Seeing it: A descriptive analysis of ultrasound viewing practices in the abortion context

Background: Ultrasound in the context of abortion care has been the target of many state level regulations. 11 states are currently considering bills that would require abortion providers to perform ultrasounds and/or offer fetal images and sounds to patients. 16 states have enacted such laws, with the most extreme requiring that a doctor explain certain features of the fetus regardless of a woman's desire for that information. Abortion opponents expect that women who view ultrasound images will be more likely to forgo having an abortion. Many reproductive rights advocates oppose these regulations, citing concerns that they are coercive and interfere with the patient - provider relationship. Despite widespread legislation, there is little evidence about ultrasound in the abortion context. This study documents the ways in which ultrasounds are presented and provided to women in the abortion setting. Methods: We collected information on ultrasound policies and practices through in-depth interviews with providers and staff at a diverse sample of 30 abortion facilities across the United States. Results: Provider practices surrounding ultrasound provision and patient viewing vary by state, clinic and individual ultrasound practitioner. The majority of providers use ultrasound before an abortion procedure for the purpose of gestational dating. Some providers routinely offer an option to view or hear about the ultrasound image, while others only respond to patient requests. These variations reflect difference in the regulatory environment, risk management, and philosophies of care. Conclusion: There is a large diversity in provider practices surrounding ultrasound viewing in the abortion context.