What to expect at pediatrician visit for birth control?

[Anonymous]

Anonymous wrote:Columbia has a great website called Go Ask Alice. I would tell her about it, it’s reliable information on a lot of stuff I wouldn’t want to talk to my teen about.

IUDs are great but it’s essential she use a barrier method for STDs. I dunno about getting on birth control at that age for that reason. Maybe just condoms would be better.

I know of 5 IUD babies. Just doesn't seem like a great option.

[Anonymous]

Anonymous wrote:Important PSA for parents of daughters. Please take some time to understand how cervical cancer screening guidelines have changed since we were teenagers. Yes when we were young we were rushed off for our first pap as soon as we became sexually active and were told we should have them every year after that. Things have changed. Dramatically. And they’ve changed for good reason. We were over screening and over intervening on women’s cervices. There has been a ton of research in the last 10 to 20 years and path guidelines have changed quite a bit based on how we know better. I encourage you to look at ASCCP.org and specifically at the screening guidelines section. Right now most practices are still adhering to first pap T 21 but as you’ll see it will be shifting to for cervical cancer screening using primary HPV testing at age 25 very soon. You really shouldn’t be going to doctors who do them every year, even if you ask or insist on it. Because the research-based guidelines don’t tell us what to do with those inevitable abnormal positives and then you’ve got a doctor just basically making stuff up.

off topic to teens but relevant to this post: I'm 43 and in perimenopause so I'm in BC or I'm a hot mess. My OB won't let me get new BC unless I get a pap every year. Is she over-paping?

[Anonymous]

Anonymous wrote:Why are letting a 14 yr old date in the first place?

This is what an 8th grader?

+1. This was the first mistake but it's too late!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Important PSA for parents of daughters. Please take some time to understand how cervical cancer screening guidelines have changed since we were teenagers. Yes when we were young we were rushed off for our first pap as soon as we became sexually active and were told we should have them every year after that. Things have changed. Dramatically. And they’ve changed for good reason. We were over screening and over intervening on women’s cervices. There has been a ton of research in the last 10 to 20 years and path guidelines have changed quite a bit based on how we know better. I encourage you to look at ASCCP.org and specifically at the screening guidelines section. Right now most practices are still adhering to first pap T 21 but as you’ll see it will be shifting to for cervical cancer screening using primary HPV testing at age 25 very soon. You really shouldn’t be going to doctors who do them every year, even if you ask or insist on it. Because the research-based guidelines don’t tell us what to do with those inevitable abnormal positives and then you’ve got a doctor just basically making stuff up.

off topic to teens but relevant to this post: I'm 43 and in perimenopause so I'm in BC or I'm a hot mess. My OB won't let me get new BC unless I get a pap every year. Is she over-paping?

She is absolutely over papping you. Over-screening is not better or more thorough care, it’s actually laziness. It can be challenging for some providers to keep up-to-date on the changing cervical cancer screening guidelines (see ASCCP GUIDELINES) but if they don’t stay informed on them I wouldn’t trust their decision making on other issues. For the last seven or eight years women over 30 should have co-testing (pap cytology +HPV) every 5 years if they are in routine screening, may be more often for certain kinds of follow up for dysplasia. Beyond that though, holding birth control hostage to a physical exam is just not good care, it’s really old school and it’s not based in any sort of evidence. I would absolutely find a different provider. Sorry to be so blunt but I’ve worked in women’s health for 14 years and these kinds of stories make me so frustrated. It’s quite common.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Important PSA for parents of daughters. Please take some time to understand how cervical cancer screening guidelines have changed since we were teenagers. Yes when we were young we were rushed off for our first pap as soon as we became sexually active and were told we should have them every year after that. Things have changed. Dramatically. And they’ve changed for good reason. We were over screening and over intervening on women’s cervices. There has been a ton of research in the last 10 to 20 years and path guidelines have changed quite a bit based on how we know better. I encourage you to look at ASCCP.org and specifically at the screening guidelines section. Right now most practices are still adhering to first pap T 21 but as you’ll see it will be shifting to for cervical cancer screening using primary HPV testing at age 25 very soon. You really shouldn’t be going to doctors who do them every year, even if you ask or insist on it. Because the research-based guidelines don’t tell us what to do with those inevitable abnormal positives and then you’ve got a doctor just basically making stuff up.

off topic to teens but relevant to this post: I'm 43 and in perimenopause so I'm in BC or I'm a hot mess. My OB won't let me get new BC unless I get a pap every year. Is she over-paping?

DP. That’s weird. My doctors are pretty conservative and love the Paps, and even they let people get a Pap only every other year. Is it supposed to be yearly after you hit 40 or something? I’m 36.

[Anonymous]

Anonymous wrote:OP I'm so glad you are looking into this for your daughter. This is a great way to teach her that her body is hers and hers alone.

The other posters telling you to control her are just setting her up to have others also try to control her sexuality. Sex is part of life - and should be treated as such, with care and caution. We focus on consent, trust, caution (birth control methods and safety) and yes pleasure, with our daughter. I want her to have a healthy approach to sex for her full life. This hasn't made her "promiscuous", instead she is thoughtful about her relationships, which is what I would want for her...but at the end of the day, it's not my body.

She is 14. You have no idea is this was a "thoughtful" decision about her relationship. This is a middle-schooler. I highly doubt the decision to have sex was a cognitive one.

With that said, of course this doesn't make her a bad person, or promiscuous and no one has said as such. But, there is no way to look at this as a good decision on her part. Having sex at 14 is a mistake, plan and simple. All teens make mistakes, but mom needs to address both birth control and mistake of choosing to have sex at such a young age, and how to move forward from here.

[Anonymous]

I am assuming that boyfriend is close in age but don’t most state laws have age restrictions re: sexual consent and for good reason??

[Anonymous]

Anonymous wrote:I am assuming that boyfriend is close in age but don’t most state laws have age restrictions re: sexual consent and for good reason??

Each state sets their own age if consent ( usually 16 or 18), and many states have a “Romeo and Juliet“ clause for younger teens who have consensual partners within a certain age range. In truth, even absent that clause, if encounters are consensual they’re pretty unlikely to be addressed by law enforcement (unless, I suppose, a parent pushed it.)

[Anonymous]

OB/GYN that has someone that mostly sees teens or young adults. Usually a nurse practitioner. Call your GYN and see who they would recommend.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why are letting a 14 yr old date in the first place?

This is what an 8th grader?

+1. This was the first mistake but it's too late!

+1000

[Anonymous]

I don't approve or like it but I'd accept it and take her to my female GYN.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Important PSA for parents of daughters. Please take some time to understand how cervical cancer screening guidelines have changed since we were teenagers. Yes when we were young we were rushed off for our first pap as soon as we became sexually active and were told we should have them every year after that. Things have changed. Dramatically. And they’ve changed for good reason. We were over screening and over intervening on women’s cervices. There has been a ton of research in the last 10 to 20 years and path guidelines have changed quite a bit based on how we know better. I encourage you to look at ASCCP.org and specifically at the screening guidelines section. Right now most practices are still adhering to first pap T 21 but as you’ll see it will be shifting to for cervical cancer screening using primary HPV testing at age 25 very soon. You really shouldn’t be going to doctors who do them every year, even if you ask or insist on it. Because the research-based guidelines don’t tell us what to do with those inevitable abnormal positives and then you’ve got a doctor just basically making stuff up.

off topic to teens but relevant to this post: I'm 43 and in perimenopause so I'm in BC or I'm a hot mess. My OB won't let me get new BC unless I get a pap every year. Is she over-paping?

She is absolutely over papping you. Over-screening is not better or more thorough care, it’s actually laziness. It can be challenging for some providers to keep up-to-date on the changing cervical cancer screening guidelines (see ASCCP GUIDELINES) but if they don’t stay informed on them I wouldn’t trust their decision making on other issues. For the last seven or eight years women over 30 should have co-testing (pap cytology +HPV) every 5 years if they are in routine screening, may be more often for certain kinds of follow up for dysplasia. Beyond that though, holding birth control hostage to a physical exam is just not good care, it’s really old school and it’s not based in any sort of evidence. I would absolutely find a different provider. Sorry to be so blunt but I’ve worked in women’s health for 14 years and these kinds of stories make me so frustrated. It’s quite common.

Thank you for this. I left a practice where my doc was holding BC hostage! Instead my PCP saw my records, saw that I was up-to-date and offered to prescribe it for me without aNOTHER exam. Some doctors do have sense. If you started another thread helping us with alternatives, and rallying against these OBs, that would be great.

As for the OP, still support you and your DD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Important PSA for parents of daughters. Please take some time to understand how cervical cancer screening guidelines have changed since we were teenagers. Yes when we were young we were rushed off for our first pap as soon as we became sexually active and were told we should have them every year after that. Things have changed. Dramatically. And they’ve changed for good reason. We were over screening and over intervening on women’s cervices. There has been a ton of research in the last 10 to 20 years and path guidelines have changed quite a bit based on how we know better. I encourage you to look at ASCCP.org and specifically at the screening guidelines section. Right now most practices are still adhering to first pap T 21 but as you’ll see it will be shifting to for cervical cancer screening using primary HPV testing at age 25 very soon. You really shouldn’t be going to doctors who do them every year, even if you ask or insist on it. Because the research-based guidelines don’t tell us what to do with those inevitable abnormal positives and then you’ve got a doctor just basically making stuff up.

off topic to teens but relevant to this post: I'm 43 and in perimenopause so I'm in BC or I'm a hot mess. My OB won't let me get new BC unless I get a pap every year. Is she over-paping?

She is absolutely over papping you. Over-screening is not better or more thorough care, it’s actually laziness. It can be challenging for some providers to keep up-to-date on the changing cervical cancer screening guidelines (see ASCCP GUIDELINES) but if they don’t stay informed on them I wouldn’t trust their decision making on other issues. For the last seven or eight years women over 30 should have co-testing (pap cytology +HPV) every 5 years if they are in routine screening, may be more often for certain kinds of follow up for dysplasia. Beyond that though, holding birth control hostage to a physical exam is just not good care, it’s really old school and it’s not based in any sort of evidence. I would absolutely find a different provider. Sorry to be so blunt but I’ve worked in women’s health for 14 years and these kinds of stories make me so frustrated. It’s quite common.

Thank you for this. I left a practice where my doc was holding BC hostage! Instead my PCP saw my records, saw that I was up-to-date and offered to prescribe it for me without aNOTHER exam. Some doctors do have sense. If you started another thread helping us with alternatives, and rallying against these OBs, that would be great.

As for the OP, still support you and your DD.

I’m the PP and glad to be helpful! I do respond with some frequency on women’s health related questions though It can be a little tricky talking about healthcare on a forum like this with such limited information and obviously I wouldn’t want anybody to substitute what they pick up on an anon form as comprehensive medical advice just helpful tips to get them started on discussions with their providers. Still, always happy to answer questions so if you post a in the healthcare section I’ll probably see it and respond.

[Anonymous]

Anonymous wrote:OP I'm so glad you are looking into this for your daughter. This is a great way to teach her that her body is hers and hers alone.

The other posters telling you to control her are just setting her up to have others also try to control her sexuality. Sex is part of life - and should be treated as such, with care and caution. We focus on consent, trust, caution (birth control methods and safety) and yes pleasure, with our daughter. I want her to have a healthy approach to sex for her full life. This hasn't made her "promiscuous", instead she is thoughtful about her relationships, which is what I would want for her...but at the end of the day, it's not my body.

Best reply yet. I bet this mother even bought her daughter a vibrator. A few of us have done that for our daughters during the pandemic.

[Anonymous]

I just took my daughter to a Family Practice for her annual physical and to discuss debilitating menstrual cramping. The CNP prescribed birth control pills.

They checked her blood pressure, and did a routine blood work up but there was no mention of an internal exam or a pap.