Remember Transvaginal Ultrasounds? They're baaack.

You have to hand it to those Republican legislators in Michigan, my beautiful, besieged state.  I swear, they must stay awake nights trying to think up ways to protect our wicked womanly bodies from the fools who happen to own them.  (That would be us, ladies.)  In late December, Gov. Snyder (R) signed a bill handed down by the Republicans setting strict limits on clinics providing abortions, in hopes they couldn't comply and would have to shut their doors.  In that same bill, doctors would now have to have a conversation with the patient, asking needless questions of mostly mentally competent women about whether or not they had been coerced. 

These same Michigan Republicans, having already thrown their weight around, passing an unpopular, unprecedented Right-to-Work law in the state where labor successes made it the birthplace of the middle class, and then going against the voters to reinstate the hated emergency manager law, have again turned their sights on that old standby attention-getter, the fertile womb.

You would think they might have other, better things to think about, considering it's the year 2013 and they haven't quite scaled all the walls of the castle yet, but here they are, socking it to us one more time with a new anti-abortion bill that includes forced ultrasounds, forced heartbeat recordings, forced lectures, forced permission slips, forced 24-hour cooling off periods--all in the interest of taking care of the little women who obviously can't even begin to fathom what's about to happen to them.

Yes, on Tuesday, February 5, 18 Republican men and three Republican women put their signatures to House Bill 4187, wherein they take on the thankful task of coming as close to banning abortion as is politically possible in this, the early part of the 18th 21st century.   

In the very first paragraph they let us know right off that whatever the hell the Federal government agreed to in Roe v. Wade, here in the the great state of Michigan, all bets are off:

Sec. 17014. The legislature recognizes that under federal constitutional law, a state is permitted to enact persuasive measures that favor childbirth over abortion, even if those measures do not further a health interest.

And that's just the beginning.  Let me grab one more section here--the highlight of the entire bill.  The ultrasound part:

(iii) The performance of a diagnostic ultrasound examination of the fetus at least 2 hours before an abortion is performed with the woman given the option to view the active ultrasound image of the fetus, hear the fetal heartbeat, receive a physical picture of the ultrasound image of the fetus, and hear an explanation of the ultrasound image of the fetus. The performance of a diagnostic ultrasound examination of the fetus, now a standard practice at abortion facilities, protects the health of the woman seeking an abortion by verifying an intrauterine pregnancy, as undiagnosed ectopic pregnancies can result in potentially fatal complications and infertility.

The performance of a diagnostic ultrasound examination of the fetus further protects the interests of the woman seeking an abortion by assessing the viability of the fetus and confirming the approximate gestational age of the fetus, as this information is necessary in order to determine appropriate medical care for the woman seeking an abortion.

(All caps and bold was their idea.  I had nothing to do with it.)

Well, I could be picking out juicy parts all over the place but I'll leave it to you to read the rest of the BS, while I get to the (seemingly) good part.

Something (seemingly) big happened yesterday (Thursday, Feb 7, 2013).  Something that could potentially change everything.  Speaker of the House Jase Bolger came out and said there would be no bill from the House that would require invasive, transvaginal ultrasounds.

And cheers were heard for miles around.  I mean!  The Republican Speaker of the House!  Said no Transvaginal Ultrasounds under his watch!  Lordamighty!

But wait. . .

House Bill 4187 doesn't use the word "transvaginal".  It's not anywhere in there.  So what is Speaker Bolger talking about when he says so carefully, "While I want to be sure women have access to the best technology available, I have absolutely no interest in forcing a woman to have a transvaginal ultrasound."

That's what he said.  So why, in the heat of this glorious first, a moment when a Republican leader-man in Michigan actually comes out in defense of women. . .why am I so, so suspicious?

Because it's Michigan and it's the House, and they're Republicans and we're talking about abortion.  Speaker Bolger didn't say he had absolutely no interest in forcing a woman to have an ultrasound.  No, he said, very specifically, a transvaginal ultrasound.

 So now we wait.  The shoe will drop from that other foot.  Mark my words.

About those Ultrasounds: What if Doctors just say no?

 
I've been wondering--haven't you?--why primary care physicians, and especially OB/GYNs, aren't speaking out about the current creepy Rightward trend toward using ultrasounds as punishment against women who dare to sign up for an abortion.  Turns out some of them are.

They're angry, they're anguished, they're dumbstruck.  (Join the club.)  And they're speaking out anonymously--sadly--because we live in a country where medical doctors can no longer talk freely about abortion, a legal medical procedure, without fear of retribution.

This from a post called "Civil Disobedience" by palMD at his blog, White Coat Underground. (Take a few minutes to read some of his other posts while you're there.  Good stuff.):

"In the case of abortions, where time is essential and providers may not be easy to find, delays in care are unconscionable.  To enforce a waiting period violates the doctor’s ethical duty to provide appropriate, timely care and to avoid causing the patient unnecessary grief.  The law forces us to violate our ethics. To force us to perform ultrasounds, transvaginal or otherwise, is battery.

No procedure can be performed on a patient without their informed consent.  To make another important procedure contingent on an unnecessary one is a clear violation of medical ethics. Abortions can be safely performed without sonography, and should be unless their is compelling medical reason to perform one—with the patient’s consent.  To say that a woman can always refuse the ultrasound as long as they refuse the abortion is an immoral argument, one which removes all autonomy from the patient, and forces a doctor to make unreasonable choices."

 Another caring doctor used John Scalzi's blog, "Whatever", to lay out a plan for civil disobedience.  He says, in part:

"I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.

In all of the discussion and all of the outrage and all of the Doonesbury comics, I find it interesting that we physicians are relatively silent.

After all, it’s our hands that will supposedly be used to insert medical equipment (tools of HEALING, for the sake of all that is good and holy) into the vaginas of coerced women.

Fellow physicians, once again we are being used as tools to screw people over. This time, it’s the politicians who want to use us to implement their morally reprehensible legislation. They want to use our ultrasound machines to invade women’s bodies, and they want our hands to be at the controls. Coerced and invaded women, you have a problem with that? Blame us evil doctors. We are such deliciously silent scapegoats.

It is our responsibility, as always, to protect our patients from things that would harm them. Therefore, as physicians, it is our duty to refuse to perform a medical procedure that is not medically indicated. Any medical procedure. Whatever the pseudo-justification.

It’s time for a little old-fashioned civil disobedience."

 The doctor then offers a five-step plan designed to keep physicians from ever having to perform an unwanted ultrasound on a female patient, starting it off with a bang:

  "1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on." 

And ends it with a bigger bang:

"It comes down to this: When the community has failed a patient by voting an ideologue into office…When the ideologue has failed the patient by writing legislation in his own interest instead of in the patient’s…When the legislative system has failed the patient by allowing the legislation to be considered… When the government has failed the patient by allowing something like this to be signed into law… We as physicians cannot and must not fail our patients by ducking our heads and meekly doing as we’re told.  Because we are their last line of defense."

Alrighty then. 

The Doc is actually echoing more forcefully the guidelines already set long ago by the American College of Obstetricians and Gynecologists--the very guidelines the state of Virginia so clearly and consciously aims to violate. ( The story here by Rick Unger in Forbes.).

In 2009 ACOG reaffirmed their recommendations on non-medical ultrasounds:

"The American College of Obstetricians and Gynecologists (ACOG) has endorsed the following statement from the American Institute of Ultrasound in Medicine (AIUM) discouraging the use of obstetric ultrasonography for non-medical purposes (eg, solely to create keepsake photographs or videos) (1):

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. Although there are no confirmed biological effects on patients caused by exposures from present diagnostic ultrasound instruments, the possibility exists that such biological effects may be identified in the future. Thus ultrasound should be used in a prudent manner to provide medical benefit to the patient."

 Of course, the states advocating this unprecedented invasion into women's lives aren't in the least impressed by protestations from anybody not connected with their own Koch-fueled, pseudo-religious circles--not even the medical pros, who are, you know, medical professionals.

According to the Guttmacher Institute, as of March 1, 2012:

•  11 states require verbal counseling or written materials to include information on accessing ultrasound services.

• 20 states regulate the provision of ultrasound by abortion providers.

•  7 states mandate that an abortion provider perform an ultrasound on each woman seeking an abortion, and require the provider to offer the woman the opportunity to view the image.

•  9 states require that a woman be provided with the opportunity to view an ultrasound image if her provider performs the procedure as part of the preparation for an abortion.

•  5 states require that a woman be provided with the opportunity to view an ultrasound image.

There are signs that some state legislatures may be rethinking their actions (Idaho, for instance), but it's a cinch they're only rethinking them in order to get around any detours to their goals.  When they come up with something this nutty in the first place,  the chances that either common sense or common decency will prevail are slim to none.

So how do we get through to them?  We can't shame them; they're shameless.  We can't shun them; they're in charge.  But we can raise our voices in decibels loud enough to be heard above the din of old-testament retribution disguised as modern-day government.

This was never how it was supposed to be.

It's Settled then: Women, We're at War

Don't expect me to be going over every single attack on women's rights, just because I'm writing about modern-day, 21st century, 2012, just-in-the-last-month attacks, which, as you might have noticed, are escalating at such a dizzying pace we can no longer ignore the rumblings of war.

It's ugly and it's all out there. Even Rush Limbaugh's scrubbed transcripts of his diatribes against Sandra Fluke, the Georgetown University student who had the temerity to attempt to testify before certain members of congress about the need for free contraception.  Even Patricia Heaton's deleted tweets about that same student (AKA G-Town Gal).  They're out there.  They're not going away.

No, we're here today to look at the big picture:  How did this latest war of the sexes start?  What was the catalyst?  And what can we do to grind it to a halt now that it's started? 

The obvious answer to question number one is that it's all Obama's fault.  As a part of his health plan (the catalyst), he told insurance companies they would have to offer contraceptive care at no cost to women.  (That would mean, for most, no  co-pay.)  Birth control aids would be free and available everywhere, and since it was mandatory, not to mention laudatory,  not to mention commonsensical and a long time coming, that was supposed to be it.  End of conversation.

Ha!  We wish! .

President Obama's first mistake was that he thought he was taking steps toward helping women more effectively and responsibly manage their reproductive years, when what he was actually doing was antagonizing pissants who have been posing as Manly Men for so long they're not about to be ousted from their comfy zones.

A whole host of Catholic Bishops, pseudo-religious politicians, and paid-to-be-mean pundits jumped on the bandwagon called Control the women by denying birth control, and weren't they surprised when the women they were so itching to suppress wouldn't give in?  A real donnybrook ensued, with everybody weighing in, pro and con, and here we are, in the middle of it all, coming out swinging, and if they want a war, okay, they've got one.

Some highlights:

• The Susan G. Komen Foundation is taken over by a Right Wing zealot who makes it known from Day One that Planned Parenthood can kiss SGK goodbye.  Susan Komen's sister/founder helps figure out a way to do it.  A huge, unprecedented fuss ensues.  Right Wing zealot goes on to greener pastures.  The sister stays and apologizes -- a Pyrrhic victory that nobody feels good about.

•   Long probes up the vagina with cameras on the end used not as medical tools but as instruments of shame-- Zap!  Gone!  Battle won!

• Gooey cold stuff massaged onto a bare belly so a government-issue wand can be waved, not to detect a zygote already determined by other methods to be there, but to establish once and for all that a woman doesn't actually have control over her own body--  Still working on it but we've got them in our sights.

•  Dozens of state legislatures scrambling to make laws against contraception and abortion so harsh Draco the Greek, if he were still alive, would be crying foul-- This one may take a while.

The legal issues, having some semblance of form and substance, are easier to deal with.  There are wise and learned people on our side ready to take them on.  But there's another, uglier issue and it's one we've faced many times before.  It's our old but formidable nemesis: blind, consuming hatred toward people of our gender.

With the rise of the Tea Party and pressure from the Religious Right-to Life-until-It-Actually-Becomes-a-Child, fortified by resident misogynist Rush Limbaugh and hard line Catholic Men in red robes and black robes and pullover sweater vests, the battle to enforce the reproductive rights we've already fought long and hard for is a battle we can't afford to lose.

 The spotlight is on Rush Limbaugh at the moment, but it's Rick Santorum we need to keep an eye on.  He showed his hand when he talked about his reaction to President Kennedy's 1960 speech to the Baptists, where JFK said he would fight hard for the separation of church and state.

Santorum wanted to throw up when he read that.  Why?  Because it's disgusting and unforgivable that  Kennedy had the chance to pave the way for an American Pope and he didn't take it.  Rick will remedy that when he's president.  And guess who will suffer the most under his reign?

The obvious goal is to make sure Rick Santorum never becomes president, but once that threat is gone we'll still be fighting those others working to take us down.  We thought that war was over, but all we really won, we know now, was détente.

Men (and, incredibly, other women) are fighting against those of us who go on believing our reproductive rights are sacrosanct.  Suddenly they're coming out of the woodwork, no longer pretending that Roe v. Wade is all that's keeping us apart.  Now it's about contraception -- a real puzzler, since birth control is the obvious remedy for unwanted pregnancies.

Only women can incubate babies.  It's a fact. If they get knocked up and it's not a good time, the sex police want us to believe they have no one to blame but themselves.  Really?  What other species on the planet punishes the female for being impregnated by a male?  Birth control is a two-way street.  It's irresponsible and gutless to pretend that women did this to themselves, and yet we're hearing it louder and clearer every day.

And why is that?  Because to the people who are coming at us with the same hoary arguments, it's not about the control of birth, it's about the control of sex. That nutty comment by Santorum backer Foster Friess about birth control being as simple as holding an aspirin between our knees?  The admonishment from Rick Santorum that all birth control should be banished because it can only lead to badness?  Rush Limbaugh's crazed, three-day masturbatory fantasy about the reasons women want free birth control?  Sex, sex, and yet again, sex.

It's the same tiresome struggle, but this time we're going to win.  Why?  Because we have a secret weapon.

It's men.  There are more than just a few good ones out there and they're on our side.  They're men who work with us, talk with us, and see us as equals.  They're men who live with us and see our roles as complementary and not competitive or without merit.  They're men who can love unconditionally and have grown so far beyond the ancient need to keep women bound and tethered, they're willing to fight beside us until this war is ended.  Some of them are already at the front lines.

So put that in your pipe and smoke it, you dirty old men of yesterday.  A new day dawns and you've been left behind.  It has to be this way.  It's the way human progress works.

(Cross-posted at Dagblog, where some of the men I most admire hang out.)