Sound Science and Unsound Ideology: Sixty Years of Obstetric Ultrasound

Ultrasound image used in an anti-abortion billboard in Ireland, 2012. Photo: The Vagenda

For decades now, ultrasound technology has been a fixture in the journey from pregnancy to parenthood. It has also become a prized weapon among abortion opponents in the battle over reproductive rights.

Ultrasound, which uses high-frequency sound waves to render images of a developing fetus, had its beginning 60 years ago this week, with the publication of a seminal paper in the British medical journal The Lancet. The development of the technology has a colorful history, one involving flying mammals, German submarines, a desert-dwelling inventor, and countless medical professionals who saw a range of patient care possibilities.


Ultrasound is a powerful tool, which can benefit patients or be used as a cudgel by abortion opponents.


But that colorful history belies the drab and fuzzy appearance of most ultrasounds. That limitation, though, has never stopped it from taking on enormous significance. When the technology was first developed, it gave obstetricians an unprecedented ability to survey fetal development, making it one of the most important advances in their field during the latter half of the 20th century.

By the same token, ultrasound has not only been a valuable medical tool but also a powerful storytelling tool. Today, it is often put to use four or more times before a patient’s due date. While the FDA and other authorities advise against ultrasounds that aren’t medically necessary — recommending just two for a low-risk pregnancy — many patients opt for additional, elective ultrasounds for the sake of having keepsake images. Posting those images online has become a popular way to share their news with family and friends. Continue reading

The Clash of Population and Prejudice in Madrigal v. Quilligan

Mural (detail) in Boyle Heights, East L.A. Photo: Mictlan Murals

In August 1973, Guadalupe Acosta was admitted to the county hospital in East Los Angeles. She had been suffering from labor pain for hours, but she would soon endure even more misery in the delivery room. She recounted later how the attending physician worked aggressively to induce labor, pushing down forcefully on her abdomen — even hitting her stomach when he was caught in the swing of her flailing arms. In the end, all the torment she endured culminated in the death of her baby in birth.

Acosta later said she was “very inattentive” in the aftermath of the experience. “People sometimes have to tell me things twice. It’s not that I don’t understand them, it’s that I’m not there.” For Acosta, it was not just the loss of her baby that devastated her but also the loss of her ability to have children in the future. She found out, months later, that the hospital physician had decided to sterilize her. At the time, she had been too traumatized to understand what was happening.


Just as the right to access birth control and abortion should be defended, so should the right to have children.


The University of Southern California – Los Angeles County Medical Center (USC-LAC Medical Center), as it was officially called in the 1970s, was a hospital that many in East L.A. tried to avoid. It was a place they would only visit out of necessity if other hospitals weren’t affordable. For Dr. Bernard Rosenfeld, who worked there as a resident in obstetrics and gynecology, it was not hard to see how his own department reinforced that reputation.

Acosta’s traumatic experience was similar to other cases Rosenfeld witnessed — cases that showed a disturbing pattern of subjecting women, especially Spanish-speaking women, to sterilization without their informed consent. According to Rosenfeld, insistent medical staff would push sterilization on patients “before they go home” — often while they were still in pain or exhausted — so that they wouldn’t “change their mind by the time they come back to clinic.” Patients who had limited understanding of English were often uncertain of what was happening. Shocked by the unethical practices, Rosenfeld secretly copied hundreds of medical records to document what was happening at USC-LAC Medical Center. Continue reading