The U.S. Supreme Court left intact a Kentucky law that forces doctors who perform abortions to first show the woman an ultrasound and give her a detailed description of the fetus, even if she doesn’t want to listen.

The justices, without comment or published dissent, on Monday rejected an appeal by the state’s only abortion clinic and its three doctors, who said the law violates their free speech rights. A divided federal appeals court upheld the 2017 measure, saying it was a legitimate “informed consent” requirement.

The appeal said the Kentucky law goes well beyond anything the Supreme Court has previously upheld, forcing doctors to say and do things likely to upset many of their patients at a vulnerable time.

“While the patient is half-naked on the exam table with her feet in stirrups, usually with an ultrasound probe inside her vagina, the physician has to keep talking to her, showing her images and describing them, even as she tries to close her eyes and cover her ears to avoid the speech,” the appeal argued.

The Supreme Court upheld an informed consent requirement in the 1992 Planned Parenthood v. Casey decision, which reaffirmed abortion rights while allowing some state regulation.

In that case, Pennsylvania required doctors to describe the nature of the procedure, the risks involved, and the probable gestational age of the fetus. Doctors also had to tell patients about the availability of state-printed materials that had information about the fetus and various forms of assistance.

Kentucky officials told the Supreme Court their rules “do nothing more than require that women who are considering an abortion be provided with information that is truthful, non-misleading, and relevant to their decision of whether to have an abortion.”

The American Civil Liberties Union represented the clinic, EMW Women’s Surgical Center in Louisville. An ACLU lawyer, Alexa Kolbi-Molinas, said in an emailed statement the high court had “rubber-stamped extreme political interference in the doctor-patient relationship.”

Kentucky Governor Matt Bevin said on his website the Supreme Court action “gives final affirmation to the common-sense notion that patients should be well-equipped with relevant information before making important medical decisions.”

Both sides pointed to a 2018 Supreme Court decision blocking a California law that imposed disclosure requirements on anti-abortion pregnancy centers. That ruling, a 5-4 decision with five conservative justices in the majority, said the disclosure wasn’t an informed consent requirement because no medical procedure was involved.

The Kentucky case is EMW Women’s Surgical Center v. Meier, 19-417.