Drs and mandatory Pelvics - Mothering Forums

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#1 of 29 Old 08-17-2005, 08:26 PM - Thread Starter
 
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I was wondering if any of you knew a starting point to get Drs to give women birth control and blood work without first having a pelvic exam or Pap. I do not get them, in my openion they are rape *to me*, and I have always had trouble getting birth control (which I'm off now) but now am I find that if I want to get lab work done in pregnancy (we're not pg yet, and planning a UC, but if I want lab work, I think I should have the option) I will be denied until I do a pelvic. This seems just wrong to me!

I understand the reasoning behind the rules/laws/whatever they are, but I am VERY informed (I transcribe dr notes for GYNs and oncologists!) and choose not to have this done. To me it would be like denying a person lab work because they smoked, or were overweight...

Any ideas? We have like NO money, but I'd like to send out some letters if anyone could tell me a good place to send them too....

Thanks!
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#2 of 29 Old 08-25-2005, 03:45 AM
 
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I don't know what you mean about sending out letters. Do you want to start some kind of grassroots movement to stop these exams? Insurance companies will never approve and they are the ones that pay most doctors.

I don't think you are going to find any doctors that are willing to dispense birth control without doing a pelvic first. This is as much to protect the doctor from liability as it is to protect you. It only makes sense to rule out any possibility of disease or problems (ovarian cysts or larger fibroids are just a couple of things that can be detected during a pelvic). And, a Pap rules out (for the most part) diseases. Would you really want to start a pregnancy without knowing you are healthy?

You may feel you are fully informed, but how much do you really know about what is going on inside your own body?

Besides, if you do get pregnant, how do you plan to avoid vaginal exams or delivery issues? If you suffer from infertility, you'll have to have these exams a lot.

Condoms and other OTC forms of birth control do not require RXs, why not use them instead?

And, sorry, but if you have never been raped, you can't say that a pelvic feels like rape. I have been raped and find it offensive to have the two compared, they are nothing alike. Say you find it distasteful or repugnant or embarrassing, but don't liken it to a violent crime.
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#3 of 29 Old 08-25-2005, 05:00 AM
 
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I actually agree with her honestly. I can certainly understand her take on this and how it feels like a violation. Yes I have been violated before as well. Not everyone is OK with having a doctor open you up, I despise it myself. At one time when I was on birth control, I felt I should be able to get birth control without having to have a pelvic exam.

I wish I knew how to fight it..maybe someone has some ideas. I personally won't ever use birth control again though other than a condom due to the issues I have had and reading up on hormones and stuff.


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#4 of 29 Old 08-25-2005, 10:48 AM
 
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I have never heard of such a thing and would not recommend starting any hormonal birthcontrol without a check of your health and particularly the system the medication will effect. Obviously you can buy condoms and femal condoms and sponges at the drug store without a doctor performing a pap smear.

It is unsafe medical practice to give presrciptions to patients without first examining them and I would not promote or recommend it.

A yearly pap smear is a very important part of your physical checkup and rates morbidity and mortality due to gyenelogical cancers and other diseases have dropped off greatly since the pap smear beacme part of the yearly physical.
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#5 of 29 Old 08-25-2005, 11:19 AM
 
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"And, sorry, but if you have never been raped, you can't say that a pelvic feels like rape. I have been raped and find it offensive to have the two compared, they are nothing alike. Say you find it distasteful or repugnant or embarrassing, but don't liken it to a violent crime."


I have been mollested and raped(not by dr's)...AND inappropriatly touched w/o my consent by 2 obgyns...how to proove it is another thing. I don't find it offensive to compare the 2...since i've experienced it both ways. Even to some, a reg. exam w/o abuse can feel invasive and the emotional state it leaves behind can be likened to a feeling of being raped.

Ahhh tea the essence of life.
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#6 of 29 Old 08-25-2005, 11:56 AM
 
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I'm sorry that you're not getting any support here. I hear you. I have never been to an OB/Gyn. Am also very educated and informed and choose not to. I have not wanted to be on the pill so that wasn't an issue (mostly I like my long cycles!) and didn't have any trouble getting pregnant. My midwives were more than happy to not poke around down there in pregnancy. I had one check in labor so the midwife could decide to stay or not (she confirmed that I had judged my dilation correctly...) and 2 after baby to check for tears and check for healing of them. That's it. Only other people down there have been lovers. I don't know your state, but in some states midwives can dispense birth control- maybe you could find an understanding midwife? I know that midwives can order blood tests here too. OR you could go to a walk-in clinic and just request the bloodwork you want.

good luck!

-Angela
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#7 of 29 Old 08-25-2005, 12:18 PM
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I have always refused vaginal/pelvic exams and am able to get birth control. I see a family practioner or else I go to one of the clinics for people who live in poverty.
If you want to make change at a particular clinic or hospital then I suggest writing to the board of directors, they are the ones who decide what is policy and where the money goes. Also, write to the owner of the clinic or hospital.
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#8 of 29 Old 08-25-2005, 12:23 PM
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Quote:
Originally Posted by grahamsmom98
You may feel you are fully informed, but how much do you really know about what is going on inside your own body?

Besides, if you do get pregnant, how do you plan to avoid vaginal exams or delivery issues? If you suffer from infertility, you'll have to have these exams a lot.
Vaginal exams -I think if a woman's vagina up and disappeared she would notice or else her partner would notice.
Pap smears are actually quite invasive and cause more problems than they help.
Any person who is given the right to know their own body will know immediately if something is wrong.
Breat exams-a doctor feeling my breast will not know a new lump from an old lump. It is just another way for them to make money off of women who are taught not to know or understand their body.
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#9 of 29 Old 08-25-2005, 12:50 PM
 
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#10 of 29 Old 08-25-2005, 12:52 PM
 
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Quote:
Originally Posted by grahamsmom98
And, sorry, but if you have never been raped, you can't say that a pelvic feels like rape. I have been raped and find it offensive to have the two compared, they are nothing alike. Say you find it distasteful or repugnant or embarrassing, but don't liken it to a violent crime.
Well, i'm also a rape survivor, and considering that I tend to have PTSD rxns to pelvic exams. . .i can definitely see the correllation the OP is making.
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#11 of 29 Old 08-25-2005, 02:35 PM
 
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I agree about midwives (although I don't know about ability to dispense birth control) - when I was pregnant, my midwife always asked my permission to do a full exam, and she worked with whatever strictures a client put on her in that regard.

With birth control, I don't know what your options are - my understanding has been that drs do a full exam once a year in renewing a scrip, as an opportunity to do a pap smear. Do they also check for anything internally that would specifically mean you're contraindicated for the Pill? If not, and they can check for contraindications another way (family history, lifestyle, other medications, etc), then I don't see why you shouldn't be able to make an informed choice to decline a pap smear.

I believe that health care providers should respect the individual's right to make choices about his or her own body. Provide guidance and advice, and cover their rears if necessary, but not coerce or refuse health care.
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#12 of 29 Old 08-25-2005, 03:01 PM
 
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I don't have anything to add but I'd like to thank you for starting this thread. I have been absolutly dreading my doctor since I delivered my baby. pelvic exams hurt me worse than crowning during labor and every time since and i don't anyone to force me to have one ever again. I've choosen to go to the health department for my birth control. They give it out like it's candy here. I'm on depo shots (I was using a condom and spericide AND I was on the pill when I concieved) I'm trying to find a midwife for my next child...or maybe just buy a taser to use during birth on anyone who comes near me!
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#13 of 29 Old 08-25-2005, 03:07 PM
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Originally Posted by swtladyfare
or maybe just buy a taser to use during birth on anyone who comes near me!
:
I love your attitude!
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#14 of 29 Old 08-25-2005, 06:18 PM
 
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I didn't need a pap to get my depo when I used it. My FP gave it to me or planned parenthood or the county health department. My OB did want to do a pap. I guess it's who you see.

I had to be heavily sedated for my first pelvic exam and I still need a support person and to be totally relaxed or I have a panic attack and flashback during the exam. It still *feels* the same to me, even though I know it's not. No stranger gets near my vagina, ever. If I need an exam my FP or MW will do it for me, I get one yearly. They both know about my past, my FP treated me through some of the worst of it. Nobody touches me without my permission and they all stop if I say stop.

I would suggest finding a dr you can trust. Barring that call your local planned parenthood, health department, or midwives office and ask for resources. You do have the right to refuse any medical procedure.
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#15 of 29 Old 08-25-2005, 08:30 PM
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Please remember there is no debating in Activism....

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#16 of 29 Old 08-25-2005, 09:41 PM
 
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I don't think you are going to find any doctors that are willing to dispense birth control without doing a pelvic first. This is as much to protect the doctor from liability as it is to protect you. It only makes sense to rule out any possibility of disease or problems (ovarian cysts or larger fibroids are just a couple of things that can be detected during a pelvic). And, a Pap rules out (for the most part) diseases. Would you really want to start a pregnancy without knowing you are healthy?

*****I don't know if my post will be considered "debate" , but i very much disagree with this poster, and for the sake of the OP getting as much info as possible, I feel like I should write in a little about my own beliefs and experiences. I hope i am not breaking any rules.******

*****UUmm, i don't need a stranger putting their hands inside me to know whether or not i am healthy. the very concept of that is insulting to me. I am my own best doctor, thank you. *****

You may feel you are fully informed, but how much do you really know about what is going on inside your own body?

***---, UUMM, lots, thank you. Certainly more than a stranger. I put lots of time and effort into being well-informed about my body and health. You might say my life depends on it. The attitude that a "regular" person can't be informed about their own body and even educated in medicine, is condescending and rude to me.

Besides, if you do get pregnant, how do you plan to avoid vaginal exams or delivery issues? If you suffer from infertility, you'll have to have these exams a lot.

**** Again, trying not to debate, but trying to give info to the OP: I personally have NEVER had a pelvic. I have used birth control and i have gone through 4 years of infertility, including treatment/drugs, and finally carried a pregnancy to term and delivered, all without ever having a stranger inside me. You can get blood work without a pelvic. Heck, You can get birth control off the web without even a prescription. Yes, there are risks, but you're an adult, it is your body, it is your decision to make.***


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#17 of 29 Old 08-25-2005, 10:31 PM
 
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I am also a survivor of sexual abuse and feel very opposed to mandatory exams.

Here is the angle I'd use on requiring them to be done before birth control or blood work or whatever.

Sure, it is recommended that women have these exams after a certain age. It's also recommended that men over 40 have rectal exams for cancerous polyps. How many over-40s do you know who do that? Maybe one in fity? One in a hundred?

If a doctor said to a middleaged man, "You have to have this invasive rectal exam before you get Viagra, or have blood work done, or get an STD treatment," There would be public uproar and I'm sure public sentiment would be that theres no reason to force invasive tests on people. People have been informed and informed and informed about cancer risks for certain age groups, sexual activity, whatever. It's up to the person himself or herself to make the decision to have the test in my opinion, as with any medical treatment.

However doctors don't think that women should be allowed to make these decisions apparently, because we still have these requirements. And for the person who asked if the pap smear checks for anything that contraindicates the pill I do not believe it does. Why? Because some states are considering making The Pill OTC with just afew questions asked by the pharmacist. Fat chance of it happening everywhere but the article I read on it said that a pap is not necessary to get the pill.

So it's just doctors trying to say that THEY know what's best for my body and not Me.

Hope that helped with something to write. I don't really know who to write it to though.
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#18 of 29 Old 08-25-2005, 10:46 PM
 
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Oh, and i forgot to add...there is basically nothing in the pelvic exam that has any bearing on hormonal contraception......basically, there is NO REASON why BC pills could not be Over-the counter...the ONLY reason it is prescription is so women will be forced to go to their OB's and submit to the yearly exam. (This is documented..google it) But then, the sOB's would lose their bread and butter..same way the Peds would lose theirs if we all decided not to vaccinate or go to the oh-so-important "well-baby" visits...., etc. It doesn't really have much to do with health, people. But then again, if you truly believed our medical system is set up for Health, you probably wouldn't be at MDC!!!.
Jess

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#19 of 29 Old 08-25-2005, 10:47 PM
 
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Quote:
Originally Posted by grahamsmom98
Besides, if you do get pregnant, how do you plan to avoid vaginal exams or delivery issues?
I believe the OP said she was planning on UP/UC. I can't think of a better way to avoid them.

On the subject of paps, it's my understanding that they're not recommended yearly unless you've had a "bad" one or are a high risk. Also, what they are checking for is esssentially an STD, so if you're at virtually no risk for those, you might be more comfortable forgoing them. Cervical cancer is almost always caused by HPV. It is very common, but it is an STD. And I have heard of some providers who will allow the patient to do the swab herself (or was that the GBS?)

Quote:
Originally Posted by grahamsmom98
Would you really want to start a pregnancy without knowing you are healthy?

You may feel you are fully informed, but how much do you really know about what is going on inside your own body?
Have you considered that you're posting this among a group of women who are, for the most part, informed and proactive about their own health? As a UP'er, I'm kinda offended.
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#20 of 29 Old 08-26-2005, 02:59 AM
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I think given the way that this thread is going....I am gonna move this to Fertility.

It is clear that it will not be a non-debate conversation, and I don't believe it fits in Activism currently.

So - to Fertility it goes.

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#21 of 29 Old 08-26-2005, 05:02 AM
 
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While I don't agree with Paps in pregnancy (because the cervix is undergoing so many cellular changes, you're more than likely to end up with an abnormal result or a result which needs to be repeated after the birth anyway....), I do happen to agree with exams for women on hormonal birth control. Hormonal birth control does increase your risk of certain cancers, as does having sex (HPV, etc.). So, in some ways, regardless of how flawed I feel Paps are, it does make sense.

That said, I find it humiliating to remember my first prenatal appointment. It was two minutes of get to know you small talk, then on my back, feet in stirrups, poke, poke, poke. You'd think they'd at least sweet talk me a bit first.

As a midwife, I only do Paps after 8 weeks postpartum.
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#22 of 29 Old 08-26-2005, 01:18 PM
 
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Wanted to add, too, that maybe you can find a really warm CNM or midwife to come to your house to do your paps - she can easily send the results in to the doctor for your bcp.
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#23 of 29 Old 08-26-2005, 04:09 PM
 
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It seems to me there are basically two issues here:

1. Are regular pelvic exams a good idea?

2. Are MANDATORY pelvic exams as a gateway to other services a good idea?

Generally, it seems to me that even the mothers at MDC who vaccinate, send their kids to school, or have hospital births (to give a few examples) tend to also support the rights of other mothers to make different choices - even ones that some might feel are unwise. Particularly when you're talking about what someone else is permitted to do with respect to your body, I think having a sense of personal autonomy is very important. Pelvic exams are a health issue. Mandatory pelvic exams are, in my view, an issue of control versus respect.
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#24 of 29 Old 08-26-2005, 04:31 PM
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Originally Posted by mammastar2
It seems to me there are basically two issues here:

1. Are regular pelvic exams a good idea?

2. Are MANDATORY pelvic exams as a gateway to other services a good idea?

Generally, it seems to me that even the mothers at MDC who vaccinate, send their kids to school, or have hospital births (to give a few examples) tend to also support the rights of other mothers to make different choices - even ones that some might feel are unwise. Particularly when you're talking about what someone else is permitted to do with respect to your body, I think having a sense of personal autonomy is very important. Pelvic exams are a health issue. Mandatory pelvic exams are, in my view, an issue of control versus respect.
I think a lot of people are misinformed about the differences between pelvic exam, vaginal exam, and getting a pap smear.
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#25 of 29 Old 08-26-2005, 10:28 PM
 
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Originally Posted by Minky

Sure, it is recommended that women have these exams after a certain age. It's also recommended that men over 40 have rectal exams for cancerous polyps. How many over-40s do you know who do that? Maybe one in fity? One in a hundred?

If a doctor said to a middleaged man, "You have to have this invasive rectal exam before you get Viagra, or have blood work done, or get an STD treatment," There would be public uproar and I'm sure public sentiment would be that theres no reason to force invasive tests on people. People have been informed and informed and informed about cancer risks for certain age groups, sexual activity, whatever. It's up to the person himself or herself to make the decision to have the test in my opinion, as with any medical treatment.
It is recomened that anyone over 40 have a regular colonoscopy, not just men.

If a middle aged man went into a Dr. and asked for viagra and didn't get an invasive rectal exam before hand the Dr. would be negligent. A mans prostate can be more easily palpated through the rectum. If he's having trouble getting and erection he should have his prostate examined.

Men are encouraged to have a once yearly physical to check for testicular lumps. Along with a monthly self exam. If they feel any suspicious lumps they should have them checked out.

It is up to each of us to take care of ourselves. Nobody is forcing you to have a yearly exam.
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#26 of 29 Old 08-26-2005, 10:49 PM
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Originally Posted by sappylady
If a middle aged man went into a Dr. and asked for viagra and didn't get an invasive rectal exam before hand the Dr. would be negligent. A mans prostate can be more easily palpated through the rectum. If he's having trouble getting and erection he should have his prostate examined.
Men actually now get a blood test and can say no to the rectal. Prostate Antigen Test.
Also, a man can get Viagra w/out a prostate test, though it is recommended. He does need to have his heart checked.
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#27 of 29 Old 08-27-2005, 03:50 PM
 
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Men actually now get a blood test and can say no to the rectal. Prostate Antigen Test.
I think that would depend on the doc. I ran a urologic oncologist's office and that was *not* the prodecure there. A DRE (digital rectal exam) was required to along with a PSA to check for enlargement of the prostate (BPH - Benign Prostatic Hypertrophy).
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#28 of 29 Old 08-27-2005, 06:23 PM
 
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I've had good paps/pelvic exams and bad ones. If I'm ttc I get an appointment for a vag exam because my dr prefers to not do them during pregnancy and especially on me since it throws me into labour and is possibly attributed to 1 of my mc's(having sex is what they believe is the for sure cause). If the exam was more than 4months prior to getting pg then my dr usually does one but will not do a pap or anything to my cervix, my cervix doesn't like to be touched.

The exams I had that were bad were done by obgyns, the first one just about lost his head twice and his nurse had to physically hold me down. I've had some by family practitioners that were not bad, but my dr is awesome about them. He had a harder time finding my cervix last week when I had mine but usually has no problem. The only time it really hurts is when he accidentally catches some hair in the speculum and it rips out. It's hard to feel uncomfortable when you're laughing during an exam. He hasn't done a pelvic/vaginal check in quite a while, usually it's just the pap which is 1-2minutes and he's done.

It is my experience that the higher the specialty(obgyns, peds, oncologists, perinatologists, ents, audiologists, neurologists, internists, etc) the more a person is talked to like they're idiots, they don't know anything and anything they do know is wrong because they didn't go to college for 15years and don't have little letters behind their names, that they're the specialists so you MUST do as they say, not question anything and if you do question anything then ugh you're wasting their time, you're just a woman what could you possibly know,

The only time i do like the specialists is when they piss me off and I see my family dr again. I went to a perinatologist when I was 11weeks for an early US to check for deformalities to see if they could find another cause for the miscarriages. The 2 idiots I saw then wouldn't do it, said they couldn't do it. They were getting up out of their chairs to leave and I kept telling them I was there for a US, my dr sent me here for one and I was not leaving until I got one. They finally consented to do one, then weren't going to say anything and so I told them that there was a problem wasn't there, then they finally told me that yes I had placenta previa(which I know isn't as big of a deal at 11weeks). I didn't know if it was complete or partial. When I got back to my regular dr's office and told him what happened he went ballistic on the perinatologists for battering his patient.
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#29 of 29 Old 08-31-2005, 09:51 PM
 
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Have haven't read all the answers to the thread, so I don't know if this has been suggested...
Planned Parenthood will provide you with birth control without a PAP or pelvic. I would think that it may differ from provider to provider, but you can just call them and ask. They did for me anyways.

Btw, it is a good idea to get a pap every now and then, you may want to ask your provider if you can retrieve the swab yourself and they can just give you a specimen set.
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