The 4th U.S. Circuit Court of Appeals on Monday declared as unconstitutional a North Carolina law requiring abortion providers to show a woman an ultrasound and describe the images in detail four hours before she can have an abortion.
The decision upholds a lower-court ruling from January and could send the issue to the Supreme Court.
"This compelled speech, even though it is a regulation of the medical profession, is ideological in intent and in kind," the 4th Circuit judges wrote in their 37-page opinion. "The means used by North Carolina extend well beyond those states have customarily employed to effectuate their undeniable interests in ensuring informed consent and in protecting the sanctity of life in all its phases."
The law requires abortion providers performing an ultrasound to place the image in the woman’s line of sight. The provider would then be required to describe the embryo or fetus in detail, even if the woman asked the doctor not to, and to offer the woman the opportunity to hear the fetal heartbeat.
The measure provided an exception only in cases of a medical emergency, and any physician who didn't comply with the requirement faced the loss of his or her medical license.
The American Civil Liberties Union, the Center for Reproductive Rights and Planned Parenthood Federation of America challenged the law, which legislators passed in 2011 over then-Gov. Beverly Perdue's veto.
U.S. District Judge Catherine Eagles stayed the narration provision of the law three months after the veto override, saying it likely violated the First Amendment. Other provisions, including the requirement for an ultrasound and a 24-hour waiting period before an abortion, were allowed to go into effect.
"The First Amendment not only protects against prohibitions of speech, but also against regulations that compel speech," the appellate judges wrote. "A regulation compelling speech is by its very nature content-based, because it requires the speaker to change the content of his speech or even to say something where he would otherwise be silent."
“We’re thrilled that the appellate court rejected this unconscionable attempt to intrude on the doctor-patient relationship,” Nancy Northup, president and chief executive 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.”