Jan 182013

Woman: “I haven’t had a period in four months, and I’m having cramping almost every week but never bleeding.”

OB/Gyn: “Any chance of pregnancy?”

Woman: “None.”

OB/Gyn: “We’ll have to do a pregnancy test just to make sure.”

Woman: “I’m not pregnant, and I won’t be doing a test.”

OB/Gyn: “How can you be sure?”

Woman: I’m a lesbian.”

OB/Gyn: “We’ll be doing a pregnancy test just to make sure.”

Woman: “…..”

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 January 18, 2013  Gyn, OB  Add comments

  67 Responses to ““…We’ll Have To Do A Pregnancy Test Just To Make Sure…””

  1. “Then you can feel free to pee on the stick, but this part of the ‘we’ will not be taking a pregnancy test.”

  2. I’m straight, and I’ve had this happen before, too.

    I can’t seem to get them to understand that, while it did happen to a woman named Mary 2000 years ago, it’s probably extremely unlikely that I would be pregnant. I’m not sure Christ is coming back here the same way this next time.

    I took Health in school. I know how pregnancy happens. If the filmstrips are to be believed, I’m not pregnant! :D

  3. Unless her girlfriend/wife/partner is a pre-op male to female transgender, I think we can safely assume that this woman is not pregnant.

    Can we focus on actually finding out what is wrong that is making her hurt?

  4. I can understand not trusting a teenager but thinking a grown woman would lie about not only her sex life but her orientation? Offensive.

    • I always hear health care professionals defend these tests (STD tests too) by claiming that they can’t trust what people say because so many will lie or be in total denial regarding the truth. I’d be interested to hear from any commenters who work in the health care field if they have experienced this with adults in their field.

      • i don’t think any of those “i didnt know i was pregnant” things on TV ever have the woman say “but i was so sure i wasnt pregnant but the Doctor tested me and i was!” nope, not even the Drs suspect in those cases.

        Also, some people failed health in school. how is a Dr supposed to know if a woman missed a day of sex ed and has been believing for however many years of adulthood that if she swallows a watermelon seed…. or that taking antibiotics can decrease effectiveness of birth control pills.

        however, i really dont know how a woman who doesnt have sex with men is supposed to get pregnant.

      • It is standard care to do a pregnancy test. I am a doctor and always ask to test for pregnancy in any female of reproductive age with unusual cramping and bleeding. If they are lesbians or virgins I always apologise and say it is a test we need to do. I would also check their urine for a urinary tract infection at the same time, even though it would be unlikely that was causing their cramping either. I would not be able to refer to a specialist without a confirmed negative pregnancy test. It is just routine care. I have never had anyone refuse when I explain why I need to do it. I always make it clear that I believe the woman and say when I get a negative result “exactly as we knew it would be- negative”.

        • Question: is an OB/GYN not already a specialist? I can understand a PCP requiring a pregnancy test in order to refer, but a gynecologist wouldn’t require a referral to herself in order to order an ultrasound on a woman who’s presenting with amenorrhea and cramping. So why would an OB/GYN need to perform a pregnancy test when the next likely steps (pelvic exam, ultrasound, hormone panel) would most likely rule out or confirm pregnancy anyhow?

        • BTW, you sound like a concerned and thorough doctor. :-)

        • I’m the OP and in this case, the woman was already seeing this OGBYN out of her own pocket to find out what was wrong and didn’t want to be charged for an unnecessary test when she knew that wasn’t the problem. Seeing a doctor at her own expense is already bad enough and she literally couldn’t afford a zillion tests. Besides, after 4 months, she would’ve been showing had she been pregnant, and my friend is quite thin.

        • ^You sound amazing, is your office in Oakland County, MI ?
          If so, where &do you accept medicaid? I would Love to be your patient! :3

  5. Um, the pregnancy test is going to confirm sexual orientation? I thought it was to confirm pregnancy. Which can’t happen unless sperm is involved. Which neither partner has. Which makes me wonder if you’re really a doctor…

  6. Okay. Oooookay. With a big, big stretch the doctor might have thought better safe than sorry, since “secret rapes” have happened after women were slipped liquid ecstasy into their drinks at a bar (one woman only noticed something had happened when she awoke with her undies on inside out…).

    but it’s more likely that he was a moron who followed protocol to a stupendous level, or they simply wanted to bill for one more test (pregnancy test) and procedure (ruling out pregnancy) – both earn the hospital money. Seriously, what a shitty treatment. :-(

    • Yeah, it’s theoretical sex can happen without the woman knowing. She could have been drugged, ghb causes amnesia and certain other drugs can cause blackout periods too, or she could be suffering from sexsomnia and be having sex in her sleep, which is real but rare. But if the doctor is *actually* concerned with such rare risks for unexpected pregnancy, then he could have phrased it a lot better! This stinks more of ‘but it’s on the check list!’

  7. Sorry if this pops up twice but somehow my comment disappeared in the online limbo? This doctor was probably a moron who couldn’t deviate from protocol/standard testing (every female MUSSSST be pregnancy tested!), or wanted to make money for the clinic for the test and the procedure of ruling out pregnancy & complications. By a very, very long stretch he could have been thinking of the women who were raped without knowing/remembering after having been slipped liquid ecstasy into their drinks (one woman noticed only because her undies where put back on inside out…). But still. I think he was just an ignorant idiot.

  8. Seems to me that if a woman was having these symptoms an ultrasound would be performed, which would prove as confirmation of any pregnancy the doctor suspected. Or is he wanting to skip any diagnostic procedures and just shove BCP down her throat to get on to the next patient?

    A similar thing happened to me. I was 15 and having lower right quadrant pain. Nurse offered to take me to the bathroom, and drilled the crap out of me assuming I was trying to hide a pregnancy from my mom, even asking if I felt safe talking about my medical history in front of her. I was livid, as was my mom when she found out. I was a virgin. She didn’t buy it. Still ran a pregnancy test. Sent me home with a “diagnosis” of “possibly appendicitis, call your doctor on Monday.” :/

  9. gross.

    I have many gay friends and one thing they experience that never ceases to disgust/ amaze me is how their sexual orientation is not taken seriously… specifically lesbians… as if even if they identify them self as being gay they are treated as though they still might be having sex with men (because lesbians aren’t really lesbians, they are just girls who make out with other girls to get boys’ attention). Or they are treated like being a lesbian is some sort of phase that will pass. ugh.

  10. You know, straight or gay, this is offensive. If a woman tells you she’s sure she can’t be pregnant, then believe her. Being a lesbian whose sex partners don’t have sperm which can impregnate her is not the only reason a woman may not be pregnant. She may be a virgin. She may not have had sex in the last year (or six months, or whatever). She may have had a hysterectomy.

    How about just believing what a woman tells you?

    • This attitude was rampant at my college’s health center. If you went in and listed nausea as one of your symptoms, you were nonstop badgered about the possibility of pregnancy. “Could you be pregnant?” No. “Are you sure?” Yes, I’m not having sex. “You know contraceptives sometimes fail.” I’m not using contraceptives. “Then you could be pregnant.” No, I’m not sexually active. Pretty sure I have the flu currently infecting half of my dorm, thanks.

      I got to the point where I would list every other symptom first and wait for them to ask me if I’d puked. Worked a lot better.

    • I’m straight and single and I get this near constantly every time I go to the doctor too. “What is your preferred method of birth control?”

      “None.” “Any chance of pregnancy?” “None.” “How can you be sure?”

      I’m bloody single! Then they always write down ‘abstinence’ on my chart, which isn’t technically correct. I’m not abstaining from sex, it’s just not available to me. If I had a partner, I certainly wouldn’t be abstaining. It’s frustrating to say the least.

  11. How about, “Have you recently attended a get-together at which you felt woozy? Have you fallen asleep unexpectedly during a social occasion or while having a male visitor?”

    Or (assuming that this is the case), “Sometimes elevated so-called pregnancy hormones in a non-pregnant woman are an indicator of certain conditions–would you prefer to pee on a stick or get a blood test?”

    Or, “Is your partner transitioning from male to female? She is? Depending on where she is in the process, she could still have little swimmers without knowing it–I think you’d better take the test.”

    But not “I am attempting to input vocal programming into the flesh mechanism in order to initiate the next step in a process I appear to have done waaaaaay too many times recently. Flesh mechanism, respond.” Doc, go home and get some sleep, for crying out loud.

    • I don’t think this doctor is covering possibility of rape or MTF transition. It’s not uncommon on here for a doctor to assume a lesibian must be sneaking in some straight-sex because how else can one enjoy themselves?!

      Similar to insisting on STD test despite the woman having been tested recently before pregnancy because either she or her partner could be cheating and just lying.

      After four months of no period, there’s no reason to need a urine sample when an ultrasound could tell you much more (and probably cost more too). Maybe the doctor doesn’t have an in office ultrasound machine, and that’s why they’re relying so heavily on pregnancy tests.

      • . . . wow, I thought the douchcanoes who were all, “You just think you’re a lesbian because you haven’t met my–I mean, the right–dick!” were online or in bars.

        In the doctor’s office? Wow. That’s . . . wow. Brings a whole new meaning to the word dickery, that it does.

      • This is my thought as well: if the woman has a positive pregnancy test, then they’ll need to order an ultrasound to determine gestational age. And if the woman has a negative pregnancy test, then you are still dealing with a woman who’s experiencing uterine cramping and amenorrhea — and therefore probably needs an ultrasound.

        So why the intermediate step? The doctor is figuring it’s the next logical step, but if all roads lead to ultrasound, then the doctor should just go for the ultrasound. Or barring that, perform a cervical exam and feel for an enlarged uterus (which would be the case in a four-month pregnancy or for, say, massive fibroids) and get more information.

        But I’m betting the doctor was of the opinion that the problem was “no bleeding” and merely wanted to rule out pregnancy before prescribing provera or whatever other medication it is that causes a bleed, then get the woman on BCPs so she’d bleed on a regular basis and thus the problem would be solved and everyone would be happy.

        {Except for the fact that the actual problem would not be solved and no one would be happy except for the doctor and the woman’s pharmacy. *sigh*}

        • Or maybe he just wants to cover his legal rear end, because if she is pregnant and she delays prenatal care because he didn’t test and there is an adverse outcome then she can sue him. People lie, I’ve known many a baby born to a teen who swore she was a virgin.

          • I’m not sure. If the doctor performs a pelvic exam and ultrasound and those don’t either prove or rule out pregnancy, then the legal rear end is covered. The doctor is only exposed to legal issues if the doctor doesn’t follow up to identify a cause of the amenorrhea and cramping. In which case, honestly, the doctor should be sanctioned, because it’s bad medicine to say, “Well, everything’s probably okay. Just go home and if you’re still crampy for another month, maybe then we’ll think about doing the tests we really ought to be doing now.”

            How many babies have you known born to virgin teens? Someone asked that upthread. Everyone’s heard about it happening, but have you ever actually been involved in a case where a woman who swore she’d never experienced genital contact was pregnant?

          • What if it’s ectopic? There are a lot of reasons why getting a pregnancy test is just good SOP. I knew two in high school, maybe a dozen more from other high schools I was in contact with. Most recant after the test comes back positive, only know one who didn’t, DNA proved it had a very human source.

          • An ectopic pregnancy that went to 4 months…?

          • Sorry, I hit “send” and then remembered the second half of the reply I was actually looking at. Were these pregnant virgins lying to their doctors? Or just lying to everyone in school and their parents? Because yeah, lying to their parents –that’s also SOP. But lying to doctors without mom or dad in the room is a bit different.

            I presume the OP was an adult who faced no disciplinary measures if she were having intercourse with a man, and therefore wouldn’t have reason to lie about it. If the pink comes and it turns out she was nineteen, then I can see more why the doctor might doubt her.

          • Most of these girls tested at school, so they never got in the situation of lying to their doctor (as the pregnancy was a known fact by then, so it is hard to say if they would or would not). As for the OP there are loads of reasons to lie, maybe she was raped, maybe she’s unfaithful, maybe she is just an extremely private person. The point is we don’t know. Maybe this visit took place at a Catholic hospital and she was already feeling judged.

          • Sorry I’m late on my post, but this was my best friend, who is 29. She’s never slept with a man, not ever, and she was seeing this doctor out of her own pocket and she did not want to be billed for unnecessary testing. As far as we know, she’s never been sleep raped or drug raped by a man, and she’s had a steady female partner for almost three years.

          • So let me get this straight, You think if the doctor preformed a pelvic exam that he/she wouldn’t notice a 3-4 month bump in the falopian tube when a plevic involves checking the ovaries for cysts and such. I think you need to pull your head out of your books and admit that the “pee on a stick” could have been skipped in favor of an ultrasound looking for fibros, cysts or other sources of pelivc pain without all the BS for this Dr. House impersonator. The correct response would have been, “Well if you are 100% certain that you are not pregnant then we will move on to more invasive procedures to identify your problem.” Logic sweetheart. Use your logic. Nobody gets sued for not doing a pregnancy test if he/she moves on to a more informative test that actually gives usefully information. They get sued when the shove the patient out the door without doing any tests at all and it turns out that a simple pelvic would have led to the discovery of an ectopic or an ultrasound would have led to the discover of a big honking blood sucking fibroid. It is the doctors who do exactly what Jane said and hand the woman an Rx for BCP that will “restore normal bleeding” without running a pregnancy test, a pelvic or an ultrasound who end up getting sued when patient or baby end up with even bigger problems that could have been dealt with if the (wait for it) OB has done his/her job. This doctor’s job is to find the source of the problem not merely to restore normal bleeding or confirm a pregnancy.

          • I think all sorts of things are possible, she could be a women having irregular cycles that ovulated and then had an ectopic that is 6-8 weeks. Its biology, loads of things are possible, and 30 seconds and 5 dollars can prove one of them didn’t happen.

          • Not when you’re a 29 year old lesbian that has never slept with a man. As far as we know, she’s never been sleep-raped or bar raped since she doesn’t go to bars, and she has a regular partner of three years who is also female. She was also seeing her doctor out of her own pocket and didn’t want to pay for unnecessary testing when she KNEW without a doubt she wasn’t pregnant. And four months? She’d be showing by now and my friend is very thin.

          • Out of concern and curiosity, is your friend okay? Also, was she able to get out of there without the test, and did she seek another doctor?

          • We don’t know yet, she still hasn’t had a period, still cramping, but I don’t think she’s in danger of dying… She’s currently looking for another doctor. She did refuse the test and refused anything else that doctor wanted her to do, so she was just stuck with the fee for the office visit and a lot of frustration.

          • Bottom line is still when patient/client who is paying says “We can skip that test.” You move on to the next test. How freaken hard is that? YOU don’t have the right to reach into a patient’s pocket and lift $5 or $500 against her wishes. (And you might want to ask an actual OB what his/her office charges a patient paying cash for a pregnancy test.) OTOH if the doctor had been as willing to work with the patient at Apologetic up thread and the patient had had the presence of mind to say “I’m paying cash and need to keep my costs in check.” I’m sure they could have worked something out. Once again lack of willingness to listen and strict adherance to SOP makes for a bad doctor.

          • An what if she was a virgin? Is it impossible for 2 teenagers to engage in sexual play without penetration? And is it impossible that semen get near or inside the vagina during this time?
            It’s not, so while I’m sure that kids aren’t upfront with their peers or parents about being sexually active, and some may even lie about it in front of a doctor (gasp!) when one of their parents is present. I doubt they would lie to the doctor.
            Why would anyone? To get out of peeing on a stick? That’s not exactly the most invasive exam available.

            To me, this sounds like a doctor who can not (and will not) believe that a woman would have a (sexual) relationship that doesn’t involve a penis.

          • It’s not impossible, but highly improbable with the rate in which it happened. Look I am not saying that this doctor is/is not being a jerk, all I am saying is that there are other legitimate reasons not to skip the test, some of them insurance related even.

          • Apologies. I got to thinking about this yesterday and then I realized that this country doesn’t have that kind of issues with insurance.
            Teen pregnancy also isn’t a very big issue over here. It just doesn’t happen that often. I didn’t hear about a single case during my time in highschool or even college.

          • I’m the OP and when my friend told me this story, she said it really rang of the OBGYNs disbelief rather than anything else, and my friend was paying out of her own pocket for this care and didn’t want to be billed for a pointless test.

          • That really is awful. Did she get the care she needed? Was she able to find out what was wrong?

          • Not as of yet, no, we still don’t know what’s wrong. I’m thinking some kind of endo and she said the cramps are lessening, but still no period. So we just don’t know.

          • Just wandering by. This caught my attention coz when I was a teen I was having amenorrhea and lactating and went to a doc where the nurse insisted I must be pregnant. I was horrified, left and never paid. Never got the results. It wasn’t until many years later I found out I have a patuitary tumor.

  12. Uggggh! What is it with docs and their thoughtline of being a woman = lying about anything to do with sex and/or pregnancy?

    I went into the ER because of some nasty endometriosis complications, and despite not having any sexual contact of any kind in several months, they kept on and on and on about me getting that pee test despite me insisting over and over pregnancy was impossible unless I got probed by aliens or something. I was dehydrated coming in so it look a lot of IV fluids and waiting for that test, and only when that test was done did I see an actual doctor who just threw a prescription of pain meds and anti-nausea suppositories at me. I’m sure that was some legal something or other to cover their behinds, but it was a serious waste of everyone’s time. Just… gah! I’m not pregnant! Forget it and move on!

    • If the ER is going to do any imaging (x-ray, cat scan), they are going to insist on a pregnancy test no matter what – it makes no difference what you say, they’re worried about being sued when the pregnant woman who didn’t think she was pregnant winds up giving birth to a baby with birth defects. This makes sense – even if you are in fact a virgin or a lesbian or abstinent (makes less sense if you have no uterus) – because they’re seeing you for the first time and they’re looking out for that 1 in a million patient who is a psychologically disturbed and would lie about or be in denial of a pregnancy. What’s stupid though is that this is just routine, so they’re not necessarily paying that much attention to the test anyway. I was in the ER recently for gastroenteritis and they did both an X-Ray and Cat Scan BEFORE a pregnancy test (because I was dehydrated and not peeing, so it took hours to do the pregnancy test and the radiology department assumed it was already done). And even though theoretically I should have taken a pregnancy test before all this radiation, each tech along the way asked me eight times if I could be pregnant. It seems like it’d be simplest to just do the damn pregnancy test first and make it clear to radiology that patients won’t be sent to them except with confirmation that they aren’t pregnant so you don’t have to keep freaking asking.

      For the OP, though, who was seeing a regular doctor and not in the ER, it makes little sense. And doctors should never behave as though they don’t believe a patient, even if the patient is obviously lying! All it does it erode trust, which will only hurt the diagnostic relationship.

      • I’m sorry, but that’s not universal. I’ve been to the ER w/abdominal pain before, and they not only did not do a pregnancy test, the x-ray tech just had me sign a paper saying 1) no, not pregnant and 2) reason I know…..just finished a period. This was a well known, larg-ish hospital in my area, too. Granted, the Doc was no real award-winning personality, but the rest of the staff was great.

        • I’m surprised! When I’ve done imaging elsewhere (like at urgent care facilities or when I was just referred for an X-ray), it’s just been a “swear to us you’re not pregnant” thing, but in the ER, always a test. Maybe the hospital we use has been sued over this kind of thing and yours hasn’t.

        • I agree it is not universal. I’ve had them take my word for it on numerous occasions. And there is absolutely no reason for you to have not seen a doctor until your results came back. As the patient I believe we also have a responsibility to not waste our time arguing about the pregnancy test and keep the focus on finding the real problem. Words like And assuming I’m not pregnant what is the next most likely source of the pain. Or when the test comes back negative what will the next step be? Can we do that test now while we are waiting? Or I really don’t have the money to do all 6 tests that you might do if I had insurance so which 2 will give us the most information? You have to work with your doctor. Of course that is hard to do when they aren’t listening.

          • I don’t know if the “you shouldn’t have to wait to see a doctor” comment was directed at me, but maybe I didn’t explain it well enough. I saw a doctor first. The way every ER visit I’ve ever been on (for myself or others) has gone is: wait forever in triage, when you go in the nurse takes basic vitals, doc or PA comes in for first run at a history and orders a hundred tests, the tests are happening somewhat simultaneously (except that they say that test A should lead to test B and so on, they all happen whenever the tech has time to do them), whatever drugs are ordered are administered by nurses when they get around to it, doctor comes back after all of the testing is done to talk to you again (which may be several hours). You won’t likely see the doctor more than twice – near the beginning to order tests/drugs and again at discharge (when they decide there’s nothing wrong or nothing they can do about it)/admission (when it’s too complicated to send you home or they are recommending in-patient treatment).

          • My you shouldn’t have to wait was directed Isella who sounds like she had a terrible experience! Once at the beginning and once at the end sounds about normal to me. Of course with hours in between unless you are on the verge of dying.

      • Actually there was no imaging taken at all when I had the ER visit which makes things more baffling. I wish I’d been more mentally with it to argue that the test was a waste of time and money, but after what my body and mind had been put through that day already I was completely shot.

  13. OP I really hope your friend gets some answers soon! Its kinda scary some of the alternate diagnoses. Best of luck to her.

  14. My sympathies, OP.
    My sister regularly gets medical staff insisting that she needs a pregnancy test before medical procedures.
    She had a hysterectomy five years ago.

  15. One of my best friends had something similar happen, and her response was amazing. She told her doc that it wasn’t possible, she’s a lesbian, never ever ever had sex with a male, etc and the doctor again insisted that my friend could be pregnant and needed to take a test. So my friend launched into a “How Babies Are Made” lecture and ended it with something along the lines of, “I’m pretty sure I haven’t had any angels coming around to tell me about an impending birth, and I am not riding a donkey to my hometown, so can you just do the Pap smear so I can leave.” This was the same GYN she’d seen since she was 16. She was 30 when she had to give this speech and this GYN’s office is in a heavily gay part of town… (which was why my friend went to this particular doc.)

  16. I honestly don’t know how I would have felt if I was in the OP’s situation. On one hand, if there is NO CHANCE of pregnancy, then why do a test?

    On the other hand, if it’s standard procedure, then that’s understandable, whether or not it would add $$$ onto the bill. It is always possible that the lady could have been impregnated by someone who raped her after spiking her drink.

    I would imagine the main reason for testing would be that, if the lady was pregnant, the bleeding/cramps might mean a miscarriage or an ectopic and that chance has to be ruled out, however remote.

    Anyway, I think the OP has every right to feel annoyed because of the way she was spoken down to.

  17. I agree that this is just ridiculous that they would insist she get a test after she indicated she could not possibly be pregnant, but just to play devil’s advocate…

    I’m not a doctor, but can’t a pregnancy test sometimes tell something else? For instance, a positive pregnancy test but no possibility of being pregnant could mean high levels of hormones associated with the growth of a cancerous tumor.
    I’m not sure, just a suggestion?

    • THis is true in men, actually. A positive pregnancy test can indicate the presence of beta HCG, which indicates testicular cancer. But I’m not aware of any such test in women…and wouldn’t the follow-up still be ultrasound imaging? :-) So the doctor really should have ordered an ultrasound.

  18. Forgot to mention, in another doc’s office a clueless staff member wanted to do some X rays that the doc had already told me weren’t necessary. We argued, and I finally said, “Look, I’ll make this easy for you. I’ll refuse them.” She said, “You can’t do that.” Um, I assure you that I can…

  19. I had a similar problem except they didn’t tell me they were doing a pregnancy test, just told me to pee in a cup on my way back to the medical room. Then my bill came and they had charged me $65 for a pregnancy test that I definitely didn’t need. although I’m not a lesbian I think I should know if I’m pregnant or not. Most woman know if there is no possibility of being pregnant and if she is concerned she can pay a lot less money at the drug store than the drs office. Maybe if the Dr thinks I’ve been drugged and raped, they could ask about drug use, partying habits, lapses of memory but they should trust that a woman knows if she’s pregnant or not. They get in testing mindset and its not only a waste of money but people should be a part of their own medical treatment decision making. Definitely should be asked and when someone doesn’t need something and knows it, the drs need to respect that.

  20. Height of stupidity: achieved.

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