Questions about the first appointment « Back to Group Discussions

[femmeknitzi]

I'm scheduled to have labs done next week and I go in for an exam with the midwife the 15th so I have plenty of time before my first appointment but I had a couple questions.

Did you/will you bring your partner to the first appointment? I want my husband to meet the midwife and have a chance to ask questions but I think they're going to do a pap and he does NOT need to be around for that. Do you think it's okay if he comes for the initial part of the visit and then leaves? Or is it just weird for him to be there at all?

Is it okay that my midwife wants to do a pap? I had my yearly scheduled for about 2 days before my period was supposed to start. I asked whether I should reschedule over on the  TTC forums and several people mentioned being concerned about having paps so early. Of course, now I'll be 7 weeks by then. Is that something I should be worried about?

Thanks everyone!

[broodymama]

It's really up to you, if you want him to come for part of it and then step out, then I think that would be fine.  There probably won't be much going on, so if you'd rather have him wait and come to one where they'll use the doppler to hear the heartbeat or if you're having any ultrasounds.

I don't have pap smears done during pregnancy.  That's just my own personal policy, I don't take my pants off at appointments so no pap smears or vaginal exams.  From what I understand it's pretty standard to have a pap at the first appointment, though.

[LillianB]

Originally Posted by Red Sonja 

 I don't take my pants off at appointments so no pap smears or vaginal exams. 

I love this policy! Has anyone ever given you flak for it? My first pregnancy was supposed to be a home birth and I had all of my prenatal care from a midwife who never did any kind of vaginal exams. Now I think I'm going to be going the more conventional route and am really dreading the prenatal visits and getting roped into doing things I don't want/need to do!

[JENinOR]

I'm taking a diff. route too this time (hossy rather than home), and plan to stick my to my guns. I've never been "checked" prenatally, and only once during birth. I WANT to do a pap since I have't had one in years and it is true that cervical/uterine cancer can spread like wild fire during preg. I know of someone who was diagnosed with cancer through a pap prenatally- late 20s early 30s mama. Hidden infection's miscarriage and birth defect risk is another concern of mine. If I had had a pap recentlyish-no way would I now!
Edited by JENinOR - 2/3/12 at 5:03pm

[broodymama]

Originally Posted by LillianB 

I love this policy! Has anyone ever given you flak for it? 

My HB midwife doesn't mind at all, I've had prenatal care with her for 3 pregnancies and she attended two of my births without any exams during pregnancy or labor.  She just knows I don't like to be touched during labor.

The Naval Hospital?  That's a different story.    I usually have a few appointments there at the beginning of each pregnancy and they are always surprised.  They don't give me any flak about it, but they're usually taken aback.  I'm on a schedule where I get routine paps every other year, and I won't be due for one again until around the time this baby is due so I'll just get one when I go for my IUD.

[LillianB]

Red Sonja, do you mind if I ask what you say to let them know that you won't be having any internal exams? Do you establish that at the first appointment? Also, do you do the GBS test?

[femmeknitzi]

Thanks for the input everyone! Red, I love hearing stories of people advocating for what they want, regardless of what the medical institution expects! I don't have anything against having a pap--I'm about 6 months overdue. I just want to be sure it's standard procedure and not a danger to the baby. It sounds pretty normal though, so I'm fine with having them do it.

I talked to my husband this weekend and he's excited to go with me for the appointment. He said he would duck out once they started the exam and that's just fine with me! :)

[1babysmom]

...........

Edited by 1babysmom - 3/19/13 at 7:58pm

[OkiMom]

Ill do a pap, mainly because Im WAY over do for one. I didn't even see a doc after my third was born, I was in the middle of moving from Japan back to the states so no time.. Other than that I have a no pants off policy. Ive never had a problem with it, even with the navel hospital. Even in labor with my third I only had 1 check to see if I was complete (I was), they didn't mind my hands off attitude.

This time we are debating whether we can afford a homebirth or not. It would be 4000 out of pocket plus a birth kit since Tricare Prime doesn't cover it.

[broodymama]

Originally Posted by LillianB 

Red Sonja, do you mind if I ask what you say to let them know that you won't be having any internal exams? Do you establish that at the first appointment? Also, do you do the GBS test?

I'm just now seeing this!  At Naval, when they point to the gown and ask me to put it on, I just say "No thanks, I won't be doing a pap smear or vaginal exams." and smile.  That's usually at the first appointment.  By the time I do the GBS test I'm with my homebirth midwife, and and do the swab myself in the restroom.  

[gratefulmum]

Eek. I didn't even think that having a pap done early could be harmful. I actually went in for my pap 8 days ago and just got my 2 days ago. I assume since I haven't had any spotting (other than super light same day as pap,) that everything's fine.

[~Caitlyn~]

This time around my MW told me in our interview that she doesn't do any vaginal exams during prenatal care... 

Even with my last pregnancy, where I started with a traditional OB, even she wouldn't do a pap at 9 weeks. She said that their policy was to let things lie during pregnancy. About 28 weeks in, I transfered to another office, a few MW's and OB's backing up. They were pretty conventional, but they didn't do paps/internal exams either (until 40+ weeks when they started sweeping membranes). 

I've never heard that cervical cancer could increase at a faster rate during pregnancy... but, hormones do interesting things. I've heard that HVP virus is highly correlated with most cases of cervical cancer. I found a few things online about not treating for this during pregnancy because it can lead to pre-term labor. Basically, it seems like they watch for changes in the cervical tissue if they have a pap that points them at something concerning... but, even if they do find something concerning... all they do is monitor it.. and not take action, because of the risks associated with pregnancy. If they are just going to wait until after delivery to treat it... Idk... why not wait until after delivery to stir things up? I am just wary because I think so much of these things just become "routine..." and don't always provide much benefit. 

Here's an article I found on the worst case findings from a pap - cervical cancer and pregnancy: "It is unfortunate that a woman cannot get pregnant after treatment for most stages of cervical cancer. This is because treatment usually includes the removal of the uterus during surgery or the ovaries are damaged during radiation therapy." -http://www.cervicalcancer.org/pregnancy.html

I guess I would ask what you stand to gain from a pap? I'd ask your care provider what they are looking for, and what they would do if they found it... 

I think it's part of the medical oath - "first, do no harm." If it's a risky procedure... weigh it out... interesting :)