alternatives, reminding their patients that they could instead choose to pursue adoption.

ANSIRH’s research has found that, when patients are forced into looking an ultrasound, they’re more likely to have a negative reaction because they feel like they’re not in control of their own medical care.

“Our findings suggest that providers, advocates, and legal experts would be best served by articulating the importance of ultrasound in the abortion care context while simultaneously opposing laws that seek to mobilize images in particular ways to manipulate women’s decision-making,” ANSIRH concludes in an issue brief on the topic. “Questions about clinical care practices are best addressed in the medical context, not the legislative arena.”

As his defenders point out, the fact that Scott Walker thinks ultrasounds are “cool” perhaps is not inherently offensive to proponents of abortion rights. But the law that he signed two years ago certainly is.