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Discussion Starter · #1 ·
I am using a MW at a birth center. I really like her and the place. However, it seems I am being forced into a pap at my first visit, tomorrow! I am already 17.5 weeks pregnant, and I really don't see why I can't just wait for the post partum visit for the pap. For one, I'll be, of course, more comfortable with my MW then! And for two, I would not allow or consent to the procedures following an abnormal pap while pregnant anyway- so why give myself the added stress and worry? Also I realize pregnancy increases the odds of a falsely abnormal pap.<br><br>
I get the feeling she won't be my care provider if I refuse! This gravely concerns me. I am sick of trying to find someone to work with me. I am a severe phobic with abuse issues, and I have not had a pap before. I realize this is concerning, but my STD risk is VERY low, and I can't imagine waiting another 20 weeks or so for my baby to arrive would really matter that much regarding a pap.<br><br>
I feel pressured by my DH and friends to just shut up and put up tomorrow when I arrive, but I want to refuse the pap. Why will no one even consider working with me???
 

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Yes you have rights and can refuse any test, but if you've never had a pap smear before, I'd get one. If you're wanting to wait until you're more comfortable with your midwife, I'd simply ask her if she could wait on the pap until you've had a chance to get more accustomed to her. She should not have any issues with that.<br><br>
But honestly, I'd get the pap since you've never before had one. But that's just me. I've never had to get one in pregnancy because it's always worked out time wise (I've gotten paps right before getting pregnant, etc.).<br><br>
Good luck with whatever you decide.
 

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Call the MW and ask her straight up what the options are in this case. You'll only get more worked up about it trying to second-guess. And sitting there half-clothed is not bound to make for empowered conversation.<br><br>
GL!
 

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You completely have the right to decline the pap smear!!! And honestly, if doing so means she won't be your care provider then I wouldn't have wanted her as my care provider anyways!!! She should be compassionate about your circumstances (if you feel comfortable sharing with her about your abuse, which I suggest doing with whomever is your CP before the birth) and be willing to work with you.
 

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My MW has no problem with me waiting until after the babe comes to get a pap. Talk to your MW about your issues and concerns. She may be more understanding and willing to work with you than your thinking she will be. Good luck. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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Discussion Starter · #6 ·
I just don't want my first one to be tomorrow, while scared, new, and pregnant, and when if it WAS abnormal, I would have THAT to fret over too, on top of my HUGE phobia of birth, etc. I am more than willing to get one PP.
 

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Discussion Starter · #7 ·
Thanks! She has made it sound like she'll just talk me into it. She even booked extra time for my appt to calm me down. However, aside from my phobia, I have done research and I REALLY feel strongly from a medical POV that phobia aside, it's just not needed and is too risky and pointless right now. DH will be mad if I refuse and she drops me, bc insurance won't cover the ONLY midwife I found in this county who WILL let me refuse the pap.
 

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My office is great about coming in to chat before they have me undress. They come in, we chat for a while, listen for babie's heartbeat, do any other stuff, then they ask me if it's ok to get undressed (and now at 33.5 weeks it's old hat, but it wasn't at the begining). They leave the room, I get undressed and get covered, and then they come back.<br><br>
See how you feel. If you aren't comfortable, ask to postpone it to the next visit. If you had a pap in the last year or so, I would say ask if you can wait. But since you've never had a pap, it is important to get one.<br><br>
Just be honest with your care provider. They should be able to be understanding.
 

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I think you should tell her everything that you put in your post. Since you are a low risk for HPV, I wouldn't think it would concern her to wait until after the baby is born. Or if she feels it's important, maybe she can lay out her reasons to you and let you think it over for a while. Good luck, you do have rights and you can refuse any test you don't want.
 

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Yes, you have rights. But don't forget - so does she, including the right not to be your midwife if she does not feel your desires are in line with the care she has to offer you. I understand not wanting the pap - I wouldn't do it either. Tell her why you don't want it, and if she's not okay with that it's good to know now that she's not the midwife for you.<br><br>
(Also be aware that false positives aren't more prevalent in pregnancy since we switched to the more accurate liquid-based tests instead of the old slide smears.)
 

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Discussion Starter · #11 ·
Is that universal, like, everywhere? Thanks for that info...<br><br>
However, it is true, though, that if I did have some abnormal cells, the birth could wash them away? And that the procedures used for abnormal cells are not generally done in pregnancy? This is why to me it is just plain stupid to do the pap right now. Especially at my stage of pregnancy (17.5 weeks)
 

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<div style="font-style:italic;">I am a severe phobic with abuse issues, and I have not had a pap before. I realize this is concerning, but my STD risk is VERY low, and I can't imagine waiting another 20 weeks or so for my baby to arrive would really matter that much regarding a pap.</div>
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Just in case you don't know this already, if you have abuse issues it is very important to work through anything that may affect your birth. I know there are some great resources out there, I just can't think of them offhand. If you haven't already found any good books/websites/people to talk to, it may be worth doing a separate post asking for advice on this.<br><br>
Also.... tell your care provider the reason for being afraid of the pap. This will help her to understand you are not just being difficult, and if you and she decide you really need to do it, she will hopefully be extra careful and gentle with you.
 

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Discussion Starter · #13 ·
I am scared to death of the pap, of exams, of the blood draw, of ALL medical procedure of any kind, except ultrasounds. I can't even describe my terror of birth, of pain, of labor, of having to go to a hospital, of an IV, of a C section (that one makes me start to shake and gasp for breath, so intense is my fear of it), and of dying in childbirth. I am an honest to god basket case and severe phobic. I often wonder how I will survive this.
 

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I'm so sorry you're having to go into this journey with such heavy things on your shoulders. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br>
I would tell your midwife straight up (assuming you haven't already), and see how she feels about recommending a counselor or therapist to you to help you deal with your phobias during this time. I would also strongly suggest you look into both a doula and getting Hypnobabies study (or taking the class), both of which can help reduce the stress levels I think.<br><br>
But I would definitely see about getting some help from a supportive psychological standpoint. I think pap smears are very important, but I understand your serious reticence about being tested. It does sound like you're using pregnancy as an excuse in this case though, since you've never had one before. I don't mean that critically. I understand why you're doing it, but I think the pregnancy can be an opportunity for you to try to look at some of the issues from a new light: doing what is best for your body and your baby. At least taking those things into consideration. And while I'm not trying to say that means you can (or should) easily dismiss abuse issues, I am saying that if you start this journey shrouded in fear and defiance, then things will be far more stressful for you (and your babe) than they have to be.<br><br>
Good luck to you. I hope you're able to find someone who can help you through this, so that you and your baby can have a happy and safe time. I would definitely approach the pap smear and any other blood tests or urine tests or other typical, common things to help monitor and maintain your health in pregnancy, with open honesty to your midwife. I would not go in with a defiant attitude if you can help it. She can be a big asset to you potentially. Try not to see her as the enemy if you can. Give her the benefit of the doubt, and know that it's only fair she do the same for you.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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I also want to mention that paps aren't just for stds. They can detect early stages of cancer. With the amount of hormones running through your body, it is important to have one done. I'm not sure, however, that waiting until after birth would hurt. I agree that you should be as honest as you can be with your midwife about your fears, and she can explain in detail why she wants it done.
 

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Is there any chance for you to have a homebirth?<br><br>
I would look into <i>Birthing From Within.</i>
 

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I agree that you need to tell your MW your history of abuse and the extent of your fears. If she doesn't know how scared you are, she can't show you the additional compassion and understanding that someone in your position needs. Don't let anyone tell you your feelings are "silly" or "foolish" or "inconvenient". This is YOUR pregnancy, they are YOUR feelings, and they are valid. If you want to have a trust based relationship with your care provider, you need to be 100% honest with her about what baggage you are bringing into it. And frankly, a trust based relationship with your care provider is going to be the biggest thing that helps you get through this without a panic attack. If she still insists that you have the pap even after you explain your history and your fears, I doubt she's the right person to be taking care of you during labor and birth. Ask her if you can put it off until the next visit, at least.
 

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Discussion Starter · #18 ·
She knows, but seems unwilling to bend on the pap. I accept the urine, blood, and scan tests, but for all the reasons mentioned, I want to wait on the pap. She can even look up my vag, just NO pap right now.<br><br>
She knows my fear. I had an orientation and explained in tears the degree of my problem. She even scheduled an extra time block for me to work me up to the pap. But I don't want it, and I do have an option (another midwife) to go to if this one drops me over the pap. That said, my insurance won't cover the home birth, open minded midwife, even though Florida law says they have to. They're military insurance... they get away with breaking the law. They don't even cover birth center birth! But we're paying for the birth at this place I go to tomorrow, assuming she doesn't drop me because I refuse the pap.<br><br>
Unfortunately, I do see medical professionals who don't care about my needs, wishes, or mental health to be my enemy <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> I have never met one who did care about me or what I wanted.<br><br>
I am under psychiatric care, but it's not helping. Only sedating me completely likely would, and no one is willing to sedate me pregnant.
 

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Discussion Starter · #19 ·
I know paps are for cancer, but, that's the MAIN reason I don't want one now. Last thing I need is something ELSE to stress over that can't be treated during pregnancy anyway!
 

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If a provider isn't willing to respect your feelings and fears then she doesn't deserve you as a patient. I understand the trouble with insurance and the other midwife, but you deserve a midwife who will listen to you and work with what YOU want. This stress and anxiety during your pregnancy isn't good for either you or your precious baby. I would strongly suggest you do everything possible to find a way to pay for the other midwife. Your husband will get over it. It's not his vagina the baby is going to be born out of so it's YOUR feelings that are more important right now. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 
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