11yr old accused of being pregnant

[browngrl]

I think it is very reasonable to first do a pregnancy test - after all common things are common but then the mother should have proceeded on to getting medical attention. As a doctor -the first thing I would do would be to do a serum HCG level - just to confirm the girl was not pregnant. Then I'd move on. An ultrasound would be an easy first test. I think part of the problem is the lack of health care options in the US for many. In Canada - I think it would be more likely that a parent would get their child to a doctor and I think it would be more likely the child would have been diagnosed sooner - just because there would be no financial consequences to seeking medical attention. Luckily - benign ovarian lesions are far more common than malignant ones and in this case it certainly sounds as if the lesion was benign - so I suspect the girl will do well (at least medically - I can't speak for the psychological consequences).

Just as an aside: bilateral dermoids are not all that uncommon - something on the order of 20 - 25% of dermoids are bilateral.

[rollmeover]

Those were the comments that made me cry. I might ask my daughter about the possibility of pregnancy because I would be concerned she had been raped and didn't have the courage to talk about it. No matter what she answered we would be heading to the doctor immediately because (a) she is pregnant and that is really dangerous for an 11 year old or (b) she has something else wrong with her. If the first doctor doesn't give us a proper answer, we would see another one the next day and the next and the next and the next until we get an answer.

It's not really about courage. I didn't talk about being raped and it wasn't because I was a coward.

[sarahbrownie]

I have my own horrifying experience with something like this. Only in my case, it was a bunch of male ER doctors who thought that nausea was a symptom of pregnancy and was never, ever present for anything else, like the stomach flu or norovirus.

When I was 15, I was in a summer theater program and living in a dorm and I caught a cold. I didn't realize that it turned into pneumonia, and then I caught a stomach virus. Hell, everyone on my floor caught that stomach virus. My problem was that I didn't get better. I was sick. SICK. The dorm supervisor took me to the ER, because I was dehydrating pretty rapidly.

They asked me in the ER if I was pregnant. I said I wasn't. They asked me if I was sure. I told them that unless I was the reincarnation of the Virgin Mary, pregnancy was out of the question, as I'd never had intercourse.

Not good enough, apparently. They did a urine dipstick pregnancy test. It was negative. They ran a blood test to see if I was pregnant. It was negative.

Then, for reasons I will never, ever understand, the doctor decided to give me a pelvic exam. I couldn't lie on my back without getting faint, so they gave me an oxygen mask. They didn't really explain what was happening. I was on a bed in an open cubicle in a busy emergency room, gasping for breath, dry heaving, and a (male) doctor and two (male) residents told me to take all my clothes off and get in a gown, then they made me lie down and stuck my feet in the stirrups. I needed an exam, they said. No one closed off the cubicle, so I was in stirrups getting my first pelvic exam in full view of all the ER staff and patients.

Apparently the urine test and the blood test hadn't convinced them. They used a full-sized speculum, despite the fact that I was a small-boned, thin adolescent who had never had intercourse. The doctor put the speculum in and I SCREAMED. "Oh," said the doctor with a barely-suppressed laugh, "I guess you really were telling the truth about boys, huh."

Pelvic exam showed nothing. I was diagnosed with pneumonia and gastroenteritits and wound up in the hospital for a week, because it's hard to take antibiotics wen you can't keep anything down.

I can still clearly remember the total contempt on the faces of the male doctors, because a 15 year old girl screamed in pain and terror when they used a full-sized speculum on her during a public, completely unneeded pelvic exam, an exam she'd never had before and didn't understand at all.

Human beings can be assholes.

Did you ever report them? If my daughter told me she was given a pelvic exam when she was having stomach pains I would have caused havoc with the hospital administration to get them fired.

[ADoyle90815]

I am so sorry you went through that. Those doctors should be barred from ever practicing medicine again.

I agree, those assholes should have been fired and banned from medicine.

[Mela99]

I have my own horrifying experience with something like this. Only in my case, it was a bunch of male ER doctors who thought that nausea was a symptom of pregnancy and was never, ever present for anything else, like the stomach flu or norovirus.

When I was 15, I was in a summer theater program and living in a dorm and I caught a cold. I didn't realize that it turned into pneumonia, and then I caught a stomach virus. Hell, everyone on my floor caught that stomach virus. My problem was that I didn't get better. I was sick. SICK. The dorm supervisor took me to the ER, because I was dehydrating pretty rapidly.

They asked me in the ER if I was pregnant. I said I wasn't. They asked me if I was sure. I told them that unless I was the reincarnation of the Virgin Mary, pregnancy was out of the question, as I'd never had intercourse.

Not good enough, apparently. They did a urine dipstick pregnancy test. It was negative. They ran a blood test to see if I was pregnant. It was negative.

Then, for reasons I will never, ever understand, the doctor decided to give me a pelvic exam. I couldn't lie on my back without getting faint, so they gave me an oxygen mask. They didn't really explain what was happening. I was on a bed in an open cubicle in a busy emergency room, gasping for breath, dry heaving, and a (male) doctor and two (male) residents told me to take all my clothes off and get in a gown, then they made me lie down and stuck my feet in the stirrups. I needed an exam, they said. No one closed off the cubicle, so I was in stirrups getting my first pelvic exam in full view of all the ER staff and patients.

Apparently the urine test and the blood test hadn't convinced them. They used a full-sized speculum, despite the fact that I was a small-boned, thin adolescent who had never had intercourse. The doctor put the speculum in and I SCREAMED. "Oh," said the doctor with a barely-suppressed laugh, "I guess you really were telling the truth about boys, huh."

Pelvic exam showed nothing. I was diagnosed with pneumonia and gastroenteritits and wound up in the hospital for a week, because it's hard to take antibiotics wen you can't keep anything down.

I can still clearly remember the total contempt on the faces of the male doctors, because a 15 year old girl screamed in pain and terror when they used a full-sized speculum on her during a public, completely unneeded pelvic exam, an exam she'd never had before and didn't understand at all.

Human beings can be assholes.

I can't even express how horrible that is. I would have kicked him in the face or shoved the speculum up his ass. Man I hope your parents raised holy hell.

[Jana814]

I can't even express how horrible that is. I would have kicked him in the face or shoved the speculum up his ass. Man I hope your parents raised holy hell.

How horrible that that was the 1st thing that they thought was going on w/ you. As for the 11 year old in the article, that is so wrong as well. I had a ovarion cyst that burst when back in 2009 (I was 29) it was the worst pain EVER!! Went to the ER they did think I was pregnant being that was 29 but when I told them NO right away they believed me!!

[penguinagogo]

it has to be in a doctors mind

all women between the ages of 10 to 55 at the outsides might possibly be ovulating and therefore possibly be pregnant

but the point is that we are much more than our reproductive systems and a medics mind cannot just stop there

I have no explanation for an internal exam being performed on someone with 2 negative pregnancy tests presenting with vomiting. Even if you were pregnant what would an internal add to your assessment? unless you were bleeding or had symptoms of miscarriage. It might be justified if there was a suggestion of sepsis or TSS - eg retained tampon, but you could be asked about that.

[Miggy]

It's not really about courage. I didn't talk about being raped and it wasn't because I was a coward.

I apologise: you are right that courage was a poor choice of words. I can't imagine what it is like to deal with rape, I don't know how you would begin to explain to someone else what happened or even whether that would make it better or worse.

[Trynn]

When my cousin sprained her ankle, they wanted to make her do a pregnancy test. I couldn't figure why until she spelled it out for me: "I'm overweight, so therefore I must be in denial." I still couldn't figure out what a possible pregnancy (which, btw, would only have been possible if there was a new star in the east) had to do with a sprained ankle.

[Dollypeeps]

11 years old and thats what everyone thinks. If that was going around here that lass would be in care as fast as the docs got to the wee test. Her mother is stupid cow 11 for fuck sake.

I would of freaked out if my daughter had a large belly and first reactions would of been shit its cancer not a fecking baby.

[browngrl]

When my cousin sprained her ankle, they wanted to make her do a pregnancy test. I couldn't figure why until she spelled it out for me: "I'm overweight, so therefore I must be in denial." I still couldn't figure out what a possible pregnancy (which, btw, would only have been possible if there was a new star in the east) had to do with a sprained ankle.

Did your cousin have X-rays? I have often done pregnancy tests to rule out pregnancy when I have to X-ray the patient. Radiation is an important consideration - especially in a very early pregnancy (when all the organ systems are developing but the patient might not even know she is pregnant).

[samithemage]

Did your cousin have X-rays? I have often done pregnancy tests to rule out pregnancy when I have to X-ray the patient. Radiation is an important consideration - especially in a very early pregnancy (when all the organ systems are developing but the patient might not even know she is pregnant).

I was just about to suggest that same thing. We recommend a pregnancy test for all girls and women of childbearing age who are more than ten days past the first day of their last period, are sexually active, and are not consistently using birth control. We don't make anyone take one, but we do document that they refused the test to for liability purposes.

[chaotic life]

My 10 year old has been throwing up every day before school since it started last fall. Funny, I went to the doctor and insisted he test her for H.pylori....not a preganncy test. When he suggested counseling, I went to a Ped GI instead and we're getting her tested and if necessary scoped after that.

How trashy do you have to be to keep testing your pre-teen instead of demanding answers from doctors???

IF my pre-teen were pregnant, I would be getting her tested fast to get a medical abortion and then have the police find and prosecute whomever was raping her! I would hope that any child of mine would feel safe enough to tell me they were raped before that point in the first place, though.

[Katiebug]

Yes, around here if a post-menarche/pre-menopause female patient needs X-rays and is more than a certain time interval from her last period and isn't on birth control it would not be unheard-of for a doctor or hospital to request a pregnancy test before doing the X-ray as a matter of routine. I was in that situation myself in college with a suspected broken ankle in need of X-rays. I wasn't on birth control since at the time I was a virgin, but had an irregular cycle and due to the time elapsed since my last period they asked if they could do a pregnancy test first. I wasn't offended or shamed in any way; not all women know they're pregnant right away and radiation in pregnancy is not a good thing during organ formation.

I wonder how much of the girl's ordeal happened due to poor or no medical insurance. A pregnancy test is cheap in comparison to an ER visit, where if you have no insurance and walk out with less than $1000 in bills it's a miracle. That doesn't mean it wasn't a very poor choice to have her keep taking tests over the course of MONTHS, but the mother may not have felt they had other viable options until the situation became obviously bad.

I know it sounds messed-up to our posters in other developed countries, but many families and children in the US have no insurance or have lousy insurance. Here, some of the poor (not all) get Medicaid. There are many working class and lower middle class families who make too much to qualify for Medicaid but have no access to insurance and those people really can't afford to pay for a doctor's visit. Depending on the state such families may or may not have access to state-run children's health care programs for kids who can't meet Medicaid income limits. Or maybe mom does have private insurance but it has a huge deductible, making routine doctor's visits unaffordable.

[penguinagogo]

no, its not personal when they ask about the possibility of pregnancy

its just before xraying a potentially pregnant woman its better to know about such things as the imaging can cause avoidable harm - just like asking if you are allergic to contrast before CT or have a pacemaker or metal implants before getting an MRI

so that the patient has a choice to undergo the test, or so that shielding for the pregnant abdomen can be put in place if the xrays are essential

Its something that should be asked when the pt is alone.

Its kind of like asking about drug use, or alcohol - its not meant to imply that your alcoholic or a drug user, its because the facts are important and making assumptions is dangerous both ways

freaked me out at 14 when broke my wrist- as the doctor asked me (correctly) without my mother present, and I burst out laughing

but totally understood when she explained why they had to ask, and ask me alone

having said all that several yrs ago I saw an xray with a full term baby, head engaged in pelvis

the lady had fallen and hurt her hip. and then developed really bad crampy back and abdo pain 2 days later

you wouldnt have picked her out of a lineup as pregnant

she was certain she could not be pregnant and the practitioner involved did not test

delivered 2 hrs later

(some details changed/omitted in this story to avoid any possibility of recognition)