Abortion rights are under attack in the United States, and it's reached an extreme. Following dangerous legislation getting passed in states like Georgia and Mississippi, abortion providers in Missouri are now forced to perform an "unnecessary" pelvic exam before procedures and medical professionals are speaking out about the invasive mandatory practice.
Lawmakers in Missouri enacted the new pelvic exam rule on May 30, according to The Week, and it's just one of a number of "targeted laws designed to shut down clinics," Rachel Maddow said on her MSNBC show on Thursday night. Maddow said lawmakers in the state want "to make it impossible to work as an abortion provider in Missouri," adding that rules such as this aim to "make it too hard and too expensive and just too awkward and difficult and uncomfortable for a woman to get an abortion if she wants one."
Dr. Colleen McNicholas, an obstetrician and gynecologist of Planned Parenthood of the St. Louis Region and Southwest Missouri, said on The Rachel Maddow Show that women already had to wait 72 hours before having an abortion and pelvic exams were conducted on the day of the procedure. And Dr. McNicholas called the new regulation "inappropriate" and "state-sanctioned, essentially, sexual assault."
"It is just so inappropriate to subject somebody to a pelvic exam, which includes putting your fingers and other instruments in the vagina when really that gives no medical information," Dr. McNicholas told Maddow. "It doesn't do anything to help the patient or myself choose what is the best approach for their abortion care."
Dr. McNicholas continued, "And I can say that of the physicians who've had to do that in the last few days, they have just been devastated. First to have to explain to patients that this is the requirement. To explain that they don't feel that there's any medical relevance to the exam and then to ultimately end up with 'but if you want to continue with care, we have to do it.' You know, for patients who've had a history of trauma, for example, I mean, it's just retraumatizing them all over."
Physicians and organizations, like the American College of Obstetricians and Gynecologists (ACOG), dedicated to providing reproductive health care, are speaking out amid the newly-implemented practice, suggesting that pelvic exams should only be performed when medical history or symptoms indicate it's necessary, or after both doctor and patient have agreed to one.
On June 3, for instance, a Missouri doctor tweeted about the practice, revealing that she was forced to perform a pelvic exam on a patient who was "terminating her pregnancy for a fetal anomaly." Dr. Amy Addante said doing the exam, which she called "invasive" and "uncomfortable," hurt her "as a physician."
"She is heartbroken over her situation and I was forced to do an invasive, uncomfortable exam," she shared on Twitter. "It broke me as a physician to do this to her."
Dr. Diane J. Horvath, medical director at Whole Woman's Health of Baltimore, told Romper in a statement that "while most clinicians typically do one pelvic examination to assess the size and position of the uterus just before an in-clinic abortion, there is no reason to have an additional exam 72 hours before that, as the Missouri state law requires."
"In most cases there's also no reason to require a pelvic examination prior to a medication abortion, which is also mandated under Missouri law," Dr. Horvath continued, adding:
It is a violation of medical ethics to subject a patient to ANY medically unnecessary intervention, particularly one that can be uncomfortable or even traumatic for some people. This is an attempt by the state of Missouri to weaponize medical care in an effort to make it even more difficult to access abortion. The relationship between a patient and their healthcare provider should be based on trust, and this law forces providers to violate that trust.
It's not just individual doctors who find this practice cruel and unnecessary. In a statement to Romper, the ACOG says that while pelvic exams have always been "considered a fundamental component of the well-woman visit," it does not support performing such procedures prior to providing abortion care. Additionally, the ACOG says pelvic exams absolutely should be performed "when indicated by medical history or symptoms," again with the consent of the patient.
The ACOG added, however, that "the decision to perform a pelvic examination should be a shared decision between the patient and her obstetrician-gynecologist or other gynecologic care provider" in any and all health care situations.
"But apart from those situations, ACOG does not recommend routine pelvic exams, and certainly not before an abortion," the ACOG's statement to Romper reads.
Planned Parenthood of the St. Louis Region and Southwest Missouri is the only place to get an abortion in Missouri, according to The Washington Post. Doctors at the clinic have been working with uncertainty after Gov. Mike Parsons signed a law banning abortion services after eight weeks, according to ABC News, and the latest regulations have added insult to injury for abortion providers.
Dr. David Eisenberg, a doctor at the clinic told the Los Angeles Times he feels he and the other physicians at that particular Planned Parenthood are being used as pawns in Republican lawmakers' anti-abortion efforts. "What I realized was I effectively have become an instrument of state abuse of power," he told the publication. "As a licensed physician, I am compelled by the state of Missouri to put my fingers in a woman's vagina when it's not medically necessary."
Though things certainly feel very grim for people seeking abortion care in Missouri, there are ways for others to help.
For starters, you can donate to the Gateway Access Fund, which aims to see that "every reproductive decision, including abortion, takes place in thriving communities that are safe, peaceful, and affordable." The group continues to raise funds necessary to help those seeking abortions in Missouri be able to afford them, and is fighting anti-abortion legislation in the state.
Missouri is merely the latest in a string of states dealing with dangerous abortion legislation. Republican lawmakers may consider each new bill and law passed a win, but it doesn't have to be that way. There are ways to fight back and ensure that people everywhere in need of reproductive health care receive the services they want or need, without enduring invasive, shame-inducing procedures beforehand.
Editor's Note: This article has been updated to include a statement from Dr. Diane J. Horvath.