Why would I get a pap smear while pregnant?

[finnegansmom]

I'm pregnant with #3.
With #1 I had an OB and had a pap smear. Wasn't fun.
I did not have one with my midwife for #2.
My new midwife (we moved out of state) wants me to get one at the next visit (I refused it at my first). She said it's normal, and when I asked about how they wouldn't do anything if it was abnormal, she said they wouldn't if abnormal but would if it was cancer.

As a note, I always get yearly check up and always get a pap smear. Like clockwork, I'm never late. I'm due for one in feb/march but I want to wait until after the baby is born in August.

WWYD? Would you just get it now or possibly offend the midwife and refuse it? She seems kind of adament about it.

[pacificbliss]

I would wait. My midwives have always said there isn't much point during pregnancy. If your last one was normal and it was only a year ago I don't see any reason. I always get one at my 6 week pp check-up.

[MaerynPearl]

Ive had one with both of my children... didn't personally see any reason not to. I was due for one anyway.

[finnegansmom]

I just don't like the off chance of injury to my cervix or any bacteria going up there causing infection. even if it's a small chance of that.
Can they do a pap smear and detect cancer? Or would they need a biopsy? I did have abnormal cells maybe 15 years ago and they did a biopsy before they did anything else.

[etsdtm99]

I am not getting one this pregnancy (unless my midwives back up OB requires it to clear me for HB or something dumb like that) I had one in June, and i am due in sept. so i can get one in october and only be a few months 'late' .. with my OB, she had me getting a pap every time i was pregnant or pretty much every time i was in her office for something not pregnancy related.. whcih ended up being more than once a year and i had i think 5 paps in 3 years.. which i thought was ridiculous .

[WaitingForKiddos]

I had one with pregnancy #1 when I was like 3 seconds pregnant. This time around I passed ( I think....I did get a vag culture done). I don't think it hurts anything but it seems pointless because I think one would postpone treatment (or further tests like a cervical biopsy) of most conditions while pregnant. I know many midwifes wont do them, or touch a cervix at all, with the idea that messing with a new pregnancy is a big no-no.

[notjustmamie]

I think it's standard because the OB/MW has you in the office regularly while you're pregnant. Also, they probably want to do it early because, if they found something, you would have the time to decide to terminate if you wished.

At least, those are my guesses.

[matthia]

I got one a few weeks ago, but that was only because I was experiencing a bit of bleeding and the MW wanted to check my cervix to see if there was any infection or anything causing the bleeding (baby's fine). It turned out I have a polyp on my cervix, which isn't really anything, but I am happy to know why I was bleeding and am much more relaxed. That being said, if I hadn't had the bleeding issues, my MW wasn't going to bother with one since I had one a few months before getting pregnant and will be right on schedule to have one after I deliver. I guess, it's really a matter of how comfortable you are with it, and if you really decide it's necessary or not.

[jecombs]

With my first, I did have a pap because I was wayyy overdue for one. It hurt A LOT. This time around I'm not having one until my 6 week pp check-up, even though I'm due for one in Feb. My paps have been 100% normal for the past 10+ years, so I feel like I'm pretty low-risk for cervical cancer and I just don't want to endure the pain I had last time while pregnant.

[LittleBirdy]

I don't see any reason why you would need to have one - you didn't mention it so I assume there's no family history of cervical cancer? Do you know if you've been tested for HPV? I had a pap come back ASCUS once but HPV was negative and the dr. pretty much said due to that fact she really didn't care that it was ASCUS (well, in so many words )

So if you've never had an abnormal pap, have no family history of cervical cancer, and especially if you can find out your HPV status I don't see any reason at all why delaying 4 or 5 months would be a big deal.

FWIW, my midwife is doing mine at 6 weeks pp even though I was due for one back in September.

[finnegansmom]

Originally Posted by jecombs

With my first, I did have a pap because I was wayyy overdue for one. It hurt A LOT. This time around I'm not having one until my 6 week pp check-up, even though I'm due for one in Feb. My paps have been 100% normal for the past 10+ years, so I feel like I'm pretty low-risk for cervical cancer and I just don't want to endure the pain I had last time while pregnant.

This is me. My first pap smear when pregnant with #1 hurt a great deal and I spotted for 2 days which is ridiculousy uncommon for me (in 26 years of having a period through 2 pregnancies and 1 mc, I have spotted twice - that being one of them). Obviously my cervix endured some trauma during the procedure. AND the pap came back abnormal and my ObGyn said to me "Oh well, we won't do anything about it anyways while you're pregnant..." Then what was the point?

I just wanted to make sure I wasn't missing something. My midwife came highly recommended from here and I was surprised she seemed to want me to have it done. I think I'll just reschedule my appt for next week and then refuse it and get it at my 6 week pp appt.

[Plummeting]

I don't see any reason why you can't wait, if you've always had normal paps in the past. The actual recommendations aren't for yearly paps for every woman anyway. The recs say women over age 30 can start going every two to three years after they get 3 normal paps in a row. I'm not sure if you're over 30 or not, but if you are, then there's no reason you even need one every year if you've had 3 good ones in a row. Also, I'm not sure how much you care about the science over the recommendations, but research shows it takes an average of 12 years from the first precancerous changes to the development of invasive cervical cancer. (It doesn't take as long for non-invasive cancer to develop, but it's still generally accepted that it's a period of years, not months.) The likelihood that going a few months late is going to hurt anything, regardless of your age, is very, very, very, very slim.

So I'd get one if I'd had any abnormal ones in the last few years. Otherwise, I'd just wait. But that's just me and I'm not a doctor and shouldn't give medical advice. lol

[lisalulu]

I declined mine. I get one yearly with my regular doc and am on schedule there.

As for the biopsy question, I think it depends. My paps are always abnormal. When they first picked it up in 2004, I had a biopsy. But now they have a DNA test they can perform from the pap sample they took to see if your abnormal cells are caused by a cancerous HPV strain. Thankfully mine aren't so thats as far as my testing has to go. Not sure what they do if they come back as a cancerous strain at that point-another test, biopsy or removal??

[megviolet]

I asked the same question awhile ago:

http://www.mothering.com/discussions...&highlight=pap

I didn't get one, but i will at my postpartum checkup

[welshwife08]

I only had one at the beginning of the pregnancy. But, I've had two abnormal paps in a row (first was biopsied and followed up with cyrosurgery; second came back with low grade lesions, the kind that usually goes away on its own). I'm anxious to get one, though, so I can know for sure that the low grade cells haven't grown to high grade.

I'm hopeful for a vaginal birth because my doc said that labor and delivery will often take care of abnormal pap smears.

[lizsky]

Originally Posted by Plummeting

So I'd get one if I'd had any abnormal ones in the last few years. Otherwise, I'd just wait.

I agree with this. One of the reasons pap tests are such a great public health tool is that they can detect pre-cancerous cells years before the development of cervical cancer. You mentioned that you did have one with abnormal results...if that was recent, I would probably do the test if I was in your shoes. If it wasn't and you've had normal paps since then, I would feel very comfortable waiting.

[finnegansmom]

Originally Posted by lizsky

I agree with this. One of the reasons pap tests are such a great public health tool is that they can detect pre-cancerous cells years before the development of cervical cancer. You mentioned that you did have one with abnormal results...if that was recent, I would probably do the test if I was in your shoes. If it wasn't and you've had normal paps since then, I would feel very comfortable waiting.

It was 13 years ago (or 14?). I was in my 20's. I went every 3 months after that for 2 years and then once a year and have never had a abnormal except the one pap I had when pregnant with #1, which I redid at 6 week pp and it was fine. I was told it was abnormal because of being pregnant at the time

I super apprecaite everyone who responded and also for that link. (which I actually posted on back then, I'm such a spazz).

[slsurface]

My OB has repeatedly asked me to do a pap ever since I started seeing him at 6 weeks preggo...even though I'm due for one until this month . I will continue to decline the pap until the baby is born in June, however. A couple month wait won't matter and with the difficult pregnancy that I am experiencing, I really don't need any additional pelvic exams right now!

[fruitfulmomma]

I've never seen an ob and have been with the same midwife since my first pregnancy. She has only ever offered them postpartum and never demanded that I get one.

[PeachyKeen]

In all actuality if you ha dseveral normal paps you don't even need to do them yearly if you are with the same partner. I get mine done every 2-3 years and I was due for a pap this time around so I just let them do it.