Let’s not forget that not only are women not showing when they go to get an abortion, but the type of ultrasound shown with the very pregnant woman isn’t the one that would work.

They’re going to need the internal sonogram, which isn’t pleasant when you want to have it done, much less when you are coerced into having one.

If someone as pregnant as the photo is having an abortion, her health/life are in jeopardy.  She’s 8 months at least, and long past any other type of legal abortion.

“Well, I’m about to hit my ninth month of pregnancy. I guess I’d better finally go out and get that abortion.”

If it will help the cause, I would be willing to donate my six week sonogram picture. I had to ask the doctor to walk me through what we were seeing because I had never seen a sonogram that early before and could only tell that it was a bunch of lumps clustered together.

The politicization of womens bodies is so irksome that I have had days where I’m convinced I’m going to give birth in prison. I lost count of the number of times a man (and it’s always men) has asked me, “Are you having twins?” And I will say no, to which they ask, “Are you sure?” Which has led me to reply, “Do I look so damn dumb that I don’t know how many babies I’m carrying?!” Then I get branded as hostile and unable to take a joke, hormonal, etc. Seriously, it is not ok to comment on womens bodies even when we are pregnant and your comment is not sexual. The world will be a better place when people look at a woman and decide to do three things—shut up, stay out of grown folks business, and realize that women are smart enough to make our own choices.

They’re going to need the internal sonogram, which isn’t pleasant when you want to have it done, much less when you are coerced into having one.

It seems to me that if you’re a rape victim getting an abortion, this would be adding to the trauma.

It seems to me that if you’re a rape victim getting an abortion, this would be adding to the trauma.

I’m pretty sure that’s half the point. If not the whole point.

serious bette: I’m sorry you have to go through that. I’m not and have never been pregnant, but even I was feeling like I was going to lose it today. A pregnant woman, not showing, joined my water aerobics class (and then the coach felt the need to inform everybody that she was pregnant, was joining the class because she was pregnant, and kept repeating to her “Don’t jump so hard! You’re pregnant!” And the other people in the class kept crossing the pool to come to the woman during class to ask her how many months along she was, if she knew the gender yet, where was her husband (!), how the pre-natal consults were going (!!) ...

@4 James

Yes, that’s a feature, not a bug.  Sonogram laws are designed to cause additional trauma and pain, and to create an opportunity for laypersons such as sonogram technicians to make judgemental remarks to the pregnant individual whose body they are violating with those offensive sonogram probes.  Of course, nobody mentions how this practice creates a situation that is rife for abuse of laws against practicing medicine without a license. 

Certainly, the last thing I’d want to hear if I were a rape survivor is some layperson babbling on about gestation and delivery while they assault my cervix with an instrument that is literally shaped like a cudgel.  Perhaps it is time that more pregnant patients formally protest, and use the opportunity to shout down anybody who displays a motivation to injure them while carrying out this unnecessary, expensive, and useless procedure.  I recommend calling the police and pressing formal battery charges, as possible.

In litigation terms, the whole idea of a sonogram is objectionable on the basis that it is designed to “vex, harass and annoy, not calculated to lead to the discovery of admissible evidence.”

They’re going to need the internal sonogram, which isn’t pleasant when you want to have it done, much less when you are coerced into having one.

That is an incredibly important point and one that many, many people are unaware of.  If the article needs to be illustrated, I say it should at least be accurately illustrated and I mean completely accurately.  Just showing a woman with a slightly smaller stomach is still wrong.  They need to show a draped woman in stirrups.  Of course that image is much less pleasant and wouldn’t serve the anti-choice interests nearly as well as the first picture.  I think the Daily Beast and other magazines need to be upfront and honest about their reasons for picking the illustrations they pick.

Health articles suffer from a similar problem in that articles about the morbidly obese are illustrated with pictures of people who would not qualify as “morbidly obese” under BMI standards while articles about less fat individuals are oten illustrated with pictures of very heavy people.

The Texas law, I think, requires the doctor to perform the ultrasound.  Part of it is that they’re trying to waste a doctor’s time—-the more time they spend doing unnecessary procedures and paperwork, the less time they have to spend on actual patient care.  It’s just more ways to abuse women, by denying them actual care.

I highly doubt the Daily Beast has an agenda.  Please read the story, which is adamantly pro-choice.  I think inaccurate art—-as someone who has to pick lots of art myself, so I can attest to this—-is the result of having limited options and an absolute need for art.  Some days I’m like “WTF can I illustrate THIS with?”

I hadn’t notice that about art used for abortion articles. I’ll have to start paying attention now.

Here’s an illustration of a trans-vaginal sonography probe.  And I can tell you from experience, it’s not pleasant, even if done to obtain medical information that was beneficial to me.  To please some church-ladies I don’t even know, how dare they!
http://www.cancer.umn.edu/cancerinfo/NCI/glossary/CDR46633.html

As for the correct type of sonogram picture, someone should create stock art with one of those internal, dildo-like wands with a smear of lube on the end. That’ll get people’s attention.

They should use today’s Awkward Stock Photo instead:  http://awkwardstockphotos.com/post/9638396369

  It seems to me that if you’re a rape victim getting an abortion, this would be adding to the trauma.

I’m pretty sure that’s half the point. If not the whole point.

“If they don’t like it, they should have kept their legs shut”.

I am so fucking sick of conservatives who want to punish everyone who they disagree with.

I do wonder if these sonograms have any influence whatsoever on a woman’s choice?  I can’t help but think some 16-year-old looking at a blurry handful of white specs is going to think “That’s a baby?  Fcuk it.  Abort away.”

Of course, I have no idea what is going on in a pregnant woman’s head, much less one who got pregnant unwillingly.  So maybe it does invoke a mental crisis.

The article was very pro-choice and well-written.  But so often well-written articles are given bad artwork and terrible headlines.  Perhaps its just due to overworked, poorly trained employees handling these two aspects of a story.  Or maybe its a subtle way to undermine the content of the article.  Occams razor suggests the former I suppose.

I do wonder if these sonograms have any influence whatsoever on a woman’s choice?  I can’t help but think some 16-year-old looking at a blurry handful of white specs is going to think “That’s a baby?  Fcuk it.  Abort away.”

Studies touted by pro legal abortion people in the past (I haven’t looked into them myself) have demonstrated that there was no effect by forcing women seeking abortion to view sonogram images. The charitable thing to believe is that the antis don’t know this and are putting women through an unpleasant at the best of times procedure by mistake.

But anyone who’s ever seen these people in action and followed what they’re up to can see they don’t deserve charitable interpretations.

And we don’t even have to bring up rape victims. There’s plenty of abortions undertaken by women who’d probably rather have a child, but don’t have support or prospects of support from the father or just are in bad situations financially or otherwise, so don’t feel they can manage a child or an additional child. Clearly those women need a kick in the fucking teeth. Family values!

We’re losing the war. The fact that the antis are openly willing to throw rape victims under the bus and not get roundly rhetorically curb-stomped for it by the general public means that people really have stopped thinking about the women in the equation at all. As far the the public mind is concerned, huge-to-bursting pregnant belly is all there is. There’s nothing else to consider.

@16 Zifnab

I get the suspicion that the images themselves don’t have much effect.  If you show someone a grainy black and white picture of an undifferentiated clump of cells, the result is pretty much “So what?”  Nothing can be ascertained by looking at such an image.

It’s not the pictures themselves that are at issue, but the context in which those pictures are obtained; namely, by performing a procedure which is designed to intentionally cause physical discomfort to the victim, I mean, patient, and presented; namely, while the person “reading” the picture recites a monologue attributing certain characteristics of personhood that an embryo does not yet demonstrate. 

Without the context, the images are entirely meaningless.

Here’s an illustration of a trans-vaginal sonography probe.  And I can tell you from experience, it’s not pleasant, even if done to obtain medical information that was beneficial to me.

I’m certainly not on the side of the anti-choicers who push these laws, and I don’t want women having additional painful things inserted into their vaginas for no good reason, but how comfortable is the actual apparatus that’s used for the abortion?

The question would be whether you get a local or general anesthesia for vaginal sonogram v. abortion.  As far as I know, you do for the latter, but not the former.

We’re on to something here. Third trimester abortions are not the norm, so pictures of very pregnant women don’t generally belong alongside articles about abortion. How about a stock photo of the vacuum and speculum? Or a bloody biohazard trashcan? Readers deserve some accuracy!

I think articles about first-trimester abortion should include a photo of a six-week sonogram, the one that anti-choicers think it’s so damn important that women see.  I bet most people will be mightily unimpressed.

Why would the trashcan be bloody? Do abortion doctors try their 3-point bank shots with the removed fetal tissue? And if so, I totally chose the wrong profession.

[Caren] Let’s not forget that not only are women not showing when they go to get an abortion, but the type of ultrasound shown with the very pregnant woman isn’t the one that would work.

Can somebody elaborate on this? My wife’s OB never used anything other than the abdominal transducer, like the one shown in the photo, as early as six weeks.  That device was capable of showing the embryonic sac.

trolling trolling trolling trolling trolling

Faaaaaaaaaiiiiiiilll.

This is a great post.  Subtle things like this are used my anti-choicers to mislead people.  It’s why I make a point to talk about embryos instead of fetuses when it comes to the most common abortions.

Comment #26: Cris (without an H) it depends on the woman and the position of the sac/embryo. I think most docs will try the abdominal one first, and if they can’t get a good picture they move on to the vaginal one.

Comment #21: keshmeshi - An addition to what Kit-Kat said, there’s the anti-choice reasoning behind requiring women to view these that’s important. And why make a woman go through that kind of invasive procedure twice if it’s not necessary?

Here’s an illustration of a trans-vaginal sonography probe.  And I can tell you from experience, it’s not pleasant, even if done to obtain medical information that was beneficial to me.

I had one of those done too, gretchen, later in a pregnancy, and didn’t find it even a bit uncomfortable.  Maybe I have a more spacious cave?

@29 Livi

Good point about the reasoning behind requiring women to view the sonogram images.

Remind me again:  What is the reasoning?

Are we, the American voters and taxpayers, to believe that viewing these images will cause women who seek abortions to change their minds and decide to continue gestating until delivery?  If that is the supposed reason, then what is the evidence?  Upon what basis did the legislators who passed these offensive and ridiculous laws make their decisions?

I want to know just exactly how much taxpayer money was spent to pass a piece of legislation that has absolutely zero empircal evidence to back it up.  Then, I want those legislators’ pay clawed back and returned to the government’s general fund.  Then, those legislators should be prosecuted to the fullest extent of the law for fraud.

If we don’t hold legislators accountable, this will just keep happening over and over.  There has to be some punishment for these outrageous acts.  Personally, I think they should be burned at the stake, but YMMV.

I like the illustration for week 15 at Babies Online because it shows the relevant information—you’ll just have to be unsnapping your regular jeans—without showing anything about the size of the rest of the model’s waist.

http://www.babiesonline.com/pregnancy/week-by-week/week15.asp

Overall I *don’t* much care for the images at BabiesOnline because, at least through week 16 (as far as I went) they don’t really illustrate much.  That one for week 15, though, illustrates the change in size very nicely.

figleaf

My transvaginal ultrasound didn’t hurt, but it was uncomfortable.  Not something I want to do again unless necessary.  I had an ultrasound tech who was well trained and determined to give me the best information possible, not some jerk with a wand who wanted to make me feel guilty and change my mind.

Many state laws have made a point of saying transvaginal ultrasounds should be used.

The ultrasound is generally unnecessary, even if you’re continuing a pregnancy.  Its being used to increase the expense and time required as yet another hoop to jump through, as well as to try to shame women for having sex, even if they were raped. 

These fuckers don’t think women are human.

I think Amanda’s totally right about pushing editors to pick better pix.  Thinking of all pregnant women as 9 months along is fucked up.  There’s not a cute baby just ready to be cuddled in there for a LONG time.

There’s a really famous picture of plus-sized model Lizzie Miller with her belly pouch on display as she’s laughing that’s really sweet and not fat shaming. Here: http://www.google.com/search?q=lizzie+miller&hl=en&client=firefox-a&hs=KJu&rls=org.mozilla:en-US:official&prmd=ivnso&tbm=isch&tbo=u&source=univ&sa=X&ei=zexfTqPcMoymsAKu6pU_&ved=0CCAQsAQ&biw=1280&bih=921

Or, those are her google image shots (in case you’d like to google a plus sized woman for body diversity in future).

I loved your RH Reality Check interview with Michelle Kinsey Bruns—it was definitely one of those “Duh” moments for me and I definitely look for the Preggobelly whenever I read mainstream or even progressive publications (and then I get pissed)...keep on it, I’ll comment every damn time I see it to until it changes.

These fuckers don’t think women are human.

Nope.  We’re breeding stock and fuckable mommies who will cook and clean for them.

And those who disobey, should be harmed and humiliated in every way possible. 

In my experience, every abortion provider I have ever worked for does an ultrasound before an abortion.  My understanding is that the more you know about exactly what is in there, the more confident you can be that you got everything out, making the procedure safer on the whole.

Also, a lot of abortion providers feel that it is more ethical to make sure the patient knows her exact gestational age and probable date of conception before the procedure, in case either of those factors would impact her decision either way.  I have personally had conversations with multiple women who say things like “if I concieved in February I want to keep it, but if I concieved in January I want to terminate” because they have no interest in parenting with the person they were sleeping with in January, but they do with the one in February.  And that is not the most self-flattering reasoning, so if just a few people will put voice to that reasoning, there are probably plenty who decide based on factors like this.

It doesn’t necessarily have to be a transvaginal untrasound, if sufficient information can be gathered from a transabtominal, a nurse or tech would perform it, not usually the Doctor herself, and the patient would always be asked what level of information she would like to recieve from the ultrasound findings, like whether she wants to look at the images or whether she wants to know if it is a multiple pregnancy.  Requiring the clinic to force a transvaginal ultrasound when it is not medically necessary, or forcing the patient to look at the screen would be a violation of patient and provider rights.  However, saying that an ultrasound is not a necessary part of safe or ethical abortion care is not really a true statement.

The really terrible thing about the law in question is the requirement that they wait 24 hours between unltasound and procedure.  This is disgustingly condescending and extremely burdensome.  Many many women have to drive great distances to access abortion care and making them take the trip twice or stay overnight would more than double many people’s cost of acquiring an abortion.

Perhaps it’s our ‘cheap and cheerful’ NHS or a difference in culture, but the NHS information page on ultrasound scans (http://www.nhs.uk/conditions/Ultrasound-scan/Pages/Introduction.aspx) indicates that internal scans are only occasionally given.  My sister (with a semi-professional interest) confirms that she wasn’t given an internal scan, nor does she know anyone who has received one amongst a fairly wide circle of relevant people.

It might be different when ultrasounds are performed as part of an abortion in the UK; the abortion information pages don’t make it clear whether such ultrasound scans are done with an internal scan. Although it does point out that calculating the stage of pregnancy from the last period is usually sufficient.

So it’s not unreasonable to suppose that requiring internal scans in the US is punishing women.

@Comment #36: GumbyAnne—

That’s a good point.  There is a huge difference between a doctor ordering an ultrasound as part of providing medical care, and a doctor ordering an ultrasound because a law says they have to while they read some government propaganda to their patient.  It’s what I find most offensive about this stuff, frankly, because you know these are the same people who are screaming bloody murder about how ObamaCare wants to put the government between you and your doctor and how that’s a huge imposition on their freedom.  While they’re insisting that the government insert itself between you and your doctor.  It’s like the parts of their brain don’t even send postcards to each other, let alone talk.

@36 GumbyAnne

I apologize for not being clear.  I was referring specifically to a transvaginal ultrasound, of the type performed with the cudgel-shaped wand, inserted vaginally.  While some patients may have never experienced discomfort during this procedure, I found it horrifying, humiliating, and painful. Just another pretext for some clumsy male with a medical instrument to try to make me feel afraid and intimidated.  YMMV.

As near as I can tell from your writing, you are referring to the ultrasound that is performed contemporaneously with the aspiration procedure, for the purpose of guiding the suction cannula.  This is necessary to reduce the risk of the provider perforating the uterine wall with the cannula tip, and the ultrasound is placed against the exterior abdominal epidermis, as shown in Amanda’s first photograph accompanying this post. 

In my experience, a provider calculated the gestational age of the embryo, but informed me in consultation that providers are required to perform their calculation such that they add anywhere from 10 to 14 days to the gestational age of any observed products of conception.  When I remarked that in order for that calculatation to be accurate, I would have had to have conceived during my last menstrual period, on a date when my uterine lining was evacuating from my body, and hence, the method of calculation could not possibly be accurate, I was told, “I’m sorry, but we’re forced to calculate it that way, even if it would have been physically impossible for implantation to have happened on that date.” 

Again, I was referring to the transvaginal ultrasound, which I still maintain is not necessary.

Many many women have to drive great distances to access abortion care and making them take the trip twice or stay overnight would more than double many people’s cost of acquiring an abortion.

That’s definitely the whole point.  Just like with contraception, it’s part of an overarching strategy of attacking access while being unable to ban things outright.

It’s incredibly important and valuable to call out (and comment on) the types of images for both the bellies and the sonograms:  photos absolutely influence people, even on a subconscious level.

Perhaps we need some hashtags to drop around the interwebs?
#thatsnota1sttrimesterbelly or #thatsan8monthbelly
#thatsnota15wksonogram or #thatsa30weeksonogram

My expertise is with clinics in the Midwest of the US, and if a patient asked me to refer her to a clinic that did not do an ultrasound prior to an abortion, I would be completely stumped.  I am not aware of any laws requiring one, but I just don’t know of anybody who DOESN’T do one.  I have worked (as non-medical staff) for 7 abortion providers and every single one uses an appointment day timeline of: untrasound—> education about procedures avalable and at current gestational age—> procedure. 

The only clinic I have worked directly with that uses ultrasound giudance DURING a procedure is the clinic that does 2nd Trimester procedures, where ultrasound guidance is used during procedures 14.6 to 21.6 weeks gestational age.  Patients at those gestational ages are still given one ultrasound before their education session, usually a couple hours before the procedure itself.

I can’t think of any reason why a specifically transvaginal ultrasound would be medically necessary if the patient was not comfortable with it, but every place I am familiar with would just offer a transabdominal one as an alternative.  I’m not saying that that is the only and best way of doing things (I am not qualified to make such an assertion) but I know that I trust the medical judgement of the heroic abortion providers that I work with, and every one of them requires an ultrasound of some kind performed in the abortion clinic during the course of an abortion appointment.

great points Amanda + all.  I had to explain to a friend once why women who needed a “late term” abortion couldn’t “just have a c-section and put the baby up for adoption”. Pics like what you pointed out for sure contribute to that kind of thinking.

I had an ultrasound at 8 weeks with my first, and it was abdominal, not transvaginal. I think you get a better image with a transvaginal ultrasound at that stage, but it’s not necessary to confirm gestation and position.

It’s like the “aborted fetuses” anti-choicers wave pictures of outside clinics.

Uncomfortable, hell. Nonconsensual transvaginal ultrasound meets the definition of penetrative sexual assault in all 50 states. And if access to medical care (and exercise of a constitutional right) is being conditioned on submitting to the probe, then any ostensible consent is coerced and therefore invalid. (Or perhaps I shouldn’t put forward that argument, because you just know some wingnut DA is going to start arresting ultrasound techs and doctors for complying with a viciously punitive law.)

This is why I was kinda amazed and horrified at the reasoning by the judge who declared that it was OK to force a woman to undergo a procedure against her will, but a violation of the first amendment to force a doctor to talk to her about it.  Any port in a storm I know, but still.

However, saying that an ultrasound is not a necessary part of safe or ethical abortion care is not really a true statement.

An U/S, as mandated by these various laws, has no place in the practice of medicine because there’s no medical indication for it, and no valid protocol or interpretation.

In the absence of data showing that pregnant women don’t understand what being pregnant means and are incapable of informed consent, performing an U/S to view the fetus* is not a valid indication.

The U/S you mentioned is done to establish an estimated gestational age (EGA) and there are validated ways to perform and interpret the test. Although widely used, this type of U/S is not mandatory because the evidence doesn’t support the requirement. Moreover, whether a patient presenting for an abortion already had an EGA U/S is irrelevant. She still has to have the political U/S.

*From the American Institute of Ultrasound in Medicine (AIUM), endorsed by ACOG:

The AIUM advocates the responsible use of diagnostic ultrasound. The AIUM strongly discourages the non-medical use of ultrasound for psychosocial or entertainment purposes. The use of either two-dimensional (2D) or three-dimensional (3D) ultrasound to only view the fetus, obtain a picture of the fetus or determine the fetal gender without a medical indication is inappropriate and contrary to responsible medical practice.

Hey, if the wingnuts manage to mandate ultrasound, I say clinics should insist on abdominal/external—to obtain the haziest possible pictures. In the first 12 to 14 weeks, I think transvaginal gives a clearer picture. An abdominal ultrasound early in pregnancy would probably not knock a woman’s socks off in the “Wow! I’m having a widdle baby!” way.

I had one or two ultrasounds in the 6- to 8-week range of pregnancy. You know what the embryo (not yet a fetus) looks like then? A bean with a blinking white spot (the heart). I had an ultrasound around 13 weeks, too. That was sort of an alien/homunculus, still quite unimpressive and subhuman looking. At 18-20 weeks, a fetus is more baby-shaped, but ultrasounds are still so grainy.

The transvaginal probe isn’t usually painful but it sure is awkward. Some friends of mine call it a “cooter wand,” which is the best terminology ever.

In my experience, every abortion provider I have ever worked for does an ultrasound before an abortion.  My understanding is that the more you know about exactly what is in there, the more confident you can be that you got everything out, making the procedure safer on the whole.

A woman of my acquaintance just had a chemical abortion for exactly this reason; the ultrasound showed some physical anomalies that would have made a surgical procedure problematic. As a diagnostic tool, an ultrasound is valuable; as a way to shame a woman, it could not be more fucked up.

Comment #40: Rachel Tyrel - regarding calculating the date of conception, the first time I got pregnant I was surprised to learn that the 40 week average pregnancy is calculated from the last menstrual period so it’s always about 14 days before actual conception. It’s not as medically accurate as calculating from conception, but the medical folks think a lot of women don’t know the precise date they conceived, but they will know when their last period was. It’s the standard way of calculating for all pregnancies. I happened to know exactly when I conceived, but since I have an average 28 day cycle the due date came out the same.

Livi’s right. The day that fertilized egg implants and pregnancy begins, you’re considered two weeks pregnant.

And for those, like me for my first, who literal had only one point when the fertilization could have occurred, totally stupid.  And when 18 yo me tells the doctor no, this is the right date, the bastard was an ass about it rather than explain they use some arbitrary thing.  I was young, not so stupid I didn’t know when I had had sex.

Livi, Orange, and helen w. h.:  Exactly.

My objection was primarily with the formulae that are used to calculate the gestational age, because those formulae result in an implantation date that happened 10-14 days before the actual sexual activity happened.  Now that I’m older and more experienced, I realize now that I should have just said, “Look, I realize that your kooky way of calculating gestational age has absolutely no basis in the reality of the mechanics of sexual activity.  Instead of getting in a snit because I’m contradicting you, just remember that you can do whatever voodoo math you want and write it in my chart, but that doesn’t change the reality of the fact that I had sexual activity on a particular date, and that is the date that I got I pregnant.  Oh, and another thing, I’m not paying you to stand here and argue with me about these nonsensical theorems you’re forced to calculate.  Rather than wasting time giving me attitude, how about you just get the damned parasite out, let me pay my bill, and be on my way.  Or, I’ll find another doctor.  Understood?”

Yeah, the doc really should have explained it better. Calculating like that is a problem for women who don’t have a 28 day cycle, but silly womens amirite?

Huh. I’ve been following this site for a couple months, but I had no idea you wrote a column for the Guardian. You should put a link on the front page or something.

I had a very regular 30-day cycle back then, to within 6 hours.  Now that I’m into the middle 40s, not at all regular and as like to be long as short (26 - 33 days within the last year alone).  I don’t know many women IRL who have true 28 day cycles. 
Anyone here?