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How Abortion Law Works in Texas

16 Mar, 12 | by Iain Brassington

Remember a little while ago there was a rash of proposals in the US that’d force women to see a sonogram of the foetus, or to listen to detailed descriptions of it, before having an abortion?

Yeah: them.  Well, via Ophelia, here’s an account of what really happens.

Halfway through my pregnancy, I learned that my baby was ill. Profoundly so. [...] “I’m worried about your baby’s head shape,” she said.  “I want you to see a specialist—now.”

[... B]efore I’d even known I was pregnant, a molecular flaw had determined that our son’s brain, spine and legs wouldn’t develop correctly.  If he were to make it to term—something our doctor couldn’t guarantee—he’d need a lifetime of medical care.  From the moment he was born, my doctor told us, our son would suffer greatly.

So, softly, haltingly, my husband asked about termination.  The doctor shot me a glance that said: Are you okay to hear this now?  I nodded, clenched my fists and focused on the cowboy boots beneath her scrubs.

She started with an apology[...]

That’s not a good start, is it?  An expression of sympathy, maybe.  But an apology?  It’s as if she knows that things are about to get worse.  And they are.

My counselor said that the law required me to have another ultrasound that day, and that I was legally obligated to hear a doctor describe my baby. I’d then have to wait 24 hours before coming back for the procedure. She said that I could either see the sonogram or listen to the baby’s heartbeat, adding weakly that this choice was mine.

“I don’t want to have to do this at all,” I told her. “I’m doing this to prevent my baby’s suffering. I don’t want another sonogram when I’ve already had two today. I don’t want to hear a description of the life I’m about to end. Please,” I said, “I can’t take any more pain.” I confess that I don’t know why I said that. I knew it was fait accompli.  The counselor could no more change the government requirement than I could.  Yet here was a superfluous layer of torment piled upon an already horrific day, and I wanted this woman to know it.

“We have no choice but to comply with the law,” she said, adding that these requirements were not what Planned Parenthood would choose.  Then, with a warmth that belied the materials in her hand, she took me through the rules.  First, she told me about my rights regarding child support and adoption.  Then she gave me information about the state inspection of the clinic.  She offered me a pamphlet called A Woman’s Right to Know, saying that it described my baby’s development as well as how the abortion procedure works.  She gave me a list of agencies that offer free sonograms, and which, by law, have no affiliation with abortion providers.  Finally, after having me sign reams of paper, she led me to the doctor who’d perform the sonography, and later the termination.

The doctor and nurse were professional and kind, and it was clear that they understood our sorrow.  They too apologized for what they had to do next.  For the third time that day, I exposed my stomach to an ultrasound machine, and we saw images of our sick child forming in blurred outlines on the screen.

“I’m so sorry that I have to do this,” the doctor told us, “but if I don’t, I can lose my license.”  Before he could even start to describe our baby, I began to sob until I could barely breathe.  Somewhere, a nurse cranked up the volume on a radio, allowing the inane pronouncements of a DJ to dull the doctor’s voice.  Still, despite the noise, I heard him.  His unwelcome words echoed off sterile walls while I, trapped on a bed, my feet in stirrups, twisted away from his voice.

“Here I see a well-developed diaphragm and here I see four healthy chambers of the heart…”

I closed my eyes and waited for it to end, as one waits for the car to stop rolling at the end of a terrible accident.

When the description was finally over, the doctor held up a script and said he was legally obliged to read me information provided by the state.  It was about the health dangers of having an abortion, the risks of infection or hemorrhage, the potential for infertility and my increased chance of getting breast cancer.  I was reminded that medical benefits may be available for my maternity care and that the baby’s father was liable to provide support, whether he’d agreed to pay for the abortion or not.

Finally, my doctor folded the paper and put it away: “When you come back in 24 hours, the legal side is over.  Then we’ll care for you and give you the information you need in the way we think is right.”

What can you say about that?  Gary Trudeau has been talking about this all week here, here, here, herehere and here.  I can’t rival that kind of articulacy.  I can’t get much beyond, “What the actual thermonuclear f….?

 

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  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    I think I’d rephrase the last few words: I doubt it’s ever a particularly good decision – but it might well be the least bad by some significant distance.
    Similarly, I don’t think anyone is pro abortion, so much as anti-anti.

  • No one

    I’m against abortion unless it’s extreme circumstances & no alternative is viable, but this is pretty fucked up. America is getting seriously fucking facist.

  • http://twitter.com/Dr_Aust_PhD Dr Aust

     I think that is a good way of putting it, Ian. Many of those of us who would be routinely characterized by the anti-termination lobby as ‘pro abortion’ would be much closer to ‘least worst option’ or ‘anti-anti’.

    Talking of the anti-abortion movement’s excesses, we have had this week in the UK the disgraceful spectacle of a US-style anti-abortion group intimidating and filming women going into a British Pregnancy Advisory Service Clinic. They later denied it all via Twitter and the media, but a quick internet search reveals they have previous form for exactly the same thing.

    I dare say they would be in total agreement with what the Texas and other legislatures have done. Enough said.

    Getting back to the US, as some of the commenters on Ophelia Benson’s blog asked, how do the doctors who are carrying out these state-mandated acts of aggression square it with their own consciences and medical ethics?  I really cannot work that out.

  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    They’re in Manchester, too: just near the Fallowfield Sainsbury’s, I believe.

    As to how the doctors do it, I think that the answer is simply that they have to.  From the article, it’s obvious that at least some don’t like it – but when the alternative is either not to provide the service to particular patients, or to risk losing the licence to practice completely, thereby being unable to help anyone… well, it might be the least bad option for them, too.

    I’d hate to be a Texan gynaecologist.

  • Ed

     ‘A woman seeking an abortion can choose whether to view the sonogram images and whether to hear the fetal heartbeat.’
    And 
    ‘The woman can decline to view the images and listen to the heartbeat.’ 

    http://www.chron.com/news/houston-texas/article/Texas-sonogram-law-goes-into-effect-today-3085314.php  

    http://usnews.msnbc.msn.com/_news/2012/02/08/10355099-texas-begins-enforcing-strict-anti-abortion-sonogram-law 

    I don’t understand why those aspects are completely optional but the listening to the description is compulsory. Dumb inconsistency if you ask me. 

    But to be perfectly honest the problem is her husband and the doctors and nurses moving straight to the abortion option. 

    The most self revealing thing she says is: 

    “I don’t want to have to do this at all,” I told her. “I’m doing this to prevent my baby’s suffering. I don’t want another sonogram when I’ve already had two today. I don’t want to hear a description of the life I’m about to end.” 

    That encapsulates everything. Some of these diagnoses are made and baby turns out to be just fine, doctors should stop promoting abortion this way it is an appalling abandonment of medical principles.  

  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    Oh, boy.  You’ve rather missed the point, haven’t you?

    Noone wants to have an abortion.  It’s never a toss up between that and going to the beach.  In some cases, it might be easier to decide than in others, but that doesn’t mean it’s easy, and in at least some cases, having to decide to abort is the worst thing that can happen bar none.  (That might apply even if the woman in question is objectively convinced that it’s the best option – say, to save her own life, or because of the likely future misery of any child.)

    The case in this story is one such example.  Jones – you’re right – admits that she would rather not have to have an abortion.  But that’s trivial: it’s like someone saying that they’d rather not have to have the painful operation.  It might still be the least bad option.

    So she made her difficult decision.  And then the State decreed that her already-bad day had to be made a lot worse, because she’d be forced to go through unnecessary procedures, and made to feel even worse about something that wasn’t exactly all bunnies for her so far, for no reason whatsoever.  Well, none except the possibility that she might be shamed into not terminating the pregnancy.

    Do you think that even vaguely decent?  Even if you think abortion to be a great evil, do you think that even vaguely decent?

    And what if the prognosis had been wrong?  Well, any prognosis can be wrong.  It’d be absurd to insist that no decisions should be taken seriously just in case they turn out not to be warranted by the facts.  All decisions can only be based on the best available evidence.  There’s no reason to suppose that this wasn’t.

    Finally, what medical principles do you mean?  The best interpretation of the facts was that the foetus would either die pre-term (and let’s not forget the complications that that can cause), or die after a pretty miserable (and possibly short) life.  So what medical principles, exactly, would deny that the woman carrying such a foetus can decide she wants to carry it no more, both for her own sake, and, possibly, the foetus’ too?

  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    I’d be interested to know more about your position. I think that the availability of abortion is good; and – as you say in your other reply – I agree that it should be free and simple. But to say that abortion per se is seems to imply that it’s the sort of thing we should be encouraging.  Is that what you mean, or do you have something else in mind?

  • BrainLogic

    A suggestion to abortion-providing physicians:  Ask your patient in what language she wants to hear the ultrasound description and other superfluous legal waste.  Perhaps she’ll choose one she doesn’t understand, so all that comes through is gibberish.  I’m not aware of any law preventing patients from making this choice, nor preventing doctors from offering it.  We have to change these laws, but in the meanwhile, hopefully such a push-back as this will be good for the patient even now.

  • EmmaGeraln

    The people that have enacted these laws a vile religious zealots. America is now little better than places like Egypt. 

  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    Yes to the first paragraph.  Your second is off, though (especially in the second half, which is just daft).

    I take no stand on the inherent badness or otherwise of abortion, save for a couple of comments.  First, a world in which there were fewer abortions because there were fewer unwanted pregnancies seems to be a better world.  Second, granted that some women have abortions because they worry about the social support required to raise their child (especially if it’s predicted to be disabled), but would otherwise have carried it to term, then a world in which that social support exists and is known to exist strikes me as being better.  If you think that that amounts to a claim that abortions are inherently bad, then so be it; I’m not sure that it does.  My hunch is that they tend to be a way out of a bad situation – that is to say, they might very well be the best option, at least sometimes.  Yet saying that they’re good doesn’t seem quite the right approach, any more than we’d say that chemotherapy is good: it’s good given the alternatives, but it’d probably be better not to need it in the first place.

    That leaves open a totally separate question about the right to make and act on decisions of all kinds, all else being equal.  Though I incline to thinking that appeals to autonomy and/ or liberty are overplayed, and I also distrust the idea that moral status is either a high-or-nothing affair, I’m also fairly satisfied that it’s unlikely that autonomy counts for so little, and the moral status of the foetus (whatever it turns out to be) for so much, that there’d be a case for forbidding termination.

  • Rosemary

    This is just horrifically and inhumanely brutal.  The people who passed this law are monsters, and so is any version of “god” whom they think would support it.

  • Rosemary

     Sounds crazy to me.  Why on earth would someone want to have an abortion unless it was really necessary?  It would be just as insane to say that you were “pro breast ablation”.  Who in their right mind would elect to have a breast removed unless it was medically necessary to save her life.

  • http://velofille.com Liz Q

    Great post – gobsmacked this crap can happen and glad i live nowhere near
    (ps spelling mistake on first word ‘Remeber’)

  • http://www.law.manchester.ac.uk/aboutus/staff/iain_brassington Iain Brassington

    Ta!
    *sneakily edits*
    Speling mistak? Whot spelink mistique?

  • Hortense

    This is a particularly  vicious form of bullying.  Vote the creeps out  – all of them – that voted for this cruelty.No one likes abortion and no one should be forced to bear a  horribly damaged child.

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