Persons of child bearing potential

[whatnow41]

Or they could have said Women and girls, given that they have also covered off transgender and non-binary people who were born female further down.

Here (if bleeding then this is asked)

A girl who is being sexually abused might react really badly to that.

And then who knows what might happen.

Why not ask in the ambulance or something?

It just seems like s massive thing to drop in a distressed 12yo who is needing an ambulance and has no one looking after her, over the phone.

I mean sure it's not going to be terribly common. But still.

I'm not questioning whether it's asked.

It just seems to me that the potential consequences haven't been taken into account if the child is being sexually abused.

I mean in the years I asked the only issue it did cause was parents shouting that their 12yo wasn't pregnant
It's a system developed in the 70s but reviewed constantly as to what questions are asked but as far as I know that one has always been on there and unlikely to change as it's used by so many trusts and not just U.K, it's an American development

Where do they think this stops? Why do they think the word "pregnant" is still acceptable? What about when someone decides they should say "offspring-containing"?

Following up a few days later with a reply to myself.

Just seen on reddit's r/ftm, a post studiously avoiding the word "pregnant".

I wish everyone would make a more inclusive environment for afab peeps who carry ... I'm tired of seeing a confident dad deciding to post how he's carrying his own...

So the poster needs to be updated to "Carrying or think you could be?" to be more inclusive.

(It can stay like that until someone decides the word "think" is offensive to people who can't due to excess hair dye...)

@NecessaryScene that makes me think of Paddington puzzling over those adverts on the Tube that say "Dogs must be carried"

It's interesting that during the end of the twentieth century the trend was to make things about the body and sex more down to earth and easy to name, to normalise perfectly routine anatomy and bodily functions. Euphemisms were increasingly regarded as silly and outmoded, a relic of social and class moralism which we could get rid of and finally call a spade a spade.

Except now the alphabet soup movement wants to have euphemisms all over the shop! It's silly nonsense IMO -- the contemporary equivalent of elderly women muttering 'she's in the "family way"' to each other behind their hands in case someone was offended by a mention of sex (apparently this particular twee mid-century euphemism is preferred by the Queen, who dislikes the vulgarity of the term "pregnant" )

I don't see much difference between the pearl-clutching silliness of going on about "undercarriages" and "down below" and "waterworks"; and all this new ridiculous stuff about "vulva-owners" and "carrying". Same old moralism about women's bodies and bodily functions being unspeakable and vulgar, just dressed up in new (emperor's) clothes.

They could simply have written: "For certain examinations, we are legally obliged to ask whether there is a chance that you may be pregnant"

No need for waffly newspeak, just let the obvious (that it applies to females) remain unsaid on the basis that no male ever thought that "if you may be pregnant" could possibly apply to him.

Yes that would be much better and avoid the whole IMO massive issue of s poster in a hosp saying blandly from age 12

@NiceGerbil

I'm not questioning whether it's asked.

It just seems to me that the potential consequences haven't been taken into account if the child is being sexually abused.

They really have NiceGerbil. Safeguarding is a big part of training of all grades of staff in the NHS and is embedded in most telephone triage systems.

A 12 yo distressed caller who says she has no one with her is likely to set great big red flags waving.

So she gets asked if she's pregnant over the phone?

That just feels really iffy to me.

@NiceGerbil yes. It HAS to be asked. Because at that point, the issue is whatever life threatening emergency they've rung 999 for so it's that over anything else. If they're not asked and they are pregnant then missing an ectopic pregnancy, or indeed a full term pregnancy where they end up delivering on their own is incredible serious
As 999 the job is to triage for the ambulance, how/why it happened isn't their job. People get asked things that are upsetting but it's for medical or safety reasons

And if the sexually abused possibly pregnant 12 yo hangs up and runs away because she's terrified of her abuser and thinks it's going to be found out?

Yes I know it's unlikely I'm just thinking how I would have coped in that situation at 12 and the answer is not well at all.

The realty is that for a girl being sexually abused at 12, 13, 14 etc their idea of what constitutes safety might be very different indeed.

And what of that fact that many girls start their periods earlier?

Why is it not a safety concern for them?

What I'm saying is there isn't anything that can be done about it. It's a giant worldwide triage system that's designed for medical emergencies (if she is ringing the police obviously it's different) and if you don't ask it then you're not following the triage and therefore your job isn't protected (and if she dies because you haven't triaged properly then you will end up in coroners court)
If she disclosed sexual assault then it would go down a different protocol which is rape/assault and so wouldn't be asked
But you have to get that the ambulance is for medical life threatening emergencies and if she has screaming abdo pain or severe PV bleed, at that point the sexual assault is neither here nor there because that isn't what she needs the ambulance for. You can't just not ask it. It will be the same with 111, doctors, a&e. If you're over 12 with pain or a bleed, are you pregnant is one of the first questions they will ask

I can say in a decade I haven't had one person who hung up when asked it, and I only had maybe 2 disclosures of rape, and both rang up because they had been raped and not for any other reason

Ambulance services and NHS11 take millions of calls every year. They are well versed in dealing with distressed callers, many of whom are vulnerable. It's what they are for and they are very good at it.

In my experience a call from a distressed 12 year old who says they have no one with them is likely to be passed to a clinician (doctor, nurse or paramedic) who are present in the call centres to support and advise call takers dealing with complex calls. Even if not, there are ways of asking and staff are trained in how to do this.

There are two triage systems used by ambulance trusts in this country: the one I'm familiar with, which is also used by the NHS 111 service, does ask if the caller has started having periods where it's relevant.

And as Paws says, it's not always relevant.

'If she disclosed sexual assault then it would go down a different protocol which is rape/assault and so wouldn't be asked'

A 12 yo who says they could be pregnant has been raped by definition.

You are asking them whether they are being sexually abused, essentially.

I understand all the things you're saying and why it's done like that.

I'm just thinking in real life if I was a child victim of sexual abuse how that question would land, what it would mean to them to give an answer, the likelihood of them lying etc. It's a lot to put on a child who is a victim of sexual violence.

I also query why this question is asked from 12 which feels arbitrary. Given the risk of ectopics that means it needs to be asked of underage girls, why only from 12?

Evidence. The system is based on best available evidence and is signed off by representatives of all the relevant Royal Colleges, professional bodies etc.

Under constant scrutiny and review. If the evidence changes, so does the system. If individual questions are proving problematic, the question is reviewed and changed if necessary. Every complaint is investigated and change made if appropriate.

To my knowledge, there have been no incidents such as your proposed scenario.

Also, this is triage, not an extended consultation. That is for later. It's what does this caller need right now? Triage is a specialist area of health care and good triage systems (which these both are) are developed by specialists.

Is it accepted by those who support the current approach that the question is actually asking a child if they are being sexually abused?

I'm sure it's not exactly common at all.

But when designing this stuff and who should be asked, I assume the impact on various vulnerable groups is considered?

@LegoCaltrops

I'm surprised they've given an age range. Given that the youngest "person" to give birth was 5 years, 7 months old, & the oldest was 66. That poster doesn't seem very inclusive to me.

WTF!!! 5 years old?! Oh my god 😔

But when designing this stuff and who should be asked, I assume the impact on various vulnerable groups is considered?

Yes

So I suppose the potential impact on a sexually abused child of being asked this question (are you being sexually abused, for a 12yo) is considered reasonable in order to assess this risk.

I would also guess that the possibility of missing an ectopic in s younger child is considered very unlikely and so that's s risk worth taking.

How many 12yo get pregnant in the UK? Enough to make the question required in guessing. Rather than 13 or even 14.

It would also be good to know if 12 yo are generally with a parent or other responsible adult when they are asked this question before an x-ray.

Sitting know?

My assumption would be yes.

If the child is sitting there with their mum or dad, how likely is it that the child will give an honest answer?