Sonograms evoke strong reactions as mandate takes effect

Rochelle Tafolla, an employee at Planned Parenthood, holds paperwork pregnant women are required to sign before undergoing new state-mandated sonograms and having abortions. Rochelle Tafolla, an employee at Planned Parenthood, holds paperwork pregnant women are required to sign before undergoing new state-mandated sonograms and having abortions. Photo: Michael Paulsen Photo: Michael Paulsen Image 1 of / 1 Caption Close Sonograms evoke strong reactions as mandate takes effect 1 / 1 Back to Gallery

Some women covered their ears as the sounds of fetal heartbeats echoed into their exam rooms at a Houston abortion clinic.

Others tried to drown out the noise with their own voices, said Planned Parenthood officials, nervously humming or talking over the sounds of fetuses in their wombs. Still others turned their heads away from ultrasound images, an effort to opt out of part of the state's new sonogram requirement for abortions, which the Department of State Health Services began enforcing Tuesday.

"These patients are livid, they are hurt," said Tram Nguyen, director of Planned Parenthood Center for Choice in Houston, describing recent scenes at her clinic. "They feel that we are the ones being condescending and questioning their decision when we are just messengers."

Elizabeth Graham, director of Texas Right to Life, said she's not surprised to hear that many women are reacting strongly to the evidence of life they're carrying.

"I'm sure that it is opening eyes," Graham said. "It's showing women that their child has arms and legs and a heartbeat, that it's another human life, not just a blob of cells."

Graham acknowledged that trips to abortion clinics are emotional, traumatic times, but called the notion that providing information about the child's development puts too much pressure on women "paternalistic nonsense."

She said women are very capable of making informed decisions and that clinics that have financial interests in "selling abortion" should not be deciding what information to give out.

Vague regulations

Officials at abortion clinics say they have attempted to follow the law since it went into effect Oct. 1, 2011. But portions of it have been vague and were only clarified late Monday as officials prepared to begin enforcing the mandate.

Women who call Planned Parenthood for abortions are asked to first set up a sonogram appointment, which, according to the law, must occur at least 24 hours prior to an abortion, unless a woman lives more than 100 miles from a licensed abortion facility, said Rochelle Tafolla, spokeswoman for Planned Parenthood Gulf Coast.

In those cases, they must get a sonogram at least two hours before an abortion.

Audio of heartbeat

At sonogram appointments, physicians explain to women that state law requires them to undergo the procedure and to listen to a description of the fetus's dimensions, cardiac activity and internal and external organs, Tafolla said.

Doctors then perform sonograms and give women the option to view an image of the fetus in their wombs. Although some women turn away from the image, others choose to view it, Tafolla said.

Physicians also attempt to detect a fetal heartbeat and, if present, play the audio, she said. Many women attempt to ignore the sound, Tafolla said.

The experience is a struggle for most, Nguyen said.

"These requirements are only about shaming and bullying women who are already here for an abortion," Nguyen said. "When women call us to make an appointment for an abortion, they have spent many hours thinking about what they need to do. They know that they want to have an abortion."

Since Oct. 1, about 80 percent of women have returned for abortions after completing sonogram appointments, Nguyen said. The drop in return patients, Tafolla said, was not indicative of a change in heart after sonograms, since the facility's count of abortions has not declined since it began complying with the law.

Skeptical of claim

Graham said that the claim that 80 percent of women go on to undergo abortions makes her skeptical whether abortion providers are really following the law. "I wonder about the manner in which they're presenting the information," Graham said.

Graham and Joe Pojman, executive director of the Texas Alliance for Life, said it was too early to have information on the law's effects.

With its decision to begin enforcing the law Tuesday, the Department of State Health Services will now hold abortion facilities accountable for the law during its random annual audits.

Elective abortions are exclusively done at clinics. Hospitals perform 0.1 percent of annual abortions, all of them therapeutic, according to the Texas Hospital Association.

Although Planned Parenthood has been making fetal heartbeats audible for all women who undergo the mandated sonograms, women do have the option to request that the ultrasound volume be turned off before the sound begins playing, department spokeswoman Carrie Williams said.

Women who believe their pregnancy is a result of sexual assault or incest, who are minors or whose fetus has an irreversible medical condition or abnormality, can opt out of hearing the description of the sonogram, seeing the fetal images or hearing the heartbeat.

zain.shauk@chron.comtodd.ackerman@chron.com