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

STD Awareness: Prevention vs. Punishment

Before antibiotics, syphilis could kill and gonorrhea was responsible for most cases of infertility. Both diseases could spread from husband to wife to baby, potentially destroying families. So you’d think medical breakthroughs in prevention and cures would be welcomed with open arms.

The actual history, like the humans who create it, is much more complicated.


Compassion, rather than fear and guilt, should guide medical practice.


During World War I, sexually transmitted diseases were a huge problem — second only to the 1918 flu pandemic in the number of sick days they caused (7 million, if you’re counting). The Roaring Twenties saw a sexual revolution, and by World War II, the military was once more fretting about losing manpower to debilitating infections that drew men away from the front lines and into the sick bays.

The armed forces did what it could to suppress prostitution and distract soldiers with recreational activities. But the human sex drive could not be contained: The vast majority of U.S. soldiers were having sex — even an estimated half of married soldiers were not faithful to their wives during WWII. Victory depended on soldiers’ health, so during both WWI and WWII, the military provided its sexually active soldiers with “prophylaxis,” medical treatments that could reduce risk for venereal disease — or VD, as sexually transmitted diseases were called back then.

Anyone who thinks condoms are a hassle or “don’t feel good” should read medical historian Allan M. Brandt’s description of a WWI-era prophylactic station, which soldiers were instructed to visit after sexual contact: Continue reading

Pro-Choice Friday News Rundown

  • clintonHillary will not be backing down to anti-choice imbeciles. (Upworthy)
  • It’s not looking good for abortion clinics in Ohio. (USA Today)
  • And Michigan clinics are being affected as a result. (RH Reality Check)
  • Anti-choice ignoramus Lindsey Graham is absolutely positive that prohibiting abortion after 20 weeks is going to result in great things! (HuffPo)
  • Instead of taking their asses somewhere to help babies who’ve been born already, a bunch of #$%&^@# in New Mexico are tooling around in a van with graphic, gory (and probably fake) images of “late-term” fetuses who’ve supposedly been aborted. (Think Progress)
  • Just because you sign my paycheck doesn’t mean you get to dictate what I do with my uterus. When will that register with these people?!?!? (NYT)
  • OK, girls, let’s have a chat — if you don’t want to get pregnant, please use contraception. Don’t assume you have special uterine powers that will automatically repel an embryo from showing up at your uterus’ door. (Jezebel)
  • Politicos who try to interfere with women’s use of birth control are in for a rude awakening come election time. #StartPackingYourBags (PolicyMic)
  • Get a load of this tripe: The buffoon known as Rush Limbaugh thinks women have no agency in their reproductive choices and are being “turned into abortion machines” by Democrats. (MSNBC)
  • Interesting Slate piece on how the victims of the Hitler regime are affecting the abortion debate. (Slate)

“I Didn’t Want to Believe It”: Lessons from Tuskegee 40 Years Later

Located among longleaf pine and hardwood trees, low ridges, and broad floodplains, Tuskegee, Alabama, is a small town that’s been a big part of American history. Despite a modest population of less than 10,000 people, Tuskegee has been able to boast many notable residents who have made names for themselves in everything from sports to the arts. Among them have been the Tuskegee Airmen, the first African American Air Force unit, which served during World War II, and Rosa Parks, the icon of the civil rights movement, who sparked the Montgomery bus boycott in 1955.


The Tuskegee syphilis experiment, conducted from 1932 to 1972, examined the natural progression of untreated syphilis in poor, rural black men — without their informed consent.


Tuskegee, though, is also remembered for one of the worst chapters in the history of medical research. Forty years ago, in 1972, newspapers revealed the story of a syphilis study that was callous in its deception of research participants, and damaging, even today, in the distrust it sowed among black Americans. The study had started another 40 years prior, in 1932, when the United States Public Health Service (USPHS) needed to rescue a financially troubled syphilis intervention in Macon County, Alabama. The intervention was first established in partnership with a Chicago-based philanthropic organization, but its future was uncertain when the organization’s funds dried up during the Great Depression.

Syphilis, the sexually transmitted disease caused by the bacterium Treponema pallidum, was the subject of conflicting scientific hypotheses at the time, including the hypothesis that the disease behaved differently in blacks and whites. Interested in testing those hypotheses and faced with disappearing funds for treatment, the USPHS turned its project into a study of untreated syphilis. Also influencing the decision was the fact that the USPHS was discouraged by the low cure rate of the treatments at the time, mercury and bismuth. But by the mid-1940s, penicillin was in use as a proven treatment for syphilis. In spite of that medical advance, the USPHS withheld treatment from a total of 399 infected patients by the time the study ended in 1972. Continue reading