There are a lot of very good reasons for women of any age to need a transvaginal ultrasound: abnormal cells in a PAP smear, pelvic pain, irregular bleeding that could indicate cysts, fibroid tumors, polyps, twisted ovaries, infections,
February 9, 2013

There are a lot of very good reasons for women of any age to need a transvaginal ultrasound: abnormal cells in a PAP smear, pelvic pain, irregular bleeding that could indicate cysts, fibroid tumors, polyps, twisted ovaries, infections, endometriosis, endometrial hyperplasia, ectopic pregnancies, and even outright cancer.

It can even be a useful diagnostic instrument in testing for urinary and kidney disease as well, transvaginal ultrasounds being the best way to obtain the clearest and most detailed internal images possible outside a MRI or CT scan. I’ve had one myself recently, for good medical reasons, and have reason to be grateful such amazing and wonderful technology exists. So it is appalling when something that was designed to promote women’s health and welfare is being abused by politicians to hurt the very people it was meant to help.

If you are pregnant, ultrasounds are quite common and sensible early on to determine the presence of more than one fetus, and to calculate your due date. Later, an ultrasound helps to check the health of the baby, the location of the placenta, the amount of amniotic fluid around the baby, the baby’s position and to calculate its expected weight at birth. But all these can be determined with a simple topical ultrasound – transvaginal ultrasounds are not a common prenatal procedure and are not used unless there is some additional medical problem that needs closer examination by a doctor.

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While being pregnant, in and of itself, doesn’t medically require a transvaginal ultrasound, any woman who intends to have an abortion certainly doesn't need one, either topical or transvaginal. There is no medical reason for forcing a woman to look at clear anatomical images of a fetus she and her doctor intend to abort, other than to traumatize women, make it often prohibitively expensive to obtain abortions, and more difficult for doctors to perform them. It’s the so-called “pro-life” mindset that wants to push their self-righteous moral agenda down your throat – or in this case, up your vagina.

Last year, US officials expanded the legal definition of rape to include men as well as women, any victim who is unable to consent to sex, and – this is the relevant bit – anyone who is violated with an object, any object, not just a penis – be it a beer bottle or hairbrush or rolling pins or scissors or mop handles or radio antennae or any myriad of foreign objects that have been recorded used against abuse victims. Rape is all about power – of completely dominating another person against their will.

All women are not the same, not cookie cutter patients who can easily be treated all the same. So if a doctor tells me she needs to do a transvaginal ultrasound for medical reasons, and I as a reasonable, informed, intelligent person consent, it’s not rape. I can tell you from personal experience that a transvaginal ultrasound is neither humiliating nor all that painful, but it is deeply and intimately personal. The radiologist who did mine was kind, gentle and very professional - and outraged when I told her about women in the States being forced to have transvaginal ultrasounds before any abortion, not just as a woman but because her medical expertise should never be used for political purposes, ever. But the procedure not being painful isn't the point - even when it's not humiliating and painful, it's still rape if it's unnecessary and against your will. A breast exam in itself isn't humiliating or painful - but if someone were squeezing your breasts and pinching your nipples when it was unnecessary and against your will, that would still be sexual assault.

So when rightwing Republican legislators introduce a bill that would require women to submit to a mandatory transvaginal ultrasound before an abortion, against her will and regardless of medical necessity, they are reaching for power they are not entitled to, and attempting to legalize rape.

They are also doing the medical community a vast disservice, since this is not only becomes sanctioned rape where such laws are in force, the media attention surrounding the issue causes distrust and reticence in women who might have a genuine reason to need a transvaginal ultrasound.

Twenty one states have a range of ultrasound laws for pregnant women and those seeking abortion; Indiana, Missouri, North Dakota, South Dakota and Utah all require that ultrasounds be offered to pregnant women, something to which I have little objection. Women should be offered decent medical care, and ultrasounds are part of that care. It's when politics become more important than health where it goes off the rails.

Arkansas, Georgia, Idaho, Michigan, Nebraska, Ohio, South Carolina, Utah and West Virginia require that if an ultrasound is conducted before an abortion, the woman must be shown the images. Alabama, Arizona, Florida, Kansas, Louisiana and Mississippi all require an ultrasound before abortion, and the images must be offered to the woman. Texas is the most draconian: an ultrasound is mandatory for any abortion, and the woman must not only be shown the images, but have them described in minute detail.

Republicans have been working hard to push similar bills in Kansas and Nebraska and Ohio. Mississippi Republicans passed a law last year that went an amazing step further than simply requiring transvaginal ultrasounds on women seeking an abortion, they included victims of rape or incest – in effect, damning women to being raped twice.

Interestingly, an amendment banning men from having vasectomies failed to pass – making it clear this isn’t so much about the ethics of preserving unborn life as it is protecting a man’s right to literally do whatever the fuck he wants to a woman.

Virginia State Delegate C. Todd Gilbert exhibited his lack of compassion and respect for women while on the floor speaking in favor of an ultrasound abortion bill by belittling a woman’s decision to have an abortion as being a “matter of lifestyle convenience.” Apparently, his colleagues in the House agreed with him; the bill passed, 63 to 36.

As for exactly who benefits from any such “lifestyle convenience”, Tennessee Republican State Senator Jim Tracy, running as a candidate in the 4th Congressional District next year, has proposed a bill requiring women to undergo an ultrasound before any abortion. He’s quite adamant his stand is one of moral conscience – not at all capitalizing on the scandal where his opponent, Republican Representative and anti-choice doctor Scott DesJarlais cheated on his wife, smoked pot, prescribed recreational drugs for lady patients he fancied, and pressured his mistress into an abortion, then blamed his behavior on the women while claiming God had forgiven him.

Seems both men found abortion quite the lifestyle convenience, y’betcha.

Rightwing pro-life advocates have repeatedly shown an abysmal lack of medical knowledge as well, from Missouri Republican Todd Akin’s ludicrous claim that women couldn’t become pregnant from a “legitimate” rape, to the self-educated rightwing pastor, radio host Kevin Swanson who claimed doctors and scientists have shown that embryos or "tiny fetuses" remain in the uterus if a woman is taking birth control pills.

Studies by the American College of Obstetricians and Gynecologists have shown that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage, the most common type of pregnancy loss, most as a result of an unhealthy developing fetus that has no chance of surviving to the end of pregnancy. Chemical pregnancies, when a fertilized egg does not attach itself to the uterine wall, account for 50-75% of all miscarriages, resulting in bleeding that occurs around the time of an expected period; a woman may not even realize she’s been pregnant.

But according to Iowa Republican State Representatives Tom Shaw and Rob Bacon, co-authors of House File 138, backed by seven other Republicans, single-celled zygotes are entitled to full human rights, and they intend to jail both women who have an abortion, and those doctors who perform the operation, for murder, even in the case of rape and incest.

If single cell zygotes smaller than your average paramecium are accorded full legal human rights, how long will it take before some Republican decides any woman who miscarries must be guilty of involuntary manslaughter? Will even women who are trying to become pregnant decide to forgo pregnancy tests or to seek pre-natal care when any pregnancy that fails is less a personal tragedy and more a potential jail sentence?

If rightwing Republican understanding of science, biology or even common sense is questionable at best, their grasp on theology is equally bizarre; from Indiana’s Richard Mourdock’s insistence that even if women did get pregnant from rape, they shouldn’t be allowed an abortion because it was “something that God intended to happen” to Alabama Senator Shadrack McGill, who wants to outlaw abortion because he fears aborted fetuses might go to Hell.

Republicans failed in massive numbers to attract women’s votes this past election – and quite probably a good number of men equally appalled at how their mothers, sisters, wives and daughters were being treated. Yet despite criticism on all sides, despite the objections of doctors themselves, despite condemnation by women’s groups, despite their losses at the polls, they’re still trying. The latest assault on women came from Michigan, but while the Republican House Speaker Jase Bolger professed he had “no interest in forcing a woman to have a transvaginal ultrasound”, the bill still mandates women seeking abortions must have a topical ultrasound before the procedure. Except there’s a loophole no one is mentioning; as women in Texas have found, if the pregnancy is too early for a normal topical ultrasound to show any distinct imaging, then the only alternative is transvaginal. Either way, Republicans are increasingly attempting to intrude – quite literally – into women’s bodies.

“This is an unnecessary and unwarranted intrusion into the health decisions of women,” said Michigan’s House Democratic Leader Tim Greime. “This is yet another example of the Republican obsession with over-regulating people’s private lives.” Actually, he understates it; this bill would go far beyond being an unwarranted intrusion into women’s medical rights, or interfering with a doctor’s care.

Allowing a woman to close her eyes, just lie back and think of England, if she doesn’t want to see the pictures doesn’t make it any less criminal. Being forced to sign a consent form before being forced to submit to having a long plastic rigid wand shoved up your vagina against your will and for no good medical reason doesn’t make this “consensual.” It’s unnecessary, sadistic, illegal, immoral and reprehensible.

It's more than that - it’s rape.

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