12:26 pm - 03/08/2012

Pregnant, no HPV, still abnormal pap?

22 year old healthy female. I have Kaiser.


Two weeks ago I found out I was pregnant, in the very very early stages. I came in for birth control and left finding out I was with child. Because I am what my doctors have referred to as "barely pregnant" I had to have 3 follow-up appointments to confirm that the pregnancy is healthy and that regular abortion methods will suffice. My appointment with "termination services" is tomorrow, although I think it's just for another check-up and to schedule the actual appointment for termination.

This has been difficult enough, especially because of how dragged-out the whole process has been. Then I got a call today saying that I had an abnormal pap-smear. I turned up negative for HPV (although I know I have been exposed to it before) and the cells are beneign. They want to do a biopsy anyway. I asked the nurse on the phone what could have caused this, and she said "poor diet and lifestyle". Well, F U nurse, because I my diet is very clean and I don't touch drugs or cigarettes. I get plenty of sleep. I did have sex the day before the pap smear though, and I hear that sex can cause murky results.


My questions are - what are my rights with all of this? I feel so clueless.
I have been extremely stressed out due to my housing situation (which was filled with mold)  and I recently lost my car. My job requires a lot of driving and  I've been making less money as a result. I'm depressed because of all my issues compounding. Could my unhealthy living situation - not lifestyle - have contributed to the abnormal results?

&  upon doing some more research on the internet, it seems like many doctors do not take the biopsy route. Do I have to get the biopsy... couldn't I just request another pap smear & only proceed with the biopsy if the second one comes back abnormal?  I am wondering this especially, since the nurse on the phone explained that it wasn't serious.

Having a biopsy, no matter how minor, is just so much for me to comprehend right now because I also have a surgical abortion to worry about. I've never gotten an abortion before and I have no idea what to expect in terms of recovery time and all that.


Any input on abortion or abnormal paps or dealing with both at the same time would be appreciated, thanks :(
un_fantasma 8th-Mar-2012 08:37 pm (UTC)
My gyno gave me a form telling me things not to do 48 hours before a pap test. Having sex, using lubricant, creams, and even tampons can cause a false positive. I'm not sure if that helps, but having sex could have definitely contributed to the results you got. I would request another pap smear rather than jumping into a biopsy.

I hope this helps ♥
faithful_summer 8th-Mar-2012 08:46 pm (UTC)
I don't think anyone can make you have a biopsy. And you're certainly entitled to get a second opinion elsewhere and/or refuse any tests. I personally think your suggestion of having another pap done later and then proceeding with biopsy if that comes back abnormal is a good plan.
nickelshoe 8th-Mar-2012 09:03 pm (UTC)
You have the right to refuse *any* procedure, even if the procedure is medically indicated. It's your body. I would suggest talking to a doctor (this one or another one) about your results and what the relative risks and benefits of each path to take (from doing nothing, to increasing the frequency of your Pap smears, to doing a biopsy, and so on). There *are* risks in overtreating, so don't let the doctor steamroll you with "better safe than sorry" talk.

Edited at 2012-03-08 09:08 pm (UTC)
archangelbeth 8th-Mar-2012 09:04 pm (UTC)
I'd suspect it was the sex causing a murky result. If you're negative for HPV and the cells are benign, I'd say the most reasonable compromise would be to have another pap in 6 months and go from there.

*offers supportive e-hugs*
pluckygirl 8th-Mar-2012 09:18 pm (UTC)
I'm with everyone about getting another pap before doing the biopsy as it maybe for not because it was murky do to the sex. :) Also, as others have said it's your body, you can refuse.

If you got the nurse's name complain. That was uncalled for.

As for the abortion thing they have to make sure (like 100%) that you're pregnant. So that's why they are dragging it out. I wasn't awake for my procedure but the recovery is pretty basic. Soreness and spotting for about a week.

If you are feeling depressed please alk to your doctor about it. Perhaps you can get counseling or meds (like fluoxetine, I'm on that). It helps. If you need to talk to someone you won't ever meet you can pm me and I will be your shoulder to cry on.

*HUGS*
misspaigeb 8th-Mar-2012 10:00 pm (UTC)
You're within your right to deny any procedure. You absolutely do not have to do what a doctor recommends.

Sex before a pap AND pregnancy can cause abnormal results. They typically do not pap test pregnant women for this reason. I'm surprised they 1) didn't mention either of those things and 2) recommended a biopsy. If I were you, I'd get another pap smear in 6 months to a year AND THEN get a biopsy if it comes back abnormal. If they try to bully you into having the biopsy, I would politely decline and then find a new doctor.
princessselene 8th-Mar-2012 11:59 pm (UTC)
They don't do pap smears if you're pregnant? Last time I was pregnant in 2010, I had a pap smear at about 8 weeks and everything came back normal. I wonder if some doctors do and some don't, then.

OP, I would go with another pap smear, although usually they have you come back and checked in six months, not automatically biopsy.

As for the abortion (and big hugs whatever you decide, since depending on genetic results I might have to do the same thing in a couple of weeks...I'm 10w right now), if you're very early, a medical abortion is one option that you could do at home. I want to say they're actually offered only up to 7 weeks from what I've seen, but I'd have to double check. If you click on the abortion info tag in the list on the left, there's a ton of information and stories from women that have had them and their experiences, along with information for your state as well.
misspaigeb 9th-Mar-2012 12:19 am (UTC)
Yeah I think it varies. I have heard that it's not really recommended though, just because pregnant women are more likely to have abnormal results and they don't usually treat it (biopsy or anything) while you're pregnant anyway. I know my best friend's first OB (she ended up switching to a different one) *INSISTED* she needed to have a pap smear when she got pregnant even though she'd had one in the past year.
sweetchild92 9th-Mar-2012 12:23 am (UTC)
I believe most providers do the medical abortion up to 8-9 weeks.
totalroyalty 9th-Mar-2012 01:59 am (UTC)
Oh good luck with you & your results, I hope everything turns out exactly the way you want it :)

& I'm glad you brought up medical abortion... after reading up on it, I decided I definitely want to go the surgical route since it's more "definite", less complicated, has been studied longer, doesn't require putting 8 different things up my vag (which I would probably fail at). My step mom definitely scared me when I was considering the RU486 because she had a couple friends who tried it and compared the pain to childbirth. But this is all heresy and I've read plenty of accounts of women who have been totally fine doing that method.

But I should add that I have been wondering if my doctors would be prolonging the abortion process (we found out I was preggers 2 frickin' weeks ago!) if they didn't know I wanted the surgical method instead of he RU 486. It seems like medical abortions are less invasive the sooner they are done. I mean, pregnancy is a pretty damn time sensitive thing!

Edited at 2012-03-09 02:01 am (UTC)
sashafarce 9th-Mar-2012 03:35 am (UTC)
For what it's worth I have no children but am surrounded by pregnant ladies, just-delivered ladies, and spend more time with gynecologists than is mentally healthy for anyone, and apparently they all do paps on the first obstetrics visit unless you've had one relatively recently.
marionravenwood 9th-Mar-2012 07:16 am (UTC)
They really shouldn't, though. I strongly disagree with doing pap tests on pregnant women. You're more likely to get a false positive, and you generally shouldn't do any of the treatments for an abnormal pap while pregnant, so what exactly is the point? Not to mention that bleeding or spotting is extremely common after pap testing, and that can be extremely frightening if you're pregnant. It has no benefit, is invasive, and adds anxiety. For most people, there's no reason not to wait until at least six months after delivery to do a pap test, if the client wants it.
sashafarce 9th-Mar-2012 07:55 am (UTC)
I'm just a person who likes to read and not a medical professional, so I don't feel comfortable stating what I feel should be done, plus I think it should be up to the individual. :) Are there other ways to check for cervical cancer during pregnancy?
marionravenwood 9th-Mar-2012 11:49 pm (UTC)
Are there other ways to check for cervical cancer during pregnancy?

I suppose you could do an HPV test, but I wouldn't recommend that either--if you get a positive result, you're back to the same dilemma. The point is, unless someone is at extremely high risk and has symptoms that suggest cervical cancer, there's no reason to screen for cervical cancer at all during pregnancy. Cervical cancer is rare and slow to develop: it usually takes over a decade to progress from low-grade abnormalities to cancer, if it ever does. (Most abnormalities regress to normal on their own without treatment.) It's not going to make a significant difference to wait 15 months or so (9 months of pregnancy plus six months after)to do a pap test.
sashafarce 10th-Mar-2012 12:26 am (UTC)
Interesting; thank you for your views! I would personally prefer to be screened so I could potentially end the pregnancy and get treatment. I also know two individuals who were discovered to have cervical cancer at their initial prenatal visit; neither had known symptoms or were considered high risk. Due to my personal gynecological adventures as well as seeing their experiences play out, I feel okay with this being the standard of care among many practitioners but I can understand why some would feel opposed or want to decline this.
marionravenwood 10th-Mar-2012 04:39 am (UTC)
I also know two individuals who were discovered to have cervical cancer at their initial prenatal visit;

Of course I don't know your friends or their diagnoses, but this is highly, highly unlikely, especially if they had been having pap tests every few years--are you absolutely certain your friends had actual cervical cancer and not abnormal pap tests or dysplasia? I don't mean to sound disbelieving of your friends' serious health problems, but there were only 12,280 diagnoses of cervical cancer in the US in 2007 (the most recent year statistics are available). The rate is less than 8 per 100,000.

For whatever reason, healthcare providers in the US often don't give much information when pap tests come back abnormal, and/or patients are so freaked out they don't understand explanations. It is very common for people to be terrified they have cancer when in fact all they have is HSIL. If your friends both actually had full-blown cancer, that is incredibly bad luck, I am very sorry for it, and hope they made a full recovery.
jadedinnocent 8th-Mar-2012 10:30 pm (UTC)
How far along in the pregnancy are you? I only ask because if you are still 'early early', have they offered you a medical rather than a surgical abortion? I believe they can offer medical abortions up to 9 weeks. I had a medical at 5 1/2 wks (found out I was pregnant at just over 4 weeks so early early early, thank god). Talking to people who had surgical abortions, mine was far less traumatic, although recovery took about 3 days and I had heavy bleeding for almost a month. (Medical abortion is basically an induced miscarriage brought on by medication administered by the clinic). It was unpleasant and not a decision i ever want to make again, but to me it was far preferable to surgery, so if it's an option for you I would recommend discussing it at your appointment tomorrow.
totalroyalty 9th-Mar-2012 02:14 am (UTC)
These are good questions, thanks :) The doctors haven't told me how far along I am. And my period has always been irregular (I'm a petite stressed out thing). They are guessing that I am about 6-7 weeks at this point.

I discussed both abortion options with my OBGYN. She explained the pros/cons of each and I did my own research online, and after finding out how terribly some women react to the RU489 (my step mom also played a part in this, because 2 women she knew compared the pain to childbirth) I believe I really want the surgical method.

My OBGYN referred me to the "termination clinic" (I was surprised they didn't have a sunnier euphemism for it) and I scheduled my appointment for today, it was the soonest they could get me in and the earliest they wanted me there. The appointment is just for an ultrasound (yes, a 4th one!) and hopefully to schedule the actual abortion.

So I'm not sure if they are prolonging the process because they know I am opting for the surgical route or what. I did consider, for a second, that they were making me wait so I could really *think about* my decision (as if I haven't?!) before I made it.

One thing I'm thankful for, however, is that despite what a pain in the ASS Kaiser has been, the "termination clinic" is unmarked. The Planned Parenthood down the street from my house always has these protestors with graphic signs and that's the last thing I would want to see when I go in/come out of something that's already so difficult.
sweetchild92 9th-Mar-2012 06:35 am (UTC)
If they don't schedule the appointment, I'd seek services elsewhere. The prolonging might just have been until now, but anything further will give me Crisis Pregnancy Center vibes.
jadedinnocent 9th-Mar-2012 06:12 pm (UTC)
Ah, fair enough - I just wanted to make sure they'd given you all your options since they appear to be dragging it out. I'm really sorry you've had to go through so many appointments - I know, when it was me, I just wanted it done as soon as possible. I feel very lucky that I live in the UK, the whole process took 3 visits (including getting the tablets), and I only had to have one ultrasound, which I didn't have to see. My tablets were administered orally, too, so I'm wondering if it's slightly different over here? Any way, that isn't the point - I hope everything goes well from here on in and you get the support - medical and emotional - that you need. I'm sending you massive hugs from across the pond x
sweetchild92 9th-Mar-2012 12:21 am (UTC)
Head over to abortioninfo. You will find tons of posts from people in situations similar/like yours, and you can get a reasonable idea of what to expect.
atalanta0jess 9th-Mar-2012 01:51 am (UTC)
As others have said, you ALWAYS have the right to refuse ANY medical procedure.

Do you know what the result of the pap smear was? There should be a specific result, e.g. ASCUS, LSIL, or something like that.

Usually in the absence of positive HPV, its ok to have another pap in a few months rather than going straight to biopsy. That may depend on the actual result of the pap though. I would definitely push your doctor for more explanation and/or more options, or seek a second opinion.
totalroyalty 9th-Mar-2012 02:19 am (UTC)
I'll definitely ask, because the direct result of my pap smear was not given to me (other than "it's not HPV" and "it's not cancer"). Kaiser has emailed me other results for blood tests and whatnot, but not this.. I will ask more questions, thanks :)
barrelofrain Abortion Policy Reminder9th-Mar-2012 02:52 am (UTC)
OP, thank you for trusting VP enough to share your story. We're honored to have you here, and we hope you receive kind thoughts and the help you seek.

Commenters: We'd like to remind you all of VP's rules, specifically with regard to abortion debate in VP on LJ:

"VaginaPagina as a body does not take a stance on abortion, or on any other controversial issues for that matter. It's not that we don't all have our own personal opinions, but political biases aren't what we're about. We're about health and access to information.

"We ask that our members refrain from arguing about abortion issues here as it's counterproductive to community cohesiveness."

Click here to read more.

VP is fabulous because of its members, so please take care to uphold the rules and your usual wonderfulness as you comment to this and every post. Thanks!

-cat
For the VP Team
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barrelofrain LJ-Cut Request 9th-Mar-2012 02:57 am (UTC)
Hi again. Could you please edit your post so that any potentially triggering information is behind a descriptive LJ-cut? For more information on what we mean, please refer to this part of our FAQ.

You can also find out more about how to make an LJ-cut tag here.

Thanks!

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barrelofrain Second Request for LJ-Cut for Triggering Material11th-Mar-2012 04:52 am (UTC)
Hi there. This is a second request for you to edit your post so that any potentially triggering information is behind a descriptive LJ-cut. Specifically, posts requesting information about having a termination can be upsetting for some people who may have had a similar experience. Please put this info behind a descriptive LJ-cut within 24 hours (so, by 11:50pm EST on Sunday, 3/11) or we will unfortunately need to delete it.

For more information on what we mean, please refer to this part of our FAQ.

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totalroyalty Re: Second Request for LJ-Cut for Triggering Material11th-Mar-2012 05:00 am (UTC)
Oops, so sorry I didn't see this the first time around. It should be fixed!
kaberett Re: Second Request for LJ-Cut for Triggering Material11th-Mar-2012 10:07 pm (UTC)
Brilliant - thanks!

Good luck, and sorry I don't have any more advice to offer.

--alex
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