The U.S. Supreme Court, in two different cases in little more than a week, has refused to review decisions by the Oklahoma Supreme Court striking down some of the most restrictive abortion laws in the country.

The justices’ most recent ruling came on Tuesday in Pruitt v. Nova Health Systems, in which the state’s attorney general unsuccessfully sought to revive a state law mandating vaginal (typically using a probe) or abdominal ultrasounds, accompanied by a simultaneous explanation to the pregnant woman of what the ultrasound depicts, before an abortion may be performed. The law also required that the images be displayed so that the woman may view them.

Last week, the high court declined to review Cline v. Oklahoma Coalition for Reproductive Justice, in which the state supreme court invalidated restrictions that, it said, effectively eliminated medical—or nonsurgical—abortions.

In both cases, the justices offered no explanation.

In the Pruitt petition, Oklahoma special assistant attorney general Teresa Stanton Collett argued that the state ultrasound law was substantially similar to informed consent requirements upheld by the justices in their 1992 abortion decision, Planned Parenthood of Southeastern Pennsylvania v. Casey. The Casey court, she wrote, found no constitutional problems with “requiring a physician to inform a woman at least 24 hours prior to an abortion of the ‘probable gestational age of the unborn child’ and availability of printed materials ‘describing the fetus.’ “

However, the challengers to the law, led by Stephanie Toti of the Center for Reproductive Rights, countered, “This is no garden-variety ‘informed consent’ law.” Oklahoma already had an abortion-related informed consent law on the books when the ultrasound law was enacted, she said.

“Under its revised law, Oklahoma now requires a woman to undergo an ultrasound examination and, while she is physically exposed during this often invasive and uncomfortable procedure, to listen to a narrative designed to discourage her from proceeding with an abortion,” Toti wrote. “The ultrasound is required even when the doctor deems the procedure medically unnecessary (for instance, if a referring physician has already performed an ultrasound examination), or detrimental to the patient. The woman may avert her eyes from the ultrasound images, but the law does not allow her to avoid listening to the required narration while on the examination table.”

The Oklahoma Legislature enacted the ultrasound law in 2010. The act contained no exception for victims of rape or incest or for women seeking to terminate a pregnancy because of a fetal anomaly. A doctor who knowingly violated the act was subject to civil, criminal and administrative sanctions.

Shortly after it took effect, the act was challenged as a violation of the state constitution. A state trial court in 2012 permanently enjoined the law after concluding it was an unconstitutional “special law” that improperly singled out abortion patients, physicians and sonographers with special informed-consent standards when “a general law could clearly be made applicable.” Last December, the Oklahoma Supreme Court held that the ultrasound law was “facially unconstitutional” under the U.S. Supreme Court’s decision in Casey.

“A woman’s personal, private medical decisions should be made in consultation with the health care professionals she trusts, without interference by politicians who presume to know better,” Nancy Northrup, president of the Center for Reproductive Rights, said in a written statement on Tuesday. “This decision is another victory for women and reproductive health care providers, and another clear message to lawmakers across the U.S. that attacks on women’s health, rights, and dignity are patently unconstitutional and will not be allowed to stand.”

The center, in its brief in opposition to the state’s appeal, told the justices that few states have enacted ultrasound statutes that require an examination combined with mandatory narration, “and to our knowledge, none is as onerous as Oklahoma’s. Only Oklahoma, Louisiana, Texas, and North Carolina require that women be given verbal descriptions of ultrasound images during a mandatory examination, and of those four states, only Oklahoma requires use of a vaginal probe.”

Contact Marcia Coyle at