Doc-Bloggers Speak Out Against Laws that Threaten Women’s Rights & Ethical Medical Practice

In my last post, I spoke out against new laws that, in their zeal to limit the practice of abortion, actually threaten the practice of medicine, as well as the rights of physicians to free speech. Not to mention the fact that the laws mandate both the physical and emotional abuse of women who choose to have a completely legal medical procedure.

In this post, I want to highlight my fellow medical bloggers who have also spoken out on this issue.  If I’ve missed your post, email me and I will add it here. If you haven’t written your post yet, consider this a challenge to do so. Let’s make our voices heard.

  • Jen Guntner calls the new laws  legalized malpractice and wonders how the Supreme Court could refuse to hear the case  challenging Pennsylvania’s  law that protects doctors who deliberately hide genetic test results from their patients.
  • Eijean Wu, MD reminds us of the women who are affected by these laws.
  • Elaine Schattner, MD tells us that women’s rights are being threatened on three fronts – birth control, access to safe abortion and to care without intimidation or emotional abuse. She also wonders why more doctors are not speaking out.
  • Skeptical OB sees the backlash against birth control as un-American.
  • PalMD tells us we cannot afford to remain apart on this issue.
  • Labor and Deliverance does not really want to get political, but tells us that we should not sacrifice women or mothers for the sake of controlling their options.
  • Judy Stone, MD has a wonderful article in Scientific American about the use of so-called “Conscience” clauses that are anything but.
  • OB Cookie, an O-Gyn resident who also loves baking ( a girl after my own heart) writes eloquently on the collateral damage to women she cares for in Texas as Rick Perry’s wages war with Planned Parenthood.
  • One of the best posts (and apparently, one with an enormous amount of traffic) is unfortunately anonymous. It’s a recipe for organized civil disobedience, all in the doctor’s office and all in accordance with our duty to protect patient autonomy. Sharon Phillips, MD discusses the relative wisdom of such an approach.

Doctors Must Speak Out Against Anti-Abortion Legislation that Threatens the Legal & Ethical Practice of Medicine

Kudos to Alabama pediatrician Pippa Abston for publicly speaking out for all doctors and their patients against legislation that violates women and forces doctors to choose between violating professional ethics or breaking the law. (HT to Rh Reality Check for their fabulous reporting on this issue)

In addition to posting the above video on You Tube (Let’s make it viral, folks…) Dr Abston has co-authored legislation that will protect doctors from being used as pawns by the anti-abortion movement. The bill is called the  “Right to Professsional Medical Judgement Act” and is short and sweet, written unemotionally and unambiguously –

No physician or health care provider licensed to practice in the State of Alabama shall be forced by state or local regulatory authority to perform any medical service or component of medical service if the service or component of service is not medically necessary or would be harmful to the patient and the patient does not desire the medical service. The right to practice within the scope of a medical license supersedes any existing or future legislative act.

Where are our Medical Societies?

I wish the AMA and ACOG would speak out more publicly on this issue. I hope they are lobbying, but working the back room is very different from speaking out publicly for the rights of both women and their physicians who are providing a legal medical procedure.  The Daily Kos has a petition circulating to the AMA asking them to speak out publicly.  I encourage you to sign it.

When the Pennsylvania Medical Society spoke out against the ultrasound law in that state, the legislators promptly backed down.

The Pennsylvania House postponed a scheduled March 12 vote on the bill. House Majority leader Mike Turzai, a Republican, said the debate was cancelled due to “concerns raised by the medical community, among others,” Philly.com reported. The Pennsylvania Medical Society, which has no official position on abortion, opposes the bill because it would potentially interfere with the physician-patient relationship.

We all must speak out together against these bills that attempt to legislate medical care. As I’ve said before –

This is not just about abortion. Or women’s rights. 

It’s about the practice of medicine and the rights of our patients. It’s about physician-patient privacy and the authority of doctors to practice medicine without the fear of breaking the law.

It is also about free speech.

The way these laws are written, physicians who perform abortion are being forced to read scientifically false information to patients.  They are being forced to tell women that an abortion will increase their risk of breast cancer – which is simply not true.

“I’m so sorry that I have to do this,” the doctor told us, “but if I don’t, I can lose my license.” …When the description was finally over, the doctor held up a script and said he was legally obliged to read me information provided by the state. It was about the health dangers of having an abortion, the risks of infection or hemorrhage, the potential for infertility and my increased chance of getting breast cancer.

All physicians and patients, whether they are male or female, pro-choice or pro-life, Republican or Democrat, should be outraged. Our medical societies and our patient advocacy groups  – every single one of them, whether related to reproductive care or not – should be fighting these laws, and engaging physicians and patients everywhere to fight back. Publicly and vocally. Or, as blogger Palmd implores us –

When it comes to the latest abortion bills we cannot afford to remain apart.  We must all speak out against this violation of our ethics and our patients’ rights.

What Can You Do?

  • Contact your state medical society and ask them what they are doing to protect the practice of medicine and the rights of women in your state
  • Write, phone and E-mail your state and national representatives to let them know you oppose any proposed legislation that threatens women and their doctors.
  • Petition the AMA to speak out publicly on this issue.
  • Speak out! Pick a medium, any medium –  be it you blog, e-mail, Facebook, Twitter, You Tube, Pinterest, Tumblr, or the latest and greatest social media network I haven’t heard about yet. Make your voice be heard.

Tomorrow, I’ll be highlighting physician bloggers who are speaking out. Stay tuned -and if you know of a blog post I need to highlight, email me.  I’ve got a list of about 10 so far.

Thank you, Rush Limbaugh

I mean it.

What Rush and his women-hating, slut-calling, reproductive rights bashing cronies have done is the best thing that could have happened for women in this election year.

I know you think things are horrible, what with us now having to fight the battle for reproductive rights all over again, and on 50 different fronts.

But don’t you see? That battle has been going on for years – you just weren’t really aware.

Rush and his pals who oppose reproductive rights were all here last year, when you thought your reproductive rights were safe. They were here in 2010, when Arizona became the first state to limit insurance coverage of abortions. They were here when the Hyde Amendment was cemented into law and when George Bush, Jr reinstated (and Obama reversed) the Global Gag Rule limiting family planning funding across the globe. They were here when 20 our 50 states passed laws regulating ultrasound use prior to abortion, while others mandate counseling (often including erroneous health information) prior to abortion or limit insurance coverage of this legal medical procedure.

During all this time, if you did know they were there, you thought they were just against abortion – you did not realize that they were also against birth control. You thought their agenda was pro-life, not anti-woman. You thought you and they shared common ground, but now you know that ground is filled with landmines targeting women’s rights and your ability to plan your own family.

Thanks to Rush, we’ve finally started the conversation about reproductive rights in America that we should have been having for the past decade.

Like a family with a secret that is finally coming out, that conversation is exceedingly uncomfortable. Fine – let’s have at it. But don’t talk amongst yourselves – make sure your local, state and federal representatives know what you think.

Because what Rush and his buddies don’t realize is that what they’ve actually done is wake up a sleeping giant. That giant is the 98% of Catholic women who have used birth control, the one in five American women who has used Planned Parenthood’s services at some point in their lives and the 40% of women who has had an abortion. That giant is the majority of Americans who support the provision of contraception as part of preventive healthcare – every woman and man who recognizes the value of a society where every child is wanted, loved and born to parents with the resources to care for them. And that understands that spending on contraception makes sense financially for us as a nation, because cutting back on contraceptive prescription coverage ultimately results in women and their partners using less effective over the counter contraceptives, resulting in higher rates of unplanned pregnancy and abortion.

So thank you, Rush, for waking us up.

Now if you’ll excuse us, we’ve got a lot or work to do.

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In 2011, states passed 92 restrictions on abortion, and many are also targeting family planning services. Where does your state stand? Do you know who represents you and how they stand? How about the Presidential candidates?  

Penne w/ Caramelized Cabbage, Anchovies & Bread Cumbs

When your husband gets doored by a cab while riding his bike home from work, and breaks his elbow, requiring a two hour operation complete with plates and screws and an arm swollen to twice its size, the best thing that can happen as a result is that your mother-in-law, the greatest home cook in the world, will come up to visit. Although her company would have been gift enough, she will spend the entire time cooking, and counting the pan of eggplant pastistio she brought with her, leave practically a week’s worth of dinners in your fridge.

The best part of the visit will be getting to cook in the kitchen with her on Saturday, where we made this delicious pasta adapted from a recipe in this week’s NY Times.

Mr TBTAM, we’ll get through this. Thanks in no small part to your wonderful Mom.

Pasta with Caramelized Cabbage, Anchovies & Bread Crumbs

We modified the NY Times recipe to suit both the size of the cabbage Irene had bought, as well as our own personal preferences for onion, more anchovies and bread crumbs. We loved it. It reheated well tonight for leftovers. Check out the original recipe if you want something with a little less cabbage. (I may try the original recipe myself one of these days soon…)

5 garlic cloves, peeled and put through a garlic press
3 tablespoons unsalted butter
1 (2 oz) can of anchovy fillets, drained
1 cup coarse bread crumbs (We used Panko)
2 tablespoon finely chopped fresh sage
1/2 teaspoon black pepper, plus more, to taste
Kosher salt, to taste
1 pound dry penne
1/3 cup extra virgin olive oil
1/4-1/2 teaspoon red chile flakes
1 medium head cabbage, shredded (About 10-12 cups)
1 large onion, peeled and sliced very thin
2/3 cup grated Parmesan (plus more for serving)
Chopped parsley for topping

1. Melt the butter in a small skillet over medium heat. Saute one clove of the pressed garlic till fragrant but not browned. Add the anchovies and cook, mashing with a fork, until they dissolve into the butter. Stir in the bread crumbs and sage and cook until crumbs are golden brown, about 2 minutes. Season well with black pepper. Set aside.

2. Heat the oil in a large skillet over medium-high heat. Add the remaining garlic and cook until golden brown. Add the chile and cook until fragrant. Stir in the onion and cabbage and cook, stirring occasionally, until it begins to caramelize, about 15 minutes. Meanwhile, cook the pasta according to package directions. Drain and toss with the cabbage/onion and bread crumb mixture. Quickly toss in the cheese and remove from heat. Scatter chopped parsley atop and serve.

Serves 8.

New Hampshire Abortion Legislation Mandates Health Misinformation and Threatens Doctors’ Safety

The latest salvo against abortion comes from the New Hampshire House of Representatives, who have passed a bill requiring, among other things, that women be told that there is “a direct link between abortion and breast cancer”. Using the worst of pseudo scientific logic, the writers of the bill start with an accepted fact – that pregnancy lowers breast cancer risk – and then proceed to weave a theory linking abortion to breast cancer that, to the lay reader, might sound quite scientific,  but in fact makes no sense given what we actually know about hormones and pregnancy.  There is no link between abortion and breast cancer – this has been shown in multiple well-done scientific studies.

An even more concerning aspect of the bill that has not received much press coverage is that doctors must certify that they gave women the educational materials and that the number of certifications a doctor has submitted is to be made available to the public. The fanatic and violent anti-abortion crowd would love to get their hands on a comprehensive list of every doctor out there performing abortions, and with this law, they would get it in New Hampshire.  This bill is a direct threat to the safety of doctors who provide abortions in new Hampshire, and is clearly designed to intimidate them.

The woman who introduced the bill also claimed that birth control pills cause prostate cancer via environmental contamination by hormones. There is no proof of such a claim.

This bill has passed the New Hampshire House, but not the  Senate. The good news is that New Hampshire’s governor is expected to veto the bill if the Senate passes it. But if I lived in New Hampshire, I wouldn’t count on my governor’s veto. I’d be calling and emailing and writing both my state senator and my governor, and telling everyone I know in New Hampshire to do the same.

Creamy Tuscan White Bean Soup – or How I Became an Immersion Blender Convert

Speaking of infectious recipes, I caught this one from my friend Noel, who served this delicious soup to us last weekend for a light and quick pre-theater dinner. I consider it more than payback for giving him my husband’s recipe for sauteed kale.

When he gave me the recipe, Noel insisted that I had to make the soup using an immersion blender, a kitchen gadget I’d been resisting buying for a long time. When I asked why it was so critical, he used those four words that can make anyone buy anything – “It changed my life”. Now before you think I’m a sucker for hyperbole, you need to know that Noel is one of the most understated people I know. So to hear him use these words – well, I knew the time had come to give in to the immersion blender trend.

So now I can say it too – My immersion blender has changed my life.

I wonder how I ever made pureed soups without it. Actually, now that I’ve used this, it’s clear that what I was calling pureed was pure grit compared to the silky texture I am getting with this little baby. And it’s not even one of the better immersion blenders, just the cheapest I could find a the last-minute, since I decided rather late in the day what to make for dinner. If this is the low-end of immersion blenders, I can’t imagine what the high-end blenders can do…

I’m already making a list of soups I want to make  with this thing – cauliflower soup being at the top of that list.  If you have a soup recipe that I absolutely must try, do let me know.  I just can’t wait to immerse myself in immersion blending again…

Creamy Tuscan White Bean Soup

This recipe is adapted from Short on Time: Fabulous Food Faster, a book in the Kosher by Design series by Susie Fishbein. If you’re long on time, and want a lower sodium content, you can use dried instead of canned beans – just increase the cooking time to 1 – 1 1/2 hours, and hold the puree till the end when the beans are cooked. Canned beans are higher in sodium than dried beans, although you can reduce the sodium content of canned beans by rinsing them well or using low- or no-sodium brands. (Eden and Whole Foods brands are no salt added beans; Goya also has a low sodium brand)

  • 2 tbsp olive oil
  • 1 large onion, diced
  • 4 cloves garlic, sliced
  • 2 sprigs of fresh thyme
  • 1 tsp ground coriander
  • 1/2 tsp ground cumin
  • 1/4 tsp cayenne pepper
  • 4 – 15 ounce cans cannellini beans, drained and rinsed well
  • 6  cups chicken stock, veggie stock or water (I also added a little water at the end to thin the soup a bit.)
  • 1 tbsp dry sherry
  • Sea salt
  • 4 tbsp butter
  • Fresh parsley or thyme for garnish
  • French bread toasts (recipe follows)

Heat the oil in a large soup pot over medium heat. Add onion and cook till translucent, 3-5 minutes. Add garlic and thyme and cook for another 2 minutes, being careful not to burn the garlic. Add the coriander, cumin and cayenne pepper and cook for another minute to allow the spices to start to toast and become aromatic. Add the beans, stock, sherry and 1 tsp salt. Using an immersion blender, puree the soup in the pot till smooth. Allow to cook another 10 minutes for the flavors to develop. Add more salt to taste if needed.  Stir in the butter. Serve garnished with parsley and with French Baguette Toasts on the side. Reheats well the second day, but you’ll need to add a little water or stock to thin it out.

French Baguette Toasts

  • 1 demi-baguette
  • olive oil
  • Salt and pepper.
  • Grated parmesan (optional)

Preheat oven to 400 degrees fahrenheit. Slice the baguette into 1 inch slices. Arrange on a cookie sheet. Brush lightly on one side with olive oil. Sprinkle with grated parmesan cheese (optional). Toast for 6-8 minutes in the middle rack of the oven.

Sauteed Kale with Garlic – An Infectious Recipe

Sauteed Kale with Garlic, one of Mr TBTAM’s signature dishes, has become the winter vegetable of choice in our household. We never tire of it. It goes well with almost anything – pasta, chicken, sausages, soups. We’ve served it at several dinners with friends, and always are asked for the recipe. Our friends Noel and Amy liked it so much they’ve started making it on a regular basis as well, and Noel served it back to us last week, individually plated and garnished with sautéed mushrooms.

That’s the hallmark of a great recipe – it’s infectious.

Mr TBTAM’s Sauteed Kale with Garlic

You can use chicken or veggie stock, and as little or as much garlic as you like. We use chicken stock and tons of garlic. And hot pepper flakes. 

Yield – 4 servings

Ingredients

  • 1 large bunch of kale
  • 2-3 tbsp olive oil
  • 1/2  cup chicken or veggie stock
  • 1-6  cloves garlic to taste, diced
  • Salt and pepper to taste
  • Hot pepper flakes to taste (Optional)

Directions

Wash kale and shake dry. Cut out center stem and then tear leaves into several pieces. Heat oil till hot in a large saute pan. Add garlic and saute over medium high heat  till soft but not brown (be careful!). Add kale and chicken stock, cover and lower heat to medium. Cook till kale is wilted (but not too soft) and still bright green, about 5 minutes or so.  Remove the lid, toss around while the excess stock cooks off, another minute or so. Season with salt and pepper. Serve piping hot.

Noel’s Sauteed Kale with Less Garlic and a Mushroom Garnish 

1-2 tbsp olive oil
Button or crimini mushrooms, washed, dried and quartered
Salt and pepper
Mr TBTAM’s sauteed kale with made with veggie stock and 1 clove garlic

Heat olive oil over high heat in a small saute pan. Add mushrooms and saute till browned nicely – don’t stir too much, you want them to brown. Season and remove from the pan to set aside while cooking the kale and garlic. Plate kale individually and with a scattering of mushrooms atop.

That Dear Old Dirty Town – Courtesy of Camera Awesome

I love these Upper Eastside NYC skyscapes I took with my new Camera Awesome iPhone app.

Camera Awesome is totally fun. It’s also free, easy to use and a snap to install on your Iphone. Take pics using either Camera Awesome or your iPhone camera app, then transform (“awesomize”) them, either setting individual components yourself or by using the various presets as I did. Then you can share your pics using Facebook, Twitter, SmugMug, Flickr, email, Picasa and Photobucket. Unlike most Iphone camera apps, Camera Awesome takes video too. That’s pretty awesome.

What’s not so awesome ….

  • Awesomized pictures saved to the iPhone camera roll interfered with iPhoto sync with my Macbook Pro. I had to delete the pics to sync. From what I can tell, you’ll need to email pics you love to yourself if you want to save them to your laptop. Then iPhoto crashed after I imported an awesomized pic. Hmm…. that’s a big limitation for those of us who store our pics locally rather than on photo servers like SmugMug.
  • Bait and Switch. While they tell you on the website that the app is free, once you’ve downloaded it, they continually tempt you with great options for awesomizing your pics only to tell you they are premium options costing $0.99 for every 9 presets. I counted 25 sets of 9, making the cost of the entire app close to $25 if you buy them all.  Starts to feel like I am being nickel and dimed, baited and switched with the “free” app. I’d be willing to pay $4.99 for it, but not $25.
  • Awesomizing = annoying. The whole”awesomizing” dialogue that occurs while your photo is processing is overly cute and gets increasingly annoying over time.
  • Can’t Undo? I couldn’t figure out how to “un-awesomize” a pic once it was done. (No “Revert to Original” option that I so love in iPhoto)
  • No support. The support link on Itunes just takes you to the app home page. I could not find support anywhere.

Bottom Line

Camera Awesome is a fun and pretty amazing little Photo app, but ala’ carte pricing makes the full package one of the most expensive Photo apps out there, and it doesn’t play well with iPhoto. Since I really don’t need the app, I won’t be purchasing any of the premium options. But if it were $4.99 for the whole package, I might consider it. (hint, hint…)

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More Camera Awesome Reviews

Grand Rounds – Take Two as Prescribed

Dr Rob has outdone himself and every other previous host (including yours truly) with not just one, but two versions of this weeks best of the medical blogosphere – the first a Super Tuesday (or is it Twos-day?…) the second version in rhyme!

Welcome to grand rounds, the best around the world of medical blogging!  

For those expecting a silly recitation of today’s posts in rhyme, this post will let you down.  But don’t be sad, as I have provided with an alternate version of grand rounds on my other blog, Llamaricks, which (if you hadn’t guessed) is not quite as dedicated to the serious side of things.  

In grattitude, may I offer this simple rhyme –

There once was a blogger profound

Who hosted a double grand rounds

Rounds one was politic

Rounds two was poetic

Dr Rob you amaze and astound!

Head on over for some great reading!

Inspiration for a Late Winter Monday

Spring is not quite here, and if the Groundhog has his say, won’t be for another couple of  weeks.  If you’re like me, you may find yourself needing a little inspiration to hold you till the daffodils bloom.

  • Jeff Zaslow’s Last Lesson – The Wall Street Journal reporter who brought us Randy Pausch’s Last Lecture himself led a life that teaches us all how to give our best at our work.  As his friend and eulogist Bob Greene tells us, what Zaslow teaches us is this –  “When you get your big break, it won’t be because you made the extra effort once. It will be because you made the extra effort every time.”  I’m tattooing that one on my brain.
  • Physician/Musician. Maryland Gastroenterologist Christopher Shih is also an accomplished award-winning pianist.  I’m writing this while listening to his beautiful rendition of  Brahms’ Variations and Fugue for Piano in B flat major on a theme by Handel.  You can listen to this and more at his website.
  • The Power of Habits – Can we rewire our brain and break behavioral circuits?  Charles Duhigg suggests that you can, and his own 30 pound weight loss  supports this . I’ve added his book to my reading list.
  • Finally, if you just can’t wait two more weeks to see the flowers bloom,  here is a video for you.

Pennsylvania Law Gags Doctors Treating Patients for Fracking Chemical Exposures

UPDATE – on  7/26/12 a  PA  Court rejected the portion of this law that forbids municipalities from limiting  natural gas drilling within their boundaries.

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A dangerous new law signed by Pennsylvania governor Tom Corbett takes away the rights of local governments to use zoning laws to regulate the location of natural gas drilling sites in their communities – even if those wells are adjacent to homes, schools, hospitals, parks or other public areas.

Even more concerning is a gag on doctors treating patients for suspected chemical exposure, all under the guise that the chemicals being injected into the ground are a “trade secret”  –

If a health professional determines that a medical emergency exists and the specific identity and amount of any chemicals claimed to be a trade secret or confidential proprietary information are necessary for emergency treatment, the vendor, service provider or operator shall immediately disclose the information to the health professional upon a verbal acknowledgment by the health professional that the information may not be used for purposes other than the health needs asserted and that the health professional shall maintain the information as confidential. The vendor, service provider or operator may request, and the health professional shall provide upon request, a written statement of need and a confidentiality agreement from the health professional as soon as circumstances permit, in conformance with regulations promulgated under this chapter.

The Pennsylvania Medical Society has already voiced frustration that the lack or research on the health effects of fracking chemicals has crippled doctors trying to take care of patients who live or work near fracking sites.

Uncertainty prompts me to write that as a doctor, I do not know what to tell Pennsylvania patients when they ask me if hydraulic fracturing—fracking—in their neighborhood or region might affect their health.

I’ve seen anecdotal stories in the media. I’ve read as much as I could find about how the hydraulic fracturing process works. But I’m still uncertain because we lack data and research on the matter.

My colleagues in the Marcellus Shale regions tell me that they are getting questions from patients every day, such as, “I’ve had well water for many years—should I have it tested now that there’s a gas well nearby?” and “I’ve had this rash off and on for a while; could it be related to the gas well they just finished a mile or so up my road?” or “A gas well was just finished near our house; my children play nearby and even though they’re not sick right now, how will I know if they get sick from it—even years from now?”

We have no definitive answers to these questions because we lack data.

By now gagging doctors who may discover health risks of fracking chemicals, Governor Corbett and his allies in the legislature are making sure that the public is kept in the dark as to the real consequences of natural gas drilling in the Marcellus Shale.

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UPDATE –

The Public Record – reports on this issue. Here is what one doc they interviewed had to say –

“I have never seen anything like this in my 37 years of practice,” says Dr. Helen Podgainy, a pediatrician from Coraopolis, Pa. She says it’s common for physicians, epidemiologists, and others in the health care field to discuss and consult with each other about the possible problems that can affect various populations. Her first priority, she says, “is to diagnose and treat, and to be proactive in preventing harm to others.” The new law, she says, not only “hinders preventative measures for our patients, it slows the treatment process by gagging free discussion.”

The Atlantic Monthly has picked up the story, with some insight into how the gag order made it into the law –

The provision was not in the initial versions of the law debated in the state Senate or House in February; it was added in during conference between the two chambers, said State Senator Daylin Leach (D), which meant that many lawmakers did not even notice that this “broad, very troubling provision” had been added. “The importance of keeping it as a proprietary secret seems minimal when compared to letting the public know what chemicals they and their children are being exposed to,” Leach told Mother Jones.

Virginia Senate is Wrong in Continuing to try to Mandate Sonograms Before Abortion

Great news, folks – Virginia’s governor has backed down on the forced ultrasound issue.

Facing an issue that could redefine his political legacy, Virginia Gov. Robert F. McDonnell (R) retreated from a measure that would require women to have invasive ultrasounds, performed by inserting a probe into the vagina, before receiving abortions.

“No person should be directed to undergo an invasive procedure by the state, without their consent, as a precondition,” McDonnell said Wednesday.

Not to be dissuaded, the Virginia Senate (115 of the 140 are men, by the way) turned around and amended the bill to mandate transabdominal sonograms instead.

Wrong move, gentlemen. Here’s why –

1. While transvaginal sonograms are invasive, transabdominal sonograms can actually be even more difficult to endure. In order to do the transabdominal study, one has to drink 32 ounces of water and sit and wait, sometimes up to an hour, until your bladder is full almost to overflowing. Then another person presses on your very full bladder for about 5-10 minutes to take pictures of your uterus. And in case you didn’t know, the urge to urinate with a barely filled bladder is one of the first and more common symptoms of early pregnancy.

2. Transabdominal sonograms are not as good as transvaginal sonograms . Transvaginal is far superior for confirming gestational age and excluding ectopic pregnancy in early first trimester pregnancies.  The law makes no sense clinically.

3. State legislators are ordering a medical test without a medical indication. And that’s bad medicine.

4. The issue of informed consent applies for any procedure, whether it’s vaginal or not. You cannot force a person as a condition of informed consent, to undergo a procedure without her consent.

Finally, the biggest argument of all –

5. Mandatory ultrasounds have little to no impact on abortion choice. In fact, they can have other than their intended effect, by reassuring women having very early abortions just how small the pregnancy is. Before 6 weeks, an embryo is not even visible within the gestational sac.  And on transabdominal sonogram, later but still early embryos will be even less visible, as will the heartbeat.

In one of the few studies of the issue — there have been none in the United States — two abortion clinics in British Columbia found that 73 percent of patients wanted to see an image if offered the chance. Eighty-four percent of the 254 women who viewed sonograms said it did not make the experience more difficult, and none reversed her decision.

That generally has also been the case in Alabama, which enacted its law, the first of its kind in the United States, in 2002.

“About half of women opt to view them,” said Diane Derzis, who owns the Birmingham clinic. “And I’ve never had one patient get off the table because she saw what her fetus looks like.”

In some instances, the ultrasounds have affected women in ways not intended by anti-abortion strategists. Because human features may barely be detectable during much of the first trimester, when 9 of 10 abortions are performed, some women find viewing the images reassuring.

“It just looked like a little egg, and I couldn’t see arms or legs or a face,” said Tiesha, 27, who chose to view her 8-week-old embryo before aborting it at the Birmingham clinic. “It was really the picture of the ultrasound that made me feel it was O.K.”

Enough. We are  spending our time and energy on fruitless attempts to limit access to a legal medical procedure.  If we were to spend a tenth of that energy working together to increase contraceptive use by both men and women, we actually might be able to reduce the need for abortions.

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Read the Va proposed legislation.

Dr Jen Gunter – Read Her Blog

Some of the most thought-provoking and intelligent writing about the recent attacks on reproductive rights are at the blog of Dr Jen Gunter, an Ob-Gyn who holds nothing back as she wields what she calls the “lasso of truth”, her words for evidence-based argument. Here are just a few recent must-reads from her blog, which I encourage you all to add to your regular reading list –

But Dr Jen is not just about reproductive rights. Here are some great posts she’s written recently on common gynecologic issues –

And finally, a doc’s honest appraisal of the weight issue and women –

This is what I love so much about blogging – it let’s docs in the know speak directly to patients without the filter and the hype of the media. We are our own media.

You go,  Dr Jen!