Transvaginal ultrasounds and state legislatures. What do I think?

As a follower of several news blogs on reproductive health (not to mention my part-time life as a public health student studying such topics), I have been thinking lately about the transvaginal ultrasound bill that has been generating buzz in Virginia. I understood from the news that the debate was over the fact that the bill included language about showing patients their fetus as an ultrasound image and having them listen to the heartbeat, something the pro-life side thought might deter them from going through with the procedure. The pro-choice side seems to be saying that forcing women to undergo transvaginal ultrasounds is akin to forced vaginal penetration (some are even saying rape). Please correct me if I'm wrong, but I feel that a nutshell would encase as much.

You can read more here: http://www.nytimes.com/2012/02/26/sunday-review/ultrasound-a-pawn-in-the-abortion-wars.html

My feelings are somewhat mixed. I do not feel that the legislature has any right to dictate what a doctor or health center's steps should be in providing abortion care, and I think this is the heart of the issue. But to compare transvaginal ultrasounds to forced penetration or rape sends the wrong message to women. My thought process is thus:

When I worked at reproductive health clinic that provided abortions in the first trimester, we always did a transvaginal ultrasound before the procedure. Of course, women always have the right to refuse medical treatment (see cobbs v. grant, etc.) but if one of our patients refused an ultrasound, she would not be allowed to obtain the abortion procedure. Ultrasounds were necessary because we needed to medically determine that the pregnancy was inside the uterus: Ectopic pregnancy, or pregnancy implanted somewhere other than the uterine wall, can be fatal. Not only will the ectopic pregnancy go undetected without an ultrasound (a pregnancy test will still show up positive in this case), the abortion will not work. In addition, certain types of abortion can only be performed when the fetus is a certain gestational age, and ultrasound is one of the most accurate means of measuring the length of a pregnancy. In other words, it must be determined that the dating is sufficiently early to have the either a vacuum aspiration or medication abortion successfully. In our clinic, if a pregnancy was not found in the uterus or if the pregnancy was too far along, we would refer the patient elsewhere for more advanced care.

Again, I do not believe that the legislature belongs in the exam room during an abortion procedure. Every health center must have the freedom to make their own rules, as mine did, about what medical policies should be. But using words like forced penetration and rape make it seem to the general public that transvaginal ultrasounds before abortions are always bad, when in fact, they can be quite helpful. The issue seems to be instead the idea of forcing women to look at the images and hear the heartbeat. In my clinic, we offered women a chance to see the image, but did not force them if they declined. Many wanted to and expressed relief at it not looking like they expected (e.g. not looking like the images on the signs of protesters they had seen).

I understand opposition to this bill, and I myself stand with such opposition. But we must be sensible in our arguments and think about the message we are sending to women about abortion. What are your thoughts?