A federal appeals court Monday ruled that a North Carolina abortion law requiring doctors to perform ultrasounds and describe sonogram images to women is unconstitutional because it violates free speech rights.

The 4th Circuit Court of Appeals in Richmond, Va., struck down a 2011 law passed by a Republican-dominated Legislature. The panel upheld a federal judge’s ruling that doctors cannot be compelled to deliver the antiabortion views of lawmakers.

A provision in the Women’s Right to Know Act requires doctors to display sonogram images of fetuses and to describe them to women at least four hours before an abortion procedure.

“Transforming the physician into the mouthpiece of the state undermines the trust that is necessary for facilitating healthy doctor-patient relationships and, through them, successful treatment outcomes,” the three-judge panel wrote.


The judges ruled that the law’s requirements constitute “compelled speech” that is “ideological in intent and in kind.” They said the law goes far beyond legislation in other states designed to ensure women give informed consent to abortion.

The decision was written by Judge J. Harvie Wilkinson III, appointed in 1984 by President Reagan. It upheld a ruling in January by U.S. District Court Judge Catherine Eagles, who said the law was too broadly written and a violation of free speech.

“Abortion may well be a special case because of the undeniable gravity of all that is involved, but it cannot be so special a case that all other professional rights and medical norms go out the window,” the appeals court wrote.

The state of North Carolina “may not coerce doctors into voicing that message on behalf of the state in the particular manner and setting attempted” by the law, the ruling said.


The law passed over a veto by then Gov. Beverly Perdue, a Democrat. Republican sponsors said the law provided women with crucial medical information as they made an irrevocable decision to terminate a pregnancy.

The law never went into effect because it was challenged in court by groups that included the American Civil Liberties Union, the Center for Reproductive Rights and Planned Parenthood Federation of America.

“We’re thrilled that the appellate court rejected this unconscionable attempt to intrude on the doctor-patient relationship,” Nancy Northup, president of the Center for Reproductive Rights, said in a statement.

“Exam rooms are no place for propaganda and doctors should never be forced to serve as mouthpieces for politicians who wish to shame and demean women.”


Ten states require an abortion provider to perform an ultrasound on a woman seeking an abortion and to offer the patient an opportunity to view the sonogram, according to the Guttmacher Institute. Louisiana, Texas and Wisconsin require the provider to display and describe the sonogram image.

Monday’s ruling is not binding on states outside the five states covered by the 4th Circuit, said Carl Tobias, a professor at the University of Richmond School of Law. But Tobias said the ruling could persuade district and appellate judges in other circuits to invalidate similar laws if they were challenged in court.

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