New study exposes flaws in GOP demands for medically unnecessary ultrasounds


Doctors have called for an end to mandatory ultrasounds ahead of abortions.

While anti-abortion politicians continue to pass laws requiring ultrasounds before people can get abortions, another study has revealed how problematic and largely unnecessary this is, in line with what doctors and abortion rights advocates have been saying for years. And eliminating the requirement that a patient undergoes an invasive ultrasound could make abortions easier and safer to obtain.

A new study conducted by Advancing New Standards in Reproductive Health, a project at the University of California San Francisco, found that with careful screening questions, most people are able to determine whether they are more than 10 weeks pregnant, which matters in determining eligibility for medication abortion, an option only approved up to the 10-week mark. 

The study asked people to answer three questions: the date of their last known period, the date they think they got pregnant, and the estimated number of weeks they have been pregnant. When people answered multiple questions, rather than just the traditional inquiry about the date of their last menstrual period, the study found, only 2.7% of people incorrectly believed they were under 10 weeks pregnant when they were actually over that amount. 

The questions can be asked in another, more straightforward way as well, the study found. People were asked whether they believed they were more than 10 weeks pregnant, were more than two months pregnant, or had missed more than two periods. When people were asked those questions, only 2.3% incorrectly thought they were under 10 weeks pregnant. 

Ultimately, the study concluded that laws or policies requiring in-person ultrasounds were "not universally necessary to establish gestation-based eligibility" for medication abortion. 

This is a significant finding, as 28 states require people to obtain an ultrasound before they can have an abortion. Six of those states require the abortion provider to show and describe the ultrasound image to the patient. New ultrasound requirements went into effect in New Hampshire, Arkansas, and Montana in 2021. 

New Hampshire's new abortion law requires an ultrasound in addition to imposing a ban on abortion after 24 weeks of gestation. In the early stages of pregnancy, an ultrasound is not the traditional "over-the-belly" style, Kayla Montgomery of Planned Parenthood of Northern New England told New Hampshire station WMUR in December. Rather, said Montgomery, the ultrasounds that patients undergo in very early stages of pregnancy — the same early weeks during which they are eligible for medication abortion — are invasive transvaginal ultrasounds that require penetration with a probe. 

Additionally, requiring an ultrasound, particularly before the 10-week mark, also means the patient must make an in-person visit and undergo a medical procedure before simply receiving abortion pills. In the era of COVID, an unnecessary doctor's visit could, the study noted, increase a patient's risk of contracting the disease. 

The American College of Obstetricians and Gynecologists has called for the removal of mandatory ultrasound laws. The group notes that most abortion care globally does not require an ultrasound and the laws limit access to abortion while undermining doctors as they try to provide the best care. 

Anti-abortion activists insist ultrasounds are necessary so people have complete information before deciding how to proceed, with the goal being that they will change their mind about having the abortion. However, showing the ultrasound seldom changes the patient's mind. A study of over 15,000 medical records published in the journal Obstetrics & Gynecology in 2014 found that 98.4% of people who saw the ultrasounds went on to have an abortion. Mandatory ultrasounds, therefore, do not even serve the anti-abortion movement's goal of changing a patient's mind. 

They also require patients to make a trip to a hospital or clinic for the ultrasound even when they are seeking an early-stage medication abortion. This is especially unneeded, given that the FDA has already concluded there is no risk in simply mailing abortion pills to patients after a telehealth consultation with a doctor. While anti-abortion legislators continue to impose this procedure, research shows it is simply not necessary. 

Published with permission of The American Independent Foundation.