trans-vaginal ultrasound for no medical reason - Virginia, anti-choice

[MitchieInge]

(and other states I think) is there a thread about this already?

The wording on the bill just says about determining gestation, not capturing detailed images, so I imagine that the proportion of people who need a transvaginal scan will be the same as in women who are having dating scans for other reasons.

When I had my abortion in the late 90s (married with two children at the time, which seems to be the norm), I was treated as a human being who knew what she was saying. I can't believe that ultrasounds are now the norm in the UK. This is a disgrace.

Dworkin

Its possible to be wrong about gestation though - thats why people who are intending to carry on with the pregnancy are also routinely offered dating scans.

I suppose at least they have the option of looking at the scan or not. I wonder if it's a back covering exercise for the clinics? So women can't turn round and say that they feel they should have been offered the option of seeing the scan. In our compensation culture the clinics maybe are worried about being sued.

A study in the uk found that 24% Of women having a termination said they'd have liked to have seen the ultrasound pictures with a further 13% having seen them.

So the majority of women don't want to see the images which is fine. But there are some that do and if some do shouldn't they be offered this option?

So women are being treated as children, they don't know their last period and so therefore should be subjected to scans, transvaginal or otherwise, because of their infantile brains. Women simply don't understand their cycles and have no idea of how long they are gone? I can't believe this. Are we simply going to to be treated in this manner?

Brainless women of the world unite!

But those that do want to see the images should pay for it privately?

Dating scans are for those who are on contraception and get pregnant. In my day that was the case.

How is that being treated as a child? Sometimes people are mistaken and are a significantly different gestation from what they thought. Sometimes the foetus isnt in the uterus at all. I dont know how women are meant to magically be sure that the pregnancy isnt ectopic.
The woman may have had a missed miscarriage. It could be helpful for people in that situation to be aware of that.

Or those unfortunate women who believed that total breastfeeding was a contraceptive measure.

I've seen women being adamant they're 7 or eight weeks only to have a scan and find they're more than 13 weeks and our hospital won't do termination at over thirteen weeks. They have to be referred to a different hospital.

So they either have got their dates wrong or they're lying in order to not have to go to a different hospital/town.

Ectopic pregnancy is a serious medical condition that is very painful, leads to the loss of a fallopian tube and sometimes the ovary and can lead to death if not detected sooner. How very dare you!

I have had two miscarriages and believe me the amount of blood lost lead me to believe that it was so. Despite that I did have to have a scan, very distressing, to ascertain that there was no longer a baby. I was lumped in with pregnant mums at the time.

As for miscarriages fewer than 8 weeks, all those I know who had them have said that it wasn't the same as a 12 week or more miscarriage. They knew they had lost the baby, but the blood loss was not the same.

but none of this offered this scan offered that is really quite the same as being compelled to have a procedure that might not be medically necessary

But viva surely a pelvic exam will ascertain the size of the uterus?

"Ectopic pregnancy is a serious medical condition that is very painful, leads to the loss of a fallopian tube and sometimes the ovary and can lead to death if not detected sooner. How very dare you!"

What is your point here?

A proprortion of ectopics do resolve on thier own, and rarely there have been live births following ectopic pregnancies. Thats not to diminish the potential huge risk of an ectopic pregnancy, but I certainly dont think that a woman should be criticised or accused of being a child if she hadnt been aware of an ectopic.

So if you go along to your GP and say, I had unprotected sex 2 weeks ago and this early test tells me I am pregnant, they will say, we cannot do anything until the embryo / foetus is big enough to be seen on a scan, come back later - when ? How many weeks?

And I flat out DO NOT BELIEVE that a rape victim would be refused an abortion on the NHS if she refused to have a trans-vaginal scan. People who are saying it is COMPULSORY - it is not - it is procedure. If a woman for some reason has a violent objection to having a scan they will find a way around it - in order to treat her - she will not be turned away - at least not in the NHS I know.

LAWMAKERS saying that women must have scans when it is none of their business is, quite frankly, an intrusion and wrong.
EXACTLY the same as Dorries attempts to hand all pregnancy / abortion / don't know what to do type advice religious organisations.

Sorry for shouting but seriously why are there people on this thread arguing that a. this is fine and b. is already in place in the UK? It's not fine, and it isn't in place. Individual trust procedures are not teh same as legal requirements and I do not for one second believe that a rape victim would be forced to have a transvaginal scan under the NHS.

I don't know to be honest Dworkin, you'd have thought so. Like I said I don't work in gynae. I'll ask one of the drs at work next week though.

Cats That is a dangerous message to post on Mumsnet. Ectopic pregnancy is a dangerous condition to women, it never resolves on it's on and it NEVER results in a live birth. Only a dead woman, and dead foetus.

Dworkin - Are you now saying that you think women should have compulsary pelvic exams where an abdominal ultrasound may suffice?

I thought ectopics often resolved and that the ruptured tube, dying in agony scenario was pretty rare?

Sardine,

I'm not arguing that it's fine, I'm really not.

I agree that local trust policy is not the same as law. However if you're a woman at that local trust it may not make much difference to you whether it's law or policy. You're probably right that if someone kicked up a stink about it then it wouldn't be done. Theyre not going to do it without consent. But I do think that they would then have to come back for an abdominal scan at a later date. From the link to the Virginia law it looks like that option will also be available to women in Virginia. Theyre not saying that they're going to make a law where all women have to have a vaginal scan.

I had a vaginal scan before my termination in 2005. I can't remember exact details, but it was something to do with the abdominal one not working properly. It was not something that I 'consented' to, exactly - if I hadn't had it, I wouldn't have had an abortion and I wanted one. I would have consented to anything as long as they agreed to perform the procedure. I would have run round the hospital stark naked at midnight if that's what they wanted.

I was not happy about it though, and I said so - at the time, I had never even managed to have a smear test as I had a real issue with gynaecological procedures. There was a definite sense of 'no scan, no abortion'.

Dworkin

I said that ectopics are hugely risky.
That doesnt change the fact that they can resolve on thier own see here of one paper I'm absolutely not saying that women with suspected ectopics should seek help, of course they should, but it is not impossible that someone could have one and not know.

And there are reports of live births following ectopics. It is very rare, but can happen. Google it if you dont believe me.

Victor, sadly that's what I saw a lot of as a student.

Women been told that there had to be a scan done before they could have a termination. I'd go to the scan with them. I saw a lot of scans where the sonographer couldn't see what they needed to so would just say they needed to do a vaginal one instead. All the women I saw said ok to this but the way it was presented to them was that it was a forgone conclusion that they'd say ok.

It was always a statement rather than a question.

Obviously those women who have an ectopic pregnancy who present to the medical profession (almost all as it's very painful like appendicitis) will have their lives saved minus a fallopian tube.

It's a dangerous condition that has the same death rate as appendicitis. Please be aware of this.

Method of abortion is dependant on dates.

Dates are often wrong because of circumstances surrounding the conception (I could cover every scenario but this is not meant as an insult but as a representation of anecdotal evidence working in a termination clinic).

Many women know exactly how pregnant they are. Knowing which these women are, is not something Dr's are capable of.

Performing the wrong technique could be hazardous to the woman and certainly open Dr up to litigation if it went wrong

I saw many a woman who had a scan performed in a newly set up termination private practice where the scan/protocol had been performed inadequately and the consequences varied but were not good for the woman. Missed ectopics. Miscarriages (incomplete abortion) given a D&C anyway (op risk and distressing to the woman who had already miscarried but this knowledge was only obtained once she had instruments inside her), unusual shape to uterus and varied risks of surgical procedure. You can have a positive preg test even when you have miscarried. You'd then have an unecessary procedure.

A scan would have given a safer procedure. I would never consider a TOP myself without one.

The womb is not measurably palpable in v early preg.

Abdominal scans are good in a slim full bladdered woman with no bowel gas.

Vaginal scans are however the technical gold standard for visualisation. It should never be performed without valid consent. Never.

I think the assumption that staff use vaginal exams as a punishment rather than as a medical examination for the patient's benefit is insulting to clinics who offer a professional, caring and sensitive service to women requesting abortion - they use it to provide gold standard care. If you decline then that should be accepted as your wish and recorded with you taking responsibility for any consequence. No problem to either party involved that way

We never ever showed the screen and we answered questions as asked and never volunteered information.

Treatment doesnt necessarily involve losing a tube. And you cant say that everyone presents for medical care, because we cant know that can we? If a proportion of the ectopics painful enough for women to present to health services resolve without treatment then it seems likely that there will be some women who have ectopics that resolve on their own without anyone knowing about it.