When States Abuse Women

Nicholas D. Kristof (The New York Times)

HERE’S what a woman in Texas now faces if she seeks an abortion.

Under a new law that took effect three weeks ago with the strong backing of Gov. Rick Perry, she first must typically endure an ultrasound probe inserted into her vagina. Then she listens to the audio thumping of the fetal heartbeat and watches the fetus on an ultrasound screen.

She must listen to a doctor explain the body parts and internal organs of the fetus as they’re shown on the monitor. She signs a document saying that she understands all this, and it is placed in her medical files. Finally, she goes home and must wait 24 hours before returning to get the abortion.

“It’s state-sanctioned abuse,” said Dr. Curtis Boyd, a Texas physician who provides abortions. “It borders on a definition of rape. Many states describe rape as putting any object into an orifice against a person’s will. Well, that’s what this is. A woman is coerced to do this, just as I’m coerced.”

“The state of Texas is waging war on women and their families,” Dr. Boyd added. “The new law is demeaning and disrespectful to the women of Texas, and insulting to the doctors and nurses who care for them.”

That law is part of a war over women’s health being fought around the country — and in much of the country, women are losing. State by state, legislatures are creating new obstacles to abortions and are treating women in ways that are patronizing and humiliating.

Twenty states now require abortion providers to conduct ultrasounds first in some situations, according to the Guttmacher Institute, a research organization. The new Texas law is the most extreme to take effect so far, but similar laws have been passed in North Carolina and Oklahoma and are on hold pending legal battles.

Alabama, Kentucky, Rhode Island and Mississippi are also considering Texas-style legislation bordering on state-sanctioned rape. And what else do you call it when states mandate invasive probes in women’s bodies?

“If you look up the term rape, that’s what it is: the penetration of the vagina without the woman’s consent,” said Linda Coleman, an Alabama state senator who is fighting the proposal in her state. “As a woman, I am livid and outraged.”

States put in place a record number of new restrictions on abortions last year, Guttmacher says. It counts 92 new curbs in 24 states.

“It was a debacle,” Elizabeth Nash, who manages state issues for Guttmacher, told me. “It’s been awful. Last year was unbelievable. We’ve never seen anything like it.”

Yes, there have been a few victories for women. The notorious Virginia proposal that would have required vaginal ultrasounds before an abortion was modified to require only abdominal ultrasounds.

Yet over all, the pattern has been retrograde: humiliating obstacles to abortions, cuts in family-planning programs, and limits on comprehensive sex education in schools.

If Texas legislators wanted to reduce abortions, the obvious approach would be to reduce unwanted pregnancies. The small proportion of women and girls who aren’t using contraceptives account for half of all abortions in America, according to Guttmacher. Yet Texas has some of the weakest sex-education programs in the nation, and last year it cut spending for family planning by 66 percent.

The new Texas law was passed last year but was held up because of a lawsuit by the Center for Reproductive Rights. In a scathing opinion, Judge Sam Sparks of Federal District Court described the law as “an attempt by the Texas legislature to discourage women from exercising their constitutional rights.” In the end, the courts upheld the law, and it took effect last month.

It requires abortion providers to give women a list of crisis pregnancy centers where, in theory, they can get unbiased counseling and in some cases ultrasounds. In fact, these centers are often set up to ensnare pregnant women and shame them or hound them if they are considering abortions.

“They are traps for women, set up by the state of Texas,” Dr. Boyd said.

The law then requires the physician to go over a politicized list of so-called dangers of abortion, like “the risks of infection and hemorrhage” and “the possibility of increased risk of breast cancer.” Then there is the mandated ultrasound, which in the first trimester normally means a vaginal ultrasound. Doctors sometimes seek vaginal ultrasounds before an abortion, with the patient’s consent, but it’s different when the state forces women to undergo the procedure.

The best formulation on this topic was Bill Clinton’s, that abortion should be “safe, legal and rare.” Achieving that isn’t easy, and there is no silver bullet to reduce unwanted pregnancies. But family planning and comprehensive sex education are a surer path than demeaning  vulnerable women with state-sanctioned abuse and humiliation.