Whether a woman should or should not have an abortion is a choice that people make and others like to have opinions about. We know this – and have done for some time. Hence, terminations are still illegal in many parts of the world, including Malta, El Salvador, and Egypt, and highly restricted in even more – the overturning of Roe v Wade in 2022 has enabled 26 US states to have either hostile or illegal policies against it.

Sometimes, the people who are trying to influence your decision are a little closer to us. It might be your partner, a family member, or a friend. One person it really shouldn’t be, though, is your doctor. And yet, far too often this seemingly obvious fact is being ignored.

We see this reality reflected in the first episode of Margo’s Got Money Troubles, Apple TV’s latest comedy drama starring Elle Fanning, adapted from Rufi Thorpe’s novel of the same name. The show tells the story of Margo, a college student who gets pregnant after sleeping with her married professor, who strongly advises her to get an abortion in the place of “aborting [her] future”.

Margo goes to the doctor, who swiftly sticks a speculum inside her, tells her that the sound she can hear is the heartbeat, before turning the screen around so that she can’t help but stare right at the foetus she was about to abort. “Do you want a copy of the photo?” he asks. Margo says that she does. After handing her the scan, the doctor blithely says, “Do we know what we want to do about the pregnancy?”

It’s unclear in the scene whether or not this is intended to be as outrageous as it comes across to viewers. In the end, Margo does decide to keep her baby, a decision that the series very much implies is hers. But as someone who has had a termination, I found myself wanting to scream at my TV in fury at the doctor’s gross misconduct. Not least because I also know women who’ve had experiences like this. They’ve gone into abortion clinics, already feeling anxious and afraid, only to have careless doctors show them scans they didn’t ask to see, and spell out sounds they didn’t need or want to hear.

The psychological impact of this is almost impossible to overstate. When I went into the clinic for my abortion, I was fortunate to have an understanding female doctor who didn’t question my decision, nor did they show or tell me anything I didn’t ask to see. Had things panned out differently as they had done for some friends, I’m not sure I would’ve been able to cope, particularly because my experience was already deeply traumatic – I’d got pregnant as a result of being sexually assaulted.

It wasn’t that being shown a scan would’ve made me doubt my choice. I was young and the victim of rape; there wasn’t a second I considered doing anything other than terminating my pregnancy, and I felt grateful to be living in a country that enabled me to be so resolute. I knew I could, so I did.

But the months and years that followed my abortion were characterised by a singular kind of PTSD, one bound up with sexual trauma, denial, and blame. Seeing a scan or hearing a heartbeat would’ve exacerbated that to a potentially dangerous degree, driving home the reality of the situation I’d been put in, and the extent to which my body had been so cruelly and callously violated.

I was spared that additional layer of damage. But not everyone is quite so lucky. In a piece published last year, comedian and writer Grace Campbell recalled how, without warning or permission, her male doctor showed her a scan of the foetus she was about to abort. Anecdotally, as I have said, it’s also alarmingly common among friends who’ve had terminations.

“This is something that comes up more than people realise,” says Dr Nadia Ahmad, a doctor specialising in women’s health and founder of The Weight Care Clinic. “We have had patients come to us who were shown scans elsewhere in a way that felt unnecessary or overwhelming. For some, it added a lot of distress at an already difficult time. When it is not clearly explained or is not something they have chosen, it can feel quite intrusive. Psychologically, it can heighten emotions like anxiety, guilt or conflict, especially if someone has already made their decision.”

In some cases, women are being forced to take extra care to ensure their emotional safety in appointments and avoid scenarios like this. “I had a termination last year and was told I needed a scan because I made the mistake of divulging that I still breastfeed my youngest,” says Laura*, 40, in Dartford. “They said I had to go and have a scan to get the tablets. I ended up using a different provider to get the tablets, and then lying on the breastfeeding question, to get the tablets; I just felt it would be psychological torture to do a scan and then end the pregnancy.”

To be clear, none of this is standard practice – and doctors who show women scans without their consent are violating their patients’ rights. In its patient information section online, the Royal College of Obstetricians & Gynaecologists outlines how scans should be dealt with in abortion settings: “You may be offered, depending on your individual situation: an ultrasound scan to date the pregnancy more accurately,” it states, adding: “Before an ultrasound is undertaken, you should be asked whether you wish to see the image or not.”

I just felt it would be psychological torture to do the scan and then end the pregnancy

Laura*

It saddens me that this is something women are being put through. Even if it isn’t being done with any intent to get get someone to think twice about their decision, it is still something that feels careless and actually quite brutal. Physical and emotional agency should be at the forefront of every medical decision surrounding an abortion. You’d think that would be a given in this country, although it was only last month that peers in the House of Lords voted to decriminalise abortions under a 164-year-old Victorian law that campaigners have been trying to overturn for years, so perhaps we’re not as advanced as we think we are.

“It is wrong to assume that women seeking an abortion never want to see a scan; what matters is choice,” says Dr Tracey Master, the College of Sexual and Reproductive Healthcare’s spokesperson on abortion care. “Best practice guidance for abortion services in the UK is clear that a routine script should be used to tell a patient that they will not see or hear anything they do not want to, unless they ask. This approach ensures women are not forced or pressurised into viewing a scan, which could be deeply distressing for some.”

Master continued: “Services have a responsibility to ensure these safeguards are followed consistently. It is unacceptable for anyone to be shown an ultrasound without their consent, and we would be deeply concerned by reports of this happening. Respecting informed patient choice must always be central to abortion care.”

Margo is, of course, a fictional character, one who ultimately made the decision that was best for her. Still, she represents women who exist in the real world. Women who gets pregnant in unexpected circumstances and who are unsure about what to do. And so I still can’t help but feel an incandescent fury at any doctor who takes a woman’s agency away from her and steals the opportunity of having a different kind of life. One that, deep down, she might have wanted all along.

*Name has been changed