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FALLS CHURCH, Virginia - Thousands of women arrive at health clinics across the United States every year, facing the heavy burden of ending pregnancies that were unplanned and unwanted.
But in a growing number of states, before being allowed to have an abortion, women are compelled to undergo a procedure that lets a medical professional hear the fetus's beating heart and describe details about its development.
Women's rights advocates say the unwanted and controversial medical procedures appear designed to convince them to keep the baby, and usurps from women the right to make a fundamental decision free from government interference.
"It's just an insult to women, purely an insult to women and to doctors," said Rosemary Codding, director of the Falls Church Healthcare Center in suburban Virginia, a short drive from the US capital Washington.
Abortion rights advocates have expressed outrage over laws in several states -- and under consideration in others -- requiring women submit to an ultrasound examination before having an abortion.
Virginia last month became the eighth state to enact such a law, after Governor Bob McDonnell signed a bill approved by the state legislature.
Beginning July 1, a woman seeking to terminate a pregnancy at Codding's clinic for example will have to undergo a procedure in which a medical wand is rubbed over her abdomen to deliver an image of the fetus the woman is about to abort.
Opponents of the Virginia law were able to beat back an earlier version of the bill which would have required women to submit to an even more invasive ultrasound -- one in which an imaging device would be inserted into the vagina.
McDonnell, a Republican, said he agreed with the lawmakers who say the procedure ensures women are well-informed about the consequences of abortion.
"The information provided by ultrasounds, along with other information given by the doctor pursuant to current law and prevailing medical practice, can help the mother make a fully informed decision," he said after signing the measure.
The battle over the pre-abortion ultrasounds pits America's social conservatives against women's rights groups, in one of this country's longest running culture wars.
The polemic comes at a time when Democrats and Republicans have traded charges that the opposite side is waging a "War on Women," which is proving to be one of the 2012 presidential campaign's most contentious issues.
The controversy has flared just as other women's issues have become major focal points of the 2012 election, including a long-dormant debate over mothers who work versus those who stay at home, and a discussion over women's access to contraception.
Opponents including the National Abortion and Reproductive Rights Action League (NARAL) predict negative fallout for politicians supporting the screenings.
"If they continue this war against women, the backlash will be so severe that they won't possibly want to touch this issue again," said Tarina Keene, director of NARAL's Virginia office.
Almost everywhere, women can refuse to see the fetuses and hear their hearts if they sign waivers, but they cannot avoid the ultrasound procedures.
An exception is Texas, where women are required to see and hear the pre-abortion fetuses. One woman, described the "nightmare" of the exam to the Texas Observer magazine.
Her doctor told her, "I can lose my license" if he did not follow all the required pre-abortion procedures.
During the exam he told her, "Here I see a well-developed diaphragm and here I see four healthy chambers of the heart."
The woman then was given a litany of information required by the state on the health risks of abortion, maternity benefits and possibilities for adoption.
The measure is one of many over the years that seek to chip away at abortion rights, which became legal after the US Supreme Court ruled in the 1973 Roe v. Wade case.
The Guttmacher Institute, a private research group, has tracked laws restricting abortion rights says 32 states forbid use of public funds to reimburse doctors who perform abortions, 46 allow health care institutions to refuse to perform abortions.
Other states meanwhile have tried -- without success so far -- to grant "personhood" to embryos, a move that would give unborn children rights.