Are the following request acceptable?

[LaraCameron]

Hi everyone! I had posted some questions earlier about getting an elective c section due to my tokophobia. Thanks to everyone's help, I've decided that if I dont find a sympathetic NHS consultant I'll be going private at the Portland.
Now because of my history of abuse, I have a severe phobia of being examined( I never even go for pap smears-stirrups make me physically SICK) and I was wondering if the following requests will accepted-

1. I dont want the transvaginal ultrasound AT ALL( they are optional in many countries, so im assuming they aren't absolutely essential?)
   
2. I dont want any pap smears under any circumstances. I'll consent to internal exams only if absolutely required( Im told they dont do these in the UK anyway- im confused)I will be ok with some towards the end like around 38 weeks to check dilation( provided they are required if you are getting a c section) and stuff, but thats it.
   
3. I'd like female nurses and midwives to prep me for the c section.
   (I will pick a female consultant if I go to Portland, but even if the consultant is male, I dont want male nurses or midwives, because it freaks me out)
   
   So is this all too much to ask for? I know legally I can refuse all I want, but doctors have a way of bullying and patronizing.
   Also, what happens when you are pregnant and its your first visit to the doctor? I havent even been to one yet. I went to my family doctor back home to confirm the pregnancy. She is familiar with my history, so it was not a problem. What will the first visit be like here?

[LaraCameron]

Sorry I meant the following "requests". Typing in a hurry.

[Dilligaf81]

Hi I think you should request a female Dr when booking in - at my Dr's if you've had a positive test they just refer you to the midwife (most are female in the UK but worth asking)
iT MIGHT BE EASIER IF YOU COULD GET YOUR dR BACK HOME TO WRITE / EMAIL THE NEW dR'S WITH YOUR HISTORY SO THAT YOU ARE TAKEN SERIOUSLY FROM THE START.

I have had 4 DC's in the UK and never have a had a transvaginal scan the only person I know who had one was because the placenta was covering her cervix and that was just to confirm it.

Again they wont carry out a smaer whilst you are pregnant.

Asking for female nurses and Dr's are fine but if for any reason it's an emergency they will not do this as your life would be at risk.

I know where I am in the UK they have started a scheme where if you have ahd a C section and on subsequent pregnancies want a natural birth they assign you one midwife who is the only one you see nad they deliver the baby too. Maybe this is something you could think about as it might give you the confidence if you feel secure with your midwife ? - I know you want a C section but if they can give one to one car in that case maybe yours too ?

Good luck

[Dilligaf81]

Sorry about the random capitals.

[whomovedmychocolate]

I've never had a transvaginal scan during pregnancy and I was not examined at all during my pregnancy with DS because I refused pointblank to allow it and made them write it on my notes in BIG LETTERS. If you are having a caesarian you need to know that they do have to check the uterus from the vagina during the surgery - but obviously you will have an epidural and won't feel it at all. Perfectly fine to insist on female midwives/nurses though. NHS or private.

[pozzled]

I would think that the first two requests would be fine. You're unlikely to need a transvaginal ultrasound, as far as I know they're only done here in the first few weeks if something needs to be checked and they can't get a clear picture on the normal ultrasound. How many weeks are you now?

I'm not sure what you mean by pap smears? Again, not something that's done routinely I think? And I didn't have any internal exams until I went into labour. So if you are going for a c-section then I shouldn't think you'll need any at all.

Not sure about asking for female nurses/ midwives, I would guess that would depend on staffing on the day and might be more difficult for them to accomodate.

As for the first doctor's appointment it's a bit of a non-event, just some form-filling and a referral to the mw usually. I wouldn't spend too much time discussing your birth choices with the GP, I would wait until you book in with the mw and then request a consultant referral. I agree with the above suggestion of asking your previous doctor who knows your history to write a letter- and make it very clear that for your own mental health you need to be supported in choosing a c-section.

I hope things work out well and that you get the support you need.

[LaraCameron]

Great! I was worried:)
I posted on another forum and the answer I got was- "If you want to be a mother you have to make sacrifices, so get over it".
Thank you for being supportive! Its better here in the UK, because, in the US and in India, internal exams are pretty routine and very difficult to get out of.

[Mumswang]

I too have never had anyone examine me internally during pregnancy. With DS 1 I had an internal examination after I'd been in labour for about 7 hrs, to see how far I was dilated. Other than that no one has been near me at that end. And both scans with each pregnancy have been external. Hope that helps reassure you

Good luck with it all

[Jaspants]

The first time I had any internal checks were at 40 + 5 when I started having contractions - from my friends experience this seems to be the norm (unless problems in the first few weeks require an ultrasound as it can't be done externally).

I'm glad that this thread has provided you with reassurance.

[Dilligaf81]

Also just to add with DC3 AND DC 4 I never had an internal examination. Not because I refused any I just didnt need any even in labour.

[captainbarnacle]

I remember your posts from a few weeks back, and how you don't really trust the MW system in the UK and would prefer obstetricans. But, as you can see, having midwife led care means you are unlikely to be subjected to internal examinations and much more likely to have a female looking after you. THere are a lot of plus points to the UK maternity care for you.

[JenniL1977]

Lara I have only had a transvaginal scan because I was in fertility treatment, and that was at 6 weeks (I'm 29+5 now). However, will you be ok if you get any sort of infection - eg, I have had hellish thrush and I've had to have a couple of vaginal swabs done at my GPs. I don't know however if with your history they may allow them to do them yourself if you asked and if you can.
Sorry to hear that you have had such problems in the past and I hope you can cope with everything; shame you got a crappy response on another topic, usually MN is ridiculously helpful. Good luck x

[VioletV]

Erm, I maybe being thick here but wtf is a transvaginal scan? Is that where they stick a condom on a stick and insert it in your to see the birth canal etc?

If so, I've had two. Both in UCLH London. I wasn't aware you could have an option if you wanted too or not. I went with it as I'm pretty certain there is more to be embarassed about whilst pg lol Although I will report back once I've finally given birth ( 6 weeks left until my EDD ) xx

[MainlyMaynie]

Transvaginal scans, you shouldn't need one as long as you wait until about 8 weeks to have your first scan. Maybe think about what you'd do if there was an issue where they couldn't see properly with a standard scan? A friend had one at her 12 week scan as her uterus was retroverted. But you can easily just choose not to have one.

Pap smears aren't done during pregnancy in the UK. But I have had to have something very similar due to late bleeding, to check for infection (no stirrups though). Again, maybe think about what you would do in a similar situation. You could ask if a low swab was possible for example, if you'd be comfortable with that. I have to say, although I would never have chosen to have the swabs, the overwhelming thought at the time was just wanting them to check the baby was ok. You might find that happens to you too if you need examining in the event of problems.

Internal exams, aren't usual until labour/being overdue anyway.

Female staff is a fairly standard request and it shouldn't be a problem, especially when you're going private.

I haven't seen a Dr at all, except when I had the bleeding. Most places you can go straight for your booking in appointment with the midwife.

[PinkFondantFancy]

I've had transvaginal scans and an internal (due to what turned out to be a vaginal infection) - both performed by women and neither involved stirrups. Not sure whether this is more reassuring to you?

[EvenLessNarkyPuffin]

If you are paying you will have much more control. If you're having a planned c-section under epidural, would you be comfortable with them taking a smear whilst you can't feel it? BTW, I've had a few smear tests and have never been put into stirrups. Ever. You go to the nurse at your GP's to have them done, so there aren't even stirrups in the building.

[Cattleprod]

I had two transvaginal scans because of bleeding. They are not done as a routine in this country and I'm afraid if you found yourself in a situation where they suggested one you would have to weigh up your fear of the exam against your fear about something being wrong with the pregnancy.

I would say they are physically nowhere near as traumatizing as a smear test. The probe is very small, and you are just lying down with your legs slightly apart, covered by a modesty cloth. The sonographer doesn't even need to look at your bits. Certainly no stirrups and other nasty implements.

I went straight to the midwife too - usually no need to involve doctors.

[BalloonSlayer]

I have had 3 caesareans, the first was emergency so I had internals with labour, but I did not have any internal examinations with my other two pregnancies and leading up to the birth. I guess I may have had something done internally while the C-section was going on, but I was not aware of it, someone mentioning it further up this thread was the first I had heard of anything being done like that.

I did have, with my first section, a painkilling suppository inserted. I did not know about this at the time, I was told afterwards I had been given one. It didn't bother me in the slightest - it worked very well! - but if it would upset you to find out they had done this, then I'd suggest you including in your requests that you aren't given it.

You will also have a catheter inserted. You will not feel it going in but it will be left in until you are able to walk to the loo, so you will feel it being removed. You will have to think about how you will feel about this - it takes all of 2 seconds for the nurse to remove it, and IMO having a catheter in is wonderful after months of getting up to the loo every hour in the night. I would not recommend trying to not have a catheter.

Good luck with everything!

[Beesok]

I have had a different experience with transvaginal scans - had a routine one during my 12 wks scan at UCH in London because the dr said she needed to check the blood flow from me to baby (or something along those lines) - I didn't have any bleeding etc and she said it was a routine chcek but I am sure that given your history you would be able to request not to get it done.

I second getting a written confirmation from your dr re your history - it should help you if you need to explain your reasons and they should take it seriously.

I don't see a problem with requesting female medical stuff - I would think lots of women have a request like that here due to religious reasons etc - I guess the only exception would be during a life-threatening emergency when that would not be a priority.

Good luck and don't be afraid to voice your requests/concerns! :)

[hazelnutlatte]

Hello, just wanted to reassure you about asking for female staff - I'm a nurse and we get requests like this sometimes and are able to accomodate it. The best thing to do is tell someone before admission and ask them no put it in your notes. Due to the high female/male ratio of nursing / midwifery staff its not a difficult request to accomodate. It can be more of an issue with doctors as there may not be a female doctor on duty - in this situation we would normally offer to chaperone the doctor whilst they are in the room with you.

[LaraCameron]

I feel a LOT better:) Thanks so much everyone:)
Obviously, if something is wrong, I'll go along with what is advised, but its good to know that I can refuse.
I thought I was being selfish by refusing the internals and ultrasounds.
They do them every time in the US, and thats so annoying. I know because my sister had her baby there. They made her feel so guilty for refusing.

I would prefer an OB, but even if Im having a planned c section, can a midwife check me up?

[Stangirl]

HI - I remember you from the other thread about ELCS. I have had transvaginal scans in pg but only before 12weeks as i was bleeding. Pap smears are not done in pg in this country due to risk of miscarriage/infection so I understand.

I share your dislike of the MW system and was given ob led care on the NHS.

[frakyouveryverymuch]

You can ask to do any vaginal swabs eg the test for GBS yourself if that makes you feel more comfortable.

Good luck with getting your ELCS if that's what you want, but do consider a natural birth with much the same provisos (no internals, female staff etc). I actually found DS's birth a very healing experience.

[stella1w]

Had my first baby in the US - seemed to have a lot more vaginal checks in later stages (to see how dilated etc). Now in the UK. Am 37 weeks, so far no vaginal checks and midwives haven't mentioned them. I would refuse if I felt uncomfortable..

[PenguinArmy]

Hi OP glad you're feeling better

I was rather ed when I saw the stirrups when I first turned up at the OB in the US, never once have I been in them in the UK (if that helps with paps etc). Luckily I will be back in the UK for DC2 (where I had DC1). I explained to the OB that in the UK they didn't do internals or smears during pg and he just couldn't comprehend it.

Of course if there are worries in the first 12 weeks internal ultrasounds are offered.

I hope your experience is relatively stress free and I'll keep my fingers crossed for you. Even with a ELCS I think regular appointments can still be with MWs. They are much more hands off over there (no weigh ins etc.)

Remember if at any point you don't like your MW or consultant then just ask for another.

[BreastmilkDoesAFabLatte]

I think your requests are fine.

If you want to ensure no transvaginal scans, you can simply refuse all scans. None are compulsory - both times I have waited until 20 weeks. And, as others have said, with perhaps the rare exception at 12 weeks, it's only ever the early ones which are transvaginal.

And in terms of the female staff prepping you for C-section... virtually all MWs and most nurses are women anyway. So it would be very unlikely that you would find yourself in a situation in which there were insufficient female staff to accommodate such a request.