Prenatal Appointments - Questions about certain procedures

I have my 10 week appointment this week and at my last appointment, they gave me a schedule of upcoming appointments, saying more-or-less what would happen at each one. On this 10-week one, they have me scheduled for a pap smear.

At my last appointment, I asked if I could decline it. I've had normal pap smears for the last 9 years (ever since I started getting them) and have read that the "standard of care" for having them during pregnancy is just because most women don't come for annual exams, so they do it while you're in for your prenatal appointments. I've also read they DON'T do them during pregnancy in other countries. I realize it's done on the outside of the cervix and there isn't any contact with the fetus whatsoever, but it just seems so counterintuitive to scrape cells away from something that is keeping the pregnancy protected. Anyway, they said nothing is "required" and I can decline it if I really want to. Am I being ridiculous? Do I need to just do this and not worry about it?
I declined and had one done at my 6 week post-partum check up
Quote:
Originally Posted by Poodlehead
Ah, it all makes sense now. Goldy is the puppet master!
Did they give you a hard time about it at all? Had you had one within the past 12months?

TIA.


Sent from my iPhone using CurlTalk
I had one about 6/7 months before getting pregnant so my pap would have been due during my pregnancy. I went to a free standing birth center run by midwives, and they offered the pap if I wanted but suggested I could wait till my pp check (which I was planning to do before they said I could).
Quote:
Originally Posted by Poodlehead
Ah, it all makes sense now. Goldy is the puppet master!
Thanks goldy. I had one just about a year before we conceived, so I'm technically "due," but I think i'd feel better waiting until the pp checkup.


Sent from my iPhone using CurlTalk
No compelling reason for you to have one so if you have doubts, go ahead and decline it. You will see if they really mean "nothing is required" or if they woll give you a hard time, and the sooner you find that out, the better
To Trenell, MizKerri and geeky:
I pray none of you ever has to live in a communist state.

Geeky is my hero. She's the true badass. The badass who doesn't even need to be a badass. There aren't enough O's in cool to describe her.
I wouldn't be comfortable with it at all and certainly never had it mentioned to me when I was pregnant. Mind you, we only do pap smears every two years here anyway so maybe that makes a difference.
3b in South Australia.
Mine is "due" next month and they asked me at my last visit if I wanted to go ahead and have it done, but I declined. Like you, I have never had an abnormal one so I am not all that worried about it, and to me the risk outweighed the benefits. I'll just get it done sometime after the baby arrives. My midwife was prefectly fine with it.
Alright, I'm feeling better about my plan to decline. What about the gonorrhea and chlamydia swabs? I haven't had any "risk," and fairly sure I was tested for these at my last well woman exam, so feel that I am justified in declining these too. What do you ladies think?
Those may be state mandated; I know they are in TX, as is an HIV blood test, but your state may be different. If they're not, I'd refuse.
"Maybe Lucy's right. Of all the Charlie Browns in the world, you're the Charlie Browniest."--Linus, A Charlie Brown Christmas
-----------------------------------------------
My fotki: http://public.fotki.com/nynaeve77/
Password: orphanannie
Most docs just use a spatula when doing a pap during pregnancy, instead of the little brush. It's pretty much a waste of time, because the spatula doesn't get enough cells to get a good reading. I think I'd be fine skipping it, if I were in your shoes.

Geeky is right...refusing something routine and seeing their reaction to it will give you a good indication of what this team of attendants will be like in late-pregnancy and labor. Better to find out now how pushy they are.
Those may be state mandated; I know they are in TX, as is an HIV blood test, but your state may be different. If they're not, I'd refuse.
Originally Posted by nynaeve77
HIV isn't mandated here. I was given the option and will decline that as well. I know I'm extremely low risk and see no need to do an extra test. I'm not sure about the others. I'll try and find out before I go. Thanks for the heads up.
Most docs just use a spatula when doing a pap during pregnancy, instead of the little brush. It's pretty much a waste of time, because the spatula doesn't get enough cells to get a good reading. I think I'd be fine skipping it, if I were in your shoes.

Geeky is right...refusing something routine and seeing their reaction to it will give you a good indication of what this team of attendants will be like in late-pregnancy and labor. Better to find out now how pushy they are.
Originally Posted by RedCatWaves
Thanks RCW. I was hoping you'd weigh in. I am touring a non-hospital birth center that is run by a different group of midwives tonight, so I may be switching groups anyway. We'll see...
Alright, I'm feeling better about my plan to decline. What about the gonorrhea and chlamydia swabs? I haven't had any "risk," and fairly sure I was tested for these at my last well woman exam, so feel that I am justified in declining these too. What do you ladies think?
Originally Posted by Like.Australia
I'm in NC and it seems here the state requires them to check for various STD's twice! Once at the beginning and then again before delivery. Maybe it's a big issue around here But since the state mandates it, I don't think I have any chance of getting out of it. I would check and see what your state requires, and see how much leeway it gives you.
This is all I've been able to find on the issue: http://www.healthystates.csg.org/NR/...giniafinal.pdf

As I had read elsewhere, HIV is opt-in for pregnant women. No mention of mandated testing for other STDs. Do other states have similar documents? Any idea where else I could look?
I had mine done, and it came back abnormal, which I had to have another test done, and that came back fine, so the first one didn't seem to work out correctly.

As for HIV tests, I don't understand why women refuse that. Its done with a blood test, they're taking your blood a dozen times anyway, why not just do it? Yes, you may be monogamous, you may have been tested before, but you just never really know. Its about the safety and health of your baby. I don't think your pride should be an issue in that case. Just do it.

Sent from my SAMSUNG-SGH-I997 using CurlTalk App
I honestly don't remember....I think I remember having one at the 6 week post-check-up...but don't remember if I had it done at 8 week check-up.

I never balked at the HIV test...I also did the early bloodwork/Sonogram to rule out down syndrome and other issues. I did that test for my peace of mind...I wasn't going to abort but I did it so I could be mentally prepared...and wouldn't be worrying about it for the rest of my pregnancy.
Sorry this will be long but I found this on the Virginia Department of Health:


prev | next Part VI
Venereal Disease
12VAC5-90-130. Prenatal testing.
Every physician, physician assistant, or nurse practitioner attending a pregnant patient during gestation shall examine and test such patient for syphilis, hepatitis B surface antigen (HBsAg), and any other sexually transmitted disease as clinically indicated within 15 days after beginning such attendance. A second prenatal test for syphilis and HBsAg shall be conducted at the beginning of the third trimester (28 weeks) for patients who are at higher risk for these diseases. Persons at higher risk for syphilis include those who have had multiple sexual partners within the previous year, those with any prior history of a sexually transmitted disease, and those living in communities and populations in which the prevalence of syphilis is high. Persons at higher risk for hepatitis B virus infection include injecting drug users and those with personal contact with a hepatitis B patient, multiple sexual partners, and/or occupational exposure to blood. If the patient first seeks care during the third trimester, only one test shall be required. As a routine component of prenatal care, every licensed practitioner who renders prenatal care, including any holder of a multistate licensure privilege to practice nursing, regardless of the site of such practice, shall inform every pregnant patient that human immunodeficiency virus (HIV) screening is recommended for all pregnant patients and that she will receive an HIV test as part of the routine panel of prenatal tests unless she declines (opt-out screening). The practitioner shall offer the pregnant patient oral or written information that includes an explanation of HIV infection, a description of interventions that can reduce HIV transmission from mother to infant, and the meaning of positive and negative test results. The confidentiality provisions of 32.1-36.1 of the Code of Virginia and the test result disclosure conditions and appropriate counseling requirements of 32.1-37.2 of the Code of Virginia shall apply to any HIV testing conducted pursuant to this section. The Centers for Disease Control and Prevention (CDC) recommends a second HIV test for patients who receive health care in jurisdictions with elevated incidence of HIV or AIDS among women aged 15 through 45 years, which includes Virginia. Practitioners should offer a second HIV test during the third trimester to all pregnant patients. Practitioners shall counsel all pregnant patients with HIV-positive test results about the dangers to the fetus and the advisability of receiving treatment in accordance with the then current CDC recommendations for HIV-positive pregnant patients. Any pregnant patient shall have the right to refuse testing for HIV infection and any recommended treatment. Documentation of such refusal shall be maintained in the patient's medical record.
Statutory Authority
32.1-35 of the Code of Virginia.
Historical Notes
Derived from VR355-28-100 6.1, eff. July 1, 1993; amended, Virginia Register Volume 15, Issue 6, eff. January 6, 1999; Volume 23, Issue 15, eff. May 2, 2007; Volume 27, Issue 13, eff. March 28, 2011.
Sorry this will be long but I found this on the Virginia Department of Health:


prev | next Part VI
Venereal Disease
12VAC5-90-130. Prenatal testing.
Every physician, physician assistant, or nurse practitioner attending a pregnant patient during gestation shall examine and test such patient for syphilis, hepatitis B surface antigen (HBsAg), and any other sexually transmitted disease as clinically indicated within 15 days after beginning such attendance. A second prenatal test for syphilis and HBsAg shall be conducted at the beginning of the third trimester (28 weeks) for patients who are at higher risk for these diseases. Persons at higher risk for syphilis include those who have had multiple sexual partners within the previous year, those with any prior history of a sexually transmitted disease, and those living in communities and populations in which the prevalence of syphilis is high. Persons at higher risk for hepatitis B virus infection include injecting drug users and those with personal contact with a hepatitis B patient, multiple sexual partners, and/or occupational exposure to blood. If the patient first seeks care during the third trimester, only one test shall be required. As a routine component of prenatal care, every licensed practitioner who renders prenatal care, including any holder of a multistate licensure privilege to practice nursing, regardless of the site of such practice, shall inform every pregnant patient that human immunodeficiency virus (HIV) screening is recommended for all pregnant patients and that she will receive an HIV test as part of the routine panel of prenatal tests unless she declines (opt-out screening). The practitioner shall offer the pregnant patient oral or written information that includes an explanation of HIV infection, a description of interventions that can reduce HIV transmission from mother to infant, and the meaning of positive and negative test results. The confidentiality provisions of 32.1-36.1 of the Code of Virginia and the test result disclosure conditions and appropriate counseling requirements of 32.1-37.2 of the Code of Virginia shall apply to any HIV testing conducted pursuant to this section. The Centers for Disease Control and Prevention (CDC) recommends a second HIV test for patients who receive health care in jurisdictions with elevated incidence of HIV or AIDS among women aged 15 through 45 years, which includes Virginia. Practitioners should offer a second HIV test during the third trimester to all pregnant patients. Practitioners shall counsel all pregnant patients with HIV-positive test results about the dangers to the fetus and the advisability of receiving treatment in accordance with the then current CDC recommendations for HIV-positive pregnant patients. Any pregnant patient shall have the right to refuse testing for HIV infection and any recommended treatment. Documentation of such refusal shall be maintained in the patient's medical record.
Statutory Authority
32.1-35 of the Code of Virginia.
Historical Notes
Derived from VR355-28-100 6.1, eff. July 1, 1993; amended, Virginia Register Volume 15, Issue 6, eff. January 6, 1999; Volume 23, Issue 15, eff. May 2, 2007; Volume 27, Issue 13, eff. March 28, 2011.
Originally Posted by SouthernWaves
Thanks, SouthernWaves. I was looking on the VDH site too and hadn't found this yet.

As for others who have posted, it has nothing to do with pride. I just don't want to take on all of the lowest common denominator tests. I am very selective in what I will and won't use a doctor for in general; why should pregnancy be any different?
Sorry this will be long but I found this on the Virginia Department of Health:


prev | next Part VI
Venereal Disease
12VAC5-90-130. Prenatal testing.
Every physician, physician assistant, or nurse practitioner attending a pregnant patient during gestation shall examine and test such patient for syphilis, hepatitis B surface antigen (HBsAg), and any other sexually transmitted disease as clinically indicated within 15 days after beginning such attendance. A second prenatal test for syphilis and HBsAg shall be conducted at the beginning of the third trimester (28 weeks) for patients who are at higher risk for these diseases. Persons at higher risk for syphilis include those who have had multiple sexual partners within the previous year, those with any prior history of a sexually transmitted disease, and those living in communities and populations in which the prevalence of syphilis is high. Persons at higher risk for hepatitis B virus infection include injecting drug users and those with personal contact with a hepatitis B patient, multiple sexual partners, and/or occupational exposure to blood. If the patient first seeks care during the third trimester, only one test shall be required. As a routine component of prenatal care, every licensed practitioner who renders prenatal care, including any holder of a multistate licensure privilege to practice nursing, regardless of the site of such practice, shall inform every pregnant patient that human immunodeficiency virus (HIV) screening is recommended for all pregnant patients and that she will receive an HIV test as part of the routine panel of prenatal tests unless she declines (opt-out screening). The practitioner shall offer the pregnant patient oral or written information that includes an explanation of HIV infection, a description of interventions that can reduce HIV transmission from mother to infant, and the meaning of positive and negative test results. The confidentiality provisions of 32.1-36.1 of the Code of Virginia and the test result disclosure conditions and appropriate counseling requirements of 32.1-37.2 of the Code of Virginia shall apply to any HIV testing conducted pursuant to this section. The Centers for Disease Control and Prevention (CDC) recommends a second HIV test for patients who receive health care in jurisdictions with elevated incidence of HIV or AIDS among women aged 15 through 45 years, which includes Virginia. Practitioners should offer a second HIV test during the third trimester to all pregnant patients. Practitioners shall counsel all pregnant patients with HIV-positive test results about the dangers to the fetus and the advisability of receiving treatment in accordance with the then current CDC recommendations for HIV-positive pregnant patients. Any pregnant patient shall have the right to refuse testing for HIV infection and any recommended treatment. Documentation of such refusal shall be maintained in the patient's medical record.
Statutory Authority
32.1-35 of the Code of Virginia.
Historical Notes
Derived from VR355-28-100 6.1, eff. July 1, 1993; amended, Virginia Register Volume 15, Issue 6, eff. January 6, 1999; Volume 23, Issue 15, eff. May 2, 2007; Volume 27, Issue 13, eff. March 28, 2011.
Originally Posted by SouthernWaves
Thanks, SouthernWaves. I was looking on the VDH site too and hadn't found this yet.

As for others who have posted, it has nothing to do with pride. I just don't want to take on all of the lowest common denominator tests. I am very selective in what I will and won't use a doctor for in general; why should pregnancy be any different?
Originally Posted by Like.Australia
I just truly don't understand why not. If they're taking your blood anyway, running other tests anyway, if its not anything invasive, or doesn't cause a health risk, or any other negative risks....why not?

Sent from my SAMSUNG-SGH-I997 using CurlTalk App

Trending Topics


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On



All times are GMT -6. The time now is 08:17 PM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright 2011 NaturallyCurly.com