MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Nearly two dozens states have laws that require or encourage ultrasound for women considering an abortion. People on both sides of the issue say ultrasound requirements are part of a larger effort to chip away at rights granted women in Roe v. Wade. Here in the studio to talk about the latest tactics in the battle over abortion: Carol Tobias of the National Right to Life Committee, Karen Tumulty of The Washington Post, and Nancy Keenan of NARAL Pro-Choice America.

MS. DIANE REHMAnd throughout the hour, we'll be taking your calls, 800-433-8850. Tell us how you feel about this very important issue. You can send email to drshow@wamu.org. Feel free to join us on Facebook or Twitter. And good morning to all of you.

MS. KAREN TUMULTYGood morning.

MS. CAROL TOBIASGood morning, Diane.

MS. NANCY KEENANGood morning, Diane.

REHMKaren Tumulty, explain what's in the Virginia law.

TUMULTYThe Virginia law would be -- Virginia would become the latest state to require that before a woman goes in for an -- when she goes in for an abortion, that an ultrasound be performed. And this is a process, at least early in the pregnancy, that requires -- it's invasive. It requires a probe. It's not the sort of just, you know, run it over your stomach.

REHMOver the stomach.

TUMULTYAnd, until this weekend, the governor, Bob McDonnell, who's a very staunchly anti-abortion, said that if this were passed by the legislature, that he would sign it if it got to his desk. But now, I think, the situation is very much in flux, and negotiations were going on late into the night last night to try and come up with some compromise. My colleague Anita Kumar in Richmond says that, apparently, there is a compromise that could be going to the floor at some point today.

TUMULTYBut, again, once -- the reason, apparently, is that the governor is saying he didn't realize how invasive the procedure actually is early in pregnancy.

REHMCarol Tobias, what kind of compromise do you think the governor might reach on this issue?

TOBIASI don't know that -- I don't know what's going to be in the compromise. I don't know that he needs to reach the compromise. These ultrasounds are already performed on women who are going in for an abortion.

REHMAre they medically necessary?

TOBIASIn many cases, yes. A National Abortion Federation survey said that at least 83 percent of abortion providers always do the ultrasound as part of the abortion procedure. Another 16 percent say that they do it frequently. So that's almost all abortions already where the ultrasound is part of the procedure, so this is not new. It's not forcing the abortion facilities to do something that they aren't already doing.

REHMIs the requirement that a woman see the ultrasound, is that new?

TOBIASWell, this law would not require her to see the ultrasound. The abortion provider would need to tell her that she can see it if she wants to. There are some states that do require her -- the screen to be positioned so that she can view if she wants to. And, right now, those states are Oklahoma, Texas and North Carolina. The Texas law is in effect. Oklahoma and North Carolina are in the courts right now.

REHMNow, are there any states that do require that the mother see...

TOBIASNo.

REHM...the ultrasound?

TOBIASNo.

REHMYou're saying no.

TOBIASNo. Those three states that require that the screen be positioned so she can see it, she can look away. She does not have to look at it.

REHMNancy Keenan, the Virginia law, what's your reaction?

KEENANWell, I think that we've seen already in Richmond the backlash, that they have overstepped on the Virginia ultrasound bill and that the governor himself is walking back on this. Look, no woman -- no woman -- should be forced to undergo a medical procedure that she has neither asked for nor is medically required.

KEENANAnd so what the politicians in Richmond, Va. and, quite honestly, in many legislatures across the country are doing are that they are requiring and getting between a woman and her doctor in requiring a procedure that she doesn't want, is not medically necessary, and that the ultimate outcome that they seek is basically to deny women legal, safe abortion. And that is their goal here.

KEENANAnd, again, women should have -- the position of NARAL Pro-Choice America is women should have the option if they ask for the procedure or a doctor recommends the procedure, but it should not be mandated to, again, have politicians and people in Richmond who have no idea what these women's specific situation is and what they're facing in their life to intrude in that very private medical decision.

REHMWhat about that point, Carol Tobias, that, you know, if a woman should choose to have a -- an ultrasound, that would be an option, but under these laws, it would be medically required?

TOBIASBut the ultrasound is already a part of the abortion procedure. If you call the Planned Parenthood of Virginia phone number, they have the description of the abortion and the process of -- I'm sorry, not the description of the abortion, but the process for the woman coming into the facility. They tell her that you come in one day. And you're going to have some lab work done, and you're going to have an ultrasound. You come in the next day, and they will do the abortion. So it is already a part of the process.

TOBIASAnd this is not an invasive procedure because, you know, the abortion itself is going to include curettage knives, tubes, vacuum machine, a suction machine, so the ultrasound itself is not any more invasive than these procedures. And it's already a part of the process that's included in the abortion procedure.

KEENANDiane, I would just say, there's a difference here. There's a difference in a law that requires a woman to undergo a medical procedure without her consent and a woman that walks in fully informed to access abortion care, and may say, I want one, I don't want one. There is nothing when she walks into a clinic that mandates that procedure.

REHMBut, Nancy, Carol has just said that if you call the Virginia Planned Parenthood organization, you will hear on the phone that, first, you will undergo an ultrasound.

KEENANI can't speak of what happens in clinics across this country. What I can speak to is this: Do we live in a country where politicians, whether they sit in Richmond, Va. or any other state House or the United States Congress, tell women what medical procedure they must undergo -- forced, forced procedure -- with one ideal in mind, to coerce, to harass, to intimidate these women to not access abortion care?

REHMKaren Tumulty.

TUMULTYYou know, well, it's interesting where this argument has gone in this country over the last few decades, that we're almost on, you know, almost four decades since Roe v. Wade. And starting in the 1990s, I think -- the big fight over partial birth abortion, I think that abortion opponents began to realize something, which is that, as long as they weren't going to get the law overturned in the courts that there were ways they could still score some victories.

TUMULTYAnd at one point, Ralph Reed -- the evangelical leader -- told me about 15 years ago, he said, look, when the question is framed with the focus on the women, we lose. And if the question is framed with the focus on the baby, we win. And so I do think that you have seen a lot of these laws being passed in legislatures across the country. Things -- and also, you know, parental modification laws, those have strong support, even among a lot of people who would call themselves pro-choice. So this argument gets won or lost as much on how you frame the question as it does on how you frame the answer.

REHMHow frequently in Planned Parenthood or other clinics across the country is sonogram not only perhaps recommended but now mandated, Karen?

TUMULTYWell, I think, you know, in the -- at this point, how many states is it? It's...

REHMTwenty-two.

TUMULTYSo it's -- you know, it would be mandated in those states. But, you know, there are certain circumstances in which, you know, a doctor would want to perform a sonogram, among other things, to figure out what the age of the fetus is because a lot of times, you know, a woman herself coming in for an abortion doesn't have -- you know, if you're just relying on her memory, you know, she could be off. And, again, so there are medical reasons that, I think, these things are performed.

REHMDo we have any idea, Carol Tobias, how many times women have changed their minds as a result of seeing these sonograms?

TOBIASI don't have that information with me. I would certainly hope that a woman after seeing the sonogram will change her mind. But the purpose of this legislation in Virginia is not to -- it's not going to stop the abortion. What it does is give the woman information so that she can make a decision. I don't know why there is concern about letting her see the ultrasound. Give her all the information that you can so that she can make an informed decision. If she changes her mind, I don't know why that's wrong. That's still her decision.

REHMWhat kind of information do you hope she will glean that could lead her to change her mind?

TOBIASWell, if she's looking at the ultrasound, she may see a head, she may see arms, she may see legs. She is going to see an ultrasound at some time in her life because grandparents have ultrasound pictures of their grandchild on the refrigerator. Parents are posting ultrasound pictures on their Facebook pages. She is going to see the ultrasound. Why not let her see the ultrasound of her baby before she makes this decision?

REHMAnd you're saying that, in every Planned Parenthood clinic across the country, one has to have an ultrasound before having an abortion.

TOBIASWell, the National Abortion Federation, about 10 years ago, had a study done that said at that time 83 percent of all abortion providers were already doing the ultrasound.

REHMCarol Tobias, president of the National Right to Life Committee. Short break.

REHMAnd the Virginia legislature is debating a new abortion requirement that, in fact, a sonogram or ultrasound examination take place before allowing a woman to proceed with an abortion. Here in the studio: Carol Tobias, president of the National Right to Life Committee, Nancy Keenan, president of NARAL Pro-Choice America, and Karen Tumulty of The Washington Post.

REHMWe, as yet, do not know what is currently going to come before the Virginia state legislature. Last night, apparently, Virginia's governor backed away from the legislation somewhat, but we don't know what the current compromise being put before that legislature might be. Nancy Keenan, I was wondering about how many states have this mandatory sonogram. How many suggest it as optional?

KEENANRight. Right now, there are probably eight states that have a mandatory ultrasound, and there are some that have an optional ultrasound. I think the issue here, though, Diane, is that in 2011 we saw twice as many anti-choice pieces of legislation in state legislatures across the country and that that increase -- these are politicians that ran on jobs and the economy, and then the first thing they did was take on women's reproductive health and reproductive choice. And so the ultrasound is just one of many.

KEENANAnd when we look across this country, which NARAL does very open and takes a look at what the trend is, we are seeing these politicians get between a doctor, a woman, her family and her God, that they think they understand that no better than most women, all women in this country who walk into that doctor's office and access this care. And I think that's -- that flies in the face of freedom, flies in the face of privacy in this country, and it is just -- it's unacceptable that politicians think they know better than women and their families and their doctors when it comes to abortion care.

REHMKaren.

TUMULTYYet these laws do take different shapes in different states. And I think Texas is probably the most aggressive on this front, in that the woman is also required to listen to the fetal heartbeat and as well to listen to a description of what exactly she's looking at.

REHMDenise Couture, the producer who worked on this program, has just informed me that 22 states encourage ultrasound, seven require, and that does not include Virginia. I have an email here from Sheila, who says, "Please determine whether ultrasound probe is indeed a part of the abortion process. I have had abortion," she says, "and have never had an ultrasound." Carol.

TOBIASWell, we can go back again to the National Abortion Federation doing a survey of their own of the people who do the abortions. Eight -- this was 10 years ago, so things have not gotten, you know, less, and they're doing it more often. Eighty-three percent always did an ultrasound as part of the abortion.

REHMEighty-three percent of...

TOBIASThe abortion providers said that they always do ultrasound as a part of the abortion procedure. Another 16 percent said that they will do it sometimes. So there were 99 percent of the abortion providers saying that, yes, they do the abortion -- the ultrasound either always or some of the time. And it's necessary because you have to know how old the baby is, how big the baby is, how the baby is positioned because you have to make sure that if you're going to remove the body parts from that baby, that all parts have to come out.

TOBIASIf this is an early abortion where you're talking about the chemical abortion, RU-486, they have to make sure of, again, of the age of the child because if you give that woman a pill and the child is older than seven weeks, then it's very dangerous. I mean, it's dangerous anyway, but it's more dangerous if the child has reached -- has gone past a certain age. So the ultrasound is a protection for the person doing the abortion, so that they can see what they are doing. So it's just part of their procedure, actually, to protect themselves somehow.

REHMSuppose a woman says, I don't want to have an ultrasound. What happens, Nancy?

KEENANWell, again, we do not know every situation as we walk into those clinics, and that women -- again, women should be able to ask for it if they want it or if a doctor recommends it. There is a difference between recommending for medical purposes and requiring. These are -- you know, these are politicians who want to get into every single clinic office in this country, and it's wrong. It is wrong to mandate a medical procedure against her will, and that's what's gong on.

REHMMatt in Plano, Texas, asked, "If this procedure, ultrasound, is already performed, then why do we need law or a 24-hour waiting period?" Karen.

TUMULTYWell, that's also a very good question. And I think, you know, again, I think this is -- as much as anything, it's trying to sort of frame the debate and put the focus on, you know, the -- essentially the, you know, whether you're talking about the woman's right or whether you're talking about the fetus. And this is certainly something that, you know, they've been winning in state legislatures because of the way the question is framed.

REHMWhat about Texas' law? I understand that, as it currently stands, Virginia's law would provide offers to see the ultrasound, whereas, Texas requires it. Is that so, Nancy?

KEENANThat is correct, but, I think -- again, let's take a look at what this is doing. First, they're telling the doctor he or she must tell this patient something about this ultrasound and must perform a procedure they did not ask for. Number two, they have to say, well, do you want to see it or hear the heartbeat? So, again, putting this woman in this position of -- in a decision that she's already made to access abortion care, now, you've got to see it or hear it. Again, coercion.

KEENANAnd then the third thing in Virginia law, they're going to take that sonogram and place it in her medical files. For what purpose? For what purpose? I am just -- I think women in the backlash that you're seeing in Richmond, 2,000 people show up. They have overstepped on this.

REHMWhat about the medical community in Texas, how they reacted?

KEENANThe same way. I think that they find that this intrusion in their practice, that you have politicians who think they are the doctors.

REHMWhat about that, Carol?

TOBIASI'm confused as to why people think women shouldn't get all the information that's available. We are trying to tell them that we know best. You come in to this abortion facility, and we will tell you what you need to know and what we think is best for you. Why not give her all the information and let her make the decision?

KEENANIf that was the case, then the anti-choice forces in this country would not be trying to outlaw abortion. If we really believe we wanted women informed and consenting, then let her decide and stay out of it and have politicians stay out of it.

TUMULTYYou know, it's interesting, though, even though the last decade-and-a-half have seen all these additional restrictions taking place on the state level, the number of abortions in this country is still something like 1.2 million. And I, in fact, just checked with these guys, and so it isn't like this is doing much to actually decrease the overall number. And, again, with things like RU-486, you know, it -- the number of providers is dropping.

TUMULTYThere are large swaths of the country now where there are no abortion providers left, and yet the number of abortions still, you know, remains almost as high as it's ever been.

REHMCarol, laws in Oklahoma and North Carolina are being challenged, on what grounds?

TOBIASI think on the grounds that they don't want to mandate these medical services.

REHMAnd, Nancy.

KEENANYeah, absolutely. Again, intrusion of politicians and government into private medical decisions.

REHMAnd...

KEENANAnd under Roe -- under the law of the land that abortion is legal in this country, that these kinds of mandates are in violation of that right to privacy and freedom.

REHMHere's an email from Mary, who says, "It's the height of outrage that contemptuous rank-pulling males, both in government and the church and who insists they want government out of our lives, are trying to invade women's lives in this way. This is total hypocrisy and a waste of everyone's time." How do you respond, Carol?

TOBIASWell, I'm certainly not a male. I'm not in government. I think unborn children should be protected. And, quite frankly, I am happy to have a debate over -- you know, Karen was talking about framing the issue in women's rights versus, you know, the rights of the unborn child. There are -- we've had 54 million abortions in this country since 1973. There are millions of women in this country who are suffering from their abortion.

TOBIASYes. I'm sure there are women who make this decision. They have the abortion. They don't look back. But there are millions of women who are suffering, some physically because of the abortion. They may never be able to get pregnant again, or they have some other complications, but many of them psychologically and emotionally. They drive by a school, and they see kids playing in the playground. And they say, my baby would be 6 years old right now. He would be out there playing.

TOBIASAnd it's something that has come -- it comes back. You know, they will never see their child, their daughter go to a prom. There are reports of attempted suicide, increased drinking and drugs trying to cover up the pain, so I want -- I would be more than happy to talk about how this impacts women. And I think it's a whole -- it's not an underground. I mean, they're very vocal about how the abortion decision affected their lives, and they regret that decision. So I would certainly be in favor of giving them all the information possible before they make that choice.

REHMNancy.

KEENANWell, I think it's very presumptuous that anyone sitting at this table or in any legislature thinks they know and understand the situation of every woman in this country and that we somehow think we know better than they do. Look, women are thoughtful. They evaluate their options. They make a decision, and they make that decision with their family, their doctor and their god. And to think that anybody else knows better than they and their situation in this country is unacceptable.

REHMKaren, how has this issue, or will this issue, enter the presidential race?

TUMULTYWell, you know, I've been out on the campaign trail quite a bit this year, and I really expected this to be an election that was all about the economy. And over the last few weeks, it's been much more about, you know, not necessarily this specific issue but about contraception and the role that, you know, the part that it plays in the implementation of the new health care law. I -- you know, Rick Santorum is out there talking about amniocentesis.

TUMULTYAnd even a few weeks ago, when I was in Florida, I heard Newt Gingrich say that stem cell research is really just an effort to use science to desensitize this country to the killing of babies. Now, this is the same Newt Gingrich who, in 2001, was arguing that President Bush did go further than he did on stem cell research and allow the use of embryos that were discarded in fertility treatments. So I -- you know, I really have been sort of surprised at the degree these issues are coming up.

REHMKaren Tumulty of The Washington Post, and you're listening to, "The Diane Rehm Show." Further, Karen, isn't Gov. McDonnell being eyed as a possible vice presidential candidate? And could that be why this whole thing has gotten muddied up?

TUMULTYWell, he is somebody who ran as a very staunchly anti-abortion candidate, so this is not a surprise. But he is a great, rising star in the party. Virginia is very much a swing state in this presidential election. And so, you know, I do think that that is one reason that so much of the rest of the country is watching just exactly what he does on this.

REHMAnd as to Rick Santorum, how come he approves of sonograms but not amniocentesis?

TUMULTYBecause he says that amniocentesis is used as a means of essentially, you know, finding defective children and getting rid of them. And the -- you know, the research does suggest that in -- between 80 to 90 percent of cases where a woman gets a diagnosis through amniocentesis of Down syndrome, for example, that she will choose to have an abortion.

TOBIASI was going to say, Diane, this is a contrast between President Obama, who supports family planning, who supports insurance coverage for birth control, so when we're talking at this time in presidential election that women can access birth control in this country without a co-pay, and then he is supportive of a woman's right to choose abortion care. And the contrast in this race, whether it's Santorum or Romney or Gingrich, no to family planning, no to insurance coverage or birth control, no to abortion care in this country. That is the contrast here that we have going into 2012.

TUMULTYThat's a little bit overstating in that. I mean, Rick Santorum, when he was in Congress, voted for Title X funds for contraception, for low-income women. He also was a great champion of family planning programs overseas. But the -- you know, the whole contraception debate has come in because of a requirement in the new health care law that employers provide this to their employees for free as part of their package of services that are covered.

REHMBut he has said, has he not, that if it were up to him, there would not be contraceptive use?

TOBIASBut, again, it is a public policy matter. He has voted in favor of Title X funding, and, you know, so his record of how he has actually voted would suggest that he sees a difference between his personal beliefs and what the government should be doing.

KEENANBut, Carol, I understand, though, that Santorum, as has Romney, all have said they want to defund family planning and Planned Parenthood specifically, so the vote that was many years ago is one thing. Right now, they are advocating on the campaign trail: defund family planning Planned Parenthood, don't have access to birth control for women.

REHMCarol.

TOBIASThey want to defund Planned Parenthood because Planned Parenthood is the largest abortion provider in the country. The debate over Obamacare and whether health care -- excuse me -- contraceptives should be provided comes down to the First Amendment and religious freedom. We have a president who is trying to tell religions that they have to do something, that they have a moral objection to it.

REHMWhere are you on the issue of family planning and the use of contraception?

TOBIASWe have no position on it. If someone wants to use it, you know, no, we have no position on family planning or birth control. We object to tax dollars being used to pay for abortions, going to organizations that perform abortions. We have no position on family planning or contraceptives.

KEENANDiane, there's a bit of hypocrisy in that. And the fact is, is that if you want to reduce the need for abortion in this country that you should have access to birth control and make it readily available to women.

REHMNancy Keenan, president of NARAL Pro-Choice America, Carol Tobias, president of the National Right to Life Committee, Karen Tumulty of The Washington Post. Short break. When we come back, your calls and emails.

REHMAnd as we talk about laws across the state requiring or recommending ultrasound examinations prior to abortion, we have here in the studio: Nancy Keenan of NARAL Pro-Choice America, Karen Tumulty of The Washington Post, and Carol Tobias. She is president of the National Right to Life Committee. Let's go first to Austin, Texas. Good morning, Cathy.

CATHYGood morning.

REHMHi there.

CATHYHi. This is kind of a very touchy subject, but I just thought I needed to speak out. I am pro-choice, but I've also had -- I mean, I have had an abortion. And I think that it is in the woman's best interest to be fully informed. I wish that I have had an ultrasound shown to me. I may have made a different choice. It's an emotionally haunting experience to have an abortion.

CATHYI have many other healthy children, and -- but I think that it's absurd that people think that women shouldn't know what's going on with their bodies. I mean, they're fully -- they deserve to know what they have -- the reality of the choice that they are making.

REHMAll right. Nancy Keenan.

KEENANYeah, Cathy, thanks for that. I don't think anybody is saying that women shouldn't have information. Women should have information. And in the case of this, they can ask for the ultrasound, or a doctor can recommend it. But she is not being forced to have one. And that's the issue at hand here. Is the -- is a woman being forced to undergo a procedure, an ultrasound, against her will for the pure purpose of dissuading her from accessing that abortion care? That's what choice is about. You get to choose.

REHMRight. To Baltimore, Md., good morning, Dan.

DANHi. Good morning. So I just had a couple of issues to raise in response to the pro-life position here. They talk about informed consent and a woman's need to know. And, as the last caller just mentioned, when doctors do these procedures -- I'm a physician. I do these ultrasounds. I don't do the D&Cs. But when we are doing these procedures, the patient is always involved in both the procedure, and they are offered information about those procedures. The difference is that if you are compelling them to do it by politics, then you take the consent out of the informed consent.

DANSo they no longer have the right to basically either refuse the procedure or refuse to see it. The other issue is the notion that the procedure is not invasive and nothing compared to an abortion. The procedure itself is using a intra-vaginal probe. It's about eight inches long, about a centimeter and a half in diameter. And to get images on fetuses at early ages, you have to position the probe and push against the cervix, and it is very uncomfortable in many circumstances. So it's not completely benign.

DANAdditionally, a lot of these first trimester abortions are done chemically with methotrexate and certainly beyond seven weeks. And we do it frequently for tubal pregnancies. So the notion that, you know, people are going to attack these women with knives, which is also a known mischaracterization of a D&C and that it is not nearly -- or that the ultrasound is completely insignificant compared to everything else, I think, is an exaggeration as well.

REHMAll right. Thanks for calling. Carol.

TOBIASWell, the abortion does involve a knife being inserted into the uterus. I'm not sure how that can be less invasive than the ultrasound.

REHMDan, do you want to comment on the knife issue?

DANYeah. It's a -- the curettage is done with a loop that has a edge on it, but it is a scraping tool. And when you use the connotation of knife, you're going to cause laypeople to start thinking that people are inserting steak knives into people's vaginas and uteruses, which is completely a mischaracterization of the fact.

TOBIASIt's still part of -- the ultrasound is still part of the abortion procedure already. I don't see why giving the information to the woman is causing so much trouble.

REHMHere's an email from Sheryl in Bethesda, who says, "During the course of treatment for breast cancer, I had to have transvaginal ultrasound yearly for five years while I was on tamoxifen. I want to tell your panelist, who announced the procedure is not invasive, that it's not only invasive, but can be extraordinarily painful. How dare someone who has never had the procedure talk about it blithely in that way?"

TOBIASI have had the procedure. I've had the ultrasound. And I did not say it -- I don't believe -- excuse me, if I said it wasn't invasive, then I would try to, I guess, change that to say that it is part of a procedure that is also invasive.

REHMNancy Keenan.

KEENANAgain, a woman walks into her doctor's office. She's accessing legal care here, and she has a choice. She has a choice of whether to ask for the procedure or that he or she recommends it as medically necessary. This is forced, forced by politicians, a procedure, and it's just unconscionable to me. It's assuming that women are not informed. It's assuming women don't think about this. It's assuming that women have not talked it through with their doctor and their family and their god.

KEENANAnd it assumes that we know better. Somehow, politicians or others know better than this woman about the procedure, her body and what she wants to access.

REHMCarol.

TOBIASI just wanted to respond because Nancy keeps talking about the relationship between the woman and her doctor. This is not her family doctor. This is someone that she has probably never met before, and she's hoping she's never going to see him again. This is someone who doesn't know her name until he walks into the room and looks at the chart that has her name on it. This is not a relationship, and she's not discussing this with the family doctor. This is something that she hopes she never sees again.

KEENANCarol, I am flabbergasted that you think you know every woman's situation in every place in this country as she walks into a clinic, a doctor's office. How presumptuous to think that we know. We know what her circumstances are. We know what her situation is, and that, for some reason, you believe that a politician or you are better at making decision for her than herself.

TOBIASI want her to have the information so she can make a decision.

REHMHere is a posting on Facebook. "The issue," it says, "is about health care cost and access. An ultrasound significantly increases the cost of the termination. It does not, however, decrease the number of terminations." That goes back to something you pointed out, Karen.

TUMULTYAnd, you know, another thing that technology has wrought in the last couple of decades is, in fact, RU-486, which is, you know, in the earliest stages of pregnancy, a woman can perform an -- you know, she can have an abortion with a pill. And so, you know, it has made the procedure, I think, at least for those women who are eligible for RU-486, you know, a lot less invasive. And I think a lot of -- you know, a lot of abortion opponents are afraid it makes it too easy.

REHMAren't there some other tactics being used by those who are anti-abortions, for example, the size of the building, the shape of the building, that sort of thing?

KEENANIn a number of states, they have passed requirements that abortion clinics look a lot more like hospitals and live up to some of the same standards. But those provisions have gotten support because, just as you can argue whether this is a question of, you know, trying to stop abortions or whether it's informed consent, you know, people have been able to argue that this is a question of medical safety.

KEENANParental notification laws are very popular across the country. So, you know, again, it's -- I'm back to my original point, which is this is all about who gets to frame the question.

REHMAll right. To Chuck in Louisville, Ky., good morning to you.

CHUCKGood morning, folks. Just wanted to throw yet another male opinion into this since that's pretty much all that appears to be, you know, getting airtime in Congress. I just wanted to say that I'm appalled by just another (word?) overreach by a largely religious agenda. Planned Parenthood has been (word?) as some sort of boogeyman for the religious life right without, you know, accurate information or anything about what they do for years.

CHUCKJust take Jon Kyl when he was on the Senate floor talking about, you know, over 90 percent of what they do is abortions. That's pure BS. It was called on a bad night and then stated that he didn't mean it to be a, you know, accurate statement. I'm also horrified at the attempts of some, like your guest Carol, to minimize the garbage legislation like this. Most abortion providers are doing this or that -- that's a junk argument. Everybody knows that any and all information will be available to anybody who asks for it.

REHMAll right. Thanks for your call. Carol.

TOBIASWell, I think it is a fact that of the women who go to a Planned Parenthood facility look because they are pregnant, and they are looking for either prenatal care or adoption help or an abortion. Ninety-seven percent of them get the abortion. So Sen. Kyl misstated the fact that it wasn't all clients coming to Planned Parenthood. It was pregnant clients coming to Planned Parenthood.

REHMAm I correct, or am I totally off base when I understand that only 3 percent of Planned Parenthood's work is involved in abortion, Nancy?

KEENANYeah, that is correct. And I think that, again, many people in this country access their basic health care through a Planned Parenthood kit clinic whether that's access to birth control in the case of access to just their basic medical needs that they have in a community. So, indeed, there has been a misrepresentation of what kind of health care they provide out there including, yes, abortion care for those women who want to access that.

KEENANBut, again, I want to go back to the hypocrisy here about when Planned Parenthood is to make available to women contraception, that they can plan their families, that they can reduce unintended pregnancy and thus reduce the need for abortion in this country. That is a good service to the women and men and families in this country.

TUMULTYYou know, ironically enough, this fight is probably the best thing that has happened to Planned Parenthood in a long time in that their fundraising has soared. And, you know, increasingly, you also -- in talking to Republicans and conservatives, you realize this is really not a road they necessarily wanted to be going down to in a year when they really just wanted to be talking about the economy.

REHMHere is an email from Eleanor in Fredericksburg, Va., who says, "Does everyone forget that abortion is legal? I personally know of a case where Planned Parenthood counselors encouraged a young woman to carry her baby to term. They helped the woman make her decision, which may or not be abortion." Carol.

TOBIASI'm glad they were able to do that. It does not happen very often. And as to the 3 percent services that Planned Parenthood puts out there, they are lumping it together because, if a woman comes in to their facility, they will do a pregnancy test. They will give her birth control pills. They will do several different things, maybe six or seven of what they would consider to be services, and the abortion is one of them.

TOBIASSo, obviously, I mean, not obviously, she came in looking for the abortion, and they gave her several different services at one time, and they would then count the abortion as one of many, even if that's the reason she came.

REHMI don't understand that if, in fact...

TOBIASAbout 12 percent of their clients actually do get abortions.

REHMTwelve percent you're saying, and yet Planned Parenthood says 3 percent of its overall activity.

TOBIASYes, but one woman may get five or six or seven different services.

REHMBut that doesn't change the statistic of how many actually get abortions, Karen?

TUMULTYWell, and again, it's -- the fact is that it's one of the most common medical procedures at this point performed in this country, and it continues to be despite all this -- you know, all this running around that politicians have been doing on it in state houses.

REHMAll right. To, let's see, New Albany, Ind. Ruth Anne, you're on the air.

RUTH ANNEYes, hi. Thank you. I just wanted to say that I believe that this psychological damage argument is somewhat of a straw man. I know several women -- I'm in my 60s myself, so I'm obviously out of the loop here, but -- for child bearing, but I have daughters and granddaughters. But I know several women who've had abortions, you know, earlier in their lives with absolutely no regrets. They knew at the time it was -- that they could not be mothers. It was the right thing for them.

RUTH ANNEAnd I know a couple women who gave their children up for adoption, who had more psychological stress because they knew that their child was walking around and, you know, they couldn't see him. So I just think that's kind of drummed up.

TOBIASIt really isn't. If someone here wants to give out an email address or a phone number and encourage your listeners who regret their abortion to call, you will be overwhelmed.

REHMAll right. And to Detroit, Mich., good morning, Barbara.

BARBARAGood morning, Diane. Thank you for taking my call.

REHMSure.

BARBARAI have a comment on two different aspects, and that, first, my husband works for the Catholic Church. And when I wasn't working on my own, we depended on his insurance. And, of course, we couldn't get contraceptives coverage or anything of the nature. Now, part of my contraceptive usage was because I had a physical problem and needed them. I still couldn't get them, and I feel that that was my personal rights and my medical needs versus the religious rights of the church to deny the insurance company to allow me to purchase anything extra to cover what I needed.

BARBARAAnd that's -- it's not a religious freedom issue. It's an individual freedom issue to choose to use a contraceptive. It's available. And if the insurance company is paying for it, not the church, then it's not damaging their freedom. Second, I think we're losing perspective here. I want you to talk to people like Ruth, who are 60 and over. My grandmother is 96 years old.

BARBARAI remember when I was 10 or 12 years old, after Roe v. Wade, she was celebrating that it passed because she remembers women in alleys getting abortion. If we continue to make abortions more difficult or to try to outlaw them, this is what we will have again.

REHMNancy.

KEENANWell, I was just going to say I -- you know, I agree. I think the Obama administration was right to ensure that millions of women in America will now have insurance coverage for contraception. And how this plays out literally, because of the president's decision, those women, including nurses, janitorial staff, college instructors, they're going to get access to contraception with respect to people's religious beliefs. But the fact is they're not going to have to ask their bosses for permission now to access birth control. And I think the Obama administration's decision was right on.

REHMLast word, Carol.

TOBIASThe administration is trying to force people to -- religious people to do something that they disagree with. If they can tell the church that you have to provide contraceptives, they can tell National Right to Life that we have to provide abortions because it's considered a preventive service. This goes way too far and needs to be overturned.

REHMCarol Tobias of National Right to Life Committee, Karen Tumulty of The Washington Post, Nancy Keenan of NARAL Pro-Choice America. Thank you, all.

KEENANThank you, Diane.

TOBIASThank you.

TUMULTYThank you.

REHMAnd thanks for listening, all. I'm Diane Rehm.

ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Nancy Robertson, Denise Couture, Monique Nazareth, Nikki Jecks, Susan Nabors and Lisa Dunn, and the engineer is Tobey Schreiner. A.C. Valdez answers the phones. Visit drshow.org for audio archives, transcripts, podcasts and CD sales. Call 202-885-1200 for more information.