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A three-month-old fetus appears on a screen during an ultrasound exam.Ng Han Guan / AP

Nearly 99 percent of women went ahead with an abortion after voluntarily viewing an ultrasound image of the fetus, according to a large new study.

Based on medical records for more than 15,000 women seeking abortion at Los Angeles Planned Parenthood clinics, researchers found only a small fraction of the women changed their minds after seeing the image.

"This study was motivated in large part by the current political and popular interest in what role ultrasound viewing plays in women's decisions about abortion," said one of the authors, Katrina Kimport at the University of California San Francisco School of Medicine.

Ten states have enacted laws that require doctors to perform ultrasounds before abortions, and three of those require the woman to view the image during the ultrasound. The others require doctors to offer women the option of viewing it.

A 2011 North Carolina ultrasound law, considered one of the strictest in the nation, was struck down by a federal judge earlier this month because it forced doctors to explain the image while showing it to the patient. The U.S. District Court held that forced speech to be unconstitutional.

Planned Parenthood clinics routinely perform ultrasounds before abortions and ask patients if they want to see the images. It's also standard practice to ask each patient how confident she is about her decision to terminate the pregnancy.

Kimport and her colleagues found that most women (85.4 percent) said they were certain they had made the right decision. Although all of the women included in the study had ultrasounds, less than half (42.5 percent) chose to see the image.

A total of 98.8 percent of the planned abortions took place. Among women who did not view their ultrasounds, 99 percent went through with the procedure. Among those who did view the images, 98.4 percent had abortions.

The images appeared to have the greatest effect among women who had expressed low or medium certainty about the procedure. In that group, those who viewed the ultrasounds were slightly less likely to go through with the abortion: 95.2 percent did have the procedure, compared to 97.5 percent of uncertain women who did not view the ultrasound.