6 week pp pap

[Storm Bride]

Can anybody tell me the purpose of the 6-week pap test? I have to have mine done by my OB, not my family doctor - it's an insurance thing. I don't really want to see him right now, as I'm still really angry about the way my c-section happened. I'm wondering if there's a valid reason to have this. Would it really pose any risks to my health to cancel it?

[Artisan]

I personally don't care for this practice. It's well documented that your cervical cells undergo many changes during pregnancy, and often your cells haven't reverted themselves completely by six weeks pp. (So the false positive rate is high.) They do it because they have you in the office any way -- there is no other medical reason. If it were me, I would wait a few more months (depending on when your last pap was, if you've ever had an abnormal reading, etc) and find a new OB that you feel more comfortable with to do the test.

ETA: My MW doesn't do six week check paps unless the mom requests one. I had one a year after my DD was born.

[DallasCPM]

Here in TX, midwives by law are allowed to care for moms during pregnancy, labor, birth and the postpartum (which according to TX law is defined as the first 6 weeks after giving birth). After that, we are not supposed to do well-woman care - then they are tecnically supposed to go to a CNM or GYN. Although a well-woman exam and PAP during the 6-week postpartum period is within our scope of practice. Depending on how closely you follow that law, may be a reason why some midwives do paps at 6wks. Although many midwives are a little more "flexible" as far as when paps are scheduled.

ETA: oh, I just re-read and you're talking about a doctor. Probably because you're already there.

[jplain]

After DD was born, I dutifully had a 6 week pap done.

The results were inconclusive. Apparently they didn't get an adequate sample ~ there were squamous cells present, but no columnar cells. I was told this isn't uncommon after a pregnancy, and they said there was no reason to repeat it until another year had passed. Next time I think I'll just wait 6 months to a year.

Carolyn

[Storm Bride]

I had a pap not long before I got pregnant...or maybe it was just after. I honestly don't remember. That's embarrassing.

This doesn't seem necessary to me. I may call and cancel. Or, maybe I'll go ahead and have the pap and talk to my OB at the same time. I think if I let him know how angry I am, I may be less angry. I have a real problem with venting anger in a healthy fashion, I'm afraid.

[Storm Bride]

Oh - and forgot to add to my original question. Is there any real reason that a pp pap is likely to provide negative results? I mean - does pregnancy itself increase the likelihood of cellular abnormalities? I just don't get why they do one so soon afterwards, even if you've had a recent pap.

[Artisan]

Yes, pregnancy in and of itself produces a higher level of abnormal results. It doesn't mean there's necessarily anything wrong, just that those cervical changes happen, which can result in an abnormal reading.

[Rmeg]

........

[Storm Bride]

Originally Posted by reader

Yes, pregnancy in and of itself produces a higher level of abnormal results.

This suggests to me that the early weeks/months pp are the most pointless time to have a pap. Why do they do this?

[Mallory]

They do it because they have you there.

It's just like getting all the shots in before kids are two, 6 weeks ppd many, many women go to a doctor.

[Sagesgirl]

Heh. I never knew they did paps at the 6 weeks pp visits, because I've never gone to one. :LOL It does seem rather pointless if the timing makes it highly likely that you'll get a false result, but really what do you expect of the profession which loves the AFP test?

[Artisan]

Originally Posted by Mallory

They do it because they have you there.

It's just like getting all the shots in before kids are two, 6 weeks ppd many, many women go to a doctor.

Yep. You're in the office already. And they figure that if you have an abnormal result, you will willingly return for followups.

[Storm Bride]

They don't even have me in - they want me to make a specific appointment for the pap test. I think I may go - I don't care about paps either way, and I can talk to my OB while I'm there.

[mandalamama]

as far as i know, it's unneccesary and innacurate at 6 weeks PP. i wasn't having any pain, excess bleeding or fever at 6 weeks PP so i skipped the exam entirely, the dr. just said to come in if i developed a fever with cramping or any other troubling signs.

i suggest you write a letter, short as you can get it, to your OB about your feelings. he can't interrupt a letter, like he could your speaking, you know? i hope it works out for you

my OB was totally against my wish for natural labor, because i had gestational diabetes and other problems. we were butting heads so much that i was hoping for an "oopsie" UC at home. i turned down the glucose IV AMA (against medical advice) and did 30 hours of labor with juice and my own insulin shots. the day after surgery, she actually hugged me and told me how proud she was of me that i worked so hard, and felt sorry that i needed a cesarean. so be prepared for suprises, you never know how a dr. is going to react.

[WinterBaby]

I'd totally go to a 6wk pp visit to go over your surgery recovery, and discuss your birth, since that's heavily on your mind. I think I recollect a post of yours dicussing a weird bladder numbness you'd been experiencing post surgery it might be worth talking about. Birth control is another thing many women want to talk about at that visit if it applies. But the pap smear seems invasive and irrelavent at this point. Just skip that part

edt. for clarity

[Storm Bride]

Birth control will be condoms again - at least until dh and I hammer out our disagreement about another baby...

Yeah - I will ask him about the bladder numbness. I don't like it one bit - yet another thing nobody ever warned me about, and I'd never come across a reference to it in any of my poking around about possible side effects of a section.