Patient Ultrasound Viewing and Abortion Care



Ultrasound in the context of abortion care has received more attention in recent years, as states have passed regulations mandating specific ultrasound procedures. Already, 19 states have enacted such laws, requiring abortion providers to perform ultrasounds and/or offer fetal images and heart tone sounds to patients. Additional laws are being introduced across the country, with the most extreme requiring that a doctor explain certain characteristics 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. The Patient Ultrasound Viewing Project documented the ways in which ultrasounds are presented and provided to women in the abortion setting.

This study consisted of a multi-site ethnography of the practice of ultrasound in the abortion context. We conducted 27 in-depth interviews with administrators and those who perform the ultrasound at a diverse sample of abortion facilities across 17 states. In addition to qualitative interviews, we observed ultrasound practices in four clinical facilities.

Our research confirmed that there is a large diversity in provider practices surrounding ultrasound viewing in the abortion context. Based on our interviews and observations, we identified three ultrasound viewing models:

    1. offered to all
    2. shown upon request
    3. managed viewing

None of the sites in our sample denied women an opportunity to view their ultrasound image. Instead, providers negotiated ultrasound viewing according to their philosophies of care. Ultrasound providers navigate between the medical, social, and personal meaning for their patients.

These different practices demonstrate the complexity and flexibility of the relationship between the woman and her ultrasound provider. While supporters of ultrasound legislation are focused on the role that ultrasound images can play in a woman’s abortion decision, abortion providers are engaged predominately with the information that ultrasound provides. This distinction between images/information may help providers, advocates and legal experts articulate the importance of ultrasound in the abortion care context while simultaneously opposing laws that seek to mobilize images in particular ways to manipulate women’s decision-making.