Nov 20

“Let’s Do A Cervical Exam To Make Sure You’re Pregnant.”

“Let’s do a cervical exam to make sure you’re pregnant.” – Certified Nurse Midwife to pregnant woman, after a dating ultrasound showed a viable 12 week fetus.

58 people dislike these words.

There are 24 comments to this post.

Lisa had this to say, Nov 20, 2012 @ 2:28 pm (Quote)

Wait, what?? Is this a case of Read-The-Chart?

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Pepper had this to say, Nov 20, 2012 @ 2:57 pm (Quote)

What will a cervical exam prove?

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Jane had this to say, Nov 20, 2012 @ 3:00 pm (Quote)

“Yeah, those ultrasounds are so inaccurate. It’s a shame you don’t trust your radiologists or the technology. Oh, you do? Then we’re already sure I’m pregnant.”

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road2vba2c had this to say, Nov 20, 2012 @ 3:21 pm (Quote)

I do not consent.

Any questions?

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Jamie had this to say, Nov 20, 2012 @ 3:23 pm (Quote)

Scam! Just another useless “test” they charge the insurance company for.

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Kristin had this to say, Nov 20, 2012 @ 3:25 pm (Quote)

Let’s not and say we did!

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Robyn Reply:
November 20th, 2012 at 3:36 pm Robyn(Quote)

No, because then you have to pay for it.

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Kristin Reply:
November 20th, 2012 at 6:48 pm Kristin(Quote)

But I could claim that the doctor was trying to defraud the insurance company by charging for procedures he didn’t perform.

I’m guessing that insurance companies don’t like paying for mythical exams.

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Jamie Reply:
November 20th, 2012 at 7:12 pm Jamie(Quote)

I’ve actually had this almost happen to me. Had a pap/pelvic 6mo before getting pregnant and they wanted me to do another pap. I told them “no” that I’d already had one prior and that my insurance wouldn’t cover it. Their response was “oh well we’ll put it under another code.” I said “that’s fraud and I’ll be down to get my records”. Total crap!

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Jespren had this to say, Nov 20, 2012 @ 3:28 pm (Quote)

And maybe afterwards we can do a tilt table test to make sure I’m alive!

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Kristin Reply:
November 20th, 2012 at 6:49 pm Kristin(Quote)

Oooh, and after that, and EKG and chest ultrasound to make sure you both have a heart AND it’s beating!

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Details had this to say, Nov 20, 2012 @ 5:01 pm (Quote)

RUN! This is one of the dumber ones since I don’t believe you can determine pregnancy by a vaginal exam plus read the chart plus I would bet money that there was either a pee test or a blood test to determine pregnancy before the ultrasound. You know, unless they were looking for a cyst and found a baby.

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Missy Reply:
November 20th, 2012 at 7:28 pm Missy(Quote)

I believe the cervix of a pregnant woman actually does look different from a non-pregnant woman. It gets engorged with blood and looks purplish. But it’s still absolutely ridiculous given the U/S showing a viable fetus!

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Jespren Reply:
November 21st, 2012 at 5:33 am Jespren(Quote)

You can confirm pregnancy by pelvic exam. The cervix looks different and you can feel changes to the womb. But, that’s something that maybe you do *if* you need a pap or pelvic anyway and you and doc are waiting for bloodwork to get back.

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Details Reply:
November 21st, 2012 at 5:54 am Details(Quote)

I’m stuck on that word “determine” since I don’t believe the state takes anything but a blood test as proof of pregnancy to get into the prenatal care medical coverage. And we did have the military doctor who couldn’t confirm pregnancy at 7 months without a lab test. I’ve heard about the purple cervix thing before, but I don’t think there is an amount of purple that qualifies as an absolute dermination of pregnancy. “Let’s do an internal with external palpitation to find out placement and size of baby and placenta.” Okay fine, but to make sure your’re pregnant – READ the Chart you moron. Besides how long does a urine test take??? This statement shows that this midwife is not a good communicator and tends to be manipulative and questions the mother’s knowledge of her own body. Not a provider I would want to deal with. I don’t think most women choose a midwife over a doctor so that they can deal with someone who can’t listen or read charts! So I’m back to RUN. RUN for the hills, This is a medwife!

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Ellen Reply:
November 27th, 2012 at 3:04 pm Ellen(Quote)

No, this is an incompetent midwife.

In midwifery school we learn about the “presumptive,” “probable,” and “positive” signs of pregnancy. Presumptive (the lowest level of evidence) include lack of menstruation, nausea, changes in pigmentation of the areola, and Chadwick’s Sign (bluish/purplish changes in cervix/vagina at 6-8 weeks LMP). Probable signs — the next level of evidence — include abdominal swelling, a positive hCG test, a rise in basal body temps, more uterine/cervical changes (including Goodell’s Sign, the softening of the cervix at 6-8 weeks LMP, and Hegar’s Sign, the compressibility/softening of the uterine isthmus at same time) — and, believe it or not, the detection of fetal outline/parts, which is still not considered absolute proof of pregnancy.

The *positive* signs of pregnancy are active fetal movement felt *by the caregiver*; detection of fetal heart tones; and — wait for it — an ultrasound or other diagnostic image of the fetus.

So this midwife has a POSITIVE sign already, and she wants to go gather up some presumptive or probable ones? That’s just pointless.

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Ellen Reply:
November 27th, 2012 at 3:57 pm Ellen(Quote)

(Tried to post this once already … let’s see if it gets through this time.)

No, this is an incompetent midwife.

The *positive* signs of pregnancy are active fetal movement felt *by the caregiver*; detection of fetal heart tones; and — wait for it — an ultrasound or other diagnostic image of the fetus.

So this midwife has a POSITIVE sign already, and she wants to go gather up some presumptive or probable ones? That’s just pointless.

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Ellen Reply:
November 27th, 2012 at 4:08 pm Ellen(Quote)

(I’ve tried to post a response to this twice and it keeps vanishing into the ether. Maybe dividing it up will help….)

No, this is an incompetent midwife.

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jenni had this to say, Nov 20, 2012 @ 5:50 pm (Quote)

with #1 i was also due for a pap, but they did just the pap, not a cervical exam on top of the u/s on top of the pee test….

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Chelsea had this to say, Nov 20, 2012 @ 9:28 pm (Quote)

What happens if that test comes up negative? Then do we have to do a pee-on-the-stick test to break the tie?

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Foleygirl24 had this to say, Nov 21, 2012 @ 6:17 am (Quote)

They checked my cervix at my first prenatal visit, but it was to make sure it was closed like its supposed to be, not to see if I was pregnant. Maybe that’s what the nurse meant but said the wrong thing? I’m probably giving them too much credit.

Thankfully, that was the only internal exam I had the whole pregnancy until I went to the hospital in labor. My practice has a very “hands off” approach.

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Dorothy Kernaghan-Baez had this to say, Nov 21, 2012 @ 7:00 am (Quote)

The stupid! It BURNS!

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Jense had this to say, Nov 21, 2012 @ 2:45 pm (Quote)

AFTER you already made sure the OP was pregnant via ultrasound?? Bwuh?? You KNOW she’s pregnant, she knows she’s pregnant, i don’t see the use in this.

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