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            I have had an abortion. Most people who know me know that. I’m very open about it and fervently pro-choice. I had to start my piece like this, so you’ll understand where I’m coming from. I’m not writing this post out of malice, but for educational purposes. I haven’t been able to find any other pieces on this subject, so maybe I’m wrong. If I am I would appreciate any readers to provide me with some cold hard medical facts. Okay?

Before my abortion I had a transvaginal ultrasound. This was in mid-2011, so before TVUs got famous. When I saw the device I was wary and my reaction was something along the lines of “woah what’s that? Do I have to have that because I don’t want it.” The woman said yes it was necessary for the procedure and she’s sorry. She didn’t say it was required by law or whatever, but that it was necessary. She didn’t show me the ultrasound or talk about it or even offer to. The whole thing was over in about two minutes. I had a surgical abortion at nine weeks and I was assured this was needed for my procedure.

Then eventually the TVU law proposals starting arriving and I was incredibly confused and hurt. Had something wrong been done to me? By that clinic? That clinic that saved my future? That clinic I was eternally grateful to? That clinic that advertises “comprehensive reproductive services in a supportive, nonjudgmental, knowledge-based environment?” That clinic that boasts that it has “the most experienced clinic staff in the region?” That clinic which is part of the National Abortion Federation?

All of these activists were and still are posting images of ultrasound wands with captions like “up mine? Up yours?” and talking about TVUs being a violation and comparing them to rape. This was/is really upsetting to me. I felt weirdly betrayed by my savior clinic. So I called them. I just briefly asked why they do TVUs and the clinic worker said because it was needed for the procedure. I felt pretty satisfied with that answer.

Of course I think this mandatory TVU legislation is terrible and wrong. It’s unethical for legislators with no medical expertise to be putting this into law. Since when are bills about medical procedure? Those are two entirely different fields. Where are the laws going into detail about thermometer or blood drawing procedure? Why is abortion any different? Why would a bill by those with no medical degree be dictating what practitioners do? Also, are states competing for the most ridiculous TVU bill? Now apparently there are bills requiring two TVUs.

Honestly I have not take part in this debate because it made me uncomfortable. The anti-choice side was clearly wrong, but for the first time I also felt the pro-choice side was wrong. They weren’t being outraged about the right things. They weren’t being outraged about why specifically this legislation was terrible instead they were just proclaiming TVUs were terrible. I don’t know why I’m talking in past tense. This is still going on. So, pro-choice activists are proclaiming that what is in some clinics vital to abortion is a violation and basically a desecration of human rights. They’re starting to sound like the anti-choicers to me. I mean what if legislators start listening? What if they start believing TVUs are a violation and try to ban them? What does that mean for the clinics that use them? Will abortion access become more difficult and expensive? Are these pro-choicers hurting the movement?

I’m working on expanding my knowledge. Nowhere on prochoice.org does it say TVUs are “medically unnecessary” like so many pro-choicers are claiming. This week I asked my abortion clinic for more in depth reasoning into their usage of TVUs. This was their response:

“There is no mandated law in TN that requires a vaginal ultrasound although they are trying to pass a law currently to require an ultrasound 24 – 72 hours before an abortion with the sound of a heart beat, verbal description of the u/s picture and a copy of the picture given to the patient.  Here at [name removed] we routinely perform a vaginal ultrasound for patients who may be under 12 weeks and an abdominal ultrasound for patient who may be over 12 weeks.  Because a patient can have missed a period and not be pregnant or can have a period and be pregnant, (it is possible to have periods all the way up until delivery) until we do an ultrasound we do not know for sure her gestational age.  An accurate gestational age supports providing the best possible care for our patients.   We do not however show her a picture, hear a heartbeat (which we don’t have the equipment for) or describe the u/s to the patient unless she requests it.”

Basically I’m demanding more education on this issue for everyone. Because honestly I’m offended that my supposed allies are telling me I was violated. It almost feels like they’re belittling rape. Why is it so difficult to find resources on this? Why can’t I find other articles with this viewpoint? Is it the abortion stigma? Are women not talking about it because they don’t feel comfortable talking about their abortion? Are abortion providers not coming forward so that they don’t disclose their profession and put themselves at risk? I’m concerned and I demand more information.

  • help-her

    Just saw your post, sorry that 11 days have passed without you having some response. You are the first person I’ve heard asking about this. What a good point you make! I feel confident in saying that no one imagined a woman who’d had a medically necessary TVU would question if something bad had been done to her, but it makes total sense now that I’ve heard your comment.

    I’m an abortion provider & have done TVUs for many years & have also had one myself because of uterine fibroids. I can’t be certain, but I think I’m also the person who initially brought up the topic when the state of Virginia first had a bill proposing mandatory ultrasound before abortion.

    • help-her

      Cont. It could easily be clarified that while physicians often order TVUs for patients they’re caring for, no medical test should be required by law. Especially when law makers with a religious agenda make these laws to impose their religion onto us and into us. The doctor and the patient can decide what is needed. Thanks again for your viewpoint. I’ll do my part to educate pro-choice people about this.

  • AussieWoman

    Hi, it’s very interesting for me to read this article as I was not even aware that there was such a debate going on around TVUs in some parts of the world. I am from Australia and I had a TVU not long ago to examine my ovaries for possible cysts and my uterus for possible scarring from a medical condition. The person conducting the ultrasound explained to me that a TVU would provide a clearer picture of those structures because it does not have to go through layers of abdominal muscle and fat. They explained that it might feel a little uncomfortable but that it was the best way for me to get the most accurate information about my condition. I was satisfied with that explanation and did not feel any more violated than I do while having a routine PAP smear which I have been doing every 2 years since I was 18 years old. I now also work in the area of prenatal diagnosis which sometimes involves the women having abortions and we give them the same information. If they suspect that they are less than 12 weeks pregnant then the ultrasound will be via a TVU because it provides more accurate information at that early stage of pregnancy than the abdominal ultrasound. Both types of ultrasound are routine here, which one is used is simply based on an assessment of what will provide the best possible care for the woman. I hope this helps you feel more comfortable with the TVU you had.

  • http://www.facebook.com/privateice Mary E Tyler

    I have been molested and raped and at age 42 had a TVU to examine my uterus for possible problems as I have been having weird peri-menopausal symptoms. Despite the compassionate tech and my husband holding my hand, it was an extremely triggering experience. I was a mess.for DAYS after. The fact is, FORCING a violation of your body by the STATE is very different than a woman and a doctor agreeing that an uncomfortable procedure is most wise. In my case, would the Abortion doctor have proceeded, knowing how traumatic the TVU would have been for me? Could I have CHOSEN not to have one, with an associate trade off of risk which I accepted? Could I have CHOSEN to have the TVU despite the trauma? At all points, do you see that the CHOICE for a medical procedure is MINE, and not the STATE’s ? That is why state required TVUs are rape. Because it removes the choice from you and your doctor and puts it in the hands of the state… which violates your 4th Amendment rights to be free of unlawful searches.

  • Dr. R

    Thanks for your post! You raise some great questions about the medical use and necessity of the TVUS. As an abortion provider, here are my thoughts: When we are providing a pregnancy termination, it is important that we know how far along the pregnancy is, and it is important that our follow up appointment can confirm that the pregnancy has ended. This can be done by performing a TVUS at the initial appointment and also at the follow up appointment, and in many clinics (like yours), this is the standard and that’s probably why you were told it is “necessary.” HOWEVER, not every clinic providing medical abortions has ultrasound machines (they are very expensive and require training to use accurately.) Evidence has shown that another safe and effective way to test the dating of a pregnancy, and the successful completion of an abortion, is through a bimanual exam in combination with measurement of quantitative hCG levels (also performed at both the initial and follow-up appointment.)

    So right now there are many clinics providing medical abortions without transvaginal ultrasounds (especially in underserved areas.) As states mandate TVUS with terminations, these clinics will no longer be able to provide these services. I certainly understand the pro-choice advocates’ characterization of these mandated TVUS’s as a violation of a women’s rights, as these states are interfering in what should be a decision between a patient and her doctor. However, I also agree with your point — TVUS’s themselves should not be demonized; they are an important tool in women’s healthcare. Having performed many TVUS’s, and having had one myself, I have also found that for most women it is a quick and relatively painless procedure.

    At my clinic, TVUS is the standard tool for dating pregnancies. However, if a patient prefers to avoid a TVUS, we honor her autonomy and use the other methods available for dating a pregnancy and monitoring a termination.