Requiring an ultrasound and counselling before an abortion

A bill given emergency status by Texas Governor Rick Perry is the largest invasion of the patient-physician relationship that I am aware of. Proposed by Senator Dan Patrick (R-Houston) and supported by Lt. Gov. David Dewhurst, the bill as originally written would require physicians to perform a ultrasound and explain the physical characteristics of the fetus to anyone contemplating an abortion.

Physicians would be required to inform women about alternatives to abortion at least 24 hours before the procedure and would be required to produce an audible fetal heartbeat for the patient to hear.  The patient would be allowed to “avert her eyes” if she chose.  Even though later amended to sound less invasive, this bill seeks to substitute the wisdom of the state for the sanctity of the individual patient-physician relationship.

I personally believe that abortion is not a good thing and that ways of decreasing the number of abortions that are felt to be necessary are very helpful, but this type of legislation only places more regulations between the patient and the physician. If the goal is to decrease the number of abortions, it seems that efforts to provide family planning and reduce the number of unplanned pregnancies would be much more effective than attempting to regulate the patient-physician relationship.  This is a laudable goal, but a bad implementation.

You may not be concerned about what is happening in Texas, but a total of 18 states regulate ultrasounds by abortion providers and nine require verbal counseling or written material on how to obtain a ultrasound.  If this is still not a concern to you, consider that if you allow legislators to engage in the practice of medicine in this area, it becomes a much smaller step to enact laws regulating anything else you do.  I know physicians that pray with their patients.  If a legislator can change the way you have to discuss abortions, why could a legislator not restrict prayer with your patients.  Far fetched example, you may say.  Maybe, but the bottom line is I believe our patients are best served by keeping the government out of our exam rooms.  I support decreasing the number of abortions that are felt to be necessary, but to interfere with the patient-physician relationship is not the right way to do it.  The government invasion of healthcare must be stopped.  That is what I am going to tell my legislator.

Robert Luedecke is an anesthesiologist and member of the Bexar County Medical Society Committee on Public Health.

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  • MomTFH

    Thanks for a balanced and thoughtful post.

    Although you did an excellent job covering some key points about legislative interference in medicine, there are even more problematic issues than the ones you mentioned. It is difficult to find an audible heart beat in the first eight weeks or so, when most women seek abortion. Most of these laws are written by people more interested in throwing up barriers than providing good health care. The language of these laws often requires invasive, unnecessary transvaginal ultrasounds to meet requirements (like the audible heart sounds or “best visualization available”) that have nothing to do with medical reality.

    When these requirements are coupled with waiting periods after counseling, patients who have to travel to access the few clinics available often have to take multiple days off of work and pay for hotel rooms. Since most women who seek abortion are already mothers, many have to leave children behind for days. This is a heavier burden on single mothers and mothers who live in poverty.

    These burdens also lead women to delay abortions, which leads to more second trimester abortions. These are more expensive and higher risk.

    I wholeheartedly agree that the answer is to increase family planning funding and education. The new recommendations in the House to cut family planning and contraception funding and to also strip Planned Parenthood of funding for non-abortion services runs contrary to this common sense. Pregnancy and new life are sacred and too important to be left up to accident, chance, and partisan politics.

  • Lola

    I’m curious if this bill applies to abortion that is done to protect the woman’s life. It would be especially unfair if this law applied to those women.

  • Male doc

    The decision to abort a pregnancy marks an emotional, difficult time in a young woman’s life. Who is anyone to impose their religious beliefs on these already frightened young women. Shame on the Texas lawmakers.

  • SarahW

    It’s unfair to any woman, except in those few cases when it provides information of utility to the practitioner that can’t be gotten in a less intrusive way.

  • Another Sarah

    My OB practice doesn’t routinely do early ultrasounds for low-risk pregnancies, and I’m told many insurance plans don’t cover them. So a woman who wants to terminate her child is required to get an ultrasound, but many of us with wanted pregnancies have to pay out of pocket if we want one before twenty weeks?

    Actually I don’t mind paying out of pocket for something that’s not medically necessary, but that’s my point — it’s even less necessary in the case of termination.

    • Another Sarah

      Umm… i meant terminate her _pregnancy_. Really inappropriate inadvertent slip of the fingers, there. (Was not trying to make any kind of point; i’ve got a ten-week wanted fetus at the moment and am staunchly pro-abortion.)

    • gzuckier

      Well, the answer is simple then; any woman NOT wishing to terminate who wants an ultrasound gratis needs to state her decision to terminate, at which point an ultrasound will be gladly provided courtesy of the self-proclaimed Godly, who in return will feel gratified to have saved another tiny soul when the mother announces she has decided not to terminate after all.

  • Marc Gorayeb, MD

    I’m curious how many of you are in favor of Obamacare. Now don’t get me wrong; I strenuously object to the government interfering with the doctor-patient relationship – in ALL of its embodiments. I don’t want the government to punish people for smoking, eating fat/salt/sugar, or doing anything else that does not substantially infringe others’ rights. The gov’t should not be telling me how to practice medicine, or telling me to get a flu shot. It should not be taking my money, laundering it, and sending it back to the states in the form of Medicaid payments with mandates on how the money is to be spent and how the programs are to be structured. It should not be giving money to clinics that perform abortions.
    The sanctity of the doctor-patient relationship is not enshrined in the Constitution. Legislators may regulate individual human behavior if the law does not infringe one’s constitutional rights. You don’t like the law? Throw out the ‘bums.’ And please don’t use the tired argument that some behavioral regulation (the kind you happen to like) is ‘in the public interest.’ That argument can be made for the very law you are complaining about in this post.

    • Robert Luedecke

      For the government to provide information as to what is the more healthy approach to living is in my opinion a very appropriate and useful function. For the government to get more tax money from cigarettes or soft drinks because they are bad for you is very appropriate and if tax money has to be raised somehow, I am very much in favor of doing it this way. It is in my opinion very different for the government to encourage me to get a flu shot than it is to infringe on the doctor-patient relationship. I am very much in favor of the government using tax money to help care for the medical needs of the poor whether through “Obamacare” or some other mechanism and this is very different than the government interfering with my ability to care for each individual patient by interfering with the doctor-patient relationship. I would prefer that Medicaid would be a federal program, fully funded by the feds, and safe from being monkeyed with by states that don’t want to help take care of poor people. This would also not be an infringement of the doctor-patient relationship and is something very different from this bill.

    • gzuckier

      I don’t like the government taking my money, laundering it, and using it to fly people to Uzbekistan to be tortured. Tell you what, let’s swap; I’ll cover your Obamacare tax bill if you cover my War on Terror tax bill.
      Point being that, fortunately or unfortunately, individuals do not get to check off various boxes on their tax forms as to what government programs they wish to support.

  • MomTFH

    The details of the Affordable Care Act (most people agree “ObamaCare” is an invented term to politicize the legislation) notwithstanding, calling taxation and utilization of revenue “money laundering” is an extremist view.

    Most citizens realize that living in a first world country involves a funded and operational government, and see funding programs for public health is no more “money laundering” than funding infrastructure like the national highway system or the military.

  • Amy Diver

    This smacks a little of mental abuse, because some of these women are already traumatized by the pregnancy, viewing the fetus as an “invader”, maybe due to the way it was conceived (rape, etc.).
    Who does the goverment think it is to add to the burden these women already bear?
    Yes, there are women who look at abortion as a form of birth control, but if we let them harden our view of this procedure, then we forget that there are women out there to whom this is a last resort, a way of holding on to sanity, and a way of preventing possible future child abuse/neglect.
    Adoption is not always an option. I know of women who were denied abortions for one reason or another, who ended up taking their own life, or who ended up in the criminal justice system because of child abuse/neglect. If they wouldn’t have been “forced” to carry to full term, maybe thing would have turned out different.
    It should all be about choice.

    • gzuckier

      Is there any doubt that those behind this measure are absolutely dedicated to eliminating all rights to abortion, even in the cases of incest, rape, mental illness, etc. etc. etc.? Even for those who pass this “ultrasound test”?

  • Kathleen Clark

    I’m sure it has not gone unnoticed by anyone that the Texas legislation was proposed by, supported by, and given emergency status by three MEN who need to rescue that fetus from that uncaring woman carrying it! How generous o them to allow the woman to avert her eyes! They have such a a clear, compassionate view of what it is like to be pregnant because they, perhaps, see pregnant women on the street??
    These men in Texas and these men (overwhelmingly) in Congress who want to protect the fetus may want to expand that protection by considering some other practices and statistics. I recently read Mayor Bloomberg’s speech to the NY Bar Association about innovations to improve our legal system. One area he addressed is medical malpractice. He cited a statistic that is appalling and shocking: doctors perform 50% more C-sections than are medically necessary. Assuming that is accurate, heartbreaking as it is, this suggests to me that doctors are putting women AND FETUSES/unborn children at risk by performing major surgery when not necessary 50% of the time. If I misunderstood something, that would be a relief. If not, are the men in government in Texas (and, no doubt,many, many other states) and Congress trying to do anything about this?

  • Jo

    In medicine aren’t all “risks/benefits of surgical procedures supposed to be provided to the patient in order for them to give “informed consent”? Looks like “choice” in other medically invasive procedures are approached by the “pro-abortion” physicians with more caution than with abortion.

    This is more than removing a cyst. Women know it now or later, and “later” is usually more devasting than “now”.

    Later if this ‘elective’ procedure happens for some reason is the only chance of the woman to concieve a child the aftermath of emotionally pain can be devastating. Also when a teenager later sees an ultrasound of a child she chooses to carry to term, again the emotional pain later can be devastating as she realizes she was lied to and was convinced it was just a “disposable product of pregnancy” when in fact it was a growing human being until she decided to end the pregnancy.

    These discussions are not taking place among the “pro-abortion” physicians and their patients, but it is reallity in many of their patients. Ultrasound is a good thing in order for the patient to make an informed consent.

    If you are saying you are for “choice” why not inform them of all of the choices available? What are you afraid of that she won’t get the abortion? Not getting one would be a good thing, right?

    • Anon

      Five years ago, I had an abortion. Why did I become pregnant? IUD failure, if you must know.

      I didn’t need an ultrasound to inform me of my choices. Given the circumstances, however, I was subjected to two (unpleasant, invasive, transvaginal) because I was <5 weeks along. Ultrasound was not diagnostic. Bloodwork was.

      I have absolutely no regrets, even though I'm currently going through menopause. In fact, if I became pregnant again (unlikely, as my husband has since had a vasectomy) I'd have another abortion.

      This is about religion and control, not science or concern for the well-being of women.

    • Robert Luedecke

      When I give informed consent to a patient before an anesthetic, I tell them what I will be doing and I answer all their questions. Some patients want to talk about their fear of remembering during surgery and some patients want to talk about their fear of nausea. I give the patient all the information they want, but I don’t spend a lot of time telling them in great detail about recall during surgery when their main concern is they might have nausea. The written consent they all sign was designed by our legislature and tells about all the very bad things that can happen. Nobody knows what the final wording of this sonogram law might be, but the original bill as endorsed by our governor is the equivalent of forcing me to spend a great deal of time telling every patient in detail that they might have recall after anesthesia. Is this necessary for informed consent or is this a government attempt to unfairly influence the patients’ decision?

      • Kathleen Clark

        Robert: It sounds like you do very thorough informed consents (referred to in some state laws as “informed patient choice”). My research suggests that many physicians hand a written informed consent to the patient for signature, without any conversation, without encouraging questions, without fully educating patients about their choices. You mentioned that the informed consent form was designed by the legislature? Another tragedy. I assumed that physicians, hospitals, and other healthcare providers designed informed consent forms. The legislature? That is shocking. I need to get busy and read about that.
        The type of legislation you refer to, all too familiar, is so tragic, interfering in the physician-patient relationship at every step. It is forcing you into the role of big brother, putting every obstacle in the patient’s path, including your authority and knowledge as a physician. I’m sure that is not news to you, so sorry if I am just repeating what you already know.

        Yes, I think the legislature can do it, especially since they designed informed consent forms in the first place. Hopefully, there will be an opportunity to speak about the many, many issues and the interference with physician-patient relationships at legislative hearings. Will there be hearings? I recommend you ask everyone in yor local, county, state medical associations to call their legislators and demand hearings. What about the ACOG? Have they spoken up?

        If this legislation appears to be moving quickly through the legislative process, under cover of darkness, you might say, raise your voices NOW, as many of you as are willing to step up. We all have so much to learn from watching Wisconsin.

        Next approach, after enactment, if that happens, is the courthouse. What state do you live in? In general, it appears that physicians hate lawyers but you’ll learn to love them (us) if you have to take your state to court!

  • Jo

    Answer to Anon:
    You may have handled it well and the experience was so positive you would do it again.

    My experience has been:
    1. I pesonally know a teenager who overdosed in attempted suicide on the would be birthday of her little girl that her parents had demanded she abort. I had to keep her on the phone and call her parents for them to wake her and take her to ER.
    2. I personally know a woman who had multiple abortions and was later diagnosed with PTSD.
    3. Many women have told me stories that they were told it was not a baby, but later found out differently when seeing ultrasounds of the unborn and seeing that premature babies the age of their aborted unborn child live. They state that if they had been shown they would not have had the abortion.
    4. I personally have a grandchild that was carried to term and given up for adoption.
    5. I had one tell me that at the abortion clinics a lot of women take “comforters” othes with them for support. Some women and men cry afterwards. (You don’t see this after a mole is removed.)
    6. I personally know a child who was a “product of rape” who now goes to Africa and feeds hungry children and does a lot of good in the world.
    7. Some women state that the forced abortion by abusers was more traumatic than the abuse.

    I do not judge anyone who decides to have abortion, I just know the increased trauma of those who have.
    Most people state it is a good thing to reduce abortions.

    Requiring ultrasound and couseling is not only a way to do so, but seeing the ultrasound and hearing of alternatives, may be an invaluable answer to that person who needs help financially, and those that are being abused.

    • Anon

      My experience has been:

      1. A fundamentalist Christian teenager who became profoundly depressed when she found out her birth control had failed… and was ecstatic when she miscarried at 9 weeks. She was relieved, delighted, buoyant (honestly, I was shocked – I’ve never in my life seen anyone so happy to miscarry). She has remained perfectly happy. No, she doesn’t know my personal history, and I didn’t advise her one way or another (which is probably why she told me she was pregnant in the first place). Someday, I’ll be a happy guest at a shower for her first child.

      2. A married woman who conceived unintentionally, with no health insurance coverage for pregnancy, who did not want the child, though her husband did, hence the lack of birth control. She had a medical abortion and was able to be weaned off her antidepressants shortly thereafter. Oh, and she divorced the husband, who was abusive.

      3. A doctoral student whose birth control failed, and was forced to travel (8 hour drive) in order to obtain a much-wanted abortion. Fifteen years later, she has no regrets.

      I have a doctorate in a biological science. I had a medical abortion, and saw the embryo I aborted. Honestly, I’ve seen mouse embryos that looked more human.

      Re: (1) and (7): an ultrasound would do nothing in these situations. Coercion of any kind is always wrong, IMO.

      Re: (2): Anyone who has “multiple” abortions likely has issues that resulted in the multiple unplanned pregnancies, and probably contributed to a tendency to develop PTSD. IMO, needed birth control counseling and a new, more reliable method after the first unplanned pregnancy.

      Re: (3): Are you serious? More than 90% of abortions are performed during the first trimester, well before viability.

      Re: (4) and (6): Excellent examples of the freedom to make one’s own decisions… which I support.

      Re: (5): I bet women who require general anesthesia or sedation bring a “comforter”… as do women or men who have their wisdom teeth removed under general anesthesia or sedation. GYN medical procedures are inherently unpleasant, IME, sedation or not. I know plenty of women who bring their boyfriends or husbands along, especially young women.

      I can tell you my ultrasounds were much more unpleasant than actually aborting. As for trauma: imagine a positive pregnancy test three years into IUD usage. If your intention is to punish and deter: yes, that might work. Despicable, though.

      As for financial help: in example (2) above, that woman would have had to pay the entire cost of her pregnancy and birth out-of-pocket, while being unable to work for the last few months of pregnancy (she’s self-employed). Who would be picking up that tab? Worst case: do you have any idea of the cost of an out-of-pocket C/S? We’re talking tens of thousands, total, in medical expenses and lost wages.

      I’m guessing you have more than one friend, relative or co-worker who had an abortion. You don’t know who these people are, because they’re doing well and have moved on with their lives.

  • gzuckier

    My religion feels that a carcinogenic tumor represents a person’s genetic descendant, merely mutated away from the sinful human form back into its primal innocence. Therefore, we support requiring all patients who wish to undergo cancer therapy to be required to look through a microscope and see their tumor cells happily swimming around and reproducing in a tissue culture flask, before committing themselves to this murderous course.

    • Jo

      How a fetus looks does and immediate relief does not address late effects of abortion trama or those who are abused.

      I have had diagnostic TVTAs and they are uncomfortable, but not painful.

      Also if alternatives of adoption are proposed, most to be adoptive parents and also pro-life clinics will pay for the pregnancy, pre-natal care and also living assistance while pregnant and help mother to get GED, so she is actually better equipped for life afterwards than before.

      Most abortions do not happen in a PCP’s office, most are in abortion clinics where patient does not have an ongoing Dr-Patient relationship. In some instances abortions are performed by nurses and not by physicans and regulation is minimal is some states.

      • Anon

        Transvaginal ultrasounds are unpleasant and humiliating. The abortion was uncomfortable, not painful. I’ve had worse menstrual cramps, honestly. Furthermore, I felt better instantly once I was no longer pregnant: no more headache, fatigue, irritability.

        In the situation (2) I described above: that woman had an MBA; she did not need anyone’s charity to earn a GED. No adoptive parent would replace her $80K salary for the months she’d be unable to work, or be willing to pay whatever clients and business she’d have lost. She wasn’t homeless, either, though at the time she was sharing her home with her rat (now ex-) husband.

        Additionally, adoptive parents want Caucasian children, preferably born to healthy, non-drinking/drug-using, young (minimize those chromosomal abnormalities), college-bound kids. Otherwise, we’d have no need for foster parents. Sometime, take a look at a few of the websites devoted to finding homes for foster kids. I don’t see many good pro-lifers lined up to take an African-American or Hispanic child with developmental delay, let alone mental and behavioral challenges, and never mind his sibling (or two). Honestly, the hypocrisy is just stunning.

        As for safety: abortion is very safe. It’s separated from other health care because of the efforts of people who intend to keep it separate, because they do not care about a woman’s ongoing relationship with her physician or, yes, nurse practitioner (NPs provide excellent care, BTW). That’s because this is not about concern for women, or even for children: it’s about control.

        • Jo

          My brother-in-law and niece are black, two grandchildren 1/2 hispanic and I would consider myself pro-life, and I know a lot of black and hispanic people are pro-life as they see what is happening to their communities and that that the good alternatives that are available are not being told to those communities.

          I recently heard that more than 30% of all black pregnancies are aborted. These mothers need to know of alternatives. Margert Sanger stated that abortion was a good way of decreasing I think she said “eliminating” the black race.

          For the first time more are retiring than are working age. We have literally aborted our future. All alternatives given to a mother once she is pregnant is a good thing for her as well as society as a whole, as less abortions are a good thing.

          • Anon

            I’m talking about real, live, African-American and Hispanic kids, available for fostering and adoption, who outnumber the Caucasian and Asian kids on every single state foster care website I’ve ever visited. No one wants them.

            Sure, fewer abortions are a good thing. The best way to do this is to prevent unplanned pregnancies, which means better education for kids (do watch that documentary, available on Netflix) and more access to affordable, effective birth control. There will always be birth control failures (like mine), and those women should be advised of their choices (as I was) and free to make the choice best for each individual woman (as I did).

            Do you support increased access to effective birth control? How about access to (or, better: public funds for) permanent birth control (like a vasectomy) for people who do not want any more children?

            From the last two paragraphs of your post, I’m guessing your answer will be “no”. Please clarify.

  • Robert Luedecke

    I know a nurse who was practicing back in the days before abortions were legal in the US. She took care of many who had illegal abortions, ladies who were so desperate to not be pregnant that they used clothes hangers to end their own pregnancies or went to places where the instruments were not sterile. She says that she never again wants to see these horrors of death from infection and mutilation. She reminds us that even though she does not like the idea of abortions being legal, abortions being illegal will only mean more “back alley” abortions, and not the end of abortions.

    I have another friend, Dr. Jan Realini, who has a nonprofit with the goal of reducing the number of teenage and unplanned pregnancies in San Antonio, TX. She has presented information showing that even though Texas and California have the same mix of the various ethnicities, California now has far fewer unplanned pregnancies than Texas. The reason is that 10 years ago California made affordable birth control easily available while the legislature in Texas has repeatedly voted against doing that. If you want to help with the most effective way of reducing abortions and all the problems of unplanned pregnancy, donate to organizations like “Healthy Futures” and encourage your state to make inexpensive birth control available.

    • Kathleen Clark

      Defunding Planned Parenthood is counterproductive. It is the number one organization dispensing affordable birth control.
      Thanks for the insight about CA vs TX in terms of the numbers of unplanned pregnancies.

    • Anon

      The documentary “The Education of Shelby Knox” thoughtfully discusses the sex education and unplanned pregnancy situation in Texas. Good flick.

      • Jo

        Other “good flicks”. Lila Rose, a Pro-life activist’s multiple recordings of Planned Parenthood clinics giving advice of how to get abortion without reporting abuse to what they thought was a 13 year old girl who had been abused by an older man.

        Like I said the current set up does not address abuse and abortion without counseling and alternatives given in such cases can be just another form of abuse.

        • Kathleen Clark

          Multiple recordings of one conversation wih a 13 year old girl? You say “clinics”, but then mention one 13 year old girl? Could this 13 year old have said she feared for her life if she reported the abuse? Could Planned Parenthood’s immediate concern for her have been the abortion? I’m sure you don’t believe that Planned Parenthood employees, who work for next to nothing because of their commitment to women, didn’t care about a 13 year old being abused. That is so antithetical to the misson of Planned Parenthood.

          • Jo

            Are you speaking of the original mission of Planned Parenthood’s hero Margaret Sanger? The answer to your question is, YES the “underpaid” workders at several Planned Parenthood clinics thought they were giving advice to a young teen who had gotten pregnant by an older man. Edited or not, the advice was given by some not to give the age of the man. The activist had heard these stories from some who had gotten abortions at a young age and could not believe it and went and recorded it when she turned 18.

  • Robert Luedecke

    Concerning this specific legislation, there continues to be progress towards passing it by the Texas Legislature despite testimony from the Texas Medical Association that “Our position on Senate Bill 16 is simple and does not pertain to the highly political issue at hand. Instead, TMA is extremely concerned about the dangerous precedent SB 16 sets for health care in Texas. Regardless of the issue, no legislation should dictate how physicians and patients communicate with one another or what procedures and diagnostic tests must be performed on a given patient. The sanctity of the patient-physician relationship is the foundation of health care in America, and it must be preserved.”

  • Anon

    An excellent reason for the immediate repeal of all parental notification laws, BTW.

  • MomTFH

    So called post abortion trauma syndrome has been discredited by every reputable professional organization and every well defined study. If black women are getting abortions, the answer is not to force them to have an ultrasound or scripted counseling. It is demeaning and frankly racist to say they are uneducated about their options. Do you really think they don’t know they have the option to maintain a pregnancy?

    And, adoption is really not a consideration for the vast majority if women who continue unplanned pregnancy. Keeping the baby is. They know their options, and good research (available at shows women who choose abortion are worried about their future, their finances, their ability to care for the children they already have. It’s not like all they are missing is an ultrasound and a script describing the embryo. They know they are pregnant and how serious it is.

    If we are worried about unplanned pregnancy in women of color, we need comprehensive sexual education in public schools and free, accessible birth control. The same people who claim to be concerned about these women are trying to cut funding to Planned Parenthood, who provides contraception to these women.

    What does nothing to help is heavily edited videos of people committing fraud in clinics that offer services to this community. That does nothing to reduce unplanned pregnancy. That does nothing to reduce statuatory rape. That does nothing to reduce trafficking.

    Also not helpful is forcing invasive unnecessary procedures like transvaginal ultrasound, scripted counseling that does not address these issues or mandatory waiting periods.

    • Anon

      Yes. Yes. Yes.

      I recall reading an article about a state (Alabama?) which does require ultrasound prior to abortion. This requirement had absolutely no effect on womens’ decisions. This did not surprise me, because I had two (2) ultrasounds prior to having an abortion (because of the IUD failure, my brief pregnancy was a complicated problem). Neither ultrasound persuaded me that I was making the wrong decision, for me.

      What a waste of resources. That money could be better spent elsewhere… say, on preventing unplanned pregnancies. There’s a thought.

  • Angie

    Blood donations save lives. Donating organs at death saves lives. When the supposedly “pro-life” people start talking about requiring some of these invasive and less invasive procedures to save the lives of living, breathing people walking around today, I’ll believe they truly are actually interested in saving lives.

    No, I do not believe any of these should ever be required, just as I do not believe that any man or woman should ever be required to sacrifice any portion of their life or health to save the life of another.

    If people truly wish to prevent abortions, then they should put their efforts into funding birth control education, rather than fighting it as most seem to do.

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