Archive for February, 2012

Penetrating Decrees

It has been ages since I last wrote a blog, but the recent outbreak of women’s reproductive issues in this election cycle has brought me back. For starters, we have the national debate on whether Catholic-led hospitals and other employers should have to comply with the health reform law requiring insurance providers to offer birth control free of charge. It’s about conscience and separation of church and state; I get it.

Next up, we have my own state of Virginia voting on the so-called personhood bill, which would give unborn children “at all stages of development,” including embryos, the same rights available to “other persons,” as laid out in Virginia and Federal law. That bill essentially defines life as beginning at conception. Saturday Night Live recently mocked this bill, asking, “What’s next? Life begins at last call? Life begins when you click send on your Match.com profile?”

But the bill that has most recently incited debate in this onslaught is Virginia’s bill requiring women to undergo an ultrasound before receiving an abortion. The bill is poised to pass the legislature this week, although a vote keeps getting delayed as protesters rally outside Richmond’s Capitol Square.

If you have been living under a rock the past few weeks, allow me to catch you up. The bill, which you can read here, requires the doctor to perform fetal ultrasound imaging on any woman seeking an abortion and to give her the opportunity to see the image and listen to the heartbeat. The woman must then sign a document that she did or did not look at the image, and the image is required to be placed in her permanent medical history. In addition, the law requires the woman wait at least 24 hours after this ultrasound is performed before she can have the abortion. (Mercifully, an exception is made for women who live more than 100 miles from their provider, in which case they must wait 2 hours.)

ImageI am not interested in having a debate about whether abortion should be legal. That is not what is up for discussion in this case, though the lawmakers’ insistence on making it as difficult and as embarrassing as possible is telling enough. What has made this bill so radioactive is that it strips the patient of consent to a medically unnecessary and highly invasive procedure. Abortions are primarily performed in the early stages of a pregnancy, and for that reason, the “jelly on the belly” type of ultrasound is insufficient. Instead, in most of these cases, the bill would require the woman to undergo a transvaginal ultrasound, in which a probe is inserted into the vagina. Talk about upping the ante!

Though the bill does not even pretend to be anything other than a thinly veiled attempt to limit abortions, there is some medical basis for performing the ultrasound. In fact, most abortion providers already routinely perform the procedure. The ultrasound allows the doctor to determine the fetus’s age, which is very important because not only do fetuses more than about 12 weeks along require different medical treatment, but they also require different legal treatment.

So what is the big deal then? I return to the statement that the bill requires denying consent to a medically unnecessary and highly invasive procedure. If a woman is three weeks along in her pregnancy and her doctor agrees that there is no need for an ultrasound, shouldn’t that be the end of it? Why does she then have to be subjected to vaginal penetration? Yes, that’s what we are talking about here, and if you are uncomfortable reading about it, imagine how the patient might feel.

Opponents of the bill have garnered attention recently for likening it to state-sponsored rape. Now, I agree that that rhetoric is inflammatory and insensitive to victims of violent crime. However, the FBI updated its definition of rape just last month, and its new definition is: “The penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” You tell me what part of the Virginia ultrasound bill does not fit that definition.

In addition, the Virginia bill does not allow any exception to the ultrasound mandate in cases of rape and incest, so if a rape victim seeks an abortion, she could once again be subjected to vaginal penetration against her wishes and with no medical purpose.

Virginia is not the first state to raise this issue; in fact, it would be the eighth state to pass similar legislation. In Texas, doctors challenged the law because they do not want to have to read from a script and make statements that are not medically indicated. When the physician is required to do a procedure that is not in the patient’s best interest and is not recommended by the physician, there is a fundamental breakdown in the doctor and patient relationship. Trust is lost, and in some cases, the doctor is forced to compound emotional distress.

One facet of this ordeal that I find fascinating is the double talk from conservative and Republican lawmakers. In the issue requiring Catholic institutions’ insurers to provide contraceptives, opponents argue that it is about conscience… that the institution should be able to follow its own morals and beliefs without the government interfering and forcing it to fund a certain aspect of care. Yet when it comes to this ultrasound bill, the government is attempting to force a private institution not to pay for something but to actually perform a procedure, and the same opponents of the contraceptives are suddenly in favor of government mandates for care.

Virginia’s governor, Republican Bob McDonnell, had stated earlier this year that he would sign the bill if it came across his desk. Now that the state legislature is poised to pass the bill, McDonnell has backed off a bit. At this point, the governor’s office is only committing to reviewing the bill. For whatever reason, McDonnell’s name has been mentioned as a possible vice presidential candidate, and he has been campaigning for Mitt Romney this season. Many political analysts believe that signing this law into effect in the midst of the current political environment would be toxic to McDonnell’s vice presidential aspirations. Then again, we have a guy named Rick Santorum leading the Republican primary polls, so maybe this is what Americans want after all.

What do you think? Does this bill take the desire to limit abortions too far or is it medically justified? Does it amount to state-sponsored rape or is that preposterous? What punishment does the father of the fetus have to be subjected to before the woman can get an abortion? Please, share your thoughts, questions, and opinions on the topic. I’d love to hear your view!


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