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Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
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Note: This only affects The Nest's community members and will not affect members on The Bump or The Knot.
Re: WOWR: Anonymous Dr.'s response to transvaginal ultrasounds
when the alternatives are non-invasive? yes.
If the ultrasound isn't mandated by law, the patient has the option of finding another doctor who may not feel the procedure medically indicated. If a doctor refuses to perform a medical procedure because the patient will not consent to a test the doctor feels is necessary for their safety, I am okay with that. But forcing a (not always necessary) test on women and their doctors because politicians want to shame them is wrong.
The difference is that the doctor (who, you know, went to medical school) considers the actual patient, what she needs and what the doctor needs to treat her.
These laws are about a bunch of legislators (who, as far as I know, for the most part, didn't go to medical school) telling doctors (the supposed experts) what they should be doing with each and every patient, not considering the medical needs.
If my doctor told me that I needed a transvaginal ultrasound for something, and explained why, I would believe her. I don't believe legislators can tell my doctor to order me to undergo an invasive medical procedure.
(four pregnancies, two kids, never one transvaginal.)
I am the 99%.
I needed the vag wand to date the pregnancy. I had it done at 8 and 11 weeks. The over the belly would not have worked. It's my understanding that this is SOP.
It matters when you are including the idea of coersion in the discussion. If there is not a law requiring an ultrasound prior to an abortion and a doctor believes it is medically necessary, then the patient is free to refuse and find another doctor that is willing to perform the abortion without an ultrsaound. If the patient can't find a doctor that doesn't believe an ultrasound is *medically* needed, then it would be hard to argue that it isn't medically needed.
It becomes coersive when the govt is threatening both the doctor and patient with a law that requires both of them to participate in a procedure that neither may deem necessary in order to perform the abortion.
You originally compared this to Birth Control and docs requiring a pap to get BC pills. Again there is no law requiring a pap to get BC pills and there are safe alternatives for birth control that don't require a doctor's involvement at all. So when an individual doctor refuses a prescription if the patient refuses a procedure, there is no real threat to the patient--they have options available that do not require the procedure, such as finding another docotr or using non-prescription alternatives. No coersion here.
If you don't see how having no other safe alternatives available for abortion doesn't increase the threat to the patient if they say no, then I'm at a loss.
my read shelf:
You don't seem to understand the slippery slope you create here. If a doctor can only require a medical procedure when the patient has alternatives to achieve the same outcome without it, then the only reason a doctor can require a pap for BCPs is because of the existence of condoms. You take the entire question of whether a doctor feels a procedure is required for safety out of the equation that way. Anyway, I give up on this particular exchange--we aren't getting anywhere.
Can I also just say in general how excited I am to save this thread about birth control and how many options there are for the next "why the government needs to cover any BC method I want at 100%" discussion? Because in those threads it inevitably seems like there are millions of people for whom a specific brand of $$$ BCPs is the only possible way they could avoid conceiving. I'm not sure what alternatives that supposedly large demographic has to avoid so-called pap-raping.
Find me here instead!
This. You don't NEED to do a transvaginal. You can do an abdominal u/s for these purposes. Which, still needs consent. The issue here is that you now have to stick something inside of me which would cause me greater discomfort vs. another method that is less invasive and causes less discomfort.
Where did I say that? Please, show me.
Let me make what I has said as simply as I can for you.
If you have 100,000 options for something you believe you need and 1 individual says no to you if you refuse to dance a jig for them first, then that 1 individual is not threatening, or coersing you, by saying no. You have 99,999 other viable options.
If you have only 1 option for something you believe you need and a law requires you to have dance a jig before you can get that something or you and someone else go to jail, then there is coersion present--you are being threatened with dance a jig or go to jail as the only two possible ways for you to get what you need.
At no point in this thread have I talked about a law. I'm talking about what doctors can and cannot require of their own patients, and whether anything along that line that could ever constitute coercion and therefore rape.
Find me here instead!
And I'm saying that doctor A requiring you to get a pap smear for them to provide you a BC prescription is not coersion when doctor B exists that doesn't require it. How is what doctor A threatening you when you have the ability to go to doctor B to get what you want?
If the govt required all doctors,A-ZZZZZZZZZZ, to doa pap smear before they could write you a prescription for BC pills, then you could argue there was coersion present, but since there are non-prescription options for BC available, I'd argue that it's the not same level of coersion as present when discussing abortion. The "threat" is not as powerful when you have other options available.
This is not true though. If you want to date your pregnancy in the early weeks it has to be internal. An external won't pick up the image properly for dating purposes.
This answers the question I've been trying to ask over and over. If an individual doctor refuses to perform an abortion without an ultrasound, and the patient refuses to comply, the doctor is within their rights to refuse to perform the abortion. There's no coercion involved there--even though the doctor holds all the power to allow or disallow the procedure. If we agree on that, then we agree.
Find me here instead!
I had an external u/s to date my pregnancy. The u/s was early too as I had done IVF. I think I had one at 7 weeks, 9 weeks, and 12 weeks and all were external. The u/s tech said that she always starts with an external u/s and sometimes she can see fine. If that doesn't work, then she will do an internal.
I am also wondering what all these alternatives are--condoms and diaphragms? Every other BC method I can think of requires a prescription. Anyway I think the argument about alternatives is irrelevant. The issue is not whether there are alternatives but the fact that the government is mandating it, rather than the individual physician.
Also this is reminding me of the whole "birth rape debate."
Iris Victoria {9.13.08} Augusto Morgan {4.30.11}
Yes. If every doctor out there suddenly, and independently, decided they no longer were willing to perform nose jobs because liability insurance has gotten to high, then the Hollywood starlettes are shittoutofluck. If the govt passes a law requiring all doctors to amputate a foot before performing a nose job or go to jail, then coersion exists.
At my hospital and for my pregnancy it had to be internal. I think they tried external and couldn't get a read. This was the case at both 8 and 11 weeks. And I have several friends who had the same issue. Look, I just want to correct the idea that these internal exams are never or rarely needed. That's just not the case.
Yes, exactly. I think that is the whole point - the individual doctor has certain procedures they follow and if you don't want to comply with them then find another doctor*. It's the difference between the doctor holding the power based on what they consider to be in the patients best interests, to be medically necessary etc (ideally) and the government stating that all doctors that do X must do Y first regardless of whether it is medically necessary. The latter is the issue for most of us.
*yes I realize going to another doctor isn't always that easy etc.
Okay, this entire thread is starting to make my head hurt.
This doctor wrote this letter because he's pissed off about a law. This entire thread was about that law. Your comparison to birth control doesn't work precisely because there IS no law mandating doctors to perform an
But since you seem to be talking about medical relationships outside of this law, I'll take a stab at it.
No, I don't think that you can accuse a doctor of rape for "coercing" a patient to have a necessary medical procedure before obtaining treatment. I also don't think that it's wrong for a doctor to require a women to consent to a vaginal exam as a new patient before that doctor will start prescribing medications related to reproductive health, because I can see how that could be viewed as a necessary medical procedure. Would you expect a doctor who's never physically seen you to prescribe random medications if you just called in with a sore throat? I also don't think it's wrong for a doctor to require patients to comply with medical recommendations on reproductive health (e.g. the new regs on tri-annual pap smears) before consenting to continue treatment for reproductive health concerns.
With that being said, I have NEVER had a doctor absolutely refuse services (i.e. refuse to refill a BCP scrip) when I haven't had time for an annual before my rx ran out. I've had a stern talking to over the phone, but I've never had a doctor refuse to fill the prescription, unless I've been a new patient.
I, do, however, think that a doctor could be accused of rape if s/he coerced a patient into a medically unnecessary procedure that involved penetration by telling her that s/he wouldn't provide medical services unless she consented to the procedure. For example, given the new regs, I think women might have a case for coercion for doctors who require patients to submit to a pap smear every year in order to continue receiving prescriptions for contraceptives.
And all of this still has NOTHING to do with the law, which is wrong no matter which way you look at it.
"You don't get to be all puke-face about your kid shooting your undead baby daddy when all you had to do was KEEP HIM IN THE FLUCKING HOUSE, LORI!" - doctorwho
I get what you're saying, but from what I can find, transvaginal ultrasounds weren't even invented until the 1990's and there have been literally millions of abortions that have safely proceeded without them.
There are different reasons to date a pregnancy that is going to move forward then there are to date a pregnancy that is going to be terminated.
Seriously? We can't quote news articles now--only medical journals? Give me a break. I am the queen of primary sources, but this is absurd.
Although I would truly enjoy a board in which the only acceptable charts were ones posters made and sourced themselves.
Find me here instead!
Look, I'm not even addressing the abortion angle. Just responding to those who say transvaginal ultrasounds are never needed. For the 100th time, that's simply NOT the case.
I didn't seeing anyone saying they aren't *ever* needed, just that they are *always* needed, well medically needed.
I had a regular over the belly u/s prior to my medical abortion (RU-486). I'm assuming it was for dating purposes, but didn't ask. They did another one 2 weeks later, I'm assuming to make sure I passed all of the tissue. The screen was turned away, so I never looked at the monitor.
It seems like forcing a trans vaginal U/S when a regular one is sufficient is a power trip - plain and simple.
didn't seeing anyone saying they aren't *ever* needed, just that they are *always* needed, well medically needed.
Oh for cripes sake. Someone said they were rare. Someone else said they weren't needed. And another person said she had 4 pregnancies and no trans vag action.
I just wanted to point out that they DO happen in normal, wanted prenancies and, in my anecdotal experience of me and my friends, ARE common.
NB - while I didn't have time to clarify this earlier, I would like to assume most of us know that in some cases a trans-vaginal u/s is needed. Considering that I've actually had a trans-vaginal u/s performed when I was roughly 6 weeks pregnant and about to miscarry, I know why you would need to perform it. However, not each and every abortion would need this done. If this law requires this be done and the woman is say 8+ weeks pregnant and an abdominal u/s can achieve the same goal, why then would you require a trans-vaginal u/s be performed?
The goal of these laws are to create more obstacles and cause more discomfort for a woman who is merely exercising an option that is legal. If I don't have to have something shoved in my vagina, I'd like to take the least invasive route. That was why I agreed with pixy. There are other methods that can achieve the same end result. This doesn't provide that option.
Ding ding ding. I went down this rabbit hole, y4m. I get that the WOW is frustrating, but there seems to be a lack of nuance. It is possible to disagree with these laws and ALSO disagree that they constitute rape.
Related only by their oddity are the sudden assertions that a) tv u/s are rare or unnecessary contrary to their ubiquity on the nest/bump and b) bcps are just one of many bc options, despite the opposite argument in BCP coverage threads as you pointed out.
There are enough arguments against these laws without all this distraction.
I would look at coercion in different terms--
In the course of medical care, a doctor states her plan for treatment and informs the patients or alternatives, risks, and benefits. In some medical situations, there are no other treatments--like late stage cancer--the option comes down to treatment Z because A-Y have been used or hospice care. Which is still a choice. But the doctor can explain that.
In this case there is only risk--probably minimal physical, but potentially more severe psychological risk. The doctor cannot offer informed consent because there is no logical reason for the procedure. Other than I assume to do psychological harm.