Epistemic Domination: Alabama’s Mandatory Ultrasound Bill


This news article from the Montgomery, Alabama Times Daily on Alabama’s pending mandatory-ultrasound bill is an excellent illustration of just how thoroughgoing an attempt these efforts are at controlling women. They don’t just push women around physically, although they certainly do that too. Virginia’s recent mandatory ultrasound law made headlines for what many commentators (including Dahlia Lithwick in a stinging must-read rebuke at Slate.com) justly observed was its intent to force abortion providers to engage in a kind of rape. More subtly, though, mandatory ultrasound measures also betray an effort to control how women know their own bodies in an act of what I shall call epistemic domination.

Alabama Senate Bill 12, which bears the Orwellian name “The Right to Know and See Act,” would force women seeking an abortion to submit first to an ultrasound. Unlike Virginia’s law, Alabama’s bill would mandate that the woman would have to submit to whichever of an abdominal or vaginal ultrasound would in her particular case yield a clearer image of the shape of the fetus. The original version of Alabama’s law, like Virginia’s, would have required vaginal ultrasounds as a practical matter, since in the early stages of pregnancy an abdominal ultrasound is unlikely to provide the detailed image the law requires. Public outcry, however, has motivated the Bill’s sponsor, Republican Senator Clay Scofield, to offer the gracious concession of allowing the woman to choose which type of ultrasound she will be forced to undergo. All other provisions of the bill remain the same.

A high level of detail in the ultrasound is crucial to the Alabama bill. The bill mandates explicitly that the ultrasound technician has to “provide a medical description” of the images to the woman being forced to undergo the ultrasound. The text of the bill presents a painstakingly detailed scenario: it mandates that the technician’s description “shall include the dimensions of the embryo or fetus and the presence of external members and internal organs, if present and viewable.” The bill graciously allows women and their physicians the option of not looking at the ultrasound images if they don’t want to. But they must presumably listen to the description. The bill does not come out and say that ultrasound technicians have to verify and attest that women and physicians with averted heads don’t also have their fingers stuck in their ears, but it is certainly implied. Since an abortion provider’s failure to comply with the law (if passed in its present form) would entail a Class C felony and also give the father or grandparents of the aborted fetus a private right of civil action against the provider, someone at the provider would have to be prepared to give testimony in order to secure compliance.

As the article linked above makes clear, Sen. Scofield’s sponsorship of the bill is explicitly tied to his desire to bully women out of obtaining a procedure that is, last I checked, completely legal:

Scofield said he hopes that, if signed into law, his bill will stop some abortions. Though the bill states a woman can look away from the ultrasound image, Scofield wants her to see it.

“So she sees that this is not just a clump of cells as she is told,” he said. “She will see the shape of the infant. And hopefully, she will choose to keep the child.”

One of SB 12’s supporters is Alabama Republican Sen. Greg Reed, the chairman of the Senate Health Committee that voted to refer the bill out to the floor of the Alabama Senate for a vote. The article relates that Sen. Reed just happens to be vice president of Preferred Medical Systems, a Memphis, TN-area company that sells diagnostic medical equipment. A review of its website suggests that all it does is distribute new and used ultrasound equipment. Sen. Reed, when asked about his obvious potential conflict of interest, protested that there is none; the article quotes him as stating recently, “I do not sell ultrasound equipment in my business to clinics that are abortion clinics.” Sen. Reed’s statement may be true, but if it is, there is certainly nothing on its website specifically warning off potential customers who provide abortion services or even requesting that potential customers state the purpose for which they are obtaining the equipment.

Already, then, the Alabama Senate’s rationale is a moral and political train wreck. Its support for the bill is, by his own remarks, motivated by little more than the desire to punish women seeking to obtain a legal procedure (but one that would likely not be legal if it had its way). On top of that, it may create an additional market for a company in which one Senator has some sort of interest.

But there is something more sinister and gruesome at work in this and other mandatory ultrasound bills than just garden-variety profiteering off of bullying and shaming of women. Sen. Reed’s other remarks as quoted in the Times Daily help clarify that in large part, such bills seek to interpose a kind of “expert” knowledge in between women and their own bodies and, in so doing, to tell women that others know better than they what their own bodies are and what they mean. They exert a form of epistemic domination in which the legislator’s and the (presumed male) expert’s “Right to Know and See” and determine meaning trumps a woman’s perspective on her own body.

I have already remarked upon the detailed epistemic scenario encapsulated in the text of the bill itself, which envisions ultrasound technicians forcibly describing details of fetal structure to women whose heads are averted away from the ultrasound monitor. It turns the office of the abortion provider into a site of potential legal testimony, with all of the implied protocols of “official,” attested knowledge that go with that. There is also Sen. Reed’s stated desire that, beyond the verbal description, he really really really wants for her to see the shape of the fetus, to feel satisfied that she sees something he wants for her to see. The Alabama Legislature would be positively remiss if it did not avail itself of the opportunity to force pregnant women to exercise their “right to see” just what he thinks they should see.

In part, the Senator’s urge is premised upon the assumption that pregnant women are fundamentally ignorant; as the article states, Sen. Reed believes SB 12 is “a good bill that would help ‘a mother to understand that a live baby is inside her body'” and that it is “not just a clump of cells as she is told.” Proponents of SB 12 like Sen. Reed apparently feel that, since women are incapable of understanding their own bodies themselves and have to be told what their bodies are and mean by someone, the Legislature needs to bring the power of the State to bear to make sure that ultrasound technicians tell pregnant women a very particular story about their bodies, instead of (I guess) godless liberals who tell them they are carrying mere clumps of cells.

The assertion of epistemic privilege by force is nothing new; it is part of the story of privilege and oppressions generally. It is there when people of color are told they are being “touchy” or “playing the race card” and that they cannot possibly be trusted to see what is right in front of their faces. It is there every time we are told that law and public policy must be “color-blind” and cannot take notice of obvious, palpable inequities that fall squarely along lines of race, or gender, or sexual orientation. It is in a hundred other places besides. In all of these there is a normative epistemic component that holds that knowledge in and of bodies is unreliable, vague, not legitimate for good, official purposes. Of course, the “ideal” “disembodied” observer is very much embodied (white, male, straight, cisgender), but since that body is the ideal norm it hardly counts as a body. It is like the God of classical philosophical theology, invisible yet omnipresent. All other bodies are painfully visible curiosities, old pagan deities that need to be excised or brought into normative line by having their meaning dictated to them.

I am not a woman. I am a man. I shall never be pregnant, much less in a position to be forced by law to undergo an ultrasound. My body is not directly implicated in mandatory ultrasound laws. My perspective on this issue is shaped by the anger and frustration of the many women I know, both in real life and via social media, who feel justifiably angry and violated by these measures. Trust for women and their bodies is the paramount concern here.

As a broader matter, though, all of us with bodies (you know, or should know, who you are) are alienated from our own bodies under conditions of epistemic domination like these, even those who designate themselves as normatively ideal. To submit to the normative body ideal is to render one’s own body invisible, even to oneself. What we all need to struggle to produce is a form of politics and community that affirms bodies, not one that sees them as a constant threat demanding eternal vigilance and constant regulation, epistemic and otherwise.

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