1st appt: What can I say no to?

[AnnieA]

So depending on how things go with the HB midwives that I meet with next week, I may have to go with my OB/GYN office. Since this is my first baby, I'm not sure what is a "must" there during the first appointment. I just had a pap done in March so I don't think that will need to be repeated. Can I just say no to any vaginal exam? I'm feeling kind of protective of that area right now and I don't want any unnecessary prodding going on. I've not even done a cervical check myself and I normally have no problem doing that! I know that blood work will be necessary but can they just do that and be done?

[finnegansmom]

You can refuse anything; it's your body. Don't let them bully you.

I don't see why they would do a cervical check at this point...So I wouldn't worry about that.

If it's your first first ever appointment with this OB, it might just be an intake appt with the nurse so you might not be examined anyways.

If it is an exam, usually they do a CBC which you can refuse but I never do because I think it's a good baseline and why not? I like to know what's up.

They check your BP. You may pee on a stick. They will weigh you.
They will tell you not to smoke or drink, and send you on your way.

[AnnieA]

I've seen them before for gyno stuff so I wouldn't be a "new" patient. I just really do not want a vaginal exam right now and I'm have bouts of crampyness and the thought of a bimanual exam makes me want to throw up!

[BlackSheepPDX]

Honestly, there's no reason for a vaginal exam at all. Now, or later. You get to say whether you want to be examined, and that's that.

[nia82]

YOu can totally refuse anything! I just refused an internal exam for my first prenatal appointment and also told them that I won't be having any internal exams throughout this pregnancy. Unless I have extreme preterm labor, I don't see the point. It's uncomfy and whatnot. I had a papsmear done in December, so that's good enough for me!
I also opted out of STD testing, they frowned, but what can they do?! I was just tested in December as well...

[AnnieA]

Originally Posted by nia82

YOu can totally refuse anything! I just refused an internal exam for my first prenatal appointment and also told them that I won't be having any internal exams throughout this pregnancy. Unless I have extreme preterm labor, I don't see the point. It's uncomfy and whatnot. I had a papsmear done in December, so that's good enough for me!
I also opted out of STD testing, they frowned, but what can they do?! I was just tested in December as well...

Good to know! Intellectually I know that I can refuse anything but for some reason, seeing those two lines on that test have totally freaked me out!

[megviolet]

Congratulations
I'll just echo what everyone else has said; they'll send you for bloodwork, that's a good thing in my opinion. They'll weigh you, check your blood pressure, maybe talk about medical history and fetal screening tests, maybe offer an ultrasound (not necessary early on, especially if you know your dates). They'll probably get you to pee test for proteins and sugars, maybe even a preg test. They might want to do a breast exam too.

there is no need for an internal or PAP or anything... STD testing is up to you (although, having a neg for chlamydia and gonorrhea can make it less awkward to refuse the eye ointment on your newborn).
At any point in pregnancy, unless you have some complication, an internal isn't going to indicate anything. Cervix should be left alone while it does it's preggo thing.

Good luck at your appointments! I hope you find a care provider that you mesh well with.

[rhiOrion]

No need for an internal exam. I know my birth center's policy was you didn't need a pap during pregnancy if you'd had one in the 6 months before, which I had. But even if I hadn't I could have, and would have, refused it. Some dr's do want to do a pap either way, but you're well within your rights to refuse it.

I also refused any bloodwork that was to look for genetic issues... such as to see if i was a carrier of CF. But I did do the bloodwork looking for any actual issues with me, like iron levels and such.

[megviolet]

Also wanted to add, if you know already that you're intending to decline other procedures... like gestational diabetes test, ultrasound, GBS swab etc (unless there is a good reason for it, but not just cus it's what they do) it *might* be a good idea to let them in on that plan, cus it would suck to be at the end of pregnancy and have them fighting with you or abandoning you, this way you could have a chance at finding someone who won't bully you.

[terra-pip]

You can say no to anything. If you just had a Pap there isn't likely to be need for another this soon. If you don't want blood work then say no...although I don't think that's much of a big deal..it's just to type you and check iron etc. Very run of the mill stuff. They would want to know your RH for instance. That's important to be aware of. You can say no to an ultrasound. If they want to confirm you are pregnant then the urine is good enough for that. With my first appointments I usually get a Pap, a weighing, give an urine sample, and get a chart going with any pertinent medical info they might need. And it's also the chance to feel out a persons birth philosophy and a chance for you to ask questions about whatever you may be concerned about.

You can deny STD testing...though I think some of that would be covered in the initial blood work anyway. You actually have to sign before they can test you for AIDS and a few others anyway. Its not necessary if you know theres not a problem. The main thing is knowing whether you're RH negative or positive. I wouldn't skip the routine blood work personally. And there's no need for more than 1 Pap..I've only ever had 1 with all my pregnancies. And no need for cervical checks at all throughout really to be honest with you.

[Baby~Braatens~Mama]

I agree with the ladies above, and also wanted to mention that you may be asked to allow them to give you an H1N1 vaccine. I refused, and though the nurse tried to argue the validity of it for a few minutes, once it was apparent that I would not allow my child, or myself to be "vaccinated" with a new vaccine, they had me sign a waver. A refusal. lol. I would gladly do it again. I guess my point is, even though I was constantly told that giving the H1N1 is "standard procedure" and "highly recomended" and "considered safe for pregnant women" I stood my ground. Sometimes they get a little pushy, in my opinion. Hold on to what you believe in, don't let anyone tell you it's for the best if you feel otherwise, and CONGRATULATIONS!

[MonP'titBoudain]

Agreed with everyone else. The only thing I wanted to add was that if this is your first, you might want to get a copy of Henci Goer's The Thinking Women's Guide to Pregnancy. It's a great resource for coming to your own decisions and arming yourself with knowledge so you don't feel pressured or bullied. Good luck and congratulations!

[luv-my-boys]

first off congrats...and remember you have the right to refuse anything that you are not comfortable with and if you really dont know how you feel about something just defer it for later and research it until you make an informed decision based on what YOU want

at the first appt they might now some of these might be spread out in the first few appts, some like to just confirm pg and have you back after 12 wks and some start the ball rolloing as soon as you come in.

1. verify pg: they probably will have you do a urine test or even give you a lab slip to check hcg levels to verify pg. This will help to pinpoint how far along you are, especially important if you have odd cycles or dont know your dates.

2. u/s: they may ask if you want an early u/s, it not only to date your pg but also to make sure it a uterine pg. as opposed to say an ectopic. Also if your dates/cycle is a little off it will help to date you

3. blood work up: a complete bloodwork up might be done, std's, rh factor and titers to check immunity.

4. health history: confirm and update your health history (meds, health problmes , last pap date, weight/height, BP

[finnegansmom]

Also, one other thing I learned when taking my first to the ped for the first few times...

You can always say the magic words.."Let me think it over and get back to you at the next appointment". If you are unsure about a test, vaccine, or whatever, refuse it for that day and go home, do research, and reschedule or have it done later if that's an option.
It's hard to make decisions when people are throwing all this information and procedures at you. You can always go back to the lab outside of a prenatal appt for blood work etc if you change you mind.

[AnnieA]

Thank you ladies for all this wonderful info! I MDC mamas!

[BreakfastyMichele]

Just FYI, if they do an ultrasound this early, they may want to do it transvaginally.

[cristeen]

Originally Posted by BreakfastyMichele

Just FYI, if they do an ultrasound this early, they may want to do it transvaginally.

You can refuse that too. No reason for an u/s at this stage unless you have bleeding or a history of m/c.

You can absolutely refuse everything. With my first pregnancy, I refused to pee in a cup for them. The nurses didn't like it much, but the doctor didn't give me any crap. I refused everything right down the line, and it didn't cause any problems until I refused the GTT. At that point they fired me and transfered my care to a perinatologist. I had one appt with her and told her I wasn't doing it, she tried to talk me into it, but then didn't give me any more flak about it.

With my second pregnancy, I raised a huge stink when they tried to do an HIV test on me without my knowledge/consent. That one got ugly (they told me they don't need my consent - I told them they weren't getting my blood then). I transferred care to a HBMW at that point and didn't go back.

[paintedfire]

Originally Posted by cristeen

With my second pregnancy, I raised a huge stink when they tried to do an HIV test on me without my knowledge/consent. That one got ugly (they told me they don't need my consent - I told them they weren't getting my blood then). I transferred care to a HBMW at that point and didn't go back.

Okay, you're my new favorite person. You rock. Seriously.

If a doctor tried to run an HIV test on me without my consent? I'd be filing a report with the state's medical license association. I hope you ran from that practice. I don't doubt you did, though.

[Tresa]

I decline the pap but did let my midwife do a quick internal at my first appointment to measure the length of my cervix and to get a reading of what it's like so when I go into labor, if/when she checks me she'll be able to better gauge where I'm at. I've had a chunk of my cervix taken out years ago, so it wasn't normal to begin with.

This time, since that reading is in my file, though? I will likely decline the very uncomfortable internal exam. You've had babies before, there should be something like that on record, too.

[BreakfastyMichele]

Originally Posted by cristeen

You can refuse that too. No reason for an u/s at this stage unless you have bleeding or a history of m/c.

Of course! Sorry if I alarmed the original poster! I just didn't want her to expect to have an ultrasound and have them refuse an external one in favor of a transvaginal one.