Scary side of Virginia ultrasound law

[0KidsAndHappy]

it's not about having consented to sex beforehand, it's about body integrity. It's about trusting that most women may actually know when the embryo was conceived and are not the irresponsible persons those legislators want you to believe they are. it's about accepting in the privacy of a doctor/patient relation to medical procedures.

I understand that and completely agree, but am just bringing another aspect into it, because Loesch has been making it a point to exploit rape victims as of late. To force a woman to go through a procedure like this is bad enough, but a woman who is a victim of rape ... I don't even have the words for it. To say that women who were raped had "no problem" and "engaged in the act" that resulted in their pregnancy. Ugh.

[emmiedahl]

I totally agree with this statement. I also think we're all so caught up in the "my body my choice" argument that we fail to realize that certain medical procedures/screenings before an abortion or prescribing birth control could potentially save a woman's life. And from what I'm reading here, nobody seems to care about that. Hell...my doctor has to examine me before prescribing medications for other medical conditions. This is no different, and failure to carry out such procedures/screenings shows a lack of concern for women's health.

If a woman wants a transvaginal ultrasound she can pay for one. I just looked and Virginia is a state where women have to pay out-of-pocket for abortion. If a woman cannot afford the procedure before she is pregnant, why do you think she will be able for pay one after? It presents another barrier and adds to the cost of the procedure. Doctors should be performing a transvaginal u/s when *they* think it is necessary.

If your doctor chooses to examine you for certain medication, that is between him/her and you. He/She is doing what they believe is medically correct. Why should a legislator decide what is medically correct?

[Witsec1]

The doctor is required to offer the patient the option to look, and required to report on her permanent medical record whether or not she looked.

I totally agree with this statement. I also think we're all so caught up in the "my body my choice" argument that we fail to realize that certain medical procedures/screenings before an abortion or prescribing birth control could potentially save a woman's life. And from what I'm reading here, nobody seems to care about that. Hell...my doctor has to examine me before prescribing medications for other medical conditions. This is no different, and failure to carry out such procedures/screenings shows a lack of concern for women's health.

Bollocks to you for the bolded part. This legislation has fuck-all to do with saving women's lives. From what I'm reading in your posts, women's personal agency and right to privacy, and the confidentiality of the doctor-patient relationship mean nothing to you.

I would like to mandate rectal exams for the VA legislature. This would save a lot of lives, I'm sure. It's in your best interest to submit to this procedure, Assemblyman, so bend over!

[No Fun My Babe]

I would like to mandate rectal exams for the VA legislature. This would save a lot of lives, I'm sure. It's in your best interest to submit to this procedure, Assemblyman, so bend over!

:clap: Brilliant!

Also, sorry to be totally off topic, but I adore your avatar. Most people here in America only know Hugh Laurie from House, and it's a great show, but he's a freakin' comedic/musical genius. I'm thinking of making a similar Stephen Fry avatar for myself. Oh Christ! I've left the iron on!!

/ off topic

[valsa]

Ummm...perhaps no insurance (or if she has insurance she may not be able to afford the copay/deductible and may not qualify for medicaid and maybe to rule out any reason why she may not be able to have children in the future.

You do realize women will have to pay for this ultrasound as well, right? And that adding the cost of an unnecessary and unwanted medical procedure to the already pretty high cost of an abortion is just another way to throw up roadblocks to women exercising their right to choose, right?

I totally agree with this statement. I also think we're all so caught up in the "my body my choice" argument that we fail to realize that certain medical procedures/screenings before an abortion or prescribing birth control could potentially save a woman's life. And from what I'm reading here, nobody seems to care about that. Hell...my doctor has to examine me before prescribing medications for other medical conditions. This is no different, and failure to carry out such procedures/screenings shows a lack of concern for women's health.

So you'd be okay with, say, forcing everyone with an ear infection who wants antibiotics from their doctor to get an MRI done first? Because that could also potentially save people's lives.

[Katiebug]

It's not a part of the law that the ultrasound has to be done transvaginally. After 8 weeks or so in many cases an abdominal ultrasound can suffice for dating purposes. Prior to that it is usually transvaginal. It depends on the woman's body, the skill of the person doing the scan, and the equipment being used. Even at 5 weeks with my pregnancy, they could visualize that it was a uterine pregnancy and see and measure the gestational sac with abdominal ultrasound - it required a transvaginal to measure the yolk sac (about all they can do at 5 weeks to assess potential viability, which was the concern since I had some spotting). I'm not a skinny woman, either.

I simply relate the fact that while transvaginal ultrasound may be necessary in some cases, it may not be in others. A first trimester ultrasound can often be done abdominally, at least well enough to have an idea of gestation. When it comes to abortion I'm of the opinion that it should be up to the doctor or nurse practitioner doing the procedure to decide whether an ultrasound is necessary to perform the procedure safely, and if so, the clinician will determine how to perform the ultrasound in order to obtain the information that s/he needs. Some women might not have good dating on a pregnancy. If a woman has unusual anatomy or the pregnancy is actually ectopic rather than uterine, that's also critical information for the clinician to know. I have absolutely no problem with a doctor deciding to do (or not do) an ultrasound if s/he thinks it's necessary to give appropriate and safe medical care. A government shouldn't be legislating how a licensed clinician does his or her job. All of these laws that require women to listen to a description of fetal development, be asked if they want to see the ultrasound or hear the heartbeat (if there is one), whatever - they're bullshit. Like someone seeking an abortion at 6 or 8 weeks will be dissuaded by a grainy image of a blob!

TL:DR - if the trained and licensed clinician doing an abortion thinks that an ultrasound is warranted in order to provide the procedure safely and legally, then that's a medical decision and not a legislative one. State governments ought to stay out of the business of deciding what constitutes appropriate medical care.

[valsa]

I think that this bill is ridiculous and I'm opposed to it in every way, shape and form... but I'm wary of pulling out the rape comparison. The way I see it, the problem with comparing it to rape is two-fold: one, it is a medical procedure and the context is different. There are women who are triggered from routine yearly pap smears, too, but that doesn't mean they're forced. I feel that calling it rape in some way diminishes the trauma and violence of actual rape (I imagine some woman who was beaten within an inch of her life and then someone saying, "I feel your pain. I had to get a transvaginal ultrasound.").

While I understand your concern somewhat (I hate the term "birth rape" for similar reasons), I don't think it's the same here. For one, not all rape is violent. And thinking that violence has to be involved for it to "really be rape" has, for countless years, created a stigma where women who were non-violently raped had to deal with people thinking they weren't raped at all. Why isn't this rape, in your opinion?

I've been under general anesthesia for surgery and, before I went under, I consented to have them put a urinary catheter in me while I was out. If they were to put anything other than a catheter into me (penis, probe, dildo, decorative spoons, whatever), they would be violating me. To me, it would feel no different than if I were passed out at a party and someone penetrated me with something there. Just because I consented to ONE THING in the first example, doesn’t mean they have any more right to stick something else in me than the person in the second example.

[Deleted03]

I totally agree with this statement. I also think we're all so caught up in the "my body my choice" argument that we fail to realize that certain medical procedures/screenings before an abortion or prescribing birth control could potentially save a woman's life. And from what I'm reading here, nobody seems to care about that. Hell...my doctor has to examine me before prescribing medications for other medical conditions. This is no different, and failure to carry out such procedures/screenings shows a lack of concern for women's health.

They recently changed the recommended frequency of pap tests just changed:

Guidelines from the American College of Obstetricians and Gynecologists recommend that women begin Pap test screening at age 21, be screened every 2 years through age 30, and then be screened every 3 years as long as their last three test results have been normal.

It's not rocket science and it is not related to your pill prescription, it is a different and separate issue. They don't withhold heart medicine if men don't go through prostate tests. Hell, I bet they won't withhold the medicine if the patient refuses another heart monitoring. Your health is what matters and withholding contraception has very direct consequences: under the counter contraceptives, unwanted pregnancies, possibly abortion.

Anyway, hopefully with the new guidelines women won't have to submit to that yearly.

[chiccy]

They recently changed the recommended frequency of pap tests just changed:

It's not rocket science and it is not related to your pill prescription, it is a different and separate issue. They don't withhold heart medicine if men don't go through prostate tests. Hell, I bet they won't withhold the medicine if the patient refuses another heart monitoring. Your health is what matters and withholding contraception has very direct consequences: under the counter contraceptives, unwanted pregnancies, possibly abortion.

Anyway, hopefully with the new guidelines women won't have to submit to that yearly.

Here's hoping so. I'm annoyed that I had to start those damn pap screenings at 17--just to get birth control--when they aren't even suggested until 21. (And I am someone at very low risk for cervical cancer.) :x

[eohiken]

Paps are related to pill Rx, to get the pill you need a pap (because the pill effects cervical fluid, blah blah blah).

Oh, and did you know that med students doing ob/gyn rotations frequently do practice pelvic exams on women under general for unrelated surgeries? Talking about consent to invasive procedures.

http://www.theglobeandmail.com/life/hea ... le1447337/

[alaeangelorum]

Not in the UK. An ultrasound is only done if you are unsure of the dates and its a toss up between medical and surgical abortion. Though some arsehole conservative is trying to bring in a similar law here. Wont happen though. Most abortions here are on the NHS and an unnecessary scan wastes money.

Hmm, all the women I saw when I sat in on termination clinic had ultrasounds before they saw the doctor. It doesn't waste that much money if one more person has a scan as they will have to have a sonographer on shift for the clinic anyway.

[emmiedahl]

eohiken, according to the article, it is only in Canada. Still appalling though, and I am sure it will change now that people are becoming aware of it.

[alaeangelorum]

Paps are related to pill Rx, to get the pill you need a pap (because the pill effects cervical fluid, blah blah blah).

Oh, and did you know that med students doing ob/gyn rotations frequently do practice pelvic exams on women under general for unrelated surgeries? Talking about consent to invasive procedures.

http://www.theglobeandmail.com/life/hea ... le1447337/

What? Why? We don't have to have smears before pill prescription here. We don't even start screening until 25.

At my medical school we are required to do some vaginal examinations on women under anaesthetic but we have to personally ask their permission and get their consent in writing before we do so. That practice should be on its way out.

[doe]

Here's hoping so. I'm annoyed that I had to start those damn pap screenings at 17--just to get birth control--when they aren't even suggested until 21. (And I am someone at very low risk for cervical cancer.) :x

I went to the health department at 18 to get birth control. I was unable to have a pap smear (nerves and thick hymen). They only gave me a 3 month supply of the pill and told me I couldn't get more until I came back and had my pap. (They instructed me to have lots of sex to get ready for it.) I never went back, but a couple of years later I had my hymen surgically removed.

Oh, and having sex is no indicator of all the things you can have put in your vagina. Being aroused and lubed up is far different from being in a medical setting where you are bone dry except for your cold sweats. Trust me, I know this well.

[eohiken]

I have read articles stating the practice happens in the US as well and have seen references to it on the big Ob/gyn forum as well. That was just the first most recent article that google gave me.

Yes, the practice should be on the way out, especially now that it's been given the light of day.

[chiccy]

Paps are related to pill Rx, to get the pill you need a pap (because the pill effects cervical fluid, blah blah blah).

Please expand upon this. Why exactly do you medically need a pap to take the Pill?

[eohiken]

The reason I was told, is that hormonal birth control effects changes to your vaginal environment, most specifically the fluid (mucus) the cervix makes. These changes need to be monitored as they *may* decrease the vagina's natural immune function. It's a CYA move, they give you the drug, they need to make sure it doesn't cause major problems.

[chiccy]

The reason I was told, is that hormonal birth control effects changes to your vaginal environment, most specifically the fluid (mucus) the cervix makes. These changes need to be monitored as they *may* decrease the vagina's natural immune function. It's a CYA move, they give you the drug, they need to make sure it doesn't cause major problems.

I'm sorry, but I think it's worse than a CYA move. I think they're mandating pap smears because they want to screen more women for cervical cancer, not for any reason related to birth control. There's nothing in place requiring that they "monitor" changes in the cervical fluid--I could get my pap at a different doctor every year, and it would be perfectly legal. I doubt the immune function thing is a serious concern, because AFAIK many (most?) states don't require pap smears for the Pill. They're just creating an unnecessary hurdle for getting birth control pills, and that is the last thing we need--even less than we need a hurdle for getting abortions.

If doctors think cervical mucus should be monitored in individual cases or for special reasons, they can use their judgment to recommend a pap smear. This is NOT lawmakers' business.

[eohiken]

The thought is unusual cell growth on the cervix may be more frequent on the pill - that's what they are monitoring. It's not legislated, it's medical practice.

[Guest Anonymous]

The doctor is required to offer the patient the option to look, and required to report on her permanent medical record whether or not she looked.

Bollocks to you for the bolded part. This legislation has fuck-all to do with saving women's lives. From what I'm reading in your posts, women's personal agency and right to privacy, and the confidentiality of the doctor-patient relationship mean nothing to you.

I would like to mandate rectal exams for the VA legislature. This would save a lot of lives, I'm sure. It's in your best interest to submit to this procedure, Assemblyman, so bend over!

OMFG...and bullshit to you on this post. I realize what this legislation is all about. But, if you cannot clearly see that performing a medical procedure without some kind of physical exam is of benefit, then it proves to me that the health of the woman means nothing to you especially when any medical exam would be covered under confidentiality just like the abortion itself would.

As for the rectal exam comment exam....I'm all for that especially before prescribing any ED drugs! So, yeah, bend over gentlemen!

[bananacat]

I'm the totally responsible type who gets a pap smear every year religiously, and I'm pretty consistent with going to the dentist and eye doctor too. I don't do monthly breast exams because I keep forgetting, and I always feel bad about it. But I am still totally against requiring a pap for BC pills. Everyone should absolutely get their paps as recommended. I can't stress that enough and I am basically a walking PSA about it. But it's completely unrelated to BC pills. I once had a doctor like that, and there was a big problem. She didn't have any open appointments for pap smears for over a month. I had just moved to the area and had been on the pill for 7 years at that point, and I just needed my prescription renewed. My pills would have run out by the time I could get the pap smear done, plus it would be another 4 weeks for the mail-in pharmacy to process and ship my order. She made an exception for me, but that was the last time I ever saw her. I switched to a different doctor who said that was an old-fashioned idea.

I started taking the pill when I was 15 and my doctor recommended that I start getting paps, but not before she gave me the prescription. She explained that if I'm taking the pill, I'm probably having sex and it's just a good idea to start getting the routine screenings. I did actually have a high-risk strain of HPV when I was 17 so it's hard for me to accept it if the recommendations are changing. On the other hand, it cleared up on its own by the time I was 21 or 22 so I guess I wouldn't have been at risk to wait until 25. And as the HPV vaccines become more common, I can see that the risk will be even lower to wait until 25. I still like to get mine every year though, just to be sure even though I got the Gardasil shots a few years ago.

[valsa]

But, if you cannot clearly see that performing a medical procedure without some kind of physical exam is of benefit, then it proves to me that the health of the woman means nothing to you especially

Are you a doctor? I'm guessing you're not.

So, why don't we let the doctors decide if an ultrasound is needed, on a case-by-case basis, prior to the abortion, rather than let a bunch of (predominately male) politicians require it when it may not be needed.

[Guest Anonymous]

You do realize women will have to pay for this ultrasound as well, right? And that adding the cost of an unnecessary and unwanted medical procedure to the already pretty high cost of an abortion is just another way to throw up roadblocks to women exercising their right to choose, right?

So you'd be okay with, say, forcing everyone with an ear infection who wants antibiotics from their doctor to get an MRI done first? Because that could also potentially save people's lives.

I don't know where the MRI thing came from, but yes, I am against doctors just randomly prescribing antibiotics without having recently examined the patient. In fact the CDC is waring doctors to stop prescribing antibiotics unless a bacterial infection is detected or as a preventative measure. Also, when it comes to maintenance medications, a lot of doctors will only refill the medications a certain number of times before requiring a check up or medical tests to make sure the medication is still working, that there are no adverse effects, and that no adjustments/changes are needed. As far as costs...well....that is something that needs to be worked on obviously, and I don't have an answer for that.

[valsa]

An ultrasound is far more invasive than just an exam.

[Witsec1]

But, if you cannot clearly see that performing a medical procedure without some kind of physical exam is of benefit, then it proves to me that the health of the woman means nothing to you

Poor reading comprehension, or poor reasoning skills? I can't decide.

As for the rectal exam comment exam....I'm all for that especially before prescribing any ED drugs! So, yeah, bend over gentlemen!

Sure, those pesky patient consent laws just get in the way of efficiency.