RICHMOND, Va. - In a unanimous decision, the United States Court of Appeals for the Fourth Circuit has permanently blocked a 2011 North Carolina law that would force women to undergo a narrated ultrasound before receiving abortion care. Today’s ruling states that "the state cannot commandeer the doctor-patient relationship to compel a physician to express its preference to the patient."

The law—which requires abortion providers to display the ultrasound and describe the images in detail to every woman before performing an abortion, even if the woman objects— was preliminarily blocked in October 2011 following a lawsuit filed on behalf of several North Carolina physicians and medical practicioners by the Center for Reproductive Rights, American Civil Liberties Union, ACLU of North Carolina Legal Foundation, Planned Parenthood, and the firm of O’Melveny & Myers.  The measure was later permanently struck down as unconstitutional by a federal district court in January 2014.

North Carolina’s coercive ultrasound law violates the First Amendment rights of physicians by forcing them to deliver politically motivated communications to a patient even over the patient’s objection. Today’s ruling affirms that "transforming the physician into the mouthpiece of the state undermines the trust that is necessary for facilitating healthy doctor-patient relationships and, through them, successful treatment outcomes."

"This law is about trying to shame a woman out of having an abortion, pure and simple," said Louise Melling, deputy legal director for the ACLU. "Politics don’t belong in the exam room, and a doctor shouldn’t have to humiliate a woman because some politicians disagree with her decision."

"We’re thrilled that the appellate court rejected this unconscionable attempt to intrude on the doctor-patient relationship," said Nancy Northup, President and CEO of the Center for Reproductive Rights. "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."

"Today’s ruling marks another major victory for women and sends a message to lawmakers across the country: it is unconstitutional for politicians to interfere in a woman’s personal medical decisions about abortion," said Cecile Richards, president of Planned Parenthood Federation of America. "Politicians are not medical experts — but politicians have written this law with the ultimate goal of restricting access to safe, legal abortion."

The North Carolina mandatory ultrasound law, which the General Assembly passed in 2011 over the veto of then-Governor Bev Perdue, is one of the most extreme ultrasound laws in the country.  In November 2013, the U.S. Supreme Court refused to review a similar law from Oklahoma, allowing the ruling from the Oklahoma Supreme Court blocking the measure as unconstitutional to stand.

While the law would allow the woman to “avert her eyes” from the ultrasound screen and to "refuse to hear" the explanation of the images, the provider would still be required to place the images in front of her and describe them in detail over her objection. The North Carolina law applies even if a woman does not want to see the ultrasound, and makes no exception for rape, incest, serious health risks or severe fetal anomalies.

Harmful and unconstitutional restrictions like these further underscore the need for the federal Women's Health Protection Act (S. 1696/H.R. 3471)—a bill that would prohibit states like North Carolina from imposing unconstitutional restrictions on reproductive health care providers that apply to no similar medical care, interfere with women’s personal decision making, and block access to safe and legal abortion service.