My word should have been enough

[EthelsAuntie]

A couple of weeks ago, I was admitted to hospital. I had severe abdominal pain, no appetite, being violently sick, couldnt even keep water down. I hadn't been to the toilet for a wee or a poo for at least 24hrs.
The dr wanted to send me for an x-ray of my tummy but wouldn't send me until I got a confirmed negative on a pregnancy test.
I repeatedly told them that I wasn't pregnant. I knew that I wasn't pregnant. However because I'm married they said they needed to do the test. This seriously held up proceedings. They had to put me on a drip. They probably would have done that anyway. But they had to wait for hours until I was able to go for a wee. Then they did a test on it and only then did they request the X-ray because lo behold I was not pregnant.
It turned out to be extremely serious and I needed emergency surgery that took 5 hours.
AIBU to have felt very strongly that they should have taken my word for it. Make me sign something to say that I wasn't pregnant. Fine. Don't just dismiss me because I'm of childbearing age.
I also wonder what would have happened had I been pregnant. Neither I nor a fetus would have survived what the actual problem was had it been left untreated.
It was an awful time and I have to say the constant asking and not taking my word for it did not help. I was feeling like shit. I am a strong, intelligent woman in my 40s but I felt I didn't have a voice to be listened to.

@Porcupineintherough

Generally I think they should check. In the case of a hysterectomy what they should check are your medical records.

Ah, such blissful ignorance - sadly, the NHS doesn't have a unified set of medical records for all of us. The hospital would need to write to OP's GP for the records in most cases - a pregnancy test is far quicker.

Patients can and do lie about prior procedures, often because they're confused or mistaken, occasionally for reasons unknown.

There’s lots of people saying ‘if it turned out you were pregnant and miscarried as a result of the procedure you’d be devastated are making a huge leap as far as I’m concerned. I’m in my forties with two kids and if I found myself unexpectedly pregnant I’d be going for an abortion. Too much risk to my health to go through another pregnancy and even if that wasn’t the case there’s no way I’d disrupt my families life by going back to the newborn stage. Might sound harsh to some, but it’s my body and my choice.

I am very amused by the people on here telling the OP she is unreasonable when she has had a HYSTERECTOMY!!!!

In fairness, she chose not to mention this in her original post, preferring to argue that they should have taken her word as an intelligent woman in her 40s. If she took the same approach at the hospital and they did not have access to her records confirming that she had had a hysterectomy, they may have wondered what was really going on.

I suspect they weren't delaying treatment but as others have said it was part of the diagnositic procedure for a woman of childbearing age presenting with abdominal pain - ectopic pregnancy would be one of the first things to rule out. A perforated bowel is much less likely though this turned out to be the cause. I hope you make a full and speedy recovery OP it sounds very traumatic.

"I am very amused by the people on here telling the OP she is unreasonable when she has had a HYSTERECTOMY!!!!"

But also lots of NHS staff saying that patients lie.

They can spend time drilling into the detail, or making legally-dubious judgment calls about whether you look honest and intelligent, or they can get on and do the test.

If they are being more rigorous than other hospitals, I expect they have experience of a mother losing her baby and blaming them for not testing beforehand.

I had to return to hospital after an ablation (amongst other surgical treatment) a few days post op due to horrendous pain. They refused to admit me onto the ward until I'd done a pregnancy test (even though it was impossible due to previous surgery). I did it just to get admitted and treated though I insisted I couldn't be pregnant. I also insisted they didn't give me morphine as I react very badly. No checks for this.

Results: Not pregnant. Did put me on morphine. Heart stopped.

Marvellous.

@EthelsAuntie

I love this board. Good job I'm not overly offended. So many assumptions being made about me. I don't mean to sound aggressive. I just wanted to get my point across. It was very serious. I had an obstruction, a perforated bowel, a few other smaller fistulas and sepsis. It was open surgery, and I now have a stoma. It will be a long time before I'm fully recovered. Maybe that sounds dramatic. It was pretty dramatic and scary. I'm still processing the whole situation as it came out of the blue. I've been very lucky and should make a good recovery but will possibly need more surgery to reverse the stoma. I just wondered if anyone else felt that perhaps that guidance needs looking at. I accept that they were following guidelines but when I was rolling around in pain, I just felt like it was a waste of time.

I’m really sorry this happened to you. Your life should have been put above the hypothetical risk to a pregnancy that you were confident was not there. If I were you I’d be speaking to PALS and pursuing a complaint. It’s important that the NHS starts treating women as more than just vessels for childbearing.

I'm an A&E doc. If you have had a hysterectomy then they should not have asked for the urine pregnancy test and you would have grounds to complain about that. That doctor needs educated.
Blood pregnancy tests can take 2 hours where I work.
People do lie to you about being sexually active. I had a woman once in labour who denied it! She admitted it after the baby was born in the department. Every female (with a uterus) from 8 to 55 with abdominal pain needs a pregnancy test.

@Geezabreak82

There’s lots of people saying ‘if it turned out you were pregnant and miscarried as a result of the procedure you’d be devastated are making a huge leap as far as I’m concerned. I’m in my forties with two kids and if I found myself unexpectedly pregnant I’d be going for an abortion. Too much risk to my health to go through another pregnancy and even if that wasn’t the case there’s no way I’d disrupt my families life by going back to the newborn stage. Might sound harsh to some, but it’s my body and my choice.

I suppose they should ask people if they could be pregnant, ask them how they'd feel if they were pregnant but lost the baby as a consequence of the procedure, maybe do a bit of counselling to demonstrate that they've really done the whole thing thoroughly, make other arrangements for people who might not have the mental capacity to respond to all of that, get an interpreter for those who don't speak confident English. Or just do a test.

No, they would have to check

Also there have been cases of women having ectopic pregnancy in the month after hysterectomy. The patient got pregnant and the embryo implanted in the Fallopian tubes or elsewhere, then the uterus was removed.

@SuspiciousScully

Many posters are saying 'of course they had to check'.

Why?

I don't understand.

The OP has made it clear that even if she was pregnant, she would have needed the same treatment because without it she would have died.

So, what difference does the pregnancy test make??

Because people complain and seek compensation all the time after the fact despite being adamant they wanted treatment to proceed at the time.

As hospital staff, we have to therefore follow due process.

Do you know how many patients a week we see who are 100000% certain they aren't pregnant and they are? Or refuse other tests because they couldn't possibly have XYZ and they come back positive? I had a woman in my care who said she had had a hysterectomy so we didn't do a pregnancy test. During her surgery guess what was sitting in her pelvis? A fully intact uterus. Your word counts for nothing when so many people either lie or make mistakes.

Surely then, (re ectopics, people simply being unaware), the question should be..

'Is it at all possible you could be pregnant' and not 'are you pregnant'.

It is NOT possible that I could be pregnant.

I have had some ask me if it's possible, and accept my answer, and I have had some ask if I am and not believe me when i say I know I am not and mess me around. So I don't believe it is a universal, blanket policy to not believe and to test every time (and I have had six x-rays in the last 12 months).

Your words should have been acceptable for the doctors.

I have had many x-ray and CT scans I've never had a pregnancy test, my word was enough.

They were doing their job. Could have been an ectopic pregnancy.

Not my point but there you go. There are better ways of asking about pregancy and in OP there was the comment that they insisted because she was married which is batshit and belongs back in the 50s.

I have 2 questions. Is it beyond anyone to administer a pregnancy test as part of the routine admissions process to anyone between the ages of 10 and 50 who is a woman. (yeah...)
And the 2nd is: if it is lifesaving treatment and the woman does, in fact, turn out to be pregnant - are they going to withhold it? what is the next step in that process.

Supplementary question: since some people who say they are not female can also be pregnant, and do often in fact look like men, why not ask everyone between the ages of say 10 and 50? or are transmen simply believed not to be pregnant? (this is not an anti trans post - I'm fine with trans people identifying how they like. But i do know that some trans people are that keen never to mention their transition/change of gender - how would we know they're not pregnant? what would be the next step there?)

if you had severe abdominal pain and a hysterectomy then an ectopic pregnancy needed to be ruled out as it life threatening. YABU

Funny that you don't mention the hysterectomy in your first post, just whip up your outrage.

I am generally impatient with stiff bureaucracy and jobsworthiness, but in this case I can fully see that it's about accountability and the medical profession's duty of care. And maybe also their insurance, although I'm hazarding a guess there.
YABU.

@tamarinda

if you had severe abdominal pain and a hysterectomy then an ectopic pregnancy needed to be ruled out as it life threatening. YABU

Yes, and that.

@Brefugee

I think they need to do their check, I’m sorry, sadly women saying they are absolutely not pregnant when they are is not uncommon and they would be negligent not to check.

how about believing women. Why don't they instead ask when the last time they had PIV sex was? or any other way of getting pregnant rather than assuming that all married women have sex?

Do they ask single women? to they guess how old you are or ask if you have had the menopause? The only really good question is: is there a chance at all that you could be pregnant? Then you sign consent forms.

I’m post menopause and still get asked to take a test. Where I am the policy is to ask every woman under the age of 70 apparently. That’s every woman - gay, straight, in possession of a uterus or not.

I think that there was maybe a communication breakdown. If you hadn't passed urine in 12 hours and have been constantly vomiting (which I'm assuming you were with the SBO) you are probably going to have some concerning vital signs (especially with the fistulas and being septic) and I'm going to be a bit worried about you. I would be bladder scanning you to make sure you aren't in retention then giving fast IV fluids. I'm probably going to get really annoying asking you if you have passed urine because that's a fairly long amount of time for your kidneys not to have produced urine and I want to make sure that you don't have acute kidney injury with how dehydrated you have been. Urinalysis and urine HCG are both important in diagnosis of your abdo pain, there are some cases of people with hysterectomy (with tubes and ovaries left) having ectopic pregnancies. My trust would not have delayed xray for a pregnancy test. Sometimes there is a wait for an xray or CT. You really don't want to be the person skipping the queue and getting rushed right in with a team of docs around.

Surgical wards can be a bit frustrating because we monitor you all day and have you on fluids and then you are sent for a scan and it seems a bit panicked when it feels like you've been waiting all day. It's usually the scan is back and then the consultant on ward round reviews it and decides to operate. Then it's gown on, catheter in, NG Tube in, stockings on, 3 IV antibiotics and fast IV fluids so you usually need more cannulas, anesthetist has to review you, doc has to consent you and we have to do our checks and get you down to theatre..sometimes within an hour. It's a lot for you as a patient to deal with but we are all used to this and know the procedure so well. I think some better communication from the nurse looking after you could have prepared you better and made things a bit easier to deal with, I imagine it's been quite a shock and you probably woke up in HDU post op which is always a bit scary. I hope your recovery is going well.

For people saying they should have catheterised her it's not an indication to cath. She has no urine in her bladder to exract because she is anuric. Its not that theres an issue passing urine (retention) its that there is no urine to pass. She needs to be rehydrated to produce urine. There are massive risks of infection even if inserted perfectly and urosepsis can be very dangerous. Not to mention how invasive and potentially traumatising it is to have one inserted.

@Brefugee

I think they need to do their check, I’m sorry, sadly women saying they are absolutely not pregnant when they are is not uncommon and they would be negligent not to check.

how about believing women. Why don't they instead ask when the last time they had PIV sex was? or any other way of getting pregnant rather than assuming that all married women have sex?

Do they ask single women? to they guess how old you are or ask if you have had the menopause? The only really good question is: is there a chance at all that you could be pregnant? Then you sign consent forms.

I’m single. I hadn’t had sex in years. At A&E they asked me if there was any chance I could be pregnant. I said no, absolutely none. Was quite amused to find out from my GP a few days that they’d confirmed via a blood test that I wasn’t pregnant. I told them I wasn’t! However, they were drawing blood for loads of other reasons anyway so I had no idea they’d tested for that, who knows what else they’d tested me for. I’d have been unimpressed if they wanted me to pee on a stick.

It’d be nice if they could believe us but it’s a risk assessment and they’d rather not deal with the devastating outcomes if the woman was pregnant. And from reading posts on here, I think a lot of women have a very vague understanding of how it all works. And medical staff have no interest in a discussion about how I haven’t even been in the same room as a naked man in years, I really, truly cannot be pregnant. A test puts them in the clear.

I think in your case, they could have done a blood test to establish the facts. I am not sure how long it would take to get the results though, probably easier (for them) to wait for a urine sample.

I'm a medical student and we have been taught that acute abdo pain in a woman of child bearing capability is ectopic pregnancy unless proven otherwise. So they were just doing their jobs!

I kept telling them about my hysterectomy. Told them to look in my notes. It would have all been there. Still the procedure is that women of child bearing age need a negative result.

I contact PALS - either there was a reason like an ectopic pregnancy or there was a lack of common sense.

Even with ectopic pregnancy - that's not a viable pg so does it matter about x-ray exposure - not sure.

I can see why the ask and check in most situations - though I did think them OTT asking 12 DD for covid vaccination - it was quite a few times it was asked but always in front of me - it was very laboured questioning despite DD2 clear no.

[quote Tabitha005]@godmum56 no, but the repercussions of being administered medication that you're allergic to is probably just as serious of not knowing you're pregnant in many situations.

What I mean is, the policies/procedures place this massive importance on knowing whether or not a woman is pregnant, but allow for a simple tick of a box when questioned about allergies and reactions to medications and drugs. To me, the two seem just as important as one another and yet your word is good enough for one, but not the other. It's always struck me as strange.[/quote]
two things.
How are you going to check on allergies? If there was a fast easy test to check on people's medication allergies then I am sure that would be done too before administering medication. There IS a fast easy way to check if someone is pregnant so why would you not? Of course I don't know what was actually said but its not usual to only test married women and hasn't been for many many years so if the OP was told that it was because she was married I think whoever told her that was wrong and should not have said it.

Secondly in this case, diagnostically allergy causing those symptoms is unlikely. Where there is a risk of anaphyllaxis then patients are asked to stay in the building or nearby until its clear that they won't react. Ectopic pregnancy or other complication of pregnancy IS diagnostically relevant so it should be tested for.