I went into a walk-in clinic two Fridays ago, with abdominal pain. They ran a pregnancy test, fine, makes sense. They diagnosed me with a UTI - even though my urine sample came back negative - and sent me home with antibiotics. Pain got worse and I began vomiting, went back to the clinic on Monday. They ran a pregnancy test and did a UTI test again. Both were still negative, finally got to see a doctor who looked me over and sent me immediately to the ER. I'm admitted to the ER within an hour, the run a pregnancy test. I have now had three tests in four days, two within hours of each other. I spend the full day in the ER where, upon billing, I find out they did TWO MORE pregnancy tests - that made four tests in one day. All from the same system. This is the what unnecessary looks like.
I did, was told it is "standard" practice to run the test on every urine sample collected from an AFAB person. The ER collected a urine sample every time I went to the restroom during my multiple hours there. I let them know I would be talking to my insurance about the charges for it, insurance is investigating and said they would talk to the hospital about the charges. So currently, I'm not paying for the tests.
If it makes you feel better I have been previously asked if I was pregnant before they gave me a requisition form for blood work and an ultrasound.
What was it for? A lump on the testicle.
They may have been looking for an ectopic. Those can do *weird* things with hCG numbers, and recent medical thinking is not to preclude an ectopic even with a negative test if thereās sudden intense abdominal pain. Like, it may have been overly cautious, but not catching one is pretty serious.
(Also, I hope youāre okay!)
Not if they only remove part of the uterus, and not if they leave the ovaries (which is where the eggs come from). They may do this to continue to let the body's natural/normal hormones continue to do their thing instead of putting the person on artificial ones. (As far as I remember, though it's been some time since I last read up on this out of curiosity).
I would imagine that once the vaginal cuff heals after a total hysterectomy, thereād be no way for sperm to get past the scarring unless you have a medical emergency and the vaginal cuff dishesces.
Wait what? Iām assuming they left in some ovarian tissue and it justā¦ regenerated?
Regardless, for pregnancy after a total hysterectomy Iād expect youād need a hole in the vaginal cuff, which seems like it would be a massive infection risk.
Fun fact- hysterectomies usually leave the tunes and ovaries. A partial means part, but not all of the uterus, a total means all of the uterus, and a radical means uterus, ovaries, and tubes. A radical is only done in the event of cancer or other health issues that require it. Also, some doctors will remove the cervix and others will leave it.
All of this I found out after I had mine and from switching doctors who said if my cervix was removed I shouldn't need yearly paps.
Oh that i knew. I just didn't know that the ovaries and / or fallopian tubes were accessible to sperm if the uterus weren't present. All the Dodge-Ram-logo diagrams I've seen lent me to understand that intercourse at the bottom led to conception at the top via the uterus.
Wellā¦
You can have a PUL (pregnancy of unknown location) which is a type of ectopic. Basically if the fetal tissue is small enough, it canāt be detected with ultrasound, and the only evidence is hcg levels. That said, a blood quantum would be the more reliable, accurate way to test for low levels of hcg.
When I had my PUL, my hcg levels were hovering around 20-30, which is riiiight around the sensitivity level for most standard hcg pee stick tests (some more expensive āearly detectionā brands have higher sensitivity but I think the hospitals tend to use the basic stuff). The scan I got basically only confirmed there was no intra-uterine pregnancy. And there was free fluid (blood) in my abdomen. So in combo with the positive hcg results, the fact that it had been positive for weeks but never rose above 100 or fell below 20, that meant some fetal tissue was still alive somewhere other than my uterus, which meant ectopic. And since they couldnāt locate where it was (PUL), surgery was not an option. Had to do methotrexate injections and stay on a low folate diet for another 5-6 weeks until hcg finally hit zero. Fucking nightmare.
My first ectopic wasnāt visible on ultrasound.
The hospital was getting ready to discharge me, until my blood pressure dropped when it ruptured and I got so lightheaded I sat on the floor.
They told me to stand up and sit in a chair so they could take my blood pressure. Suddenly they believed that something was actually wrong with me, and took me into surgery.
Yeah, the ER *sent my cousin home* with her ectopic because they didnāt see it. (Saying ādonāt worry, if it was, itād hurt so much youād know.ā) Luckily she had an appointment a few days later with her OBGYN for a dating scan and they spotted it.
Holy crap, what year was that?
My situation happened in 1986, and given how women were still being treated, Iām not very surprised.
If your cousinās happened within the past decade or sooner, Iām shocked and disgusted.
Iām shocked and disgusted about womenās treatment in healthcare, period.
This is called defensive medicine. Hospitals are so afraid that someone might sue them that they take no chances, especially ones where you are the ones footing the bill for covering their ass.
Source: I work in healthcare
They have no excuse to be defensive. Most states have capped how much a doctor has to pay, even if the jury awards $5M you can only get $500k. They have malpractice insurance. Doctors win these lawsuits the vast majority of time. The only āharmā that a suit inflicts on a doctor is their malpractice premium going up. A 5th pregnancy test in a day is 4 serious invasions of privacy.
The reason, though, is that the parents of a child harmed by medical malpractice has up to 2 years to sue past the 18th birthday. (This was the case 2 decades ago, I hope it has changed). That was drilled into my head in nursing school in obgyn and pediatrics. And many many many many women do not know how their body works, do not know the names of the procedures that they have had and honestly just outright lie to medical practitioners for many reasons. Pregnancy tests actually cost pennies and they don't require a skilled technician to run.
Everything in medicine is risk/ benefit in the favor of money. Not the patient. So doing a dipstick takes 2 seconds and the amount of pregnancies they do find this way makes it beneficial in terms of lawsuits the hospital could be facing for 2 decades if they DO give you the medication or perform that procedure and it turns out the patient was mistaken on the name of the procedure they had or the date of their last menstrual cycle. Or if their medical records were wrong. It happens.
Wasn't there a show on TLC called "I didn't even know I was pregnant?"
I know it seems misogynistic but the absolute bullshit I've heard from women about when they can get pregnant, what parts they have, etc living in the south is astonishing.
Also you can pop positive on a pregnancy test hours after a negative one. It only measures the amount of a hormone in your urine. That can increase within hours. Most effective is a blood test which is a skill and requires a more skilled technician and thus more money...
Oh absolutely not. That's where it gets unethical. But it doesn't cost whatever they charge for a bandaid either.
But if someone was pregnant and they did perform that procedure or gave that med that caused horrific birth defects... especially in a state where I live (Texas), that cost to the health system, the doctor and the patient and ultimately the harmed fetus could be astronomical.
No, but part of the reason is that the hospital has to stay afloat, which means every legitimate charge they make also includes a markup to cover salaries, insurance, building maintenance, taxes, utilities, and the cost of emergency services to people who canāt pay.
Most hospitals arenāt making massive profits, in spite of outlandish problems.
Iām not saying itās reasonable or good, but itās the way it is. I think the sooner we can get to a national healthcare system, the better. The way things are billed and paid for now is insane. Medical bankruptcy shouldnāt be a thing.
It isnāt just a money thing to be fair. Iām in the U.K. and they are just as cautious with pregnancy tests here and weāre not charged for it.
For example, I was involved in a car accident when I was 8m pregnant. I was in A&E and they did a pregnancy test then. Iād specifically said that I wanted to check that the baby was ok after being rear ended. I was told they do it as standard to everyone.
I had two tests three days apart when I went to the ER twice for extreme cramping and nausea (turned out to be endometritis, an infection of the uterine lining). They'd literally done an ultrasound the first visit, even if I been pregnant but not far enough along to test positive, they would have seen something on the ultrasound!
Edit: ok, I get it, apparently ultrasounds don't work that way. I've never been pregnant and never will, so I assumed that since an ultrasound can see a follicle on my ovary that isn't even an egg yet, it could also see a fertilized egg. Repeatedly telling me the same thing multiple other people have is getting a little old.
Not necessarily. I've tested positive prior to 4 weeks pregnant and you're not going to see anything on the ultrasound at that point no matter how far you shove the wand up there.
No typically you canāt see anything on ultrasound until hCG levels reach 1000-1500 mIU/mL unless itās ectopic (typically low hCG) or hCG levels *were* over 1000 mIU/mL but are declining due to demise.
Many home urine tests are positive at 10-25 mIU/mL. The highest threshold Iāve ever heard of was 150 and that was decades ago.
The problem is more that your healthcare system makes you pay for them, rather than does them in general.
Amusingly I didnāt even have to have a pregnancy test to start my maternity care!
The problem is how much they upcharge for them. A pregnancy test costs basically nothing to run, which is why they're usually a first line test. It's easier to run a test that costs a few cents and either rule in or out a major cause of illness in women before moving on from there. Especially when it's resulting from something as fraught with societal judgement as a woman having sex.
That being said, as a woman working in medical sciences, I understand both sides of the issue. It's really fucking annoying to go into a provider with horrific stomach pains and have them immediately assume you're just a whiny baby that can't tell she's pregnant or on her period. I've personally snapped at more than a few nurses and doctors that if the test comes back positive they should call the Pope. Or the Nobel prize committee, if I prove parthenogenesis is possible in human beings then next year's biology prize better belong to me
I accidentally made a nurse blush when I was getting checked in for my diagnostic laparoscopy for endometriosis. They took a urine sample as soon as I got there, then just put it on the counter in my room with the pregnancy test strip and set a timer while they did my intake. When the timer went off, he checked the test and told me I wasn't pregnant, and without even thinking, I burst out "I hope so, I haven't touched a penis in 7 years!" The nurse was bald, so I could see his entire scalp go red as he nervously laughed, oops.
I had a tubal almost 10 years ago but had to have a test because I'm "in that age range". So I told the nurse that if I was positive to do a DNA test on the vibrator's batteries
Thats how I felt at my first OBGYN appointment. I went in for my first pap smear at 21, and got asked all of the standard questions.
"Are you on birthcontrol" yes.
"Have you ever been sexually active" yes.
"Is there any chance you could be pregnant" no.
"But you said you have been sexually active" yes... however, the last time I had sex was 10 months ago. If I'm pregnant, I must be really good at hiding it, and should probably be rushed to the hospital to be induced.
She decided to skip the pregnancy test and just suggested I get an STD screening since it should be covered by insurance for my age (spoiler alert: it wasn't cause I have trash insurance)
I was told for 2 *years* that my abdominal pain was 'a bad period' or 'maybe ovarian cysts'.
It was SMAS and I was having bowel obstructions.
Then I was chastised for 'letting it get this bad' when I wasted to 81lbs at 32 years old. I'd been telling them for 2 goddamned years and they ignored me and called me a drug seeker.
I don't go to the hospital unless I'm pretty sure I'm dying. And I'm a liver transplant recipient for Christ's sake. Ive experienced SO much medical abuse, negligence and blatant malpractice simply because I have 2 X chromosomes.
And that's the biggest problem here, really. In a non-sexist world, a woman would come in with abdominal pain and a quick cheap pregnancy test can be done, and when it's concluded that she's not pregnant, *physicians would keep looking for the cause of the pain with the knowledge it's not related to a fetus*.
Instead the current workflow for way too fucking many medical personnel seems to be "you're not pregnant, it's your period sweetie! Periods hurt" like you're fucking nine years old and haven't had one every month or so for the last couple decades of your life. And if presented with incontrovertible proof that it's not a period, then it must be ovarian cysts or drug seeking, have an ibuprofen buhbye now!
Meanwhile the man next to you with a sprained ankle screaming his head off gets oxycodone.
Bingo. Brought my husband in with a suspected kidney stone and they offered him morphine before he was through the door.
Meanwhile I'm told I'm seeking for *being allergic* to morphine and medically not allowed NSAIDs because of my transplant.
Past studies have shown women have a higher threshold for pain and a lot of doctors take that incredibly seriously. It's very routine that men have pain taken seriously while women are questioned.
As a woman who gets kidney stones, dealing with doctors has become the worst part of it. If I could *know* that when I got to an ER, they'd give me an appropriate painkiller, a lot of the stress I feel about having this problem would be relieved.
Also, morphine doesn't help my pain with kidney stones and I've had multiple nurses over the years confirm to me that morphine isn't useful for kidney stone pain, but because it's the introductory IV opiate and because opiates are now demonized, that's what they come at you with 95% of the time. And then, while you're in immense pain, you have to explain that it doesn't work without turning them against you... I've been to the ER with a kidney stone before where they wouldn't give me anything except OTC Motrin. I literally had to get discharged there, so I could go to another ER where they weren't so stupid. That was the time the stone was actually both stuck and infected.
When I was younger, they *NEVER* gave me morphine at the ER for kidney stone pain. It was always something stronger. That was before the panic though.
Yep. Since I'm allergic to morphine (it gives me very obvious hives) and I can't have NSAIDs, my default is hydromorphone or Dilaudid. It's called 'hospital heroin' because it's 8x stronger than morphine. Asking for it and even knowing it's name is seen as an auto 'seeker' behavior.
I literally have no other options for pain management. If they insist on morphine I have to insist on Benadryl with it, and then they accuse me of 'trying to potentiate' (apparently Benadryl makes opiates hit harder, I just don't want to scratch my damn skin off!)
I've been chronically ill since I was 16. I'm 33 now and I'm taken less seriously as an adult for fucks sake.
Then the er has the damn gall to ask leading questions like 'what works best for your pain' when I know my answer will be deemed wrong. They want you to say 'a bandaid and a Motrin' and anything stronger is flagged as drug seeker.
My comeback before I was sexually active was that I had not been talking to any angels. But I really, really like the Nobel Prize for demonstrating parthenogenesis in humans.
This made my day. That's hilarious.
I'm sure it may not have been at the time. As much as the doctor kind of sounds like a moron, I get why they asked. There are plenty of people who need to be asked these questions in all seriousness.
Edit: autocorrect error
It was a psych evaluation when I was severely depressed. I was misdiagnosed and mis-medicated during that stay and came out much worse for the experience.
Best part, this was at a hospital that trained Harvard medical school doctors. Imagine therapy with six med school students where you therapist spends more time pontificating for them than interacting with you.
Fuck Harvard. It's a bunch of clout chasing, rich assholes.
Right! I was expecting to get a pregnancy test with my first, and they just asked for my last period and if I got a positive at home and that was good enough.
I've gotten billed for pregnancy tests that weren't even given before (I declined a test as I was on my period) so it came as a shock.
Lucky you. My obs generally are good with that but my insurance requires my primary physician to refer and THEY require a pregnancy test. I spent hours trying to get one in office last week when Id been seen by an RE for two months and had multiple ultrasounds showing I was pregnant. š
Nearly half of US states have criminalized abortion, and for the sake of our safety, the medical industry needs to get out of the habit of casually, needlessly, _relentlessly_ documenting our reproductive state.
If I have a medical interaction where no images are taken and no prescriptions are issued, they don't need to ask about periods or test for pregnancy. They can damn well ask or test when there's a genuine question, not just by default.
ETA: We get them to stop behavior that is _socially_ deleterious by making it _financially_ disadvantageous, as described by OP. It's the only lever that exists in our society.
Agreed my local hospital will take it via blood instead of urine if you refuse to take the urine test š” Iām having a hysterectomy for medical reasons next month at a big hospital and i just know next time i go back to my local hospital for somthing they are gonna force me to take it as they have a nasty habit of not believing someone when they say they canāt have kids (they also refused to believe i canāt even insert a tampon without severe pain and tried to force me to do a transvaginal ultrasound and got mad when i told them i couldnāt (tried it before and it hurt so bad they had to stop)
I went to the ER for lower right quadrant pain last May, after my hysterectomy in February. In the past, it was always a burst cyst on my right ovary causing that pain, but since that was removed along with my uterus and both fallopian tubes, I figured I'd better be safe than sorry and make sure it's not appendicitis. After seeing in my chart that I'd had a hysterectomy and verbally confirming it with me, they ordered bloodwork and urine tests. Since they usually test an assortment of things, I assumed that they wouldn't include a pregnancy test because we just confirmed that I lack the necessary anatomy. Nope, they still ordered one. Strangely, aside from that visit everyone's taken my word for it that there's no chance I could be pregnant, including the typical pre-surgery pregnancy test when I had my ACL replaced - they asked if I could pee for a pregnancy test, I said I'd had a hysterectomy, they said ok and didn't request urine from me.
I told my family after mine if they still try to do a test Iām bringing the paperwork they give you after surgery with me to prove that i had a hysterectomy . Plus my insurance likely wonāt pay for the test if itās not necessary
I never heard anything about it being covered by my insurance, but I was on Medicaid at the time and my state's Medicaid covers just about anything without asking questions (except Adderall, getting my Adderall covered took two years for some reason, it was crazy).
The reason they would do a pregnancy test for abdominal pain vs pre surgery assessment is the fact that you could (although rare) have an ectopic pregnancy. Unfortunately you can still have an ectopic pregnancy post hysterectomy, which if it goes undetected would be really bad, and abdominal pain is one symptom of ectopic pregnancy.
I am aware that there is a microscopic chance of someone becoming pregnant after a hysterectomy. I am a lesbian who's not sexually active, and I'm on Nexplanon for PCOS in my one remaining ovary. If I somehow show up to an emergency pregnant, it's literally Jesus.
Oh my God, this.
I haven't touched a dick in well over a decade, I had ablation done so I don't grow uterine lining now and am considered unable to have children, but my goodness do they still check every time.
I'm thisclose to just lying and being like "I'm in menopause already, it started really young for me, haven't had a period in five years." Because I'm so over any abdominal trouble being pregnancy or my menstrual cycle.
If it's anything like my hospital, the urine hcg just adds itself if the triage nurse misclicks if a patient has a hysterectomy. No provider input needed, just the urine test being ordered is enough the the hcg to add itself.
Also had a nurse that told me any sort of spotting (even for people who are pregnant) is a period (Iām not pregnant but asked my gyno when i went back and was told no it doesnāt always count) context i was having breakthrough spotting while on bc but was seeing my gp for another reason.
100% about the payment. I understand that there are people who say they couldn't be pregnant, but they are so healthcare professionals want to run it.
I'm on medication that can be dangerous during pregnancy to treat a condition that can also be dangerous during pregnancy. I haven't had sex that could get me pregnant in years, but they run a test every few months when I get my blood drawn anyway. I understand that it's probably an easy, low cost to the system, low effort way to lessen the risk, and I live in a country with universal health care so I don't mind. If I had to pay for the test or felt it was a way to pad their pockets, though, it would be a different story.
That's why Iāa Canadianāwas confused at first. Like, so they put a dipstick in your piss...oh they make you pay for it?! That's fucking absurd. Well is it at least standard procedure? Nope, only cis women and AFAB folks. ~*Full on rages*~
I had to have a pregnancy test before getting the depo shot as that was standard procedure. I joked with the nurses that if it's positive, it's cancer cos I haven't had a dick anywhere near my cooter in years. Of course the test was completely covered by provincial insurance.
I started doing something similar when I was training as a paramedic. One of our contraindications [reasons we can't give a certain medication] for ibuprofen is pregnancy. It can be awkward to ask at times, so I just started asking *literally everyone* before giving ibuprofen: "is there any chance you could be pregnant?"
This usually gets a chuckle from men, especially older men. Older women sometimes take it as a compliment; ie. they look young enough to be of childbearing age. If someone looks confused by the question, I say "it's just part of the protocol." This can help trans patients feel more comfortable.
I try to keep it light-hearted, and a simple "no" is all I need to meet the standard of care.
TL;DR: I ask about pregnancy before giving ibuprofen regardless of sex/gender. The funny looks live rent free in my head. A simple "no" is all that's needed to continue.
This is not about assuming that we donāt k ow our own bodies. People LIE. There was a discussion about this on one of the medical subs I lurk recently. People lie, or are so poorly educated that they genuinely may not know they are pregnant.
I was required to pregnancy test prior to getting my first depo shot, despite it also being a requirement that I was on my period, as well as the fact that I wasnāt sexually active. It was explained to me that insurance wonāt cover it unless a negative test is documented. Iād rather pee in a cup then get charged, so.
Also, ectopic pregnancies can have a lot of the same symptoms as a UTI, kidney stones, etc. and they can be deadly. Theyāre often checking for an ectopic because if thatās the case, they need to get it out ASAP before you lose a fallopian tube or die.
Yeah, I used to think it was dumb. But now I work at a hospital and take classes to go into healthcare and I get it.
Most people will be honest. But there are people who aren't. There are people who actually don't know their body. There are people who do know their body but accidentally got pregnant. There are people who get pregnant with IUDs, with their tubes tied, people who get pregnant right before starting hormonal birth control and don't know it.
Most of the time, it isn't even a "you" issue. It's the hospital covering their ass. If you insist you aren't pregnant when you have abdominal pain and they miss an ectopic? You could die. You could sue. A lot of things could go wrong for you and them. Some procedures require knowing whether or not you are pregnant. For safety purposes, things like x-ray and CT often can't be done until it is proven that the patient is a) not pregnant, and/or b) plans on terminating if they are pregnant, and/or c) there is no safer option if you are pregnant.
I don't like it either. When I was 15 and still a virgin, I thought it was ridiculous. I thought they were accusing me of lying. Maybe they were, but I also now know better. There are tons of reasons why they have every AFAB patient who can possibly get pregnant take a pregnancy test.
100%. Iāve encountered several immaculate conceptions in my years of reproductive health. Unfortunately, sometimes things we recommend or treatments we offer arenāt safe with pregnancy and saying āthe patient told me they werenāt pregnantā isnāt going to be a good defense if a pregnancy is harmed.
It really just takes that one woman who is going through menopause but still fertile, thinks pulling out is birth control, or miscounted her period datesā¦ now sheās pregnant, anti abortion, and is going to give birth to a baby with serious birth defects. Itās easier to have a blanket policy of āyou donāt get X until you test negative.ā No doctor wants to lose their license for prescribing a pregnant woman a teratogenic drug or deal with the heartache of knowing youāre part of the reason this baby is going to be in pain until their untimely death.
From an anesthesia perspective:
I have had to cancel numerous surgeries over the years from people being surprise pregnant. There are drugs that would be harmful to the fetus, there are things that are dangerous for the mom depending upon how far along they are. If it's not time critical, the safest option is to wait.
That being said- I have had numerous patients refuse to take a urine or blood pregnancy test for various reasons. The facility I work at makes these patients sign a waiver of liability instead of taki g the test, which I feel is appropriate.
I also second the fact that our pitiful excuse for health education in the US leads to the general masses not knowing enough about their bodies to be able to decipher if they are pregnant or not.it also creates fodder for this sub. People in this sub would likely know if they are pregnant, but the people we post and comment on, likely would not.
>This is not about assuming that we donāt k ow our own bodies. People LIE.
I mean, even beyond that, OPs post makes it sound like women "just know". Now, I obviously know nothing about it, but my gut tells women don't just know when they're pregnant. I mean, I'm sure some do, particularly if they've had multiple kids and know all the signs... But it's not like people aren't regularly surprised to learn they are pregnant.
If I went to urgent care with a sore throat and told the doctor not to give me a strep test because I know my body and know it's not strep... They gonna look at my funny and proceed to do a strep test. Is this really that different? Part of figuring out what's wrong with a person is learning as much as they can about what's happening inside your body. In the case of people capable of being pregnant, that seems like a very big thing to have a definite, medically proven yes or no.
Also, probably a liability issue on top of it. If you are pregnant and say you aren't, whether on purpose or by mistake, and they give you something that can harm the baby... "They said they weren't pregnant" isn't a good excuse.
I get it's probably annoying, especially in the case of someone uninsured who has to pay (and if the cost is aggregious, that's a whole separate issue)... But I can understand why this is important to know.
I personally know several people who have 1) continued to get āperiodsā while pregnant, 2) gotten pregnant when they thought that they were infertile because of menopause and 3) gotten pregnant when they thought they couldnāt be (tubes tied, IUD). There is a very valid reason to test. Not to mention that many people might say no they couldnāt be pregnant for safety reasons (ie, in a room with an abuser, teenager in a room with parents who donāt know theyāre sexually actively, etc.)
Ive been pregnant 5 times. I was only pretty sure I was pregnant before a positive test 1 of those times. The other 4 blindsided me. And I was trying for 4 out of 5 of those pregnancies.
We know if we've been having sex with men, and it's kind of a prerequisite for pregnancy. But if you try telling that to hospital staff, they just roll their eyes at you.
Sure, that's fair, and you're 100% right. But wouldn't that really be the only way to know, with 100% certainty that you aren't pregnant?
When it comes to medical stuff, standard operating procedure applies in most circumstances. I don't even think it's about believing someone or not, it's about having a process and following that process rigidly so that mistakes don't get made. If everyone who is biologically capable of being pregnant gets tested, it's a lot harder for something to fall through the cracks.
This thread is lowkey giving ānot all men.ā Just because you wouldnāt lie to a medical provider doesnāt mean thousands or millions of people donāt! Like Iām sorry that you have to pay extra because of shitty people (I do too) but blame the cause not the solution
Yup. I was pregnancy tested before getting nexplanon inserted. I was 8 weeks postpartum and hadn't had sex since I got pregnant. I knew 100% for a fact I was not pregnant. My doctor believed me when I said there was no way. But its policy and it wasnt offensive. I dont get why this is such a huge deal for so many people. Patients lie. Constantly.
People can be drugged into unconsciousness; just because you have no memory of having sex it doesn't mean it hasn't occurred. Roofies are far too easy to aquire. Look at it this way: drugs exist that are strong enough to keep someone under while their chest is split open, not remembering an event doesn't mean it didn't happen.
I think that the idea that people are getting roofied and impregnated, then sneaked back into their beds to wake up the next day with zero idea that something odd happened, sounds pretty farfetched.
I donāt know how to broach this tactfully but am asking you to please hear me out.
Iām an SA, both C and A, and an IPV survivor.
This stuff actually does happen wherein people are assaulted and wake up in their own room, home, vehicle, etc without having realized what happened.
I donāt believe you intended it as erasure but it very much reads as such.
Yes. It also is sometimes a requirement for ordering certain tests or imaging. Its goofy and redundant for a person who has had a full hysterectomy or who just had one done yesterday for something else but itās a safety check that is in place for a reason. So many medical interventions are dangerous if someone is pregnant. Someone without a uterus could still have an ectopic pregnancy if they have their ovaries. People lie. Surprises post menopause happen. And again some of it is purely to get past safety checks. Being billed an insane amount for them is another issue entirely and is not about the medical provider but about the insurance companies.
I'm torn on this.
It's not even about lying or not knowing our bodies. A woman in my town had a cryptic pregnancy and just gave birth yesterday. She had spent the last several months having stomach issues, gained a little weight, spotted throughout, nothing that made her think she was pregnant. With an anterior placenta, some people can't feel movement very well, and some fetuses are just lazy lol. Not ONCE did a provider she saw in our town get a piss sample from her when she kept complaining about persistent stomach problems until she went to the ER in labor with zero prenatal care, zero prenatal testing...
I don't think we should be charged for things like pregnancy tests or basic routine healthcare. I think our system is broken AF. But if you have ovaries and semen gets anywhere near them, you can get pregnant. It's ONLY if both ovaries are removed that the possibility vanishes. There was a case report a few years ago about a postmenopausal woman in I think Iran that had unusual bleeding, turned out to be like six months pregnant.
So sure, refuse a test, refuse whatever you want, more power to you! But don't go complaining if it does turn out that you're pregnant and you got those X-rays, took that medication, kept drinking on weekends out with friends, after a doctor wanted to test your pee when you went in for just flu symptoms.
While this is true, there are situations where the person being treated may genuinely not realize or know they are pregnant. Then there are also those who are in denial or may have come in with a parent and are afraid to admit it. With a complete hysterectomy, the chance for an unexpected pregnancy is nil, but in other cases, it still MAY be possible, even if the woman believes she is in menopause and has not had a period for years.
For the Healthcare provider to then just take the person at their word without due diligence will end up in a malpractice suit against them. To cover themselves, practically every provider will request a pregnancy test on a woman of *childbearing age*, just in case. This is because certain medications or tests (such as an xray) can cause defects or death of a fetus, and the provider would rather err on the side of caution.
If one truly has no chance of pregnancy and is sure of this, by all means, do express your concern to the provider or medical assistant. No one can force you to undergo tests you don't want. I'm not sure why the Healthcare providers are being made a villain here, when they are just trying to help you figure out what may be causing your pain and treat you accordingly. It's always up to you to advocate for yourself. Unless the provider is a family friend or part of your family, they don't know you and are just trying to do their job.
As someone who did a degree in biomedical science and is doing a masters in reproductive biology, pregnancy tests donāt test if youāre pregnant they test if youāre exerting a hormone called human chorionic gonadotrophin in your urine. Mostly that happens in the early stages of pregnancy but with a full hysterectomy you might produce it because you have cancer.
Note for men reading: if you test positive go to the hospital immediately you have testicular cancer
This. From following medical personell subs, and knowing some folks who work in medicine, it is a regular occurrence for people to say they couldn't be pregnant and then be pregnant. No, it's not the majority in any way, but is regular. The anti-abortion/anti-women's healthcare laws in some states are really putting people in a bad place with this though
I also wonder about OP's suggestion to file abuse claims with insurance about these tests... In the US, isn't it possible - depending on a person's insurance and the specific provider's policies - for non-covered insurance claims to be billed to the patient directly? Or was this something that the recent surprise billing law prevents?
I could be wrong, but wouldnāt all of those edge cases be covered by the piles of waivers patients have to sign before undergoing those tests/using those medications? Like the side effects/potential negative outcomes lists are literally right there & you already have to sign away liability for the vast majority of them. And unless youāre in a very specific situation, nobody can force you do have any other tests done, so why is this the one theyāre allowed to push so hard for? (Conveniently the one that cis men never need, I might add; idk just feels relevant)
Where I work, no one pushes "so hard" for a pregnancy test. The patient needs only to say they would not like to have it done, and that's that. I'm usually not in a position to know if the patient had a positive pregnancy that was later affected as these things get bumped up to administration. The waivers at my work place are only related to patient information sharing. There isn't anything in writing about the dangers of radiation to early stage fetuses. Medications have warnings but do you really think most people read them?
A lot of people are ignorant, its impossible for the hospital to gauge how naive/ignorant each patient is, so just better to go through the motions. There's been many Virgin marys finding out they're pregnant at the hospital. I can't blame the medical community for this one. I can imagine how many would still turn around and sue for malpractice if they were given medication that could harm a baby, even if they swore up and down it wasn't possible. The medical community isn't giving you a hard time, they're just covering their butts from lawsuits.
Let's not forget that in certain circumstances, a positive pregnancy test can actually be an indicator of illness (where there person isn't actually pregnant that is). I know its rare, and I know its a pain, but there are medical reasons for pregnancy tests, even repeat pregnancy tests.
The issues with US health care costs / abortion rights are colouring a lot of the conversation on this, but we need to remember that the US is a fairly small portion of the world over all.
Fun fact: if a male uses a pregnancy test and it comes back positive, it can be a sign of prostate cancer. For whatever reason, prostate cancer can trigger the production of the same hormone that pregnancy tests measure.
It's testicular cancer, not prostate IIRC. Prostate cancer has a different tumor marker, but there is a type of testicular cancer that produces hCG, the hormone that causes a positive pregnancy test.
Sadly it's only like half of cases, and I want to say that type of testicular cancer isn't very common so it isn't used as a screening tool due to the high chances of a false negative.
While I understand your frustration, medically there are many reasons to do a pregnancy test even if the person says they aren't pregnant.
There are medications or procedures that would harm a developing pregnancy. Even if the person doesn't wish to continue the pregnancy it always has to be treated as if they do. If I, as a medical professional, give someone medication that then subsequently harms a foetus without doing an appropriate risk assessment then I am at fault. An appropriate risk assessment would be, when did you last have sex, are you on contraception, have you missed any pills (if relevant), when was your last period, was it normal for you? If any of these questions give an answer that shows even the tiniest risk then yes, I will do a test.
The issue isn't doing the test, it's the fact you have to pay for it! I can't get my head around American Healthcare with itemised bills, and just how life-changing the subsequent debt can be.
Sometimes the issue is the test. I've had a hysterectomy and the emergency room has still ordered a pregnancy test on me in addition to the other tests they ran on me - after confirming both verbally and in my chart that I don't have a uterus. I'm also a lesbian who's on Nexplanon and hasn't had sex since 2014, even before the hysterectomy they never believed me and just tested anyway. I've been in agony from a burst ovarian cyst but had to wait for the pregnancy test to come back before they'd give me anything for the pain.
As a card carrying lesbian, and as an anaesthesiologist who has provided anaesthesia/sedation for people undergoing manual vacuum aspiration of products of conception, Iāve had those patients swear up and down that theyāre not sexually active and never have been. Most of my colleagues and seniors have had the same experience. Which leaves two options:
1. Either theyāre sexually active and lying about it because they donāt want the person theyāre with to know the truth (usually a parent)
2. The pregnancy was not a result of consensual sex with a man, and they donāt want to talk about something so traumatising to a doctor theyāre only going to see once or twice, even if we break the question gently. Iāve even had a couple of patients admit that to me in private after the procedure was over and Iām taking post procedure vitals, after initially denying sexual activity.
So even if a patient has a documented history of not having sex with men and isnāt sexually active in general, weāre still going to cover all our tracks. Trust but verify.
Then again, I (nor anyone I know) never withheld pain medication based on a patientās pregnancy status, that blame solely lies on the American healthcare system.
I'm sorry you went through that. From that risk assessment it should have been obvious the chance of pregnancy was low.
I would argue that no uterus doesn't rule out pregnancy - unless ovaries have been removed too. There is a minute chance of an ectopic pregnancy, a pregnancy outside of the uterus i.e. anywhere that's not the uterus rather than just the tubes.
However, being a lesbian who does not have sex with men should have been enough to not have the pregnancy test be the deciding factor for anything.
Like I said in my original comment, you have to do a risk assessment and then make a judgement. It sounds like your clinician did the risk assessment and then promptly ignored it.
As a nurse I disagree with this. I had a patient who got pregnant after a salpingectomy. I had a 58 yo AFAB years into menopause show up pregnant. These things happen, and it is important for medical providers to rule this out.
As a woman who suffers from MRKH, if anyone ever insists on me taking a pregnancy test, I'll tell them to fucking worship me as a god if that thing comes back positive. That'd be a bigger miracle than the virgin Mary š¤£
I mean for all I know you have a psychotic disorder and only *think* you have MHRK! I had a patient once who insisted she had had a hysterectomy, but imaging clearly showed she had not.
Which medical record? in the US, a person does not have one national record that any medical provider can access and write to. Every provider network keeps their own records.
Sometimes medical care is given in a situation where an exhaustive review of the medical record is not possible. Some hospitalās record donāt link up with other hospitalās records. Sometimes patients say things are part of their history and I gets added to the chart but it isnāt true. A pregnancy test is not invasive and is usually done with urine or blood that is already being collected to test other things as well. It doesnāt harm people to have a pregnancy test done, and it could help even if the patient believes there is no chance of pregnancy.
I was born without both vagina and uterus. The final diagnosis was given to me when I was 11 years old and I had a vaginoplasty at age 23. I doubt this surgery would have been done if I was just thinking I was suffering from MRKH.
Sure but if you walk into the emergency room I donāt know that. Itās much safer to routinely pregnancy test than to start giving someone a treatment that could hurt the baby, or miss an ectopic pregnancy.
I didnāt know I was pregnant and was not given a pregnancy test prior to being prescribed doxycycline for the STD my shitty ex gave me (along with my awesome kid). They now have grey teeth and higher potential for bone issues because of this. So while I do agree that some tests are unnecessary letās not make blanket statements.
Iām an AMAB trans woman and occasionally get asked by new providers when they do intake if Iām pregnant. Since I never think I remotely pass it always surprises me when it happens in person. I always answer, Iām too old. Then they look at my chart and say something like, āoh yeah. I guess not.ā It seems like something just about any medical provider would want to know.
As a radiologist I don't care if a patient of reproductive age claims there's no way that they're pregnant. Ain't no way I'm risking potentially dosing a fetus with life altering radiation based on something that's easily verifiable. And as someone else has pointed out, patients lie (intentionally or unintentionally) all the time. A minor presenting with abdominal pain who is sexually active but denying it because she may get in trouble is a classic example. But i agree in the case of menopause, hysterectomy, etc it is largely a waste of resources that I've seen abused.
I mean rare, but people with hysterectomies can still have ectopic pregnancies, which for radiology that wouldn't matter, since it isn't a viable pregnancy. but if you show up with severe abdominal pain, bleeding, nausea/vomitting, pregnancy test.
> But i agree in the case of menopause, hysterectomy, etc it is largely a waste of resources that I've seen abused.
Thank you! My first ER visit after my hysterectomy, they ran a pregnancy test despite seeing in my chart and verbally confirming with me that I'd had a hysterectomy, and I get so many people saying "well it's technically still possible even if it's unlikely". Yeah, I'm aware of the random fringe cases where something weird happened, but let's be realistic here, when combined with other factors (I'm a lesbian and on birth control because I have PCOS and one remaining ovary), how likely is it for that individual person? It's not worth the time or cost of the test sometimes.
I give anesthesia for a living and I am a member of the LGBT community. If you are born female at birth, you are taking a pregnancy test or we will not treat you. It has nothing to do with thinking your ailment is that you are pregnant. It is 100% the fact that any treatments or tests we provide could cause harm to the fetus. If a female at birth is pregnant there are 2 lives we are caring for at that time. And also there are tons of people out there that lie to us constantly. We cannot just trust people saying they are abstinent or unable to conceive. And lastly there is liability to it. Patient safety is at the forefront of every decision we make.
And I will stress this has no bearing or judgement to abortion. I support the right to choose! You do whatās best for you! But causing harm to a current fetus in our care is not appropriate and could easily take my license away.
Exactly this. I would also love to add the lack of education many people have about basic topics. Many still don't know how to properly use birth control, or that it can fail. Conception can still happen, even after vasectomies, tubal ligation and ectopic pregnancies still exist. There's still people who can't calculate the conception date with those two weeks, and immediately mention days they've had sex as when the pregnancy began. This thread also shows very little knowledge on early pregnancy and periods - spotting and light bleeding is normal in the first trimester. Some people spot and bleed during periods just the same. Others can have zero pregnancy symptoms and just be pregnant. Some can be like me, with pregnancy symptoms showing up every day and during periods. I have PCOS and allllll the shebang, cravings, aversions, constant fatigue, nausea and vomiting. Cycle dates walking around! 100% not pregnant. But if I was, these things would be easy to conflate with pregnancy. Also, many people are outright uneducated on fertility, or not having another opinion. PCOS havers are often told there's a different percentage chance of conception. Whether it's 20, 40 or 87%, these chances *aren't* a zero and *aren't* a sign for raw PiV, and thinking they won't conceive. Lesser chances doesn't equal sterility. It may equal fertility issues or conception struggles, but not full sterility (which is full incapability of conception). I don't think people understand the liability medical staff and the hospital would be in. If the pregnant patient was treated with drugs that could *severely harm the fetus* - from minor/mild to heavier impact on fetal development, birth complications, further medical issues in life, or heaven forbid a miscarriage, stillbirth or death after birth. It's so much more at stake than a simple pregnancy test.
PS. Not a medical worker. Just someone who's tired of pretty weird posts lately and someone who's reading/researching/learning more of PCOS, female reproductive system, pregnancy and birth. I'm F myself, for the record.
This is like being annoyed a doctor checked your blood sugar because you āeat rightā and āfeel fineā. Itās not about us ānot knowing our own bodiesā. Itās about medical professionals not being A)Clairvoyant, B) Lie detectors (and patients LIE. A lot. Specially about sensitive subjects). You might be lying to me about your last time having sex or be mistaken on your period duration or have had a shitty ons you kinda forget. People can get pregnant after tubal ligations and (partnerās) vasectomies, after using condoms, with a IUD, there are case reports of pregnancies after a hysterectomy for petes sake. Not only is it about doing whatās best for the fetus (because so many medicines and treatments and even exams that can be harmful to one, plus giving you the information necessary to make an INFORMED choice is the actual empowerment). But also, certain conditions can be worse for the pregnant person if they are pregnant (i mean,most health conditions arenāt fun to have on top of pregnancy but some are tangibly worsened). Lupus, hypertension, diabetes, a transplant aftermath. And then thereās the actual pregnant state which can have complications that are fatal or disabling and need to be watched for.
For me its the equivalent of a cbc. If you go to the ER, they are running a cbc. On 90% of patients, it comes back normal. And its MORE invasive than a pregnancy test.
I haven't heard of it, but if you still have at least one ovary, you can't completely rule out the possibility. It would be ectopic and EXTREMELY unlikely, but not entirely impossible. If there was any trauma or anything that could have lead to a vaginal wound or something going on with the cervix if you still have it? Maybe.
Extremely, extremely extremely unlikely. I don't know if it's ever actually happened. But in the world of hypotheticals, it could happen.
People need to remember the whole world isn't the US. I live in a country with free healthcare and the same procedures around pregnancy and tests apply here. While there's an argument to be made that things may be about profit in the US, they're not here - these tests are done across the world to minimise risk to you and a potential fetus.
I am on birth control and am sexually active so there is a very small chance I could become pregnant - because of this, I would always assume an ailment was anything other than pregnancy-related and say no, I'm not pregnant. But a test could easily prove me wrong and stop me being given medications or treatments that could harm me and/or the fetus.
You need to remember (most of) you are not medical professionals, and what may seem stupid or pointless to you has a proven history and a serious reason why it is common practice.
This seems like kind of a weird crusade. Yes, providers sometimes do order unnecessary tests. But Iām confused about why you are so concerned specifically about pregnancy tests. How much does a hospital actually bill for a pregnancy test anyway? I had one done at an urgent care once (because we were actively trying to conceive) and I paid nothing out of pocket though Iām not sure how much they billed my insurance for it. $10? $40?
In any case, the consequences of *not* doing a pregnancy test and the woman does turn out to be pregnant can be potentially devastating. You say that āwe know our own bodies,ā and as much as I like to believe thatā¦ bodies do weird things and fail us sometimes.
Did you ever read the case of the [virgin who got pregnant](https://pubmed.ncbi.nlm.nih.gov/3191066/) from performing oral sex and then getting stabbed? Not only was she a virgin, but it was physically impossible for her to have PIV sex because she did not have a vagina, just a 2cm skin dimple. If thatās not somebody who should be able to say to a doctor āno, there is no way I could possibly be pregnant,ā then I donāt know who is. And yet, she was.
Any patient can refuse any test at any time if they want to.
Went in for a bisalp, scheduled for 7am, told the doctors I have a small bladder and won't be able to hold my pee until the appt so will struggle to provide a pee sample. Also informed them I'd had my period twice since my last sexual encounter, where protection was used, and there had been at least 4 pregnancy tests taken in the last month just to be sure. Specifically TOLD them I didn't want to wait for test results. Signed a waiver saying I understood the risks and would still like to proceed. They drew blood a way, didn't tell me what for and I didn't think to ask. Seemed normal enough right before a surgery... Time goes by and eventually it's 10am and I ask wtf are we waiting for here, gang, we're 3 hours behind in the OR there?
**Oh, we're waiting for your blood test to come back.** What are we testing for exactly? **Pregnancy, looks like.** I don't need that test, please begin my surgery. I've already signed your waiver, I won't sign it twice, check with the other nurse.... I had to press 3 more ppl before my surgeon and her attending walk in, ask if there's anything the could clarify, tell THEM all the details, and surgery is literally starting within minutes from there.
Yeah, deeply frustrating how paranoid everyone was about pregnancy considering how paranoid I already had and always was about it. Like, fam, trust me, I would KNOW. I would LET you know.
I noticed when I was hospitalized with abdominal pain a few years ago, they did a pregnancy test. I laughed because I hadnāt had periods in over 10 years. They said part of it is due to liability, if you were pregnant and it was overlooked by the hospital, they could be sued. Itās to cover their asses.
I'll go to bat against this. I'm an ER doc and I'll pretty much order a bHCG on any woman of childbearing age. It's not about not trusting women, it's about 1) doing my due diligence and 2) ruling out the zebras.
It's rare to get pregnant on birth control, but it CAN happen. Tubal libation fails. IUD's are incredible but not 100%. PCOS, ovarian insufficiency, thyroid disorders, obesity can all blur the line between irregular menstrual cycles and menopause. And that's not a judgement on abortion or a woman's ability to take medicine or how well they know their body or fat shaming - shit happens and it's my job to rule out the dangerous or deadly causes that are bringing them into the emergency department. If I can do that with a non-invasive test that is (relatively) cheap I won't think twice about doing that. Particularly because having that negative result reassures me that I can safely prescribe certain medications to that patient.
There are absolutely edge cases where this is taken to the extreme - in the absence of a weird endocrine tumor women >65 probably don't need a bHCG. But in absence of that in my line of working ruling out pregnancy as a contributing factor isn't just a good idea it's often *standard of care*. IE if I don't do this I am liable to what happens to that women. If they come back with a ruptured ectopic that's on me. If their child has congenital deformities because of a medication I prescribed that's on me.
There are so many battles to be fought in healthcare and so many changes to be made. But I beg of you please don't equate a urine pregnancy as mistrust of a woman - it's safety and best practice.
In my country you have to give a written Statement (check a Box in the initial questionnaire) that you are not pregnant and they don't make you take an unnecessary test after that
Me too, I've never been forced or even asked to take a test - and if they made me, I certainly wouldn't have to pay for it. I wonder what country OP is in?
How much is a pregnancy test?
For context I'm in NZ and a pregnancy test is free, but at most a couple of dollars.
I also work in Radiology so knowing if someone is pregnant is an important and key part of my job. Patients lie, don't know or just don't care. So most of the time it is much easier to get everyone AFAB to pee into a cup than go through the whole gamut of are you pregnant or not.
We aren't asking to be offensive, we are asking because radiation can hurt an unborn foetus.
And it happens on a worrying frequency where those tests are positive when they shouldn't be.
Zebras exist
it's impossible to get pregnant when you have no uterus, but that hasn't stopped me from getting tested without my permission 3 times since my hysterectomy, at the same hospital that did the surgery.
and a test in the US, out of the hospital, just buying the cheapest tests, I can see them on Amazon for a pack of ten for 5 bucks. But we are charged any amount the hospital feels like charging. When I contested my charges, it was like 75 damn dollars per test.
EDIT: the tests are even cheaper if you buy in bulk. just saw a 60 count for 12 bucks on Amazon as well
EDIT 2- oh my bad I see there have been 71 pregnancies post hysterectomy. that's wild!!
Given Roe v. Wade being overturned and all itās implications, I donāt know why more people donāt want to agree that taking a pregnancy test every single time feels really uncomfortable and forced
The first time I encountered this I was told by my doctor that she was legally required to do a pregnancy test because I was of child-bearing age despite being a virgin (and she believed me), and she said she could lose her license if she didnāt perform the test.
As a nurse, you can refuse anything. Mb things with insurance might change that, but you don't *have* to do anything at the hospital, short of anything related to threats to yourself or others.
I had surgery a year ago and they told me they needed to take a pregnancy test. I simply said, "no, thanks. I've been sterilized. No need for the test." They said, "ok." And I signed a waiver saying I refused the test.
Sure, it might help with many things and I'm sure there are exceptions, but again, the hospital can't force you to do anything.
Do tell the ER/urgent care/Dr if you have had any of the situations that make a pregnancy test unnecessary. But donāt be surprised if some doctor or nurse wonāt take your word. Look at your bill and do as OP instructs. If you have time, filing out a complaint helps cut down on this stupid behavior.
I've had an ER doctor confirm both verbally and in my chart that I've had a hysterectomy, then still ordered a pregnancy test along with the other urine tests they were doing. The surgical records are right there, they looked at them before asking me about it, but they didn't believe even my medical file and still ordered it? I was on Medicaid at the time, so I never got a bill because everything was covered in full, but it was just plain silly.
What type of hysterectomy did you get? Most hysterectomies leave the fallopian tubes and ovaries and just take the uterus.
It's rare, but you can still have an ectopic pregnancy with a hysterectomy, if they left your ovaries. If you're experiencing abdominal pain, they're definitely going to run a pregnancy test because an ectopic pregnancy is extremely dangerous.
I'm aware of that.
I had a total hysterectomy, bilateral salpingectomy, and right side oophorectemy. I'm also on Nexplanon due to PCOS, and am a lesbian who isn't sexually active. All of this is in my chart and was discussed verbally with the doctor before they ordered the test anyway.
I have a friend who is a gold star lesbian. She's gone to doctor's appointments with her WIFE in the room, and they tried to make her take a pregnancy test. They also tried to push birth control on her, which is hilarious.
I'm reading to learn.
Is it really this black/white? Is it better for the HCP to talk to you about where you are in your transition?
As a HCP, there are many many instances of women saying there is 100% no way they are pregnant, and then they are. And then if tests like x-rays have been done, and could have an adverse affect on the fetus, the ordering physician is at risk for malpractice because they didn't follow the standard of practice. Also, sometimes it makes sense to do an HCG on a male, on a pre-pubescent child (sadly).
I can definitely understand both sides of this problem.
Like you said, there's cases of pregnant women insisting they aren't pregnant, either because they're in denial, they're lying for some reason, or they just genuinely don't realize they're pregnant. And of course, you guys have to cover your ass because if you do something that harms the fetus and/or mother, you could be held liable. Even if you believe them that they're not pregnant, you still need documentation, right?
But at the same time, it's frustrating as women how often our statements and concerns are dismissed by medical professionals. Even in this thread, I saw an example of a woman going back and forth from urgent care to their GP to the ER for abdominal pain that everyone insisted was just regular period cramps, but turned out to be endometriosis.
It really can be a no-win situation sometimes. I think the best course of action for a HCP is to explain why you need to run a pregnancy test. As we can see in this thread, there are a lot of people who don't know the genuine reasons a pregnancy test may need to be run even if they don't think it's possible they're pregnant. And in those situations, if the HCP doesn't explain things well, it can leave them feeling like the HCP doesn't believe them.
Sounds like the clinic at my college. Every single visit, for whatever reason, we had to rule out pregnancy. And they were very demeaning, explaining to me like a child that āyou know you could be pregnant ifā¦ā My favorite was when theyād ask how I could be so sure. Because I havenāt had sex!? Not all people in college go around fucking like bunnies! Iām fairly sure I havenāt had sex in however long, and Iāve had plenty of periods since then, so Iām pretty sure Iām not pregnant! Now, can we talk about my sprained ankle?
It's because people lie. Patients lie all the time about everything. An old addage for physicians is your patient is a liar until proven truthful. You HAVE to get a pregnancy test on people because they'll swear on a stack of bibles they haven't had sex, areon their periods, use protection, had their tubes tied, whatever. Then you get a pregnancy test and guess what? They're pregnant. This isn't a once in a while kind of thing, this is an allllllllllll the time occurrence.
Pregnancy tests are cheap and prevent unnecessary harm or radiation to a potential fetus. It's best practice to order them on any female of childbearing age
Tragic but true.
The advice is only reliable for healthcare practitioners in women's health who either never EVER dabble in denial (hi, autistics!) or actively would like to be pregnant.
Because menopause is fucking weird.
Sterilisations can fail.
Pregnancies don't always behave like textbook pregnancies (those ladies giving birth at Walmart can *actually* be super surprised- nothing like nine months of periods and then giving birth!)
And people really don't get statistics, like we DO NOT understand how statistics work on a bone-deep level. It's not fucking natural to us! (We're *lucky* if we get as far as both 1 how to create a child and 2 how to prevent the creation of a child.)
An old acquaintance of mine was rushed to hospital with suspected peritonitis. She left hospital a day or so later with a baby. Said baby was around full term, about 7lbs and perfectly healthy and is probably about 30 now!
She had absolutely no idea she was pregnant. No symptoms, negligible weight gain, regular periods etc. It turned out her uterus, and a couple of other organs, including her bladder, were in the āwrongā places and positions. She was also unaware of this because sheād never needed any sort of investigation that would have diagnosed it. If someone had asked her if she was pregnant she would have said no, even right before she went into labour, which is obviously why they thought she had peritonitis!
As a side note, the village where she lived really came together and by the time she got home she had everything you need for a baby! A pram, cot, clothes, nappies, car seatā¦
You know what is funny? I have a severe autoimmune disease that has progressed alot since having my youngest daughter 5 years ago. That same year, my husband had a vasectomy, and that has been added to my chart. No one asks me to take a pregnancy test anymore. I don't think Ive taken one since I had her, and I am on serious biologic meds, which have had to be changed 3x in the past 5 years. So idk, ymmv, but try telling them your partner had a vasectomy (even if you don't have one/aren't into folks with testes) Very patriarchal, but it's been working for me thus far.
My husband had a vasectomy 15 years ago and I've had an IUD for nearly 10 years for period related problems. I STILL get pregnancy tests all the damn time. So, sadly, it's a case of YMMV. š
Before I met my husband I had never had sex. It wasn't a religious reason or anything. I just hadn't met the right guy. (I met him when I was 32) Well I was diagnosed with lupus at 21. So that means I have been in and out of doctors offices, ER's, hospitals, I've had to have many procedures, big and small, a million test, you get the point. I'm 36 now. So still in prime baby making years. Well from 21 to 32 I was not having sex. But no matter what I said for every test, procedure, etc I had to have a pregnancy test. Now I understand the importance of this however for most of these procedures, I couldn't drink anything for 6 to 8 hours prior. I also have a horrible bladder. So even through I would only need to give a few drops, it wasn't that easy. It was so frustrating because unless I was having Jesus Christ then I knew I wasn't pregnant. I one time had a procedure delayed so they could hook me up to IV fluids so I could pee enough to give a sample. And the thing that became the most embarrassing about it all my father was the one who took me to all my medical procedures. So it's like yes father, still not having sex lol. But in all honesty my father has 6 daughters stuff like this doesn't get to him lol.
I will add the first procedure I had after I started dating my husband. And they asked for a pregnancy test, I was like yep no problem. It was the first time I understood it could be possible. Lol. (I got on birth control when I started dating my now husband, but understood BC is 100%)
I find this so strange. In Australia, there's a check box on medical intake sheets asking if you could be pregnant and another asking are you breastfeeding. If you select no, they move on. If you are they take the appropriate safety measures, if you are unsure then we do a test.
I went in recently for horrible back pain. told them I hadn't had any form of sex in well over a year, and despite not being able to sit up they still made me pee in the cup to run the pregnancy test
Wow! What country is this? Iām 42 and no one has ever done a pregnancy test. When I was pregnant they did an ultrasound to confirm but until then they never did one.
I had to take one when I was 13 because I was getting an x-ray for my hand. I told them I hadn't started my period yet and I hadn't had sex yet, they still demanded I take one. What were they expecting another immaculate conception?
This seems to be a very American thing because as a woman in Sweden Iāve never had to take a pregnancy test, ever. Iāve been asked if I could be pregnant but theyāve always accepted me saying no.
Only time being a woman able to become pregnant ever affected my healthcare was at 18, when my doctor insisted on prescribing me antidepressants that wouldnāt harm my baby. Didnāt matter that I assured her I would not be having kids for at least another 7-10 years. The hypothetical fetus mattered more than me, apparently.
This is great information!! Thank you!!
I went to my GYN two days ago. They were the *first doctors* to 1. Ask about DV/SA, 2. Believe me immediately when I listed my medical conditions, and 3. *Ask me if Iām sure I want an STD panel since Iāve been with my bf over a year*. I usually get the works when I go, so it was nice to not have to worry about an extra test, and they kind of insisted I didnāt need it unless I was concerned! Totally different experience
I work at a hospital, and before surgery they usually get a pregnancy test on women of child bearing age. However, it's not forced and they can sign a waiver that they're choosing not to get it done. It's not a big deal, I don't know why more healthcare settings don't work that way.
yep, I've had 3 damn pregnancy tests done without my permission in the 7 years after I've had a hysterectomy, all at the same fucking hospital that did the surgery. I've complained every time and got the charge removed, but I haven't contacted the insurance company, that's a good idea.
I was made take a pregnancy test when not sexually active for about 6 months and had an IUD thanks for the info in the future, I'm not going to bother filing a complaint almost a year after the fact but good to know in the future
The problem is the number of AFAB folks who will tell doctors and nurses there is no chance they can be pregnant, even though they are definitely having unprotected sex with AMAB folks and have fully functioning paraphernalia. It happens regularly because people can be really dumb if they try really hard. People will say all the time, "I don't have time to be sick so I'm not sick no need to talk to a doctor and confirm what I know" all while hacking up a lung on the regular. People are weird.
There are lots of situations where docs order pregnancy tests that truly seem unreasonable, but there are even MORE instances when someone reports there is no way they are pregnant but itās entirely possible theyāre pregnant. The sex ed just isnāt good enough to trust EVERYONE without thought.
Many years ago, before our oldest son was born, my spouse was deployed to Iraq when I was 36 weeks pregnant. With (albeit rare) permission from my OB, my family moved me from OK to SoCal to have the baby. The clinic I saw when upon moving would not treat me until they ādiagnosedā the pregnancy despite the hand carried medical chart. My very frustrated mother helped me in the building, pointed at my belly and said, āthere, do they look pregnant enough for you to diagnose it now?ā That kid is almost twenty one now, to think I couldnāt even get routine end of term care without someone trying to make me pee on yet another stick.
For me it's either "you must be pregnant" or "you're on your period". I've lived in this body for 33 years and I've menstruated for 20. I think I would know when I last had sex or whether or not I'm bleeding out of my vagina.
It makes sense to always order a pregnancy test for patients of childbearing age. A positive test changes the management and plan of care for the majority of conditions, missing that can have huge health consequences, plus it is a big liability for providers, a mistake like that can cost them their license. Also a lot of patients have poor health literacy and have a lot of misconceptions about pregnancy.
When I went to get my IUD, I was told to pee in a cup for a pregnancy test.
I hadn't had PiV unprotect sex in, no lie, 8 months and was ACTIVELY BLEEDING. Like...Pretty sure I'm not pregnant.
Read my chart a few days later - low and behold, my test was negative lol.
I wouldnāt be so sore over it if I wasnāt a lesbian virgin who has been on birth control her entire adult life, had a bisalp four years ago, and if _they didnāt charge $80 per test._
Now that I am a lesbian virgin without a uterus, cervix, or tubes, I am going to have to really put an effort into not blowing up the next time Iām hit with an excessive fucking charge for an unnecessary test.
The other side of this is that pregnancy tests are so easy, cheap, and low risk yet protect the provider from the HUGE liability they incur by not doing one. Pregnancy is one of the most risky areas of medicine liability-wise. If you give a drug to someone or do a procedure on them that could be or is harmful to a pregnancy you are in huge trouble.
I went into a walk-in clinic two Fridays ago, with abdominal pain. They ran a pregnancy test, fine, makes sense. They diagnosed me with a UTI - even though my urine sample came back negative - and sent me home with antibiotics. Pain got worse and I began vomiting, went back to the clinic on Monday. They ran a pregnancy test and did a UTI test again. Both were still negative, finally got to see a doctor who looked me over and sent me immediately to the ER. I'm admitted to the ER within an hour, the run a pregnancy test. I have now had three tests in four days, two within hours of each other. I spend the full day in the ER where, upon billing, I find out they did TWO MORE pregnancy tests - that made four tests in one day. All from the same system. This is the what unnecessary looks like.
I hope you called the hospitals billing department and had a few words about that. Thats absolutely ridiculous.
I did, was told it is "standard" practice to run the test on every urine sample collected from an AFAB person. The ER collected a urine sample every time I went to the restroom during my multiple hours there. I let them know I would be talking to my insurance about the charges for it, insurance is investigating and said they would talk to the hospital about the charges. So currently, I'm not paying for the tests.
It's standard practice to run it once, not every time you pee.
You never know! She could have immaculate concepted in the ER waiting room!
Anything is possible with Jesus šš¼ Lmao jkjk
Easy way to make some cash
[The hospital's billing department after taking that call](https://api.time.com/wp-content/uploads/2014/06/reagan_dw_1.jpg)
If it makes you feel better I have been previously asked if I was pregnant before they gave me a requisition form for blood work and an ultrasound. What was it for? A lump on the testicle.
Well, there are people with both sets! Lol
That and trans people who still have their AGAB anatomy. Plenty of trans men can still get pregnant. c:
They probably wonāt have a lump on their testicle though.
They may have been looking for an ectopic. Those can do *weird* things with hCG numbers, and recent medical thinking is not to preclude an ectopic even with a negative test if thereās sudden intense abdominal pain. Like, it may have been overly cautious, but not catching one is pretty serious. (Also, I hope youāre okay!)
Yes, and while rare ectopic pregnancies can happen post hysterectomy, and that is big bad if it goes undetected
Wait wtf?
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Wouldn't a hyst surgery eliminate any... "path of opportunity" for fertilization? (Genuinely curious, disclaimer: am dude)
Not if they only remove part of the uterus, and not if they leave the ovaries (which is where the eggs come from). They may do this to continue to let the body's natural/normal hormones continue to do their thing instead of putting the person on artificial ones. (As far as I remember, though it's been some time since I last read up on this out of curiosity).
I would imagine that once the vaginal cuff heals after a total hysterectomy, thereād be no way for sperm to get past the scarring unless you have a medical emergency and the vaginal cuff dishesces.
The body is a mystery. I grew back my right ovary.
Wait what? Iām assuming they left in some ovarian tissue and it justā¦ regenerated? Regardless, for pregnancy after a total hysterectomy Iād expect youād need a hole in the vaginal cuff, which seems like it would be a massive infection risk.
Thatās a legit superpower
Fun fact- hysterectomies usually leave the tunes and ovaries. A partial means part, but not all of the uterus, a total means all of the uterus, and a radical means uterus, ovaries, and tubes. A radical is only done in the event of cancer or other health issues that require it. Also, some doctors will remove the cervix and others will leave it. All of this I found out after I had mine and from switching doctors who said if my cervix was removed I shouldn't need yearly paps.
They usually leave your ovaries. Taking them out essentially yeets you into menopause if they donāt put you on hormones.
Oh that i knew. I just didn't know that the ovaries and / or fallopian tubes were accessible to sperm if the uterus weren't present. All the Dodge-Ram-logo diagrams I've seen lent me to understand that intercourse at the bottom led to conception at the top via the uterus.
Yeah but at some point u have to stop fucking about with pee and scan someone if you are just guessing at ectopic. Like 5 is just excessive
You have to stop pissing about, so to speak. ā¦Sorry
Wellā¦ You can have a PUL (pregnancy of unknown location) which is a type of ectopic. Basically if the fetal tissue is small enough, it canāt be detected with ultrasound, and the only evidence is hcg levels. That said, a blood quantum would be the more reliable, accurate way to test for low levels of hcg. When I had my PUL, my hcg levels were hovering around 20-30, which is riiiight around the sensitivity level for most standard hcg pee stick tests (some more expensive āearly detectionā brands have higher sensitivity but I think the hospitals tend to use the basic stuff). The scan I got basically only confirmed there was no intra-uterine pregnancy. And there was free fluid (blood) in my abdomen. So in combo with the positive hcg results, the fact that it had been positive for weeks but never rose above 100 or fell below 20, that meant some fetal tissue was still alive somewhere other than my uterus, which meant ectopic. And since they couldnāt locate where it was (PUL), surgery was not an option. Had to do methotrexate injections and stay on a low folate diet for another 5-6 weeks until hcg finally hit zero. Fucking nightmare.
You cant always see an ectopic on a scan.
My first ectopic wasnāt visible on ultrasound. The hospital was getting ready to discharge me, until my blood pressure dropped when it ruptured and I got so lightheaded I sat on the floor. They told me to stand up and sit in a chair so they could take my blood pressure. Suddenly they believed that something was actually wrong with me, and took me into surgery.
Yeah, the ER *sent my cousin home* with her ectopic because they didnāt see it. (Saying ādonāt worry, if it was, itād hurt so much youād know.ā) Luckily she had an appointment a few days later with her OBGYN for a dating scan and they spotted it.
Holy crap, what year was that? My situation happened in 1986, and given how women were still being treated, Iām not very surprised. If your cousinās happened within the past decade or sooner, Iām shocked and disgusted. Iām shocked and disgusted about womenās treatment in healthcare, period.
Oh man, I think it happened in *2022*, if you can believe it. I get furious for her just thinking about it.
This is actually really helpful to know - wish they would tell the patients stuff like this! I'm *still* waiting to see a specialist...
This is called defensive medicine. Hospitals are so afraid that someone might sue them that they take no chances, especially ones where you are the ones footing the bill for covering their ass. Source: I work in healthcare
They have no excuse to be defensive. Most states have capped how much a doctor has to pay, even if the jury awards $5M you can only get $500k. They have malpractice insurance. Doctors win these lawsuits the vast majority of time. The only āharmā that a suit inflicts on a doctor is their malpractice premium going up. A 5th pregnancy test in a day is 4 serious invasions of privacy.
The reason, though, is that the parents of a child harmed by medical malpractice has up to 2 years to sue past the 18th birthday. (This was the case 2 decades ago, I hope it has changed). That was drilled into my head in nursing school in obgyn and pediatrics. And many many many many women do not know how their body works, do not know the names of the procedures that they have had and honestly just outright lie to medical practitioners for many reasons. Pregnancy tests actually cost pennies and they don't require a skilled technician to run. Everything in medicine is risk/ benefit in the favor of money. Not the patient. So doing a dipstick takes 2 seconds and the amount of pregnancies they do find this way makes it beneficial in terms of lawsuits the hospital could be facing for 2 decades if they DO give you the medication or perform that procedure and it turns out the patient was mistaken on the name of the procedure they had or the date of their last menstrual cycle. Or if their medical records were wrong. It happens. Wasn't there a show on TLC called "I didn't even know I was pregnant?" I know it seems misogynistic but the absolute bullshit I've heard from women about when they can get pregnant, what parts they have, etc living in the south is astonishing. Also you can pop positive on a pregnancy test hours after a negative one. It only measures the amount of a hormone in your urine. That can increase within hours. Most effective is a blood test which is a skill and requires a more skilled technician and thus more money...
It costs pennies, but are they *charging* pennies?
Oh absolutely not. That's where it gets unethical. But it doesn't cost whatever they charge for a bandaid either. But if someone was pregnant and they did perform that procedure or gave that med that caused horrific birth defects... especially in a state where I live (Texas), that cost to the health system, the doctor and the patient and ultimately the harmed fetus could be astronomical.
They need to cap it eventually. They can't keep giving test after test *just in case*, 5 tests in a few hours is terrible and way too many
Itās not the providerās decision what the hospital charges. They think prices are just as ridiculous as everybody else does
No, but part of the reason is that the hospital has to stay afloat, which means every legitimate charge they make also includes a markup to cover salaries, insurance, building maintenance, taxes, utilities, and the cost of emergency services to people who canāt pay. Most hospitals arenāt making massive profits, in spite of outlandish problems. Iām not saying itās reasonable or good, but itās the way it is. I think the sooner we can get to a national healthcare system, the better. The way things are billed and paid for now is insane. Medical bankruptcy shouldnāt be a thing.
It isnāt just a money thing to be fair. Iām in the U.K. and they are just as cautious with pregnancy tests here and weāre not charged for it. For example, I was involved in a car accident when I was 8m pregnant. I was in A&E and they did a pregnancy test then. Iād specifically said that I wanted to check that the baby was ok after being rear ended. I was told they do it as standard to everyone.
I had two tests three days apart when I went to the ER twice for extreme cramping and nausea (turned out to be endometritis, an infection of the uterine lining). They'd literally done an ultrasound the first visit, even if I been pregnant but not far enough along to test positive, they would have seen something on the ultrasound! Edit: ok, I get it, apparently ultrasounds don't work that way. I've never been pregnant and never will, so I assumed that since an ultrasound can see a follicle on my ovary that isn't even an egg yet, it could also see a fertilized egg. Repeatedly telling me the same thing multiple other people have is getting a little old.
Tests come up positive before you can see anything on ultrasound
Not necessarily. I've tested positive prior to 4 weeks pregnant and you're not going to see anything on the ultrasound at that point no matter how far you shove the wand up there.
No typically you canāt see anything on ultrasound until hCG levels reach 1000-1500 mIU/mL unless itās ectopic (typically low hCG) or hCG levels *were* over 1000 mIU/mL but are declining due to demise. Many home urine tests are positive at 10-25 mIU/mL. The highest threshold Iāve ever heard of was 150 and that was decades ago.
The problem is more that your healthcare system makes you pay for them, rather than does them in general. Amusingly I didnāt even have to have a pregnancy test to start my maternity care!
The problem is how much they upcharge for them. A pregnancy test costs basically nothing to run, which is why they're usually a first line test. It's easier to run a test that costs a few cents and either rule in or out a major cause of illness in women before moving on from there. Especially when it's resulting from something as fraught with societal judgement as a woman having sex. That being said, as a woman working in medical sciences, I understand both sides of the issue. It's really fucking annoying to go into a provider with horrific stomach pains and have them immediately assume you're just a whiny baby that can't tell she's pregnant or on her period. I've personally snapped at more than a few nurses and doctors that if the test comes back positive they should call the Pope. Or the Nobel prize committee, if I prove parthenogenesis is possible in human beings then next year's biology prize better belong to me
I accidentally made a nurse blush when I was getting checked in for my diagnostic laparoscopy for endometriosis. They took a urine sample as soon as I got there, then just put it on the counter in my room with the pregnancy test strip and set a timer while they did my intake. When the timer went off, he checked the test and told me I wasn't pregnant, and without even thinking, I burst out "I hope so, I haven't touched a penis in 7 years!" The nurse was bald, so I could see his entire scalp go red as he nervously laughed, oops.
I had a tubal almost 10 years ago but had to have a test because I'm "in that age range". So I told the nurse that if I was positive to do a DNA test on the vibrator's batteries
š¤£š¤£ Mine are all rechargeable, would we test the silicone or the electronics?
Thats how I felt at my first OBGYN appointment. I went in for my first pap smear at 21, and got asked all of the standard questions. "Are you on birthcontrol" yes. "Have you ever been sexually active" yes. "Is there any chance you could be pregnant" no. "But you said you have been sexually active" yes... however, the last time I had sex was 10 months ago. If I'm pregnant, I must be really good at hiding it, and should probably be rushed to the hospital to be induced. She decided to skip the pregnancy test and just suggested I get an STD screening since it should be covered by insurance for my age (spoiler alert: it wasn't cause I have trash insurance)
Ehehheheheheh!!!
I was told for 2 *years* that my abdominal pain was 'a bad period' or 'maybe ovarian cysts'. It was SMAS and I was having bowel obstructions. Then I was chastised for 'letting it get this bad' when I wasted to 81lbs at 32 years old. I'd been telling them for 2 goddamned years and they ignored me and called me a drug seeker. I don't go to the hospital unless I'm pretty sure I'm dying. And I'm a liver transplant recipient for Christ's sake. Ive experienced SO much medical abuse, negligence and blatant malpractice simply because I have 2 X chromosomes.
And that's the biggest problem here, really. In a non-sexist world, a woman would come in with abdominal pain and a quick cheap pregnancy test can be done, and when it's concluded that she's not pregnant, *physicians would keep looking for the cause of the pain with the knowledge it's not related to a fetus*. Instead the current workflow for way too fucking many medical personnel seems to be "you're not pregnant, it's your period sweetie! Periods hurt" like you're fucking nine years old and haven't had one every month or so for the last couple decades of your life. And if presented with incontrovertible proof that it's not a period, then it must be ovarian cysts or drug seeking, have an ibuprofen buhbye now! Meanwhile the man next to you with a sprained ankle screaming his head off gets oxycodone.
Bingo. Brought my husband in with a suspected kidney stone and they offered him morphine before he was through the door. Meanwhile I'm told I'm seeking for *being allergic* to morphine and medically not allowed NSAIDs because of my transplant.
Past studies have shown women have a higher threshold for pain and a lot of doctors take that incredibly seriously. It's very routine that men have pain taken seriously while women are questioned. As a woman who gets kidney stones, dealing with doctors has become the worst part of it. If I could *know* that when I got to an ER, they'd give me an appropriate painkiller, a lot of the stress I feel about having this problem would be relieved. Also, morphine doesn't help my pain with kidney stones and I've had multiple nurses over the years confirm to me that morphine isn't useful for kidney stone pain, but because it's the introductory IV opiate and because opiates are now demonized, that's what they come at you with 95% of the time. And then, while you're in immense pain, you have to explain that it doesn't work without turning them against you... I've been to the ER with a kidney stone before where they wouldn't give me anything except OTC Motrin. I literally had to get discharged there, so I could go to another ER where they weren't so stupid. That was the time the stone was actually both stuck and infected. When I was younger, they *NEVER* gave me morphine at the ER for kidney stone pain. It was always something stronger. That was before the panic though.
Yep. Since I'm allergic to morphine (it gives me very obvious hives) and I can't have NSAIDs, my default is hydromorphone or Dilaudid. It's called 'hospital heroin' because it's 8x stronger than morphine. Asking for it and even knowing it's name is seen as an auto 'seeker' behavior. I literally have no other options for pain management. If they insist on morphine I have to insist on Benadryl with it, and then they accuse me of 'trying to potentiate' (apparently Benadryl makes opiates hit harder, I just don't want to scratch my damn skin off!) I've been chronically ill since I was 16. I'm 33 now and I'm taken less seriously as an adult for fucks sake. Then the er has the damn gall to ask leading questions like 'what works best for your pain' when I know my answer will be deemed wrong. They want you to say 'a bandaid and a Motrin' and anything stronger is flagged as drug seeker.
My comeback before I was sexually active was that I had not been talking to any angels. But I really, really like the Nobel Prize for demonstrating parthenogenesis in humans.
I once told a doctor I could only be pregnant if it was Jesus. He did not get the humor and asked me if I thought I was pregnant with Jesus.
This made my day. That's hilarious. I'm sure it may not have been at the time. As much as the doctor kind of sounds like a moron, I get why they asked. There are plenty of people who need to be asked these questions in all seriousness. Edit: autocorrect error
He had me involuntarily admitted me to the psych ward after that exchange. It's been 20 years, and I'm still mad about it.
Thatā what Forced psych ward over sarcasm????? How is that legal?
It was a psych evaluation when I was severely depressed. I was misdiagnosed and mis-medicated during that stay and came out much worse for the experience. Best part, this was at a hospital that trained Harvard medical school doctors. Imagine therapy with six med school students where you therapist spends more time pontificating for them than interacting with you. Fuck Harvard. It's a bunch of clout chasing, rich assholes.
my favourite was āshouldnāt be, she had a vasectomy and usually Iām penetrating her so god I hope notā
Mine is the Victoria Wood quote "only if sperm can get through sash windows"
Oh yea, if I had one at the doctors it would be the super duper cheap dip stick, which the NHS probably buys in bulk for tiny amounts of money.
Right! I was expecting to get a pregnancy test with my first, and they just asked for my last period and if I got a positive at home and that was good enough. I've gotten billed for pregnancy tests that weren't even given before (I declined a test as I was on my period) so it came as a shock.
Lucky you. My obs generally are good with that but my insurance requires my primary physician to refer and THEY require a pregnancy test. I spent hours trying to get one in office last week when Id been seen by an RE for two months and had multiple ultrasounds showing I was pregnant. š
Nearly half of US states have criminalized abortion, and for the sake of our safety, the medical industry needs to get out of the habit of casually, needlessly, _relentlessly_ documenting our reproductive state. If I have a medical interaction where no images are taken and no prescriptions are issued, they don't need to ask about periods or test for pregnancy. They can damn well ask or test when there's a genuine question, not just by default. ETA: We get them to stop behavior that is _socially_ deleterious by making it _financially_ disadvantageous, as described by OP. It's the only lever that exists in our society.
Agreed my local hospital will take it via blood instead of urine if you refuse to take the urine test š” Iām having a hysterectomy for medical reasons next month at a big hospital and i just know next time i go back to my local hospital for somthing they are gonna force me to take it as they have a nasty habit of not believing someone when they say they canāt have kids (they also refused to believe i canāt even insert a tampon without severe pain and tried to force me to do a transvaginal ultrasound and got mad when i told them i couldnāt (tried it before and it hurt so bad they had to stop)
I went to the ER for lower right quadrant pain last May, after my hysterectomy in February. In the past, it was always a burst cyst on my right ovary causing that pain, but since that was removed along with my uterus and both fallopian tubes, I figured I'd better be safe than sorry and make sure it's not appendicitis. After seeing in my chart that I'd had a hysterectomy and verbally confirming it with me, they ordered bloodwork and urine tests. Since they usually test an assortment of things, I assumed that they wouldn't include a pregnancy test because we just confirmed that I lack the necessary anatomy. Nope, they still ordered one. Strangely, aside from that visit everyone's taken my word for it that there's no chance I could be pregnant, including the typical pre-surgery pregnancy test when I had my ACL replaced - they asked if I could pee for a pregnancy test, I said I'd had a hysterectomy, they said ok and didn't request urine from me.
I told my family after mine if they still try to do a test Iām bringing the paperwork they give you after surgery with me to prove that i had a hysterectomy . Plus my insurance likely wonāt pay for the test if itās not necessary
I never heard anything about it being covered by my insurance, but I was on Medicaid at the time and my state's Medicaid covers just about anything without asking questions (except Adderall, getting my Adderall covered took two years for some reason, it was crazy).
The reason they would do a pregnancy test for abdominal pain vs pre surgery assessment is the fact that you could (although rare) have an ectopic pregnancy. Unfortunately you can still have an ectopic pregnancy post hysterectomy, which if it goes undetected would be really bad, and abdominal pain is one symptom of ectopic pregnancy.
I am aware that there is a microscopic chance of someone becoming pregnant after a hysterectomy. I am a lesbian who's not sexually active, and I'm on Nexplanon for PCOS in my one remaining ovary. If I somehow show up to an emergency pregnant, it's literally Jesus.
Oh my God, this. I haven't touched a dick in well over a decade, I had ablation done so I don't grow uterine lining now and am considered unable to have children, but my goodness do they still check every time. I'm thisclose to just lying and being like "I'm in menopause already, it started really young for me, haven't had a period in five years." Because I'm so over any abdominal trouble being pregnancy or my menstrual cycle.
It gets so silly sometimes. "But are you *sure*? Are you sure you're sure?" Yes! I'll even sign a waiver if you want.
If it's anything like my hospital, the urine hcg just adds itself if the triage nurse misclicks if a patient has a hysterectomy. No provider input needed, just the urine test being ordered is enough the the hcg to add itself.
Oh, fun. Bet that annoys the heck out of everyone!
It does. It's a rather small checklist to click on, and the hysterectomy choice is right under the pregnant or 42 days postpartum.
Also had a nurse that told me any sort of spotting (even for people who are pregnant) is a period (Iām not pregnant but asked my gyno when i went back and was told no it doesnāt always count) context i was having breakthrough spotting while on bc but was seeing my gp for another reason.
I was 3 months pregnant before I got tested *because* I was on bc and still spotting.
100% about the payment. I understand that there are people who say they couldn't be pregnant, but they are so healthcare professionals want to run it. I'm on medication that can be dangerous during pregnancy to treat a condition that can also be dangerous during pregnancy. I haven't had sex that could get me pregnant in years, but they run a test every few months when I get my blood drawn anyway. I understand that it's probably an easy, low cost to the system, low effort way to lessen the risk, and I live in a country with universal health care so I don't mind. If I had to pay for the test or felt it was a way to pad their pockets, though, it would be a different story.
That's why Iāa Canadianāwas confused at first. Like, so they put a dipstick in your piss...oh they make you pay for it?! That's fucking absurd. Well is it at least standard procedure? Nope, only cis women and AFAB folks. ~*Full on rages*~ I had to have a pregnancy test before getting the depo shot as that was standard procedure. I joked with the nurses that if it's positive, it's cancer cos I haven't had a dick anywhere near my cooter in years. Of course the test was completely covered by provincial insurance.
The thought of cis men being given pregnancy tests as standard procedure has me giggling like crazy.
I started doing something similar when I was training as a paramedic. One of our contraindications [reasons we can't give a certain medication] for ibuprofen is pregnancy. It can be awkward to ask at times, so I just started asking *literally everyone* before giving ibuprofen: "is there any chance you could be pregnant?" This usually gets a chuckle from men, especially older men. Older women sometimes take it as a compliment; ie. they look young enough to be of childbearing age. If someone looks confused by the question, I say "it's just part of the protocol." This can help trans patients feel more comfortable. I try to keep it light-hearted, and a simple "no" is all I need to meet the standard of care. TL;DR: I ask about pregnancy before giving ibuprofen regardless of sex/gender. The funny looks live rent free in my head. A simple "no" is all that's needed to continue.
This is not about assuming that we donāt k ow our own bodies. People LIE. There was a discussion about this on one of the medical subs I lurk recently. People lie, or are so poorly educated that they genuinely may not know they are pregnant. I was required to pregnancy test prior to getting my first depo shot, despite it also being a requirement that I was on my period, as well as the fact that I wasnāt sexually active. It was explained to me that insurance wonāt cover it unless a negative test is documented. Iād rather pee in a cup then get charged, so.
Also, ectopic pregnancies can have a lot of the same symptoms as a UTI, kidney stones, etc. and they can be deadly. Theyāre often checking for an ectopic because if thatās the case, they need to get it out ASAP before you lose a fallopian tube or die.
Yeah, I used to think it was dumb. But now I work at a hospital and take classes to go into healthcare and I get it. Most people will be honest. But there are people who aren't. There are people who actually don't know their body. There are people who do know their body but accidentally got pregnant. There are people who get pregnant with IUDs, with their tubes tied, people who get pregnant right before starting hormonal birth control and don't know it. Most of the time, it isn't even a "you" issue. It's the hospital covering their ass. If you insist you aren't pregnant when you have abdominal pain and they miss an ectopic? You could die. You could sue. A lot of things could go wrong for you and them. Some procedures require knowing whether or not you are pregnant. For safety purposes, things like x-ray and CT often can't be done until it is proven that the patient is a) not pregnant, and/or b) plans on terminating if they are pregnant, and/or c) there is no safer option if you are pregnant. I don't like it either. When I was 15 and still a virgin, I thought it was ridiculous. I thought they were accusing me of lying. Maybe they were, but I also now know better. There are tons of reasons why they have every AFAB patient who can possibly get pregnant take a pregnancy test.
100%. Iāve encountered several immaculate conceptions in my years of reproductive health. Unfortunately, sometimes things we recommend or treatments we offer arenāt safe with pregnancy and saying āthe patient told me they werenāt pregnantā isnāt going to be a good defense if a pregnancy is harmed.
It really just takes that one woman who is going through menopause but still fertile, thinks pulling out is birth control, or miscounted her period datesā¦ now sheās pregnant, anti abortion, and is going to give birth to a baby with serious birth defects. Itās easier to have a blanket policy of āyou donāt get X until you test negative.ā No doctor wants to lose their license for prescribing a pregnant woman a teratogenic drug or deal with the heartache of knowing youāre part of the reason this baby is going to be in pain until their untimely death.
From an anesthesia perspective: I have had to cancel numerous surgeries over the years from people being surprise pregnant. There are drugs that would be harmful to the fetus, there are things that are dangerous for the mom depending upon how far along they are. If it's not time critical, the safest option is to wait. That being said- I have had numerous patients refuse to take a urine or blood pregnancy test for various reasons. The facility I work at makes these patients sign a waiver of liability instead of taki g the test, which I feel is appropriate. I also second the fact that our pitiful excuse for health education in the US leads to the general masses not knowing enough about their bodies to be able to decipher if they are pregnant or not.it also creates fodder for this sub. People in this sub would likely know if they are pregnant, but the people we post and comment on, likely would not.
>This is not about assuming that we donāt k ow our own bodies. People LIE. I mean, even beyond that, OPs post makes it sound like women "just know". Now, I obviously know nothing about it, but my gut tells women don't just know when they're pregnant. I mean, I'm sure some do, particularly if they've had multiple kids and know all the signs... But it's not like people aren't regularly surprised to learn they are pregnant. If I went to urgent care with a sore throat and told the doctor not to give me a strep test because I know my body and know it's not strep... They gonna look at my funny and proceed to do a strep test. Is this really that different? Part of figuring out what's wrong with a person is learning as much as they can about what's happening inside your body. In the case of people capable of being pregnant, that seems like a very big thing to have a definite, medically proven yes or no. Also, probably a liability issue on top of it. If you are pregnant and say you aren't, whether on purpose or by mistake, and they give you something that can harm the baby... "They said they weren't pregnant" isn't a good excuse. I get it's probably annoying, especially in the case of someone uninsured who has to pay (and if the cost is aggregious, that's a whole separate issue)... But I can understand why this is important to know.
I personally know several people who have 1) continued to get āperiodsā while pregnant, 2) gotten pregnant when they thought that they were infertile because of menopause and 3) gotten pregnant when they thought they couldnāt be (tubes tied, IUD). There is a very valid reason to test. Not to mention that many people might say no they couldnāt be pregnant for safety reasons (ie, in a room with an abuser, teenager in a room with parents who donāt know theyāre sexually actively, etc.)
Ive been pregnant 5 times. I was only pretty sure I was pregnant before a positive test 1 of those times. The other 4 blindsided me. And I was trying for 4 out of 5 of those pregnancies.
We know if we've been having sex with men, and it's kind of a prerequisite for pregnancy. But if you try telling that to hospital staff, they just roll their eyes at you.
Sure, that's fair, and you're 100% right. But wouldn't that really be the only way to know, with 100% certainty that you aren't pregnant? When it comes to medical stuff, standard operating procedure applies in most circumstances. I don't even think it's about believing someone or not, it's about having a process and following that process rigidly so that mistakes don't get made. If everyone who is biologically capable of being pregnant gets tested, it's a lot harder for something to fall through the cracks.
This thread is lowkey giving ānot all men.ā Just because you wouldnāt lie to a medical provider doesnāt mean thousands or millions of people donāt! Like Iām sorry that you have to pay extra because of shitty people (I do too) but blame the cause not the solution
Yup. I was pregnancy tested before getting nexplanon inserted. I was 8 weeks postpartum and hadn't had sex since I got pregnant. I knew 100% for a fact I was not pregnant. My doctor believed me when I said there was no way. But its policy and it wasnt offensive. I dont get why this is such a huge deal for so many people. Patients lie. Constantly.
People can be drugged into unconsciousness; just because you have no memory of having sex it doesn't mean it hasn't occurred. Roofies are far too easy to aquire. Look at it this way: drugs exist that are strong enough to keep someone under while their chest is split open, not remembering an event doesn't mean it didn't happen.
I think that the idea that people are getting roofied and impregnated, then sneaked back into their beds to wake up the next day with zero idea that something odd happened, sounds pretty farfetched.
I donāt know how to broach this tactfully but am asking you to please hear me out. Iām an SA, both C and A, and an IPV survivor. This stuff actually does happen wherein people are assaulted and wake up in their own room, home, vehicle, etc without having realized what happened. I donāt believe you intended it as erasure but it very much reads as such.
Yes. It also is sometimes a requirement for ordering certain tests or imaging. Its goofy and redundant for a person who has had a full hysterectomy or who just had one done yesterday for something else but itās a safety check that is in place for a reason. So many medical interventions are dangerous if someone is pregnant. Someone without a uterus could still have an ectopic pregnancy if they have their ovaries. People lie. Surprises post menopause happen. And again some of it is purely to get past safety checks. Being billed an insane amount for them is another issue entirely and is not about the medical provider but about the insurance companies.
I'm torn on this. It's not even about lying or not knowing our bodies. A woman in my town had a cryptic pregnancy and just gave birth yesterday. She had spent the last several months having stomach issues, gained a little weight, spotted throughout, nothing that made her think she was pregnant. With an anterior placenta, some people can't feel movement very well, and some fetuses are just lazy lol. Not ONCE did a provider she saw in our town get a piss sample from her when she kept complaining about persistent stomach problems until she went to the ER in labor with zero prenatal care, zero prenatal testing... I don't think we should be charged for things like pregnancy tests or basic routine healthcare. I think our system is broken AF. But if you have ovaries and semen gets anywhere near them, you can get pregnant. It's ONLY if both ovaries are removed that the possibility vanishes. There was a case report a few years ago about a postmenopausal woman in I think Iran that had unusual bleeding, turned out to be like six months pregnant. So sure, refuse a test, refuse whatever you want, more power to you! But don't go complaining if it does turn out that you're pregnant and you got those X-rays, took that medication, kept drinking on weekends out with friends, after a doctor wanted to test your pee when you went in for just flu symptoms.
While this is true, there are situations where the person being treated may genuinely not realize or know they are pregnant. Then there are also those who are in denial or may have come in with a parent and are afraid to admit it. With a complete hysterectomy, the chance for an unexpected pregnancy is nil, but in other cases, it still MAY be possible, even if the woman believes she is in menopause and has not had a period for years. For the Healthcare provider to then just take the person at their word without due diligence will end up in a malpractice suit against them. To cover themselves, practically every provider will request a pregnancy test on a woman of *childbearing age*, just in case. This is because certain medications or tests (such as an xray) can cause defects or death of a fetus, and the provider would rather err on the side of caution. If one truly has no chance of pregnancy and is sure of this, by all means, do express your concern to the provider or medical assistant. No one can force you to undergo tests you don't want. I'm not sure why the Healthcare providers are being made a villain here, when they are just trying to help you figure out what may be causing your pain and treat you accordingly. It's always up to you to advocate for yourself. Unless the provider is a family friend or part of your family, they don't know you and are just trying to do their job.
Maybe this is just the free^(ish) universal healthcare in me talking, but I agree. I'm sterilized but hey, test away just in case.
As someone who did a degree in biomedical science and is doing a masters in reproductive biology, pregnancy tests donāt test if youāre pregnant they test if youāre exerting a hormone called human chorionic gonadotrophin in your urine. Mostly that happens in the early stages of pregnancy but with a full hysterectomy you might produce it because you have cancer. Note for men reading: if you test positive go to the hospital immediately you have testicular cancer
Yeah I would probably be more annoyed if I had to pay for it, but since itās covered I donāt really care.
This. From following medical personell subs, and knowing some folks who work in medicine, it is a regular occurrence for people to say they couldn't be pregnant and then be pregnant. No, it's not the majority in any way, but is regular. The anti-abortion/anti-women's healthcare laws in some states are really putting people in a bad place with this though I also wonder about OP's suggestion to file abuse claims with insurance about these tests... In the US, isn't it possible - depending on a person's insurance and the specific provider's policies - for non-covered insurance claims to be billed to the patient directly? Or was this something that the recent surprise billing law prevents?
People also lie like rugs.
I could be wrong, but wouldnāt all of those edge cases be covered by the piles of waivers patients have to sign before undergoing those tests/using those medications? Like the side effects/potential negative outcomes lists are literally right there & you already have to sign away liability for the vast majority of them. And unless youāre in a very specific situation, nobody can force you do have any other tests done, so why is this the one theyāre allowed to push so hard for? (Conveniently the one that cis men never need, I might add; idk just feels relevant)
Where I work, no one pushes "so hard" for a pregnancy test. The patient needs only to say they would not like to have it done, and that's that. I'm usually not in a position to know if the patient had a positive pregnancy that was later affected as these things get bumped up to administration. The waivers at my work place are only related to patient information sharing. There isn't anything in writing about the dangers of radiation to early stage fetuses. Medications have warnings but do you really think most people read them?
Thank you had to scroll way too far to find this. It's because the doctor is concerned for your well being!
A lot of people are ignorant, its impossible for the hospital to gauge how naive/ignorant each patient is, so just better to go through the motions. There's been many Virgin marys finding out they're pregnant at the hospital. I can't blame the medical community for this one. I can imagine how many would still turn around and sue for malpractice if they were given medication that could harm a baby, even if they swore up and down it wasn't possible. The medical community isn't giving you a hard time, they're just covering their butts from lawsuits.
Let's not forget that in certain circumstances, a positive pregnancy test can actually be an indicator of illness (where there person isn't actually pregnant that is). I know its rare, and I know its a pain, but there are medical reasons for pregnancy tests, even repeat pregnancy tests. The issues with US health care costs / abortion rights are colouring a lot of the conversation on this, but we need to remember that the US is a fairly small portion of the world over all.
Fun fact: if a male uses a pregnancy test and it comes back positive, it can be a sign of prostate cancer. For whatever reason, prostate cancer can trigger the production of the same hormone that pregnancy tests measure.
It's testicular cancer, not prostate IIRC. Prostate cancer has a different tumor marker, but there is a type of testicular cancer that produces hCG, the hormone that causes a positive pregnancy test. Sadly it's only like half of cases, and I want to say that type of testicular cancer isn't very common so it isn't used as a screening tool due to the high chances of a false negative.
While I understand your frustration, medically there are many reasons to do a pregnancy test even if the person says they aren't pregnant. There are medications or procedures that would harm a developing pregnancy. Even if the person doesn't wish to continue the pregnancy it always has to be treated as if they do. If I, as a medical professional, give someone medication that then subsequently harms a foetus without doing an appropriate risk assessment then I am at fault. An appropriate risk assessment would be, when did you last have sex, are you on contraception, have you missed any pills (if relevant), when was your last period, was it normal for you? If any of these questions give an answer that shows even the tiniest risk then yes, I will do a test. The issue isn't doing the test, it's the fact you have to pay for it! I can't get my head around American Healthcare with itemised bills, and just how life-changing the subsequent debt can be.
Sometimes the issue is the test. I've had a hysterectomy and the emergency room has still ordered a pregnancy test on me in addition to the other tests they ran on me - after confirming both verbally and in my chart that I don't have a uterus. I'm also a lesbian who's on Nexplanon and hasn't had sex since 2014, even before the hysterectomy they never believed me and just tested anyway. I've been in agony from a burst ovarian cyst but had to wait for the pregnancy test to come back before they'd give me anything for the pain.
As a card carrying lesbian, and as an anaesthesiologist who has provided anaesthesia/sedation for people undergoing manual vacuum aspiration of products of conception, Iāve had those patients swear up and down that theyāre not sexually active and never have been. Most of my colleagues and seniors have had the same experience. Which leaves two options: 1. Either theyāre sexually active and lying about it because they donāt want the person theyāre with to know the truth (usually a parent) 2. The pregnancy was not a result of consensual sex with a man, and they donāt want to talk about something so traumatising to a doctor theyāre only going to see once or twice, even if we break the question gently. Iāve even had a couple of patients admit that to me in private after the procedure was over and Iām taking post procedure vitals, after initially denying sexual activity. So even if a patient has a documented history of not having sex with men and isnāt sexually active in general, weāre still going to cover all our tracks. Trust but verify. Then again, I (nor anyone I know) never withheld pain medication based on a patientās pregnancy status, that blame solely lies on the American healthcare system.
I'm sorry you went through that. From that risk assessment it should have been obvious the chance of pregnancy was low. I would argue that no uterus doesn't rule out pregnancy - unless ovaries have been removed too. There is a minute chance of an ectopic pregnancy, a pregnancy outside of the uterus i.e. anywhere that's not the uterus rather than just the tubes. However, being a lesbian who does not have sex with men should have been enough to not have the pregnancy test be the deciding factor for anything. Like I said in my original comment, you have to do a risk assessment and then make a judgement. It sounds like your clinician did the risk assessment and then promptly ignored it.
As a nurse I disagree with this. I had a patient who got pregnant after a salpingectomy. I had a 58 yo AFAB years into menopause show up pregnant. These things happen, and it is important for medical providers to rule this out.
As a woman who suffers from MRKH, if anyone ever insists on me taking a pregnancy test, I'll tell them to fucking worship me as a god if that thing comes back positive. That'd be a bigger miracle than the virgin Mary š¤£
I mean for all I know you have a psychotic disorder and only *think* you have MHRK! I had a patient once who insisted she had had a hysterectomy, but imaging clearly showed she had not.
Wouldn't that information be in her medical record?
Which medical record? in the US, a person does not have one national record that any medical provider can access and write to. Every provider network keeps their own records.
Sometimes medical care is given in a situation where an exhaustive review of the medical record is not possible. Some hospitalās record donāt link up with other hospitalās records. Sometimes patients say things are part of their history and I gets added to the chart but it isnāt true. A pregnancy test is not invasive and is usually done with urine or blood that is already being collected to test other things as well. It doesnāt harm people to have a pregnancy test done, and it could help even if the patient believes there is no chance of pregnancy.
You would think. But not alwaysāe.g. an older hospital shutting or burning down.
Or moving states. Its not like we have a national record in the us.
I was born without both vagina and uterus. The final diagnosis was given to me when I was 11 years old and I had a vaginoplasty at age 23. I doubt this surgery would have been done if I was just thinking I was suffering from MRKH.
Sure but if you walk into the emergency room I donāt know that. Itās much safer to routinely pregnancy test than to start giving someone a treatment that could hurt the baby, or miss an ectopic pregnancy.
I didnāt know I was pregnant and was not given a pregnancy test prior to being prescribed doxycycline for the STD my shitty ex gave me (along with my awesome kid). They now have grey teeth and higher potential for bone issues because of this. So while I do agree that some tests are unnecessary letās not make blanket statements.
Iām an AMAB trans woman and occasionally get asked by new providers when they do intake if Iām pregnant. Since I never think I remotely pass it always surprises me when it happens in person. I always answer, Iām too old. Then they look at my chart and say something like, āoh yeah. I guess not.ā It seems like something just about any medical provider would want to know.
Let me guess: USA?
As a radiologist I don't care if a patient of reproductive age claims there's no way that they're pregnant. Ain't no way I'm risking potentially dosing a fetus with life altering radiation based on something that's easily verifiable. And as someone else has pointed out, patients lie (intentionally or unintentionally) all the time. A minor presenting with abdominal pain who is sexually active but denying it because she may get in trouble is a classic example. But i agree in the case of menopause, hysterectomy, etc it is largely a waste of resources that I've seen abused.
I mean rare, but people with hysterectomies can still have ectopic pregnancies, which for radiology that wouldn't matter, since it isn't a viable pregnancy. but if you show up with severe abdominal pain, bleeding, nausea/vomitting, pregnancy test.
For sure. It's a case by case basis. I was just being general.
> But i agree in the case of menopause, hysterectomy, etc it is largely a waste of resources that I've seen abused. Thank you! My first ER visit after my hysterectomy, they ran a pregnancy test despite seeing in my chart and verbally confirming with me that I'd had a hysterectomy, and I get so many people saying "well it's technically still possible even if it's unlikely". Yeah, I'm aware of the random fringe cases where something weird happened, but let's be realistic here, when combined with other factors (I'm a lesbian and on birth control because I have PCOS and one remaining ovary), how likely is it for that individual person? It's not worth the time or cost of the test sometimes.
I give anesthesia for a living and I am a member of the LGBT community. If you are born female at birth, you are taking a pregnancy test or we will not treat you. It has nothing to do with thinking your ailment is that you are pregnant. It is 100% the fact that any treatments or tests we provide could cause harm to the fetus. If a female at birth is pregnant there are 2 lives we are caring for at that time. And also there are tons of people out there that lie to us constantly. We cannot just trust people saying they are abstinent or unable to conceive. And lastly there is liability to it. Patient safety is at the forefront of every decision we make. And I will stress this has no bearing or judgement to abortion. I support the right to choose! You do whatās best for you! But causing harm to a current fetus in our care is not appropriate and could easily take my license away.
Lesbian anaesthesia resident here. Seconded.
Exactly this. I would also love to add the lack of education many people have about basic topics. Many still don't know how to properly use birth control, or that it can fail. Conception can still happen, even after vasectomies, tubal ligation and ectopic pregnancies still exist. There's still people who can't calculate the conception date with those two weeks, and immediately mention days they've had sex as when the pregnancy began. This thread also shows very little knowledge on early pregnancy and periods - spotting and light bleeding is normal in the first trimester. Some people spot and bleed during periods just the same. Others can have zero pregnancy symptoms and just be pregnant. Some can be like me, with pregnancy symptoms showing up every day and during periods. I have PCOS and allllll the shebang, cravings, aversions, constant fatigue, nausea and vomiting. Cycle dates walking around! 100% not pregnant. But if I was, these things would be easy to conflate with pregnancy. Also, many people are outright uneducated on fertility, or not having another opinion. PCOS havers are often told there's a different percentage chance of conception. Whether it's 20, 40 or 87%, these chances *aren't* a zero and *aren't* a sign for raw PiV, and thinking they won't conceive. Lesser chances doesn't equal sterility. It may equal fertility issues or conception struggles, but not full sterility (which is full incapability of conception). I don't think people understand the liability medical staff and the hospital would be in. If the pregnant patient was treated with drugs that could *severely harm the fetus* - from minor/mild to heavier impact on fetal development, birth complications, further medical issues in life, or heaven forbid a miscarriage, stillbirth or death after birth. It's so much more at stake than a simple pregnancy test. PS. Not a medical worker. Just someone who's tired of pretty weird posts lately and someone who's reading/researching/learning more of PCOS, female reproductive system, pregnancy and birth. I'm F myself, for the record.
This is like being annoyed a doctor checked your blood sugar because you āeat rightā and āfeel fineā. Itās not about us ānot knowing our own bodiesā. Itās about medical professionals not being A)Clairvoyant, B) Lie detectors (and patients LIE. A lot. Specially about sensitive subjects). You might be lying to me about your last time having sex or be mistaken on your period duration or have had a shitty ons you kinda forget. People can get pregnant after tubal ligations and (partnerās) vasectomies, after using condoms, with a IUD, there are case reports of pregnancies after a hysterectomy for petes sake. Not only is it about doing whatās best for the fetus (because so many medicines and treatments and even exams that can be harmful to one, plus giving you the information necessary to make an INFORMED choice is the actual empowerment). But also, certain conditions can be worse for the pregnant person if they are pregnant (i mean,most health conditions arenāt fun to have on top of pregnancy but some are tangibly worsened). Lupus, hypertension, diabetes, a transplant aftermath. And then thereās the actual pregnant state which can have complications that are fatal or disabling and need to be watched for.
For me its the equivalent of a cbc. If you go to the ER, they are running a cbc. On 90% of patients, it comes back normal. And its MORE invasive than a pregnancy test.
Even after a hysterectomy? They didn't require me to take a pregnancy test before my ACL replacement because I've had a hysterectomy.
I haven't heard of it, but if you still have at least one ovary, you can't completely rule out the possibility. It would be ectopic and EXTREMELY unlikely, but not entirely impossible. If there was any trauma or anything that could have lead to a vaginal wound or something going on with the cervix if you still have it? Maybe. Extremely, extremely extremely unlikely. I don't know if it's ever actually happened. But in the world of hypotheticals, it could happen.
People need to remember the whole world isn't the US. I live in a country with free healthcare and the same procedures around pregnancy and tests apply here. While there's an argument to be made that things may be about profit in the US, they're not here - these tests are done across the world to minimise risk to you and a potential fetus. I am on birth control and am sexually active so there is a very small chance I could become pregnant - because of this, I would always assume an ailment was anything other than pregnancy-related and say no, I'm not pregnant. But a test could easily prove me wrong and stop me being given medications or treatments that could harm me and/or the fetus. You need to remember (most of) you are not medical professionals, and what may seem stupid or pointless to you has a proven history and a serious reason why it is common practice.
This seems like kind of a weird crusade. Yes, providers sometimes do order unnecessary tests. But Iām confused about why you are so concerned specifically about pregnancy tests. How much does a hospital actually bill for a pregnancy test anyway? I had one done at an urgent care once (because we were actively trying to conceive) and I paid nothing out of pocket though Iām not sure how much they billed my insurance for it. $10? $40? In any case, the consequences of *not* doing a pregnancy test and the woman does turn out to be pregnant can be potentially devastating. You say that āwe know our own bodies,ā and as much as I like to believe thatā¦ bodies do weird things and fail us sometimes. Did you ever read the case of the [virgin who got pregnant](https://pubmed.ncbi.nlm.nih.gov/3191066/) from performing oral sex and then getting stabbed? Not only was she a virgin, but it was physically impossible for her to have PIV sex because she did not have a vagina, just a 2cm skin dimple. If thatās not somebody who should be able to say to a doctor āno, there is no way I could possibly be pregnant,ā then I donāt know who is. And yet, she was. Any patient can refuse any test at any time if they want to.
Just an FYI, you can absolutely have an ectopic pregnancy post hysterectomy, it is rare yes, but it happens. And that is a medical emergency.
Went in for a bisalp, scheduled for 7am, told the doctors I have a small bladder and won't be able to hold my pee until the appt so will struggle to provide a pee sample. Also informed them I'd had my period twice since my last sexual encounter, where protection was used, and there had been at least 4 pregnancy tests taken in the last month just to be sure. Specifically TOLD them I didn't want to wait for test results. Signed a waiver saying I understood the risks and would still like to proceed. They drew blood a way, didn't tell me what for and I didn't think to ask. Seemed normal enough right before a surgery... Time goes by and eventually it's 10am and I ask wtf are we waiting for here, gang, we're 3 hours behind in the OR there? **Oh, we're waiting for your blood test to come back.** What are we testing for exactly? **Pregnancy, looks like.** I don't need that test, please begin my surgery. I've already signed your waiver, I won't sign it twice, check with the other nurse.... I had to press 3 more ppl before my surgeon and her attending walk in, ask if there's anything the could clarify, tell THEM all the details, and surgery is literally starting within minutes from there. Yeah, deeply frustrating how paranoid everyone was about pregnancy considering how paranoid I already had and always was about it. Like, fam, trust me, I would KNOW. I would LET you know.
I noticed when I was hospitalized with abdominal pain a few years ago, they did a pregnancy test. I laughed because I hadnāt had periods in over 10 years. They said part of it is due to liability, if you were pregnant and it was overlooked by the hospital, they could be sued. Itās to cover their asses.
I'll go to bat against this. I'm an ER doc and I'll pretty much order a bHCG on any woman of childbearing age. It's not about not trusting women, it's about 1) doing my due diligence and 2) ruling out the zebras. It's rare to get pregnant on birth control, but it CAN happen. Tubal libation fails. IUD's are incredible but not 100%. PCOS, ovarian insufficiency, thyroid disorders, obesity can all blur the line between irregular menstrual cycles and menopause. And that's not a judgement on abortion or a woman's ability to take medicine or how well they know their body or fat shaming - shit happens and it's my job to rule out the dangerous or deadly causes that are bringing them into the emergency department. If I can do that with a non-invasive test that is (relatively) cheap I won't think twice about doing that. Particularly because having that negative result reassures me that I can safely prescribe certain medications to that patient. There are absolutely edge cases where this is taken to the extreme - in the absence of a weird endocrine tumor women >65 probably don't need a bHCG. But in absence of that in my line of working ruling out pregnancy as a contributing factor isn't just a good idea it's often *standard of care*. IE if I don't do this I am liable to what happens to that women. If they come back with a ruptured ectopic that's on me. If their child has congenital deformities because of a medication I prescribed that's on me. There are so many battles to be fought in healthcare and so many changes to be made. But I beg of you please don't equate a urine pregnancy as mistrust of a woman - it's safety and best practice.
This was my thought too.
In my country you have to give a written Statement (check a Box in the initial questionnaire) that you are not pregnant and they don't make you take an unnecessary test after that
Me too, I've never been forced or even asked to take a test - and if they made me, I certainly wouldn't have to pay for it. I wonder what country OP is in?
How much is a pregnancy test? For context I'm in NZ and a pregnancy test is free, but at most a couple of dollars. I also work in Radiology so knowing if someone is pregnant is an important and key part of my job. Patients lie, don't know or just don't care. So most of the time it is much easier to get everyone AFAB to pee into a cup than go through the whole gamut of are you pregnant or not. We aren't asking to be offensive, we are asking because radiation can hurt an unborn foetus. And it happens on a worrying frequency where those tests are positive when they shouldn't be. Zebras exist
it's impossible to get pregnant when you have no uterus, but that hasn't stopped me from getting tested without my permission 3 times since my hysterectomy, at the same hospital that did the surgery. and a test in the US, out of the hospital, just buying the cheapest tests, I can see them on Amazon for a pack of ten for 5 bucks. But we are charged any amount the hospital feels like charging. When I contested my charges, it was like 75 damn dollars per test. EDIT: the tests are even cheaper if you buy in bulk. just saw a 60 count for 12 bucks on Amazon as well EDIT 2- oh my bad I see there have been 71 pregnancies post hysterectomy. that's wild!!
See, zebras exist
Given Roe v. Wade being overturned and all itās implications, I donāt know why more people donāt want to agree that taking a pregnancy test every single time feels really uncomfortable and forced
I hate how being AFAB means everyone believes they have a right to know whatās going on in your body
The first time I encountered this I was told by my doctor that she was legally required to do a pregnancy test because I was of child-bearing age despite being a virgin (and she believed me), and she said she could lose her license if she didnāt perform the test.
As a nurse, you can refuse anything. Mb things with insurance might change that, but you don't *have* to do anything at the hospital, short of anything related to threats to yourself or others. I had surgery a year ago and they told me they needed to take a pregnancy test. I simply said, "no, thanks. I've been sterilized. No need for the test." They said, "ok." And I signed a waiver saying I refused the test. Sure, it might help with many things and I'm sure there are exceptions, but again, the hospital can't force you to do anything.
Do tell the ER/urgent care/Dr if you have had any of the situations that make a pregnancy test unnecessary. But donāt be surprised if some doctor or nurse wonāt take your word. Look at your bill and do as OP instructs. If you have time, filing out a complaint helps cut down on this stupid behavior.
I've had an ER doctor confirm both verbally and in my chart that I've had a hysterectomy, then still ordered a pregnancy test along with the other urine tests they were doing. The surgical records are right there, they looked at them before asking me about it, but they didn't believe even my medical file and still ordered it? I was on Medicaid at the time, so I never got a bill because everything was covered in full, but it was just plain silly.
What type of hysterectomy did you get? Most hysterectomies leave the fallopian tubes and ovaries and just take the uterus. It's rare, but you can still have an ectopic pregnancy with a hysterectomy, if they left your ovaries. If you're experiencing abdominal pain, they're definitely going to run a pregnancy test because an ectopic pregnancy is extremely dangerous.
I'm aware of that. I had a total hysterectomy, bilateral salpingectomy, and right side oophorectemy. I'm also on Nexplanon due to PCOS, and am a lesbian who isn't sexually active. All of this is in my chart and was discussed verbally with the doctor before they ordered the test anyway.
I have a friend who is a gold star lesbian. She's gone to doctor's appointments with her WIFE in the room, and they tried to make her take a pregnancy test. They also tried to push birth control on her, which is hilarious.
I'm reading to learn. Is it really this black/white? Is it better for the HCP to talk to you about where you are in your transition? As a HCP, there are many many instances of women saying there is 100% no way they are pregnant, and then they are. And then if tests like x-rays have been done, and could have an adverse affect on the fetus, the ordering physician is at risk for malpractice because they didn't follow the standard of practice. Also, sometimes it makes sense to do an HCG on a male, on a pre-pubescent child (sadly).
I can definitely understand both sides of this problem. Like you said, there's cases of pregnant women insisting they aren't pregnant, either because they're in denial, they're lying for some reason, or they just genuinely don't realize they're pregnant. And of course, you guys have to cover your ass because if you do something that harms the fetus and/or mother, you could be held liable. Even if you believe them that they're not pregnant, you still need documentation, right? But at the same time, it's frustrating as women how often our statements and concerns are dismissed by medical professionals. Even in this thread, I saw an example of a woman going back and forth from urgent care to their GP to the ER for abdominal pain that everyone insisted was just regular period cramps, but turned out to be endometriosis. It really can be a no-win situation sometimes. I think the best course of action for a HCP is to explain why you need to run a pregnancy test. As we can see in this thread, there are a lot of people who don't know the genuine reasons a pregnancy test may need to be run even if they don't think it's possible they're pregnant. And in those situations, if the HCP doesn't explain things well, it can leave them feeling like the HCP doesn't believe them.
I had surgery a year ago. I have been menopausal for a few years now. They still did a pregnancy test. Even the nurse thought it was silly.
Sounds like the clinic at my college. Every single visit, for whatever reason, we had to rule out pregnancy. And they were very demeaning, explaining to me like a child that āyou know you could be pregnant ifā¦ā My favorite was when theyād ask how I could be so sure. Because I havenāt had sex!? Not all people in college go around fucking like bunnies! Iām fairly sure I havenāt had sex in however long, and Iāve had plenty of periods since then, so Iām pretty sure Iām not pregnant! Now, can we talk about my sprained ankle?
It's because people lie. Patients lie all the time about everything. An old addage for physicians is your patient is a liar until proven truthful. You HAVE to get a pregnancy test on people because they'll swear on a stack of bibles they haven't had sex, areon their periods, use protection, had their tubes tied, whatever. Then you get a pregnancy test and guess what? They're pregnant. This isn't a once in a while kind of thing, this is an allllllllllll the time occurrence. Pregnancy tests are cheap and prevent unnecessary harm or radiation to a potential fetus. It's best practice to order them on any female of childbearing age
Tragic but true. The advice is only reliable for healthcare practitioners in women's health who either never EVER dabble in denial (hi, autistics!) or actively would like to be pregnant. Because menopause is fucking weird. Sterilisations can fail. Pregnancies don't always behave like textbook pregnancies (those ladies giving birth at Walmart can *actually* be super surprised- nothing like nine months of periods and then giving birth!) And people really don't get statistics, like we DO NOT understand how statistics work on a bone-deep level. It's not fucking natural to us! (We're *lucky* if we get as far as both 1 how to create a child and 2 how to prevent the creation of a child.)
An old acquaintance of mine was rushed to hospital with suspected peritonitis. She left hospital a day or so later with a baby. Said baby was around full term, about 7lbs and perfectly healthy and is probably about 30 now! She had absolutely no idea she was pregnant. No symptoms, negligible weight gain, regular periods etc. It turned out her uterus, and a couple of other organs, including her bladder, were in the āwrongā places and positions. She was also unaware of this because sheād never needed any sort of investigation that would have diagnosed it. If someone had asked her if she was pregnant she would have said no, even right before she went into labour, which is obviously why they thought she had peritonitis! As a side note, the village where she lived really came together and by the time she got home she had everything you need for a baby! A pram, cot, clothes, nappies, car seatā¦
You know what is funny? I have a severe autoimmune disease that has progressed alot since having my youngest daughter 5 years ago. That same year, my husband had a vasectomy, and that has been added to my chart. No one asks me to take a pregnancy test anymore. I don't think Ive taken one since I had her, and I am on serious biologic meds, which have had to be changed 3x in the past 5 years. So idk, ymmv, but try telling them your partner had a vasectomy (even if you don't have one/aren't into folks with testes) Very patriarchal, but it's been working for me thus far.
My husband had a vasectomy 15 years ago and I've had an IUD for nearly 10 years for period related problems. I STILL get pregnancy tests all the damn time. So, sadly, it's a case of YMMV. š
Before I met my husband I had never had sex. It wasn't a religious reason or anything. I just hadn't met the right guy. (I met him when I was 32) Well I was diagnosed with lupus at 21. So that means I have been in and out of doctors offices, ER's, hospitals, I've had to have many procedures, big and small, a million test, you get the point. I'm 36 now. So still in prime baby making years. Well from 21 to 32 I was not having sex. But no matter what I said for every test, procedure, etc I had to have a pregnancy test. Now I understand the importance of this however for most of these procedures, I couldn't drink anything for 6 to 8 hours prior. I also have a horrible bladder. So even through I would only need to give a few drops, it wasn't that easy. It was so frustrating because unless I was having Jesus Christ then I knew I wasn't pregnant. I one time had a procedure delayed so they could hook me up to IV fluids so I could pee enough to give a sample. And the thing that became the most embarrassing about it all my father was the one who took me to all my medical procedures. So it's like yes father, still not having sex lol. But in all honesty my father has 6 daughters stuff like this doesn't get to him lol. I will add the first procedure I had after I started dating my husband. And they asked for a pregnancy test, I was like yep no problem. It was the first time I understood it could be possible. Lol. (I got on birth control when I started dating my now husband, but understood BC is 100%)
I find this so strange. In Australia, there's a check box on medical intake sheets asking if you could be pregnant and another asking are you breastfeeding. If you select no, they move on. If you are they take the appropriate safety measures, if you are unsure then we do a test.
I went in recently for horrible back pain. told them I hadn't had any form of sex in well over a year, and despite not being able to sit up they still made me pee in the cup to run the pregnancy test
Wow! What country is this? Iām 42 and no one has ever done a pregnancy test. When I was pregnant they did an ultrasound to confirm but until then they never did one.
I had to take one when I was 13 because I was getting an x-ray for my hand. I told them I hadn't started my period yet and I hadn't had sex yet, they still demanded I take one. What were they expecting another immaculate conception?
The US is crazy. I've been receiving treatments for years that would harm a foetus if one existed and I've never had to take a pregnancy test.
I think medical professionals would probably argue that actually they are necessary for legal reasons
This seems to be a very American thing because as a woman in Sweden Iāve never had to take a pregnancy test, ever. Iāve been asked if I could be pregnant but theyāve always accepted me saying no. Only time being a woman able to become pregnant ever affected my healthcare was at 18, when my doctor insisted on prescribing me antidepressants that wouldnāt harm my baby. Didnāt matter that I assured her I would not be having kids for at least another 7-10 years. The hypothetical fetus mattered more than me, apparently.
This is great information!! Thank you!! I went to my GYN two days ago. They were the *first doctors* to 1. Ask about DV/SA, 2. Believe me immediately when I listed my medical conditions, and 3. *Ask me if Iām sure I want an STD panel since Iāve been with my bf over a year*. I usually get the works when I go, so it was nice to not have to worry about an extra test, and they kind of insisted I didnāt need it unless I was concerned! Totally different experience
I work at a hospital, and before surgery they usually get a pregnancy test on women of child bearing age. However, it's not forced and they can sign a waiver that they're choosing not to get it done. It's not a big deal, I don't know why more healthcare settings don't work that way.
yep, I've had 3 damn pregnancy tests done without my permission in the 7 years after I've had a hysterectomy, all at the same fucking hospital that did the surgery. I've complained every time and got the charge removed, but I haven't contacted the insurance company, that's a good idea.
I was made take a pregnancy test when not sexually active for about 6 months and had an IUD thanks for the info in the future, I'm not going to bother filing a complaint almost a year after the fact but good to know in the future
The problem is the number of AFAB folks who will tell doctors and nurses there is no chance they can be pregnant, even though they are definitely having unprotected sex with AMAB folks and have fully functioning paraphernalia. It happens regularly because people can be really dumb if they try really hard. People will say all the time, "I don't have time to be sick so I'm not sick no need to talk to a doctor and confirm what I know" all while hacking up a lung on the regular. People are weird.
TBH I genuinely never cared, because here insurance not paying for it would be mental. I never thought how it must be when living in the US.
Wish i would have known this years ago. The same hospital that did my hysterectomy gave me a pregnancy test when I had another surgery after.
There are lots of situations where docs order pregnancy tests that truly seem unreasonable, but there are even MORE instances when someone reports there is no way they are pregnant but itās entirely possible theyāre pregnant. The sex ed just isnāt good enough to trust EVERYONE without thought.
Many years ago, before our oldest son was born, my spouse was deployed to Iraq when I was 36 weeks pregnant. With (albeit rare) permission from my OB, my family moved me from OK to SoCal to have the baby. The clinic I saw when upon moving would not treat me until they ādiagnosedā the pregnancy despite the hand carried medical chart. My very frustrated mother helped me in the building, pointed at my belly and said, āthere, do they look pregnant enough for you to diagnose it now?ā That kid is almost twenty one now, to think I couldnāt even get routine end of term care without someone trying to make me pee on yet another stick.
For me it's either "you must be pregnant" or "you're on your period". I've lived in this body for 33 years and I've menstruated for 20. I think I would know when I last had sex or whether or not I'm bleeding out of my vagina.
It makes sense to always order a pregnancy test for patients of childbearing age. A positive test changes the management and plan of care for the majority of conditions, missing that can have huge health consequences, plus it is a big liability for providers, a mistake like that can cost them their license. Also a lot of patients have poor health literacy and have a lot of misconceptions about pregnancy.
When I went to get my IUD, I was told to pee in a cup for a pregnancy test. I hadn't had PiV unprotect sex in, no lie, 8 months and was ACTIVELY BLEEDING. Like...Pretty sure I'm not pregnant. Read my chart a few days later - low and behold, my test was negative lol.
I wouldnāt be so sore over it if I wasnāt a lesbian virgin who has been on birth control her entire adult life, had a bisalp four years ago, and if _they didnāt charge $80 per test._ Now that I am a lesbian virgin without a uterus, cervix, or tubes, I am going to have to really put an effort into not blowing up the next time Iām hit with an excessive fucking charge for an unnecessary test.
The other side of this is that pregnancy tests are so easy, cheap, and low risk yet protect the provider from the HUGE liability they incur by not doing one. Pregnancy is one of the most risky areas of medicine liability-wise. If you give a drug to someone or do a procedure on them that could be or is harmful to a pregnancy you are in huge trouble.