The 4th U.S. Circuit Court of Appeals yesterday struck down a North Carolina anti-abortion bill that, like Arkansas, required an ultrasound test of women seeking an abortion.

The North Carolina law went further than the 2013 Arkansas law, which mandates that an ultrasound be performed and the woman seeking an abortion be told if a heartbeat was detected.

The law was passed by the state’s Republican-controlled legislature in 2011 over the objections of then-Gov. Bev Perdue (D). The Woman’s Right to Know Act, which Perdue vetoed, requires a doctor to give a woman an ultrasound prior to the procedure and to describe the fetus in detail, regardless of the patient’s wishes. The doctor also would be compelled to give the patient the choice as to whether she wants to listen to the fetal heartbeat. The law provided an exception only for medical emergencies, and providers who refused to comply with the bill would face losing their medical licenses.

On Monday, the court said that the narration provision was medically unnecessary and constituted a form of forced government speech.

“This compelled speech, even though it is a regulation of the medical profession, is ideological in intent and in kind,” the federal judges wrote in their opinion. “The means used by North Carolina extend well beyond those states have customarily employed to effectuate their undeniable interests in ensuring informed consent and in protecting the sanctity of life in all its phases.”

“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,” the decision continues. “Abortion may well be a special case because of the undeniable gravity of all that is involved, but it cannot be so special a case that all other professional rights and medical norms go out the window.”

The Arkansas State Medical Board voted narrowly, 7-6, to implement the law as directed by legislation. Doctors objected to be directed by the state on how to practice medicine.  The law also shortened the time period for an abortion to the first 12 weeks of pregnancy. Federal Judge Susan Webber Wright struck down that part of the law, but said the mandated ultrasound test was within the limits allowed by past court decisions.