The Ultrasound: Medicine or Propaganda?

Ultrasound: Medicine or Propaganda?

If you’re pro-choice and follow the issues, you’ll certainly be aware of how, over the years, “rights” talk has been taken up by anti-abortion activists and used quite effectively against women’s reproductive rights.

One area it’s being used in New Zealand is via the “right” to informed consent. (Others include (1) the right of medical professionals to conscientious objection, with no equivalent right for women to exercise their consciences. Click here for more on that; and (2) mandatory notification aka the right of parents to know if their under-16 daughters are seeking abortion, click here and here).

For several years now, Right to Life has been lobbying the Minister of Health, the Abortion Supervisory Committee and District Health Boards on the ultrasound issue. DHB’s have been asked to include questions about ultrasound viewing in their consent forms, for example: “have you been offered the opportunity to view an ultrasound scan of your baby?” Or, “were you offered the opportunity to view your ultrasound scan?” – rather less loaded. According to RTL, some have agreed to do so, though with precisely what wording is unclear.

In the Wairarapa, according to an article last year in the Wairarapa Times Age  RTL was very concerned that “98 percent of women who were considering an abortion when offered the opportunity to view a scan of their baby declined the opportunity.” RTL wrote to the Wairarapa DHB  asking if the offer to view the ultrasound was being made “in a neutral manner”. It cited those stats of unknown origin that are ubiquitous among anti-choice advocates (“between 62 to 95% of the women after seeing their baby chose life for their baby”) and argued that “the overwhelming number of women choosing not to view the ultrasound scan suggests that the offer to women to view the scan may be presented in a very negative way.”

(Naturally, Garth George, who frequently echoes RTL, wrote a column on the ultrasound issue. He also cited the 62-95% figure, attributing it to “pregnancy counseling services” – though didn’t say which ones.)

Bogus Stats

On that alleged 62 to 95 percent rate, cited by RTL, of women who apparently change their minds after seeing an ultrasound: RTL hasn’t, to our knowledge, given the source for this, but it appears to come from U.S. Crisis Pregnancy Centers run by anti-abortion groups. We’ve asked around and done a little research, and haven’t found any reputable studies of the question. [But wait! See update at the end of this post.]

As one correspondent to The New Zealand Herald explained:

The “success” reported by so-called pregnancy counselling service in the United States is neither a miracle nor a coincidence but the result of a calculated shift in anti-abortion activism from picketing outside abortion clinics to masquerading as support services. There are now thousands of these “services” throughout the United States. These clinics offer free scans, not conducted by qualified radiologists but by “counsellors” who use emotive and manipulative language in describing what women see. Women using these services are also frequently shown around a display baby nursery, given plastic models of fetuses, gifts of booties and clothes, and counselled on the risks of abortion and the joys of motherhood. The “change of heart” is not the result of fetal ultra-sound imaging but the emotional blackmail and manipulation of anti-abortion activists who are appropriating the use of technology for ideological means.

But whatever the statistics show or don’t show, as Rachel Benson Gold put it in an excellent article in Guttmacher Policy review, “Providing women information specifically geared to dissuading them from having an abortion is a perversion of medical ethics in general and the informed consent process in particular.”

At least one anti-abortion pregnancy counseling centre in New Zealand provides ultrasounds. In addition, Pro-Life Times (which ceased publication last year) ran an article in 2009 about plans to set up a “mobile pregnancy centre.” A van had been donated to the effort, and organizers said they were liaising with Focus on the Family in the US to fund ultrasound equipment. We don’t know if the mobile centre ever got off the ground. But Focus on the Family reported last month on its [Links to a PDF!] “Option Ultrasound” campaign that it had just made its “first international placement” of an ultrasound machine, and it wasn’t to New Zealand, but to Bucharest, Romania. (In the U.S., 384 machines have been placed in 49 states.)

 Is It Good Medicine?

In its [Links to a PDF!] latest update on ultrasound requirements in the U.S., Guttmacher points out that

“since routine ultrasound is not considered medically necessary as a component of first-trimester abortion, the requirements appear to be a veiled attempt to personify the fetus and dissuade a woman from obtaining an abortion. Moreover, an ultrasound can add significantly to the cost of the procedure.”

The British Royal College of Obstetricians and Gynaecologists considers routine pre-abortion ultrasounds unnecessary. Its Guidelines (2004) “The Care of Women Requesting Abortion” (it is currently updating these) state:

Rec 22. All services must have access to scanning as it can be a necessary part of pre-abortion assessment, particularly where gestation is in doubt or where extrauterine pregnancy is suspected. However ultrasound scanning is not considered to be an essential prerequisite in all cases.

Rec 23. when ultrasound scanning is undertaken, it should be in a setting and manner sensitive to the woman's situation. It is inappropriate for pre-abortion scanning to be undertaken in an antenatal department alongside women with wanted pregnancies.

New Zealand’s own Abortion Supervisory Committee, in its guidelines, currently recommends ultrasounds in order to “more accurately” establish “gestational age, viability and site.” 

Our Thoughts

ALRANZ has no specific policy on voluntary use of ultrasound – that is, where the woman requests it – but opposes mandatory and/or non-medically justified use. If a woman seeking abortion does undergo an ultrasound for medical reasons or because she requests it, she is (and should be) free to ask to view it, but she should not be pressed, and the emphasis must be on sensitivity to the woman’s situation.

As for consent procedures, while we support women being given all the information they want and need regarding their health and well-being, we are extremely wary of expanding formal consent to include items that are well-known anti-choice propagandist tools. Clearly, no woman who has an ultrasound will be unaware of that fact, and she will ask to see the scan if she wishes.  

More Discussion

Last, but most definitely not least, for a really interesting discussion of some of the issues surrounding ultrasound, do have a look at this recent post by New Zealand blogger ladybroseph (blogging at Feminethicist). And we’re grateful for the link.

Update

An article at LiveScience says: "a study, published in 2009 in the European Journal of Contraception and Reproductive Health Care, found that, when given the option, 72 percent of women chose to view the sonogram image. Of those, 86 percent said it was a positive experience. None changed their mind about the abortion."

END

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