Forced Ultrasounds for Abortion in Oklahoma - Because Your Government Can Demand That An Object Be Inserted Into Your Vagina

I’ll admit that I haven’t been furiously blogging about every single anti-woman bit of legislation to roll through each of the 50 states this year, because there’s simply too much of it, and I generally assume that the most ridiculous of them will never make it out of committee. I also have a bit of fatigue from all of the proposed bills which seem to have as their underlying premise the notion that women are somehow intellectually deficient as a sex, and I think many of the arguments I would make have been reasonably hashed out elsewhere.

There is one recent state law, however, that I feel compelled to point out, even if other bloggers have already thoroughly covered it, because I have readers who aren’t likely to visit many of the feminist blogs where this has been discussed. Late last month, the Oklahoma legislature passed a bill that would require women to have an ultrasound performed prior to obtaining an abortion (and it’s not the first state to do so). The Governor vetoed the legislation, stating that, “this legislation does not provide an essential exemption for victims of rape and incest. By forcing the victims of such horrific acts to undergo and view ultrasounds after they have made such a difficult and heartbreaking decision, the state victimizes the victim for a second time. It would be unconscionable to subject victims of rape and incest to such treatment. Because of this critical flaw, I cannot in good conscience sign this legislation.” The legislature then overrode the veto, making the bill law.

Oklahoma’s Governor, however, missed one crucial element in explaining his veto. The law states that, one hour prior to beginning the abortion procedure, the provider must “Perform an obstetric ultrasound on the pregnant woman, using either a vaginal transducer or an abdominal transducer, whichever would display the embryo or fetus more clearly.”

Let’s just take a moment to get this straight. Sometimes an ultrasound is performed prior to an abortion. Sometimes this ultrasound is a transvaginal ultrasound because it may offer a better view. The exact percentage of times an ultrasound is performed, and how often that ultrasound is transvaginal, is almost irrelevant from one perspective, although early abortions (which most abortions are) will require the transvaginal route. What is relevant is that the law, as written, has no regard for the clinician’s judgment or the woman’s consent - it is aimed only at getting the best picture of the embryo or fetus.

It inserts the government into medical decision-making with no regard for the patient, and is based on the premise that women seeking abortion simply have no idea what they’re doing, and so might need to be informed that there’s actually something in their uterus. I think they know that, or they wouldn’t be at the abortion provider in the first damn place.

This law takes away a woman’s ability to refuse consent to an ultrasound or method of ultrasound and a provider’s judgment about the type of ultrasound needed (and if it is needed) in order to perform a legal medical procedure, for the sole purpose of making sure a woman can see her soon-to-be-aborted fetus, which she likely could have done anyway if she desired - although the law allows her to “avert her eyes.”

But lets get back to the transvaginal vs. abdominal issue. Given the likelihood that the transvaginal ultrasound would “display the embryo or fetus more clearly,” Oklahoma’s legislature has mandated that a woman seeking abortion have an object (what couples blogging about fertility call a “dildo cam”) inserted into her vagina.

Let that sink in. The state has effectively mandated that women seeking an abortion have an object stuck in their vaginas. Whether they consent to that specific thing or not, because they can’t have the procedure they did consent to if they don’t. Whether the provider believes it is medically necessary to stick the object in her vagina or not. Because these women might not know what they’re doing, might need to be emotionally coerced, might be too stupid to understand what an abortion clinic actually does.

I’ve written before about how coerced ultrasounds are a long-standing tactic of anti-abortion activists, who believe that women who see an ultrasound will suddenly *get it* (again, because they couldn’t possibly have known what they were doing) and flee from their decision. As I wrote in the past, “A woman may feel warm and fuzzy at the point of the ultrasound, but that feeling is not going to support her through the pregnancy, is not going to erase poverty, abuse, rape, or health concerns that may cause a woman to choose abortion. It’s not going to help her finish high school. It’s not going to be accompanied by information on all of her options, but is going to be used as part of a campaign to get her to have a baby.” If you think this law has anything whatsoever to do with protecting women in a legitimate way or the legitimate practice of medicine (as performed through abortion services), you have not been paying attention to the political maneuvering going on around this issue. So here we are. Apparently Oklahoma legislators believe coercion is an appropriate use of medical technology, consent be damned, and that effectively assaulting/raping women with an object is an appropriate use of their power.

More commentary on this:
-An ob/gyn notes at Alternet that the fine for not complying is greater than the fine for negligent homicide
-From the same physician as above, a list of what’s wrong with this law
-Amie Newman at RHReality Check says that anti-choice advocates pushing ultrasound measures are “pretending to care about women’s health and well-being when in fact they are using precious legislative, human and financial resources that could be funneled towards laws and advocacy that actually help women; laws that expand health care coverage, protect women from domestic violence, provide needed resources for child-care and more.”
-Lindsay puts it more succinctly than I could: “‘Excuse me, lady, you say you want an abortion. Did you realize that there’s a fetus in there? You don’t know what you’re doing. Let me stick this tube into you, so that you can be competent to make a decision.’”
-Aunt B notes, “If a woman’s boyfriend or husband said ‘If you want an abortion, you have to let me put my dick or my finger or this dildo inside you first, until I’m satisfied you understand what you’re doing,’ we would have no problem–I don’t believe there’s a person reading this who can’t understand how wrong that would be–no problem at all calling that the evil it is, regardless of what you believe about abortion.” Also, please see Bridgett’s comments about cost.

OBOS Post: Revisiting Depression, and Abortion

Today at Our Bodies Our Blog:

“A new study in BMJ Public Health examines depression in women and the relationship of past abortions to the condition. This new report is particularly interesting because it attempts to control for the effects of sociodemographic factors and considers the women’s experiences of intimate partner violence, recognizing that multiple factors may impact a woman’s mental health.”

Head on over for details.

NPR Uncovers More Info on POPLINE Controversy

Morning Edition has a piece today on the POPLINE controversy, indicating that the issue arose because one recent issue of A Magazine “focused on abortion as a human rights issue and profiled abortion rights advocates around the world,” and USAID did not want these articles included in the database.

In other words, federally-funded USAID didn’t like the politics of one issue of the publication, so decided that it should not be accessible through the major database on global reproductive health.

It seems strange that this one specific issue of the magazine was targeted for removal because USAID objected to its “advocacy.” A quick search of POPLINE retrieved other citations that USAID could easily remove by this standard, such as a document from the International Women’s Health Coalition entitled, “The Global Gag Rule: putting politics before public health.”

I found records for numerous other publications that discuss global access to safe abortion as an important public health and women’s rights issue, such as a 2002 issue of Reproductive Health Matters which the editorial describes thusly: “These papers are by women’s health advocates, medical professionals, researchers and others working for safe, legal abortion in their countries. These papers advocate safe abortion as a public health goal and legal abortion as a woman’s right, including for marginalised populations such as refugee women.”

What guarantee do we have that USAID will not also press for the removal of these and other citations? Will every individual reference that does not bolster their political agenda be removed quietly, with no notification to database users that they are not retrieving as much information as they should be? I am personally deeply offended by the suggestion that, when our government chooses not to fund a specific procedure, we should also be limited in our ability to find opinions opposing that position.

Ipas, the international reproductive rights and public health organization producing the magazine in question, has issued a response, in which they question the logic of USAID’s approach of restricting “the free flow of information about this important topic.” Ipas Vice President Ana Kumar stated: “Ipas approaches abortion from a human-rights and public health perspective. Thousands of women are dying from unsafe abortion and millions more are injured. Women are putting their lives at risk while we are dithering about words. How is this not a human-rights issue?”

Cross-posted at Our Bodies Our Blog.

Shameless Self-Promotion - Baltimore Sun Covers POPLINE Controversy

Stephanie Desmon of the Baltimore Sun published a piece yesterday on the POPLINE controversy, and included a brief quote from yours truly. If I remember correctly, we were discussing what had happened and how/why the librarians got involved (prior to the reversal of “abortion” being blocked in the database):

“The citations are still there,” said Rachel Walden, a biomedical librarian in Nashville who writes a blog called Women’s Health News. “The actual references haven’t been removed. But it’s been made quite a bit more difficult for the average user to get. Most people in this profession are really interested in people having access to information … and for it to be reliable.”

Desmon also has comments from the Presidents of the American Library Association and the Association of Reproductive Health Professionals, which I hadn’t seen until this piece. Thanks to the Sun for covering this issue.

Access to Abortion Search to be Restored in POPLINE; Johns Hopkins Releases Statement

Following Wednesday’s revelation that the USAID-funded POPLINE reproductive health database had deliberately blocked users from performing a simple search on “abortion” because, “As a federally funded project, we decided this was best for now,” medical librarians, feminists, public health professionals and others responded with outraged blog posts and calls and letters to the Johns Hopkins Bloomberg School of Public Health, where the database is managed.

Today, Michael J. Klag, MD, MPH (Dean of the School at Hopkins) has released a statement detailing the events and indicating that the ability to search the database for “abortion” will be restored.

Dr. Klag notes:

I was informed this morning that the word “abortion” was blocked as a search term in the POPLINE family planning database administered by the Bloomberg School’s Center for Communication Programs. POPLINE provides evidence-based information on reproductive health and family planning and is the world’s largest database on these issues.

 

USAID, which funds POPLINE, found two items in the database related to abortion that did not fit POPLINE criteria. The agency then made an inquiry to POPLINE administrators. Following this inquiry, the POPLINE administrators at the Center for Communication Programs made the decision to restrict abortion as a search term.

 

I could not disagree more strongly with this decision, and I have ordered that the POPLINE administrators restore “abortion” as a search term immediately. I will also launch an inquiry to determine why this change occurred.

 

The Johns Hopkins Bloomberg School of Public Health is dedicated to the advancement and dissemination of knowledge and not its restriction.

Thank you to everyone who worked to call attention to this issue.

Cross-posted at Our Bodies Our Blog

Wired has some additional follow-up, as does the New York Times.

Why is a Government-Funded Reproductive Health Database Blocking Users from Searching for Abortion Articles?

Cross-posted at Our Bodies Our Blog

Today through medical librarian channels, I got word that entering “abortion” as a search term in the POPLINE database now returns zero results because of a move by the database personnel to block that search. For background, POPLINE is “the world’s largest database on reproductive health, containing citations with abstracts to scientific articles, reports, books, and unpublished reports in the field of population, family planning, and related health issues.” This may seem like a long and libraryland-focused post, but I think it’s important, because it touches on government, reproductive health, and access to information, so stick with me on this one.

The librarian who noted the problem inquired about it, and was informed that it wasn’t a simple technical glitch; the response she received was, “We recently made all abortion terms stop words. As a federally funded project, we decided this was best for now.”

If you’re not familiar with “stop words,” they are typically words like “a,” “an,” and “the” that are omitted automatically from the search, because they is assumed to have no added value or meaning. Suffice it to say, it’s quite unusual for a word with “real” meaning to be a stop word, especially one so relevant to the resource being searched.

The librarian was then advised to do a search for unwanted pregnancy as a substitute, which ignores the fact that these words are not synonyms, as a pregnancy can be unwanted but carried to term or desperately wanted but aborted for various health reasons.

Now, a little digging reveals that the POPLINE folks haven’t actually removed the term “abortion” (or related ones) as subject terms from the citations, or from their Thesaurus which tells you which subjects appear in the database. If you know to use the “Browse Index”* you can still find the term and come up with almost 25,000 results. However, if you simply enter the word “abortion” in the Subject search box, as the instructions directly above the box suggest you should be able to do, the search returns 0 results. Another work-around is to enter the search as =”Abortion” as the Index search would do, and you can still get the results. Of course, that applies for now, until they realize that the work-around is there and remove it as well.

Right now, this move is essentially a barrier to your basic search/er - an advanced searcher might get 25,000 results, while someone just following directions will get none. As the librarian reporting the problem noted, “It is important to remember that this database is used by both professional searchers and the public. The average user goes directly to the query box and searches; they will retrieve nothing when the term “abortion” is entered.” She also notes that using the advanced options was *not* among the suggestions from POPLINE personnel in response to her inquiry.

It’s not clear at this time why POPLINE made this change, whether it was a top-down or a local decision for this federally-funded project, or why they chose not to release any information about the change until people started asking questions. Perhaps this will seem silly to someone at the offices of “the world’s largest database on reproductive health” and access to these citations will be restored. However, it’s important to note that POPLINE isn’t just a project of the Johns Hopkins Bloomberg School of Public Health (the logo displayed at the top of the screen), but is in fact funded by USAID.

Yes, that USAID, of Global Gag Rule fame, which has been criticized because family planning agencies around the world are prevented from receiving assistance if they perform or counsel their clients about abortion (even if that work is funded through other sources), and through which much controversial abstinence-only money is channeled.

I’d really love to assume that political pressure didn’t encourage anyone to deliberately make it more difficult for people to find references to articles about abortion.

*And can get it to work - it failed in multiple browsers on a Mac and Firefox on a PC.

Update: Other bloggers on this topic; I’ll add more as I find them.
-Angular Uncomformities (Scott Hanley)
-BoingBoing
-Crooks and Liars
-The Experiment
-Feministing
-Feminist Peace Network
-Infomusings
-Jezebel
-Librarian Activist
-Library Stuff
-Maud Newton
-No Maps for These Territories (brassratgirl)
-Oh, we’re going to talk about me, are we? Goody. (kylegirl)
-LACUNY Blog
-Pear Popsicle
-Population Action Blog
-ResourceShelf [ResourceShelf has been promised a comment from the POPLINE team - stay tuned.]
-RH Reality Check (first post outside the library community that I’m aware of)
-Social Justice Librarian
-Strange Librarian
-Threat Level - Wired Blogs

Update #2: The Dean of the Johns Hopkins School of Public Health has issued a statement, and access to the search will be restored - see update.

If Mifepristone Were Really Like Ecstasy and Weed, It Would Probably Be *More* Popular

As further proof that some people who want to restrict abortion access don’t bother with logical consistency, a bill that just passed in the Missouri house (and was intended to deal with the sale of drugs that can be used in meth production, such as cold medicines with pseudoephedrine) now has an amendment added by Rep. Ray Salva which adds mifepristone (a medical abortion drug) to the list of Schedule I Controlled Substances. The specific criteria for Schedule I is that the substance has high potential for abuse; and has no accepted medical use in treatment in the United States or lacks accepted safety for use in treatment under medical supervision. This class includes drugs such as ecstasy, heroin, marijuana, and LSD.

I wonder if the Representative knows that mifepristone is not only approved and legal for medical abortion, but can also be used for cervical ripening and induction of labor, either at term or following intrauterine fetal death? It’s not exactly a “street drug” with no accepted medical uses, and is not addictive.

The amendment is expected to be removed if it gets anywhere in the state Senate.

Related news coverage is available from the Kansas City Star and Missourian.

Bill Clinton Responds to Anti-Choice Hecklers

I posted today at OBOS about Bill getting heckled by a student anti-choice group (with links to summaries on the presidential candidates’ histories and positions on abortion). Here’s the video of his riled up response:

Blog for Choice Day 2008

The theme of this year’s Blog for Choice Day, on the anniversary of Roe v. Wade, is why it’s important to vote pro-choice. I know there are those of you who may disagree on this issue, but it’s important to me, especially in an election year, to have this discussion.

I vote pro-choice because, in my state, there are politicians who, every year, propose bills intended not to make women and families better able to successfully raise children, not to encourage access to birth control and healthcare, not to improve sex education and education generally, but solely to restrict women’s ability to make this legal and personal decision. I vote pro-choice because I believe that when politicians are focused only on the act of abortion and not all of the personal and societal reasons that women choose abortion, we all - women, families, and communities - lose.

I vote pro-choice because when these same politicians propose legislation that suggests that women just haven’t thought about what they’re doing (waiting periods), that they don’t know what pregnancy is (ultrasound provisions), that they would choose differently if they just knew better, those politicians demonstrate an appalling underestimation of women’s intelligence and capacity as fully functioning human beings, if not outright contempt for women and their families. These politicians further attempt to shame women with proposed bills such as the one to mandate death certificates for aborted fetuses, while not requiring the same for miscarriages that take place at the same gestational stage as most abortions. I vote pro-choice because I believe women are smart, capable, and know exactly what they’re doing when they make this personal choice.

I vote pro-choice because methods of bringing on a late period (inducing miscarriage) and terminating pregnancies have existed as long as women have existed, and will continue long after any legislation makes them illegal. I believe that voting pro-choice protects existing women, families and communities which we have invested in as a society by keeping abortion as safe as possible. I vote pro-choice because I believe that making abortion illegal would increase the rate of unnecessary death for fully grown women, and make criminals of women and doctors who are making what they believe is the best decision for them, in their own times and places and situations.

I vote pro-choice because I believe that there is an inescapable ethical and legal conflict inherent in any situation in which one being depends solely on the body and resources of another being for its existence, and this conflict is never more pronounced than when a fetus inhabits a woman’s body. To codify this conflict such that one party always necessarily wins seems to me a poor solution, whether the fully grown woman must always carry a pregnancy to term or a pregnant woman must always have an abortion. I vote pro-choice because I believe this conflict cannot be resolved in extremes, and is best resolved on an individual level rather than by a faceless, unaccountable government.

I vote pro-choice because I do not trust my government. My government turned its head while poor, Southern, black men were systematically denied treatment for syphilis. My government allowed laws to be passed permitting involuntary sterilization. My government has suppressed responsible sex education, allowed abstinence-only provisions to be largely written and spearheaded by a man who says, “Abstinence at the federal level is not primarily an STD prevention program. It is rather a marital preparation program. Also, it’s not about preventing teen pregnancy,” and pulled factual information on condom efficacy and abortion and breast cancer from its websites that did not support its political agenda. I vote pro-choice because the default position in our political system should be our government saying, “yes, we trust you” (with accurate information, and with personal decisions), not the other way around. I vote pro-choice because we are people, not pawns in a game with no consequences for those moving the pieces. I vote pro-choice because my government cannot be trusted to make my decisions for me, or for any other woman or families on such a personal level.

Inaugural Pro-Choice Blog Carnival

Hosted by Abortion is a Woman’s Right, the first edition of the Pro-Choice Blog Carnival has been published. It includes a number of good essays on the topic, from bloggers you know (such as Jill at Feministe) and many others you should check out.

I have two pieces in the issue, How Operation Rescue and National Right to Life Spin Abortion Research and More Disturbing Ballot Initiatives - Abortion Access in Missouri (an OBOS post).

The next edition will be at Abortion is a Woman’s Right on February 28th, and the deadline for submissions is February 27th. You may send your submissions via the Carnival Submission Form, or to the organizing blogger at burningtimes1645@yahoo.co.uk.