Pap in Pregnancy? - Page 2

[Talula Fairie]

Uh, a pap smear does not have a 1% chance of miscarriage. I mean, if you think a pap smear can cause a miscarriage, then there would be a whole lot of miscarriages considering the amount of pregnant women out there that have vaginal exams or sex. All they do for a pap is take a q tip and touch your cervix with it. It's not invasive.

All women need to get paps every 1-2 years after age 18. Cervical cancer can happen even if you are a virgin, it doesn't have to be caused by HPV afaik.

I can see putting off the pap smear, but I don't see how it's risky to do it.

[momileigh]

The following link from the American Cancer Society does a good job of explaining risk factors for cervical cancer:

http://tinyurl.com/652ur

Special attention to this quote from that page: "Doctors believe that women must have been infected by HPV before they develop cervical cancer."

Your chance of developing cervical cancer as a virgin is incredibly small. (As a matter of fact, it might be pretty much impossible, and cases of virgins with cervical cancer might have more to do with women falsely reporting that they are virgins, or women who were raped without their knowledge.) I have done my own risk-benefit analysis and come down on the side of "no paps for me." I believe every woman has the right to make this decision for herself. Most women find paps to be "no big deal," so they don't need to worry about it, they can just keep getting them. But for any of us who don't have significant risk factors AND for whom getting them is something we don't really want, we have the right to informed refusal. (Well, I guess EVERYONE has a right to informed refusal, even if they have high risk factors... but I would hope someone w/ any risk factors would not refuse pap screening.)

Now on to what I agree with you on, Talula...

This idea that pap smears cause miscarriage. I don't believe it. They don't. However, because so many women either believe this or think it *could* be true, I don't do paps in the first trimester. Why? Because that's when you're most likely to have a miscarriage anyway. And if I do a pap, and then you miscarry soon thereafter, all the reassurance in the world is never going to erase the thought in your mind that the pap caused the miscarriage, even though it was just a coincidence. It is easy enough to wait until the second trimester when the risk of miscarriage goes down significantly.


P.S. I feel like I should add this, because it is possible someone might read my posts and decide not to get paps. This is a serious decision, because getting a pap is relatively easy, painless for most women, and can save your life. If there is any possible chance that you have or have had hpv at any point, you should get paps. HPV is present in fully 50% of the sexually active American population. If you or your partner has ever had sex with anyone else, ever, at all, you have a good chance of having HPV. (Perhaps not the kind that causes cancer, but it could be.) If you get the cancer-causing HPV and cancer develops, a pap is practically the only way you're going to catch it. Cervical cancer is slow-growing and VERY treatable. If it is caught in time (and there's usually plenty of time, which is why an annual or every-3-year pap is plenty sufficient) you can look forward to a full life, fertility and sexuality intact. Paps are a good thing for the vast majority of women.

[Talula Fairie]

Just becuase women believe something doesn't make it true. Pap smears have never been scientifically linked to miscarriage. When you think about it logically, it just doesn't make sense. If they really did possibly cause miscarriage, imagine what sex or a vaginal/cervical exam would do.

[momileigh]

Um, are you trying to argue with me when I very clearly just agreed with you?

[BoringTales]

Originally Posted by sweetsunshine85

THANK YOU! Thats how I feel about it personally. My friend would handle the Pap just fine if she had to, but she just doesn't like the idea. But I definitely don't think that it should be abnormal to have a fear of getting one! I have NEVER had one and don't look forward to the first one. But thats just my personal feeling.

There are a lot of things in life that we, as adults, just have to put our big girl panties on and deal with. No one likes paps, they certainly aren't fun or pleasant, but letting anxiety rule your life just isn't an option for me.

Not getting regular pap smears because you are anxious about it or just don't want to is irresponsible. Encouraging others to do the same and making it out to be a legitimate choice is downright dangerous.

Encourage your friend to work through her fears and get a simple, non invasive, potentially life-saving test. Closing your eyes and covering your ears and telling yourself that it just won't happen to you isn't smart, logical, or healthy.

[Jilian]

Wow, I'm amazed to see that so many people just skip paps completely. I can understand not getting one during pregnancy but not getting them at all YIKES! It doesn't matter if you are a virgin or have only been with one partner, you can still get reproductive cancer and the pap has proven to be the most effective way to identify reproductive cancer early on - you know while treatment can still save your life. My mom surprised us all by getting uterine cancer at 27 years old. Her pap was her first clue that something was going on. She had a hysterectomy and is still cancer free over 20 years later. Her pap likely saved her life. Same thing happened to my aunt when she was in her early 30's.

[sweetsunshine85]

I was brought up half by nuns, who don't think it appropriate to have any internal exams. And I have never been to an OB. I hate doctors. I don't ever go to one really, so it never occurred to me that I needed a Pap.

[lovebug]

Question

:


not to derail the thread but what if you do have HPV? would that change birth plans? if not then why check in the 1st trimester?

[mamatolevi]

why are folks so scared of paps??

HPV is not the only way to develop cervical cancer. At a very basic level, cancer generally happens when cells do not reproduce correctly and then continue to grow and reproduce other cells w/incorrect DNA. Various things can cause this - diet, disease, genetics, age, etc. It can happen anywhere in our bodies. Just b/c someone is at a very low to no risk of HPV, does does not mean that they shouldn't get a cervical exam at the recommended times (and there is valid discussion as to what those times should be and why for each individual's circumstance).

While I don't believe it's necessary to have a PAP test done in the first trimester of pregnancy, I do strongly believe that it's part of regular maintenance and a it's good idea to know what's going on with our bodies. It's not very invasive (depending on one's perspective/history) and with a considerate provider (ask around!) pretty much painless.

Has your friend never had a pelvic exam before? I remember being terrified of my first exam. I was 17. My mother had taken me to her GYN (female) for an exam and I refused b/c I didn't know what would happen. No explanations were offered. I wasn't even asked if I knew what the exam entailed. All I knew was that the exam included someone's hands where I didn't want them. The mw I later saw on my own was the exact opposite. She asked if I knew what to expect. She had a model and showed me what would happen and what they were looking for. She made what would have been a scary uncomfortable experience into something positive I was doing for my health.

[momileigh]

Originally Posted by BoringTales

There are a lot of things in life that we, as adults, just have to put our big girl panties on and deal with.

Agreed.

And looking objectively at the facts and making a cost/benefit analysis and making an informed decision is part of that process.

Just because someone makes a different choice than you do doesn't mean they are irresponsible OR that they are still in diapers, as you imply.

Let's try to respect each other's decisions when it comes to our own health care, ok?

[momileigh]

Lovebug: they usually want to check during pregnancy because that is the only time some women are getting care. If they catch it then, they know that after the birth she will need to be treated. No, it does not change your birth plans.

mamatolevi: I think I am the only person in this thread who admitted to being "so scared" of paps. Everyone else has only mentioned feeling "uncomfortable" or just not wanting one. I think my reaction to paps is highly abnormal. I only brought it up to demonstrate that no matter how much someone is afraid of paps, it means NOTHING about their ability to give birth.

[sweetsunshine85]

Thank you for that. I started this thread to ask what her options were at this point, not to start a name calling session or to be disrespected. Lets all try to just be objective and supportive of each other.

[sparkysgirl]

i chose not to get a pap/pelvic during this pregnancy mainly because I knew that I am just now due for one and that if anything abnormal was detected that they wouldn't do anything until after the birth, so why risk having to worry throughout the pregnancy? And the pelvic seemed pointless as well. If you have a good argument for why you are refusing something then she shouldn't have any trouble having those wishes respected. After I have this baby I plan to see a midwife for well woman care because I don't like obs or the enviornment they practice in. Seems like it would be much better to have it done in my own home or at a midwifes office, I would rather have that for my daughters as well. Much more personal/less intimidating for a young girl or someone who has never had it done

[georgiegirl1974]

Since she has never had a pap, she would get one. My DH is a radiation oncologist and has treated many women with cervical cancer. If it is caught early, it is very treatable. My husband comes home with so many sad stories (32 year old woman with 3 kids who is dying from cervical cancer), and it breaks my heart to think that many of these deaths could have been prevented by early detection.

I had one at my first appointment, but I hadn't had one in over 2.5 years (at my 6 week post partum check-up with DD.)

If you are in a monogamous relationship and you have never had an abnormal pap, then you only need one every 2 years.

[sunshynbaby]

I am genetically predisposed to cervical cancer, so I always get a pap. I would encourage everyone to get checked. It is less than 15 seconds of mild discomfort that could save your life.

[mamatolevi]

Being emotionally uncomfortable with something isn't that different from being afraid of it. It's just a different level of fear.

This board is not the only one where I see this fear. I didn't intend to come across as pikcing on anyone, just expressing that I don't get the (what seems to me to be) widespread fear of exams (when there's been no history or abuse or assault)

[sweetsunshine85]

Not to be confrontational, but how do you know there is no history of abuse?

[momileigh]

Well, mamatolevi, I think it is difficult to explain *why* you have an irrational fear of something. I used to be terrified of spiders. If asked why, I might say, "Because they have EIGHT LEGS!!!" or something equally irrational. I grew out of my intense fear of spiders (even though I still don't like them) and perhaps some day I'll grow out of my fear of paps. (I thought that giving birth might help me get over it, but it did not!)

But you remember feeling terrified of your first pap. What if, instead of getting comfortable with the idea, you were still terrified when they started doing it? What if you felt like you should say no, but felt paralyzed to do so? What if you told them to stop, and they didn't? What if it took longer than they told you it would, and the whole entire time you were feeling violated? Can you imagine how all the odd sensations of the pap would get wrapped up with this feeling of violation and helplessness, haunting you for years to come?

I think that if you haven't had a pap before, you should not only be told and shown exactly what it entails, but you should be given all the information and get to make your own choice about it. (The vast majority of women will get paps when they are given all the information, and the idea that they shouldn't get a choice is paternalistic and, if I may, evil.) You should then be given the option of doing it yourself. (Yes, you can do your own pap, with some guidance and the use of a mirror.) A lot of women will find it easier to have it done for them, which is fine. But doing it yourself is an empowering and educational option that ought to be standard.

[momileigh]

Originally Posted by sweetsunshine85

Not to be confrontational, but how do you know there is no history of abuse?

Well you make a good point; often there is. Or, as in my case, the first pap might be processed as a violation, whether or not there was any true medical impropriety.

[rabbitmum]

Originally Posted by Amatullah0

IMO, i dont go for regular brain/lung/skin/you-name-it cancers, so why cervical? just because its easy to check?

Cervical cancer doesn't have any noticeable symptoms before it has gone quite far. If found early on, it is very easy to treat.

Originally Posted by SandraS

And FWIW, my doc says a woman with no family history of cervical cancer doesn't need an annual pap. Every 2-3 years is fine, as long as she's had several negative results in early paps. I only go about every three years.

I have no family history of cervical cancer. I never had anything but negative results for years and years, and had my paps every three years as recommended. Last September, when my youngest was two and a half years old, I was diagnosed with cervical cancer. There was a tumour more than five centimeters across, too large for surgery. I had to go through eight weeks of radiation therapy and chemo. It was tough. I had to stop breastfeeding, and I can no longer have children.

It never crossed my mind that I would get cancer, and I didn't feel anything or notice any symptoms before I suddenly started bleeding between periods. It can happen to anyone!

I met several young women with a similar experience as mine at the hospital during treatment. One doctor told me that it made him angry that women are told that they are safe as long as they have paps every three years, because cervical cancer actually can grow very quickly.