trans-vaginal ultrasound for no medical reason - Virginia, anti-choice

I must have missed the bit in the bill where it says it wants to show patients images that 'accurately portray' the external members and internal organs of the foetus.

I just saw the bill saying that patients should be offered the choice of seeing scan images.

But the bill is aimed at clinics and drs. If it becomes law to have an ultrasound then the clincs and drs will have to abide by this.

A copy of the ultrasound image would be required to be entered into the woman's medical records (at the facility) for 7 years. Why would that be necessary? It would be interesting to know if medical facilities are required by Sate law to keep images of, say, tumours or wisdom teeth that they have x-rayed and then removed. Here's the bill

Mark my words - within 3 years, there will be a direct challenge on Roe v Wade.

Viva - if it is best practice to have a scan before a termination, and there are concerns about shoddy clinics, then the bill should be aimed at doctors/clinics proving that they adhere to best practice. This bill has nothing to say about that.

It was the last bit that really shocked me. Trying to make the woman look at the scan images as a means to applying pressure not to continue with the abortion. That is that bit that shifts it from being a (possibly) medically justifiable procedure to pure politics.

But what if it is best practice to have a scan before a termination? Because from what I understand it is. Maybe this law is protecting women from shoddy clinics?

I would definetly have a problem with women having to have vaginal ultrasounds which is what the title of this thread made it sound like. But this isn't the case.

It's no good arguing about how terminations are carried out here or anywhere else. That's not the issue.

The language that lawmakers use is very specific. In this case it's "every pregnant female shall undergo" ? there's no ifs or buts about that, certainly no leeway for the woman, or the doctors or medical staff if they're dealing with a distressed woman. The oaths the doctors swore (variations of "first, do no harm") when they graduated have been completely over-written by lawmakers. But, as I said upthread, this bill isn't about best practice by medical staff, it's about the law mandating what all women shall undergo, whether that's necessary/in her best interests or not. The last thing this bill is about is "informed consent", because there cannot be "consent" when it's required by law.

Thats not what I said.

Missing an ectopic risks a life, a tube, future fertility... implying many/most are absorbed is disgraceful

Treatment doesnt necessarily involve losing a tube. And you cant say that everyone presents for medical care, because we cant know that can we? If a proportion of the ectopics painful enough for women to present to health services resolve without treatment then it seems likely that there will be some women who have ectopics that resolve on their own without anyone knowing about it.

Method of abortion is dependant on dates.

Dates are often wrong because of circumstances surrounding the conception (I could cover every scenario but this is not meant as an insult but as a representation of anecdotal evidence working in a termination clinic).

Many women know exactly how pregnant they are. Knowing which these women are, is not something Dr's are capable of.

Performing the wrong technique could be hazardous to the woman and certainly open Dr up to litigation if it went wrong

I saw many a woman who had a scan performed in a newly set up termination private practice where the scan/protocol had been performed inadequately and the consequences varied but were not good for the woman. Missed ectopics. Miscarriages (incomplete abortion) given a D&C anyway (op risk and distressing to the woman who had already miscarried but this knowledge was only obtained once she had instruments inside her), unusual shape to uterus and varied risks of surgical procedure. You can have a positive preg test even when you have miscarried. You'd then have an unecessary procedure.

A scan would have given a safer procedure. I would never consider a TOP myself without one.

The womb is not measurably palpable in v early preg.

Abdominal scans are good in a slim full bladdered woman with no bowel gas.

Vaginal scans are however the technical gold standard for visualisation. It should never be performed without valid consent. Never.

I think the assumption that staff use vaginal exams as a punishment rather than as a medical examination for the patient's benefit is insulting to clinics who offer a professional, caring and sensitive service to women requesting abortion - they use it to provide gold standard care. If you decline then that should be accepted as your wish and recorded with you taking responsibility for any consequence. No problem to either party involved that way

We never ever showed the screen and we answered questions as asked and never volunteered information.

Obviously those women who have an ectopic pregnancy who present to the medical profession (almost all as it's very painful like appendicitis) will have their lives saved minus a fallopian tube.

It's a dangerous condition that has the same death rate as appendicitis. Please be aware of this.

Victor, sadly that's what I saw a lot of as a student.

Women been told that there had to be a scan done before they could have a termination. I'd go to the scan with them. I saw a lot of scans where the sonographer couldn't see what they needed to so would just say they needed to do a vaginal one instead. All the women I saw said ok to this but the way it was presented to them was that it was a forgone conclusion that they'd say ok.

It was always a statement rather than a question.

Dworkin

I said that ectopics are hugely risky.
That doesnt change the fact that they can resolve on thier own see here of one paper I'm absolutely not saying that women with suspected ectopics should seek help, of course they should, but it is not impossible that someone could have one and not know.

And there are reports of live births following ectopics. It is very rare, but can happen. Google it if you dont believe me.

I had a vaginal scan before my termination in 2005. I can't remember exact details, but it was something to do with the abdominal one not working properly. It was not something that I 'consented' to, exactly - if I hadn't had it, I wouldn't have had an abortion and I wanted one. I would have consented to anything as long as they agreed to perform the procedure. I would have run round the hospital stark naked at midnight if that's what they wanted.

I was not happy about it though, and I said so - at the time, I had never even managed to have a smear test as I had a real issue with gynaecological procedures. There was a definite sense of 'no scan, no abortion'.

Sardine,

I'm not arguing that it's fine, I'm really not.

I agree that local trust policy is not the same as law. However if you're a woman at that local trust it may not make much difference to you whether it's law or policy. You're probably right that if someone kicked up a stink about it then it wouldn't be done. Theyre not going to do it without consent. But I do think that they would then have to come back for an abdominal scan at a later date. From the link to the Virginia law it looks like that option will also be available to women in Virginia. Theyre not saying that they're going to make a law where all women have to have a vaginal scan.

Dworkin - Are you now saying that you think women should have compulsary pelvic exams where an abdominal ultrasound may suffice?

Cats That is a dangerous message to post on Mumsnet. Ectopic pregnancy is a dangerous condition to women, it never resolves on it's on and it NEVER results in a live birth. Only a dead woman, and dead foetus.

I don't know to be honest Dworkin, you'd have thought so. Like I said I don't work in gynae. I'll ask one of the drs at work next week though.

So if you go along to your GP and say, I had unprotected sex 2 weeks ago and this early test tells me I am pregnant, they will say, we cannot do anything until the embryo / foetus is big enough to be seen on a scan, come back later - when ? How many weeks?

And I flat out DO NOT BELIEVE that a rape victim would be refused an abortion on the NHS if she refused to have a trans-vaginal scan. People who are saying it is COMPULSORY - it is not - it is procedure. If a woman for some reason has a violent objection to having a scan they will find a way around it - in order to treat her - she will not be turned away - at least not in the NHS I know.

LAWMAKERS saying that women must have scans when it is none of their business is, quite frankly, an intrusion and wrong.
EXACTLY the same as Dorries attempts to hand all pregnancy / abortion / don't know what to do type advice religious organisations.

Sorry for shouting but seriously why are there people on this thread arguing that a. this is fine and b. is already in place in the UK? It's not fine, and it isn't in place. Individual trust procedures are not teh same as legal requirements and I do not for one second believe that a rape victim would be forced to have a transvaginal scan under the NHS.

"Ectopic pregnancy is a serious medical condition that is very painful, leads to the loss of a fallopian tube and sometimes the ovary and can lead to death if not detected sooner. How very dare you!"

What is your point here?

A proprortion of ectopics do resolve on thier own, and rarely there have been live births following ectopic pregnancies. Thats not to diminish the potential huge risk of an ectopic pregnancy, but I certainly dont think that a woman should be criticised or accused of being a child if she hadnt been aware of an ectopic.

But viva surely a pelvic exam will ascertain the size of the uterus?