State lawmakers in Virginia have amended a controversial ultrasound bill to remove language requiring women to undergo a “trans-vaginal” ultrasound before an abortion. 

The story attracted a lot of national attention, especially from liberal pundits, and even earned a satirical mention on Saturday Night Live.

The change came after hundreds of women protested outside the Virginia capitol, calling the requirement “state-mandated rape.” Backers of the legislation denied that characterization, but backed down from the requirement after Republican Governor Bob McDonnell withdrew his support. 

North Carolina’s ultrasound law, passed last year over the governor’s veto, didn’t provoke the same level of controversy. It doesn't include the words "trans-vaginal probe," either. But it effectively requires the procedure for many, if not most, abortions.

The new law requires an ultrasound before any abortion procedure. The woman has to be shown the image of the fetus, have the image described to her, and be offered the opportunity to hear the fetal heartbeat.

In early pregnancy—up until about 8 weeks—the only way a doctor can comply with those requirements is by using a trans-vaginal sonogram probe.

Rex Healthcare’s Rhonda Thomas is president of the NC Ultrasound Society. She says abdominal ultrasounds can’t see much before the two-month mark, especially if the patient has had prior pregnancies or is overweight.

“They’re just more sensitive,” Thomas said of trans-vaginal scans. ”That’s the test of choice.”

A trans-vaginal sonogram is also the only way to hear a fetal heartbeat in early pregnancy. Thomas says the heartbeat isn’t audible via stethoscope until about 10 weeks.

Planned Parenthood of Central NC spokeswoman Paige Johnson said her group lobbied hard against other parts of the bill, but didn’t make a big issue of the probe. That’s because her group uses them, too.

Johnson says Planned Parenthood requires an ultrasound before every abortion to “date” the pregnancy. NC law allows abortion only within the first 20 weeks, except when the mother’s life or health is threatened.

If it’s early in the pregnancy, Johnson says, the clinic’s doctors use a trans-vaginal probe for the scan. And most cases are early: she says 90 percent of abortions are performed within the first 12 weeks.

“Before the law, if a woman didn’t want to undergo the scan, she could go elsewhere,” Johnson said. “Now she doesn’t have that choice.”

A federal judge has temporarily stayed the part of NC’s law that requires the doctor to describe the ultrasound image to the patient. But the requirement for the ultrasound itself is law, as are the waiting period and the mandate that doctors counsel women seeking abortion about adoption services and the availability of food stamps.