font-family: 'Arizonia', cursive; Michael Stichauf - "As I understand it now...'til it changes": The Mandatory Trans-vaginal ultrasound debate

Tuesday, March 10, 2015

The Mandatory Trans-vaginal ultrasound debate

As a man, I get apprehensive about writing pieces which deal with women's issues, especially women's reproductive issues. I know there are feelings and experiences, attached to these issues, that I could never begin to understand. That being said, because of my position on these issues, I'm hoping that women won't have a problem with my expressing and espousing these very positions. My goal is to promote, what I feel is, every woman's right to have the decision to do what they want with their own bodies. For too long, the Congress of the United States of America and just about every other politician, male or female, have thought that it's their job to tell a woman just what it is that she is allowed to do with her very own body! In January of this year, our "esteemed" (?!?!) politicians were at it again!

On January 22, 2015, House Republican, Jeff Duncan (R-
Rep. Duncan (R-S.C.)
So.Car.), along with ten other Republican men, introduced a bill which would make it mandatory for women, who are seeking an abortion, to go through an extremely intrusive ultrasound procedure before they would be allowed (?!) to have that abortion. The implications are easy to understand; NO intrusive ultrasound, NO abortion! Here is just another attempt by the Republican party to get another step closer to making abortion impossible for women. Now, Republicans will probably say, "This bill isn't framed to stop women from getting an abortion. Quite the contrary, in fact! The bill is intended to give women the best care possible with the best available equipment." On it's face, that comment would seem to be correct and genuine. The bill does state that the ultrasound must be performed with the best possible technology available. These days, that means the ultrasound must be a trans-vaginal ultrasound. Here's the rub, though; Making these trans-vaginal ultrasounds "mandatory", is bad medicine. As I'll talk about later, the majority of abortion cases never need a transvaginal ultrasound. That is- the majority of them don't. So, if that's the case, why are the Republicans trying to make them mandatory? The Republicans want to cloak the forcing of their moral and religious beliefs on women in language that sounds like they care for the health of the woman seeking the abortion. While I'm sure they don't want to see harm come to these women, they care more about forcing their beliefs on them. Also, o
ne of the consequences of this intrusive procedure is that it raises the cost of the whole abortion process to the point where most middle to lower income women can't afford it. More on that later, also.

Two Different Ultrasound Procedures

In prenatal medical care, there are two different kinds of ultrasound procedures. The most common one is the "topical" ultrasound. The other one is called a "trans-vaginal" ultrasound. 

Trans-Vaginal probe,left - Topical Ultrasound, right

Web MD describes ultrasounds as such;

"A prenatal ultrasound test uses high-frequency sound waves, inaudible to the human ear, that are transmitted through the abdomen via a device called a transducer to look at the inside of the abdomen. With prenatal ultrasound, the echoes are recorded and transformed into video or photographic images of your baby. The ultrasound can be used during pregnancy to show images of the baby, amniotic sac, placenta, and ovaries. Major anatomical abnormalities or birth defects are visible on an ultrasound. An ultrasound is generally performed for all pregnant women around 20 weeks into her pregnancy. During this ultrasound, the doctor will confirm that the placenta is healthy and that your baby is growing properly in the uterus. The baby's heartbeat and movement of its body, arms and legs can also be seen on the ultrasound."

Next, they describe trans-vaginal ultrasound;

"Most prenatal ultrasound procedures are performed topically, or on the surface of the skin, using a gel as a conductive medium to aid in the image quality. However, a transvaginal ultrasound is an alternative procedure in which a tubular probe is inserted into the vaginal canal. This method of ultrasound produces an image quality that is greatly enhanced, but it is not a common prenatal procedure. However, it may be used early in pregnancy to get a clearer view of the uterus or ovaries if a problem is suspected. It may also be used early in pregnancy to determine how far along you are in your pregnancy (gestational age)."

Over the years, ultrasounds have been used as a normal procedure for prenatal care. For years they have been using the "topical" form, meaning on the surface of the skin. Recently, trans-vaginal ultrasounds have been used because the picture they provide doctors and healthcare professionals is, hands-down, a better quality picture. No one doubts that. No one also doubts that, when necessary, a woman will agree to the trans-vaginal ultrasound when their doctor tells them that it is a needed medical procedure (NOT a mandated one), because he/she can't get the image that they need from a topical ultrasound. From the information that I've read, the "necessary need" for a trans-vaginal ultrasound is rather rare, although it is "needed" for some things. 

The Heart of the Debate

The Conservatives

The issue at the heart of this debate is the unnecessary mandating of trans-vaginal ultrasounds by the "state". It calls to mind the "Big Brother" image that our state and federal governments have been pushing on us for decades now! Slowly but surely, government has decided that they know what's best for our citizenry. With the appointments of certain judges to the supreme court, the chances that laws which end up governing the human body and what we can do with our own bodies, are not likely to be overturned! We are entering a dangerous period in "Democratic" governing if "we", as citizens of the United States, won't stand-up and tell our government that we won't allow them to dictate what kind of control we have over our bodies. Without sounding like some "fringe nut-job" we aren't a far cry away from, for example, our government, fearing that our population may be expanding at too great a rate, to start to propose "population control" laws such as the "one child law" that Communist China had enacted in 1979 and still exists today! Now, I don't believe we have a population problem but it's an example of what governments are capable of doing once they think that they've got their citizens in the palm of their hand. I understand that this kind of thinking is extreme but with the legislation that the Republicans have suggested here, it is a slippery slope that we find ourselves on. Don't forget, it was only twelve to thirteen years ago when "Dubya" (our previous, "Grand Leader") enacted the current laws that were initially supposed to be used ONLY for spying on terrorists. Now we've come to realize that those very laws are being used to spy on our own people. I'm sure no one thought that domestic spying would be allowed to flourish, AGAIN, in our country after the fiasco that was uncovered by the Church Committee of the 70s. Ladies and gentlemen, once your government takes something away from you, you will NEVER get it back! These "spying" laws and the

infringements on our civil rights that we were told were only to last as long as the war on terror existed, will never be reversed! We have permanently lost some of our freedom and we've laid down and let the government do it to us! My point to this little digression is that if we let the Republicans get away with deciding that it's their right to tell women what they can and cannot do with their body, that slippery slope we find ourselves on now, turns to a sheet of ice! 

Some Insights and Consequences on the Bill

The Republican sponsored bill mandates that abortion clinics must have their patient view an ultrasound of their baby, as well as listen to the baby's heartbeat, prior to allowing her to have the abortion. It also stipulates that the ultrasound must be performed with the best possible technology available. Hence, the trans-vaginal ultrasound mandate. Trans-vaginal ultrasounds are much better
Fetal Ultrasound
quality procedures than the topical kind. Next, this all must occur 24 hours prior to the abortion and it must be performed by the very same doctor who is performing the abortion, requiring the doctor to be at the clinic two days in a row. 

Using the language, "the ultrasound must be performed with the best possible technology available" is rather disingenuous. While it promotes an air of making sure the woman gets the best possible treatment devices available, making the Republicans look good, it's really an underhanded way of forcing a woman to undergo a procedure that is very intrusive and uncomfortable, in order for the Republicans to force their morals and beliefs upon the women of our society. The Republicans believe that forcing a woman to see and hear their baby's heartbeat will make them reconsider their choice of having an abortion. To date, there still isn't conclusive data that this approach will force a woman to decide not to have the abortion. Some doctors have actually said that in some cases, it has strengthened a woman's resolve to continue with the abortion. Still, an approach such as this is a reprehensible act for what used to be a distinguished American political party. 

$431.00 California Welfare Check

Another consequence to this legislation will be the rise in the cost of an abortion. Having the procedure the day before the abortion, by the same doctor doing the abortion, forces the doctor to be at the clinic two days in a row which drives up the cost to the woman seeking the abortion. Usually the procedure itself is performed by a technician who is capable of doing the procedure, which doesn't force the doctor to be at the clinic when it is administered. Another way that the cost is driven up is by the mere fact that in most cases, a trans-vaginal ultrasound is never needed in prenatal care prior to an abortion. With the average cost of an abortion running between $5oo - $1000, the cost can quickly jump to $750 - $1250. That's more than some poverty level women make in a month, requiring them to take the money from some other area of their expenses, like food or rent. Government and insurance companies have been complaining for years about the rise in the cost of health care and here the government goes and automatically drives up the cost for an abortion with the mandating of this procedure. Nevermind that it's all because of their hidden moral agenda directed at the women of America, it's bad medicine!

The "Males Know Best "Club
House Republican Leadership
People in general get resentful when their decisions about their own health care are taken out of their hands. What makes this so egregious is the fact that these male-chauvinist Republicans are so arrogant as to think that they, and only they, know what's right for a women to be doing with her health care and her body! Don't forget, this "males know best" attitude is what started the women's movement in the first place and for the Republicans to be proposing a bill such as this, at this particular time, is just another instance of their blind hubris and arrogance. They act as if they have no clue that they've already lost women in America! 

Medical Rape

Women and women's groups are referring to this as "medical rape" and I can see why they feel that way. Just so we understand- rape; "the crime... of forcing another person to have sexual intercourse... against their will" (Oxford Dictionaries). Although many consider this example as extreme, it's certainly understandable why it's being used. Obviously, the operative phrase here is, "against their will". This legislation is being proposed by congress and eleven men who are trying to enact it, "against the will of women". There hasn't been a single woman representative, Republican or Democrat, willing to sign on as a sponsor and that's a very telling piece of information. Why is it that a bill that is put forth as legislation, which will end up governing the bodies of women, doesn't have a single woman sponsoring it? It's because it's an archaic proposal which has no place on our law books! Archaic because it harkens back to the bad old "paternalistic" attitudes of our U.S. Congress and their condescending view of women. It is against the will of women! It is also considered "medical rape" because, in a more literal manner, the mandating of a trans-vaginal ultrasound without a woman's consent is the forcing of a probe, into the vagina of a woman, without her consent; i.e., "the forcing of another person to have sexual intercourse... against their will"! Now, I know there will be people saying that this is just too extreme of an example but, is it really? Let's face it folks, women are fighting a bill that could amount to turning back the clock forty years in the history of women's medicine. I'm not sure that anything is too extreme for this fight!

There is Hope

I do have some bright news, though! The outrage has begun over this legislation. Women are not willing to let a congress go back to their old-time, paternalistic, arrogant ways. It's not just women, though. There are many groups willing to get involved because this particular legislation could stand as a sort of precedent for the congress to pass laws governing the bodies of women and men. Action has already begun and one group is circulating a petition to send to congress to get them to drop the "forced ultrasound bill". Ultraviolet is a "community of people from all walks of life mobilized to fight sexism and expand women’s rights, from politics and government to media and pop culture." If you are as outraged as others are over this legislation, you can go to this website to sign their petition; "Tell congress to drop the forced ultrasound bill"

Let's all get behind this campaign to end the proposal of this particular bill. Even if the "medical rape" example is too extreme for you, the fact that there are numerous other reasons that make this bill unacceptable should be enough for you to make sure it shouldn't even see the light of day. When this particular medical procedure is needed, let it be because a doctor is requesting it because there is a medical need for his request. When this procedure is needed, let's make sure it's because a doctor says it's needed, because the doctor explains the legitimate reason as to why it's needed! When this is done in the confines of a doctor's office or clinic, with a woman knowing she has the right to refuse, it's a whole different situation. Under those circumstances, most women would agree to the procedure... or maybe most women wouldn't agree to the situation. Either way, a woman would have a choice in the matter. That's the way it should be. That's the way women have been demanding that it should be! Women have fought for this respect for a long time now and they deserve it! Yet, when politicians make a trans-vaginal ultrasound mandatory, and in this case all the sponsors are men, they trigger memories of decades of arrogance and disdain which women suffered under from the medical profession and politicians alike. Again, women would have someone other than themselves telling them what they can and can not do with their bodies. It's been just over forty years now since the legalization of abortion, enough time for almost two generations of women to have control of their bodies when it comes to abortion and their health care. Let's not set "Women's Heath Care" back to the old days when men, not women, were in charge of a woman's body.

And that's, "As I understand it now... 'til it changes".
Thanks for reading.
Michael K. Stichauf.