Carole Joffe: Averting Their Eyes from an Assault on Women’s Health

"Nothing in this section shall be construed to prevent a pregnant woman from averting her eyes from the ultrasound images required to be provided to and reviewed with her." This is the "good news" of an egregious law recently passed in Oklahoma making ultrasounds mandatory for abortion patients. But though I read the law carefully, I couldn't find anything allowing women to also cover their ears during the ultrasound.

This is unfortunate, because the law requires that those performing the ultrasound "provide a simultaneous explanation of what the ultrasound is depicting," and also "provide a medical description of the ultrasound images, which shall include the dimensions of the embryo or fetus, the presence of cardiac activity, if present and viewable, and the presence of external members and internal organs, if present and viewable." Even those women who are aborting a pregnancy caused by rape or incest are compelled to undergo such mandated ultrasounds.

Ultrasounds have become one of the key weapons of anti-abortion legislators. A number of states require abortion providers to make ultrasounds available; a handful of others make viewing mandatory, but Oklahoma is the first state, according to the a href="http://www.reproductiverights.org/pr_08_1010OKULTRA.html">Center for Reproductive Rights, that requires a woman to hear the description of an ultrasound image.

The Oklahoma law has the added perverse feature of preventing a woman from suing her doctor if he or she intentionally withholds other information about the fetus, such as an anomaly. So, women are forced to hear something they may not choose to hear, but are not entitled to information that would be presumably of critical importance to them. Such is the state of public policy when it is in the hands of anti-abortion fanatics.

The Center has filed a challenge against the law, on behalf of a clinic in Tulsa, Reproductive Services, arguing that this law "profoundly intrudes upon a patient's privacy, endangers her health, and assaults her dignity."

This Oklahoma law is particularly interesting to me, because I am in the midst of writing a book on contemporary abortion provision. I have been of course documenting the many assaults–physical, legal, and cultural–on abortion providers, but I also have been writing about what constitutes good abortion care. After interviewing and observing numerous providers, and participating in their listserv discussions, I realize that one of the core principles of this field is that all women can't be treated alike. One-size-fits-all policies just don't make sense, given the different needs and backgrounds of abortion patients. I have been continually struck by the accounts I have heard of providers attempting to "meet the woman where she is at," to quote a phrase frequently used in this field.

For example, the fact that abortion providers are predictably appalled by the Oklahoma law does not preclude their recognition that some abortion patients do in fact wish to see their ultrasound. And these women's requests are honored. Common sense.

But it is not common sense–or common decency–that is driving the Oklahoma legislators who passed this law. Rather, the intent here, as with so many of the hundreds of anti-abortion bills that have been passed, is to harass patients and make operations difficult, if not impossible, for the provider community. In the case of Reproductive Services, the clinic challenging the law, the legislators may be successful. An article in the Tulsa World quotes the administrator of the clinic saying her facility will probably not be able to survive financially, if this law is upheld, because of the added costs. The clinic, incidentally, also provides contraceptive services and adoption counseling and referrals.

As one of the wisest women I know in the abortion providing community frequently says, when confronted with such blatantly cruel legislation, "Dude, where's our country?"