Shame and money used to attack rights, critics of abortion law say
A woman is forced to endure a medical procedure likened to rape. No, it's not Egypt, where army doctors are accused of subjecting protesters to grotesque "virginity tests".
Instead it's Texas, where a controversial law, signed last year by failed Republican presidential candidate Governor Rick Perry, took effect in February.
Aimed at women who seek abortions, a legal right since 1973, the "Sonogram Bill" compels doctors to describe, and patients to listen to, a description of the fetus revealed by an ultrasound.
"A patient must make two visits," explains Rochelle Tafolla, a spokeswoman for Planned Parenthood Gulf Coast.
"During the first visit the doctor who is going to perform the abortion must perform the ultrasound. The doctor must display the ultrasound image to the woman. She can look away but the doctor must describe the image. If there is cardiac activity that suggests a heartbeat the doctor is required to turn up the audio so the woman can hear it."
This invasive procedure involves inserting an ultrasound device, or "wand", into the vagina to get a clear image of the fetus and detect any heartbeat in the first 12 weeks of a pregnancy, when most American women seek abortions.
Thereafter the woman must wait 24 hours before returning to the same clinic for her abortion.
"What we have seen here at our clinics is that women are upset, both angered and emotionally upset, by this particular requirement," says Tafolla. "But it isn't deterring them or changing their minds. They are returning for their abortions."
Doctors must comply with the law or risk losing their licence.
The Texas law, and copyright legislation being considered by other states, has provoked an outcry among women's groups as social issues - abortion and birth control - come to the fore in a presidential season previously dominated by economic concerns.
As former Senator Rick Santorum - an evangelical Catholic opposed to birth control, abortion and same-sex marriage - surges in the primaries, the 2012 contest is shaping up as a fight to defend women's rights.
In the past few weeks a nasty electoral season has turned uglier, as talk-show host Rush Limbaugh calls a woman who advocates birth control a "slut" and a "prostitute", Republicans in Congress try to deny funding to Planned Parenthood, the women's health group founded in 1916, and conservative states ponder laws to emulate Texas.
And in a nation where half of pregnancies are unintended, the New Yorker reports states imposed 80 new restrictions on accessing abortion rights last year, up from 23 in 2010.
To many women it is a fundamentalist jihad to turn the clock back to some pre-feminist 1950s fantasy, when women were content to marry, have children, and stay at home.
As such, Texas is ground zero for this gender battle.
"They're really targeting abortion providers," says Julie Rikelman, an attorney with the Centre for Reproductive Rights, one of the litigants who failed to stop the Texas law.
"In no other area of medicine does the government go so far in telling doctors what they have to do and say. And take away their ability to exercise medical judgment.
"Women know what they're doing ... In the US about 60 per cent of women who get abortions already have children. They know exactly what it means to be pregnant."
Many also know what it means to be poor. In a classic confluence of economics and sexual politics, the two-visit demand is an onerous burden in a vast state where women sometimes have to travel long distances for abortions.
The measure was pushed through by Republicans, even as they chose to ignore a move to ban texting while driving as "government intrusion", says Tafolla. "And in the next breath he said it was a state emergency to force women to undergo an invasive, unnecessary medical procedure."
At the same time Texas has cut US$73 million ($89 million) in state funding for family planning - including breast exams, cervical cancer screenings and birth control - for women on low incomes, leaving 260,000 women bereft.
The governor wants to end state contributions to a federal scheme that helps poor women with preventative family planning care.
"Perry is blinded by his anti-choice and anti-Planned Parenthood ideology and wants to shut down the entire programme," says Tafolla. "If he is successful ... more than 130,000 low-income women will be left without healthcare."
Statistics show that unintended pregnancies soar among women who don't use birth control or who use it incorrectly.
Abortion was legalised in 1973 with Roe v Wade, a landmark US Supreme Court decision. Pro-life conservatives have failed to squash this ruling, but have repeatedly made it harder for many poorer women to terminate pregnancies.
Emotions were cranked up this week when Garry Trudeau, creator of the Doonesbury comic strip, which is syndicated to about 1400 newspapers worldwide, ran a story line critical of the Texas Sonogram Bill.
The strip depicts a young woman who, seeking an abortion, is sent to a "shaming room" at a sonogram clinic. Asked by a state legislator if this is her first visit, she replies she has got contraceptives there in the past. "Do your parents know you're a slut?" he asks. When she says she does not want a vaginal examination, a nurse tells her, "The male Republicans who run Texas require that all abortion-seekers be examined with a 10-inch shaming rod."
Trudeau compares the compulsory procedure in Texas to rape. Several United States papers, including the Fort Worth Star-Telegram in Texas, the Gainesville Sun and the Ocala Star Banner, both in Florida, decided not to run the strip.
While Santorum's opposition to "things in the sexual realm that is [sic] counter to how things are supposed to be" pleases his base, he risks alienating the wider electorate.
Since 1964, women have composed the majority of eligible voters in US national elections, and since 1980 more women than men have cast votes. At the same time the Guttmacher Institute, a US nonprofit that seeks to "advance sexual and reproductive health worldwide", reports 99 per cent of American women who have had sex have used contraceptives.
Among Catholics the total is 98 per cent. As women voice anger online and rally against forced ultrasound bills, Tafolla says the "attacks [on birth control] make it seem like we're living in a time warp".
The widespread use of birth control by American women has helped them make giant strides in the workplace. The Richer Sex, by Washington Post reporter Liza Mundy, says 40 per cent of working women earn more than their husbands, with half expected to do so by 2030.
Women also comprise more than half of university students and counting. It is an advance made possible, in part, by birth control and a woman's ability to decide if, and when, she wants children.
Rather than celebrating this achievement, social conservatives seem intent on vilifying women who demand birth control. Trudeau's strip and use of the word "slut" echoes Limbaugh's abuse of Sandra Fluke, a Georgetown Law School student who testified to Congress that religious-affiliated workplaces, such as universities, should cover the insurance cost of birth control for staff.
While the GOP-backed Blunt Amendment - framed to exempt employers with a "moral objection" from providing coverage for birth control, HIV testing, mammograms, maternity care or mental health services under the Affordable Care Act - just failed to pass in the Senate, this attack on the Obama Administration's health reform highlights GOP misogyny.
"If the right has its way it will take us back decades, if not centuries," says Rikelman. "The attack in contraception is just unbelievable. Birth control is one of the things that has allowed women to control their lives, advance their careers and improve their economic state."
Limbaugh's demand that he be allowed to watch online videos of Fluke having sex, in return for funding her birth control, solicited a wave of national revulsion and may be a sign the religious right have overplayed their hand in efforts to reverse progress in women's rights.
Nancy Cohen, author of Delirium: How the Sexual Counterrevolution is Polarising America, postulates this obsession dates back to the feminist movement and the 1960s sexual revolution, and argues the far right has used fiscal conservatism, most recently with the Tea Party, as "a shadow movement" to advance sexual fundamentalism.
"It's about shaming women," says Cohen. "Because they have these very reactionary views about where women belong."
It is a risky and, maybe, suicidal dream. Writing in Politico, Jennifer Granholm, the former Democrat governor of Michigan, asked how men would feel if a female-run legislature ruled that to obtain a Viagra prescription males needed an affidavit from a female partner "verifying that you are indeed incapable of an erection".
Granholm compared the Texas law and GOP assaults on Planned Parenthood as a "form of legislative sexual McCarthyism". She noted Democrats lead the GOP by 15 points among women on who should control Congress, while President Obama outpolled rivals by 20 points among women. Hell hath no fury.
Per cent earn more than their husbands
Per cent of Catholic women who have had sex have used contraception
Per cent of US college students are female American women