The ultrasound laws reflect a particular distrust between the public and abortion providers that is unique in the healthcare sector. This distrust is not simply predicated on the moral dispute between what constitutes a person and when human life begins or what is choice. It is far from bumper sticker simple 40 years after Roe.

The cash-on-delivery healthcare sector (abortion and elective plastics to name two) have a way of attracting predatory physicians who are often, not qualified for the procedures that they perform, do not have surgical admitting privileges at hospitals and have a tendency to become indicted felons.  You do not see this in ortho, peds, general surgery or podiatry.

Regular abortion providers are unique in that this population routinely include physicians who (1) “Dump” the expected end  of their incompetency on E.Rs. (2) Are sometimes one procedure family practice physicians, not residency trained gyn surgeons with surgical admitting privileges (3) Employ non-physicians and non-RNs to perform abortions and administer narcotics. The Gosnell indictment is a shocking 281 pages horror story. With a 30 year career, he was undoubtedly known in the Ob/Gyn community as one who was a “bit loose” with fetal dating.  (4) In 2010 one doc was jailed for manslaughter  (5) In January, 2012 two physicians were indicted for one and five counts of manslaughter respectively. One doc curiously started an abortion in NJ and attempted to complete it in MD.  – a routine practice of his. (6) Both Brigham and Gosnell had a habit of freezing dozens of aborted fetuses and Gosnell even had a jar of preserved fetal feet on his desk. This screams for a high level regulatory oversight and reveals a distorted psychology.  The fact that Gosnell worked for 30 years and Brigham 15 suggests knowledge of their practices in the medical community.  (6) Just this week, Ann Kristen Neuhaus, M.D. lost her license to practice medicine for failing to meet the standard of care 11 times in vulnerable patients between the ages of 11 and 18.

The distrust between the public and the abortion provider appears legitimate and ultrasound laws, parental notification laws, waiting period laws, etc., is in part a reflection of that distrust.  It is also a transparent strategy to limit abortion access but that strategy is only effective because practices like the above exist for decades and the ob-gyn community – the experts – could care less.

It seems that for the abortion sector of ob-gyn the norm is to ignore problems and to have no standards of care; not even something as simple and as routine as ultrasound,  real surgeons or inspected clinics. It is either the standard of care to ultrasound a woman who is having a uterine surgical procedure or it is not. If not, let’s publish a paper and send it to Blue Cross. I am certain that they would be thrilled to disallow any ultrasounds until the 12th week.  Maybe a non-continuing pregnancy is not an indication for ultrasound, but  I cannot see how one can say in 2012 that it is the standard of care to determine uterine anatomy by physical exam alone or the presence of an ectopic pregnancy by labs and exam alone.  In fact, I am yet to see any Ob-Gyn say that ultrasound is not standard, reasonable or necessary in a pregnant patient at virtually any time.

But when it comes to abortion, no standard of care is fine – and that is distressing.

In no circumstance would you see family practice docs doing any other surgery.  In no ob-gyn practice would you observe intrauterine surgery performed or RU-486 administered without an ultrasound.  In no circumstance would you have a surgical procedure started in NJ and completed in MD. In no circumstance would you find a physician dropping off his critical patient to an ER and leave, refusing to offer a history or even his name. In no circumstance would you find a medical practice and an oxcycontin distributorship.  In no surgical procedure would you have an imaging procedure that is not reviewed by the surgeon and patient together. But in abortion, this is the stated norm.

This aspect of healthcare screams for regulatory oversight because leaving it between a patient and her paid in cash doctor is not working very well.  Many “good” docs are not interested and woe to the woman who lives in a state that lacks aggressive oversight – she may die or be maimed, be treated by a non-physician or have anesthesia administered by a teen – all of which occurred in 2011. The surgical suite may reek of cat urine and the halls and clinic may not meet code; as was the case in Philly. The above links are not events from the bad old days but widely reported events from within the last year.

Ultrasound laws have little to do with the right to choose or not, it has to do with an unregulated surgical practice that seems to attract a disproportionate number of felons and bottom feeding predatory doctors. Roe was 40 years ago and women continue to actually die. The only recourse is for the public to exercise their right to self-govern because mainstream medicine and accredited physicians have abandoned the oversight of abortion patient decades ago.  The standard is “whatever” and in 2012 that is not good enough.