A Doctor on Transvaginal Ultrasounds

Artemis of Ephesus: Vatican Museum, 1993
Artemis of Ephesus: Vatican Museum, 1993

Not all doctors are ok with conservative legislatures mandating medical procedures, such as this anonymous doctor who advises civil disobedience:

I do not feel that it is reactionary or even inaccurate to describe an unwanted, non-indicated transvaginal ultrasound as “rape”. If I insert ANY object into ANY orifice without informed consent, it is rape. And coercion of any kind negates consent, informed or otherwise.


It’s time for a little old-fashioned civil disobedience. Here are a few steps we can take as physicians to protect our patients from legislation such as this.


1) Just don’t comply. No matter how much our autonomy as physicians has been eroded, we still have control of what our hands do and do not do with a transvaginal ultrasound wand. If this legislation is completely ignored by the people who are supposed to implement it, it will soon be worth less than the paper it is written on.

2) Reinforce patient autonomy. It does not matter what a politician says. A woman is in charge of determining what does and what does not go into her body. If she WANTS a transvaginal ultrasound, fine. If it’s medically indicated, fine… have that discussion with her. We have informed consent for a reason. If she has to be forced to get a transvaginal ultrasound through coercion or overly impassioned argument or implied threats of withdrawal of care, that is NOT FINE. Our position is to recommend medically-indicated tests and treatments that have a favorable benefit-to-harm ratio… and it is up to the patient to decide what she will and will not allow. Period. Politicians do not have any role in this process. NO ONE has a role in this process but the patient and her physician. If anyone tries to get in the way of that, it is our duty to run interference.

3) If you are forced to document a non-indicated transvaginal ultrasound because of this legislation, document that the patient refused the procedure or that it was not medically indicated. (Because both of those are true.) Hell, document that you attempted but the patient kicked you in the nose, if you have to.

4) If you are forced to enter an image of the ultrasound itself into the patient chart, ultrasound the bedsheets and enter that picture with a comment of “poor acoustic window”. If you’re really gutsy, enter a comment of “poor acoustic window…plus, I’m not a rapist.” (I was going to propose repeatedly entering a single identical image in affected patient’s charts nationwide, as a recognizable visual protest…but I don’t have an ultrasound image that I own to the point that I could offer it for that purpose.)

5) Do anything else you can think of to protect your patients and the integrity of the medical profession. IN THAT ORDER. We already know how vulnerable patients can be; we invisibly protect them on a daily basis from all kinds of dangers inside and outside of the hospital. Their safety is our responsibility, and we practically kill ourselves to ensure it at all costs. But it’s also our responsibility to guard the practice of medicine from people who would hijack our tools of healing for their own political or monetary gain.

(click here to continue reading Guest Post: A Doctor on Transvaginal Ultrasounds – Whatever.)

1 thought on “A Doctor on Transvaginal Ultrasounds

  1. John Cutting says:

    I’m very happy to see these comments from the viewpoint of a medical provider!! Wow, it never occurred to me to consider that physicians could have such power. Of course! …I especially love knowing that it could be refused by a woman, and that leaves the physician in perfect compliance with the letter of the law regardless. I sure hope that’s true.

    Does this mean insurance companies will come up with a monetary incentive to entice physicians to lean toward such a procedure, and against their own intuition or conscience? Every procedure not documented is, after all, money lost somewhere along the chain of monetary gain. Some doctors prescribe unnecessary medication or surgery in order to experience a monetary gain (i.e., a “kickback”) from that prescription.

    Does this indicate there’s a difference in moral standards between a General Practitioner or a Surgeon say, and a Gynecologist? Or, does it indicate the level of naiveté under which I, myself have been operating about doctors all these years?

    I will expand my consciousness immediately to incorporate the obvious lack on my part – and which was built up inside me by modern media sensationalizing, no doubt (and I’m sorry for succumbing to that) – to include physicians as a people on this planet who really mean it when they say, “do no harm.”

    Thank them, please, for their comments – and for setting the record straight in my own mind. Money doesn’t create evil deeds, …it just finances them. And a woman’s body does still fall under the jurisdiction of the individual woman. Yeah, for them.

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