Anonymous
Post 07/05/2015 08:23     Subject: First annual exam
I see this is an old post. I wanted to point out that a parental plan to have a pelvic exam is a bad idea. She should be taken to see the doctor and the two of them can talk about her lifestyle and risks. Her and the doctor should be the ones to decide if she has a pelvic exam. Instruct her to be honest with the doctor.
Anonymous
Post 07/04/2015 18:45     Subject: Re:First annual exam
If she's not 18 yet, I would go with her. However, I would ask once we were in the waiting room whether she wanted me to come back to the exam room or wait for her there. If she opted for me going back to the exam room with her, I would also add that I can wait in the hall during the physical exam if she would be more comfortable. Going to the gynecologist needs to be something that she does regularly, so she needs to be comfortable doing this.

Personally, as soon as girls start menstruating, I make sure they see the gynecologist, so that they can build a rapport before they need pelvic exams. It also helps when they have questions or want to talk to someone else.
Anonymous
Post 07/04/2015 05:52     Subject: First annual exam
STD screening and contraceptive counseling are done without a speculum exam. Cervical cancer screening is not started until 21 years of age. She should definitely have her HPV vaccination and have a discussion of long acting reversible contraceptives (LARC).

For what it's worth, do you know for sure she has not yet had such discussions with her doctor or nurse or gone on her own to a school based clinic or planned parenthood?
Anonymous
Post 07/04/2015 05:29     Subject: First annual exam
I like the midwife idea. But like with any practitioner, you should find out which values they'll promote.
Anonymous
Post 07/04/2015 04:26     Subject: First annual exam
Anonymous wrote:
Anonymous wrote:For what it's worth, healthy, low-risk women do not need routine annual pelvic exams.

http://www.health.harvard.edu/blog/expert-panel-says-healthy-women-dont-need-yearly-pelvic-exam-201407027250

However, I agree that it would be good for a sexually-active 18-year-old to talk to a doctor (whether a gynecologist or generalist) about disease prevention and contraception, especially long-acting reversible contraception, which is highly effective.

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Adolescents-and-Long-Acting-Reversible-Contraception


I wish they would quit saying that. I skipped one annual exam because of that guideline and guess what I got? Cervical cancer, stage 2. I had never had any kind of issue before that and had I done my usual annual exam it would have been caught and handled before it ever progressed to cancer.


The guidelines relate to age. The evidence shows that young women often clear HPV on their own and that too many young women were undergoing invasive procedures on their cervix that were largely uneccesary. I'm so sorry to hear you got cervical cancer, but there are a ton of variables in the guidelines so I don't know if your situation is applicable to all women.

OP, why don't you take her to a midwife? She's trained to include the woman more and will probably make it more of a positive experience.
Anonymous
Post 07/04/2015 02:37     Subject: First annual exam
Anonymous wrote:Do not go in the room unless she wants you there. The doctor will go over everything. And definitely don't tell her she may need support for the speculum. That will only make her anxious and for most girls just isn;t necessary. Also, don't quiz her on what they discussed.

I've taken my DD at this age. She went in by herself. Its important that they take ownership if their health at this age.
Anonymous
Post 04/25/2015 00:42     Subject: First annual exam
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Frankly, I would feel violated if a mother (or mother figure) even asked me if I wanted them in the room!

She's having sex, OP. I think she can handle a speculum.


Maybe you're not as close with your mother as my daughter is with me. I've worked really hard to cultivate a relationship with her where she could view me as a part of her support system.


Actually, I am incredibly close with my mother. But I am also very private about my body, and once I was comfortable enough to have sex I was comfortable enough to visit a gynecologist alone (partly because my mother helped me take mature steps one at a time). I just fail to see why a sexual, young adult (almost) WOMAN would be so broken up about an annual exam that she'd need company. I think that is unusual.


12:40 here. In my case you're absolutely correct that it was a highly unusual set of circumstances. I was young (15), not yet sexually active at all by consensual choice and terribly embarrassed of just the idea of such acts, the victim of a very violent sexual assault in my childhood (hence the wording on the sexually active statement), and physically disabled to the extent that I could not physically accomplish the standard exam and modifications had to be made (I knew this would be the case going into the appointment, it wasn't a surprise).

My doctor was a female, who behaved perfectly ethically throughout the entire exam (as I rationally knew to expect), and thus was certainly no threat to me... but yes I was absolutely terrified and would have benefited from the presence of a third party for support and a feeling of safety. Note that I am in no way accusing the doctor of any impropriety, but I (unjustly, irrationally, but hey I was 15 and not the wisest kid) very much feared she would do something like that and that negatively impacted my entire appointment.

I vote ask DSD if she wants anyone there with her, and then make a genuine effort to get that person there if she asks for anyone.
Anonymous
Post 04/24/2015 11:12     Subject: First annual exam
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Frankly, I would feel violated if a mother (or mother figure) even asked me if I wanted them in the room!

She's having sex, OP. I think she can handle a speculum.


Maybe you're not as close with your mother as my daughter is with me. I've worked really hard to cultivate a relationship with her where she could view me as a part of her support system.


Actually, I am incredibly close with my mother. But I am also very private about my body, and once I was comfortable enough to have sex I was comfortable enough to visit a gynecologist alone (partly because my mother helped me take mature steps one at a time). I just fail to see why a sexual, young adult (almost) WOMAN would be so broken up about an annual exam that she'd need company. I think that is unusual.


NP here. You fail to see why because that's not how YOU felt about it. Some of us felt differently. I did, and was grateful for the support. OP, I think giving her the option, being prepared for whatever she wishes, is the perfect way to go. Sounds like you are a very considerate mom/stepmom!
Anonymous
Post 04/23/2015 22:57     Subject: First annual exam
I scheduled my own first exam at the college health center. I didn't even tell my mother, let alone invite her to it! Often doctors discourage it, with teenagers, because they are less likely to get straight answers if a parental figure is in the room. I would ask DSD if she wants you in there, but assume she will not.

Don't get me wrong, I think it's great that you've scheduled this for her.
Anonymous
Post 04/23/2015 20:33     Subject: First annual exam
Anonymous wrote:For what it's worth, healthy, low-risk women do not need routine annual pelvic exams.

http://www.health.harvard.edu/blog/expert-panel-says-healthy-women-dont-need-yearly-pelvic-exam-201407027250

However, I agree that it would be good for a sexually-active 18-year-old to talk to a doctor (whether a gynecologist or generalist) about disease prevention and contraception, especially long-acting reversible contraception, which is highly effective.

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Adolescents-and-Long-Acting-Reversible-Contraception


I wish they would quit saying that. I skipped one annual exam because of that guideline and guess what I got? Cervical cancer, stage 2. I had never had any kind of issue before that and had I done my usual annual exam it would have been caught and handled before it ever progressed to cancer.
Anonymous
Post 04/23/2015 15:26     Subject: First annual exam
Anonymous wrote:
Anonymous wrote:For another perspective, would you be willing to ask her if there's anyone she would wish to accompany her?

I had to have my first such exam well before I became sexually active, for medical reasons, but I was deeply uncomfortable being alone with the doctor in that situation and would have really preferred for either my mom, my closest friend, or at least a nurse to have been there with me. It would have made things much easier for me, honestly.

I wish my mom would have asked if I wanted her there; I would have said yes but was afraid it was too invasive and needy to ask her to come back with me since she gave the impression that obviously such an appointment SHOULD be private and maybe a little embarrassing to even have to drive me to. Asking is all about ensuring you know and respect someone's boundaries, provided your question is a question and leaves them a legitimate option to gracefully decline, so I wouldn't feel violated or upset by most any well-meaning question. Especially a question of the nature, "what if any support do you prefer to have for (something), and how can we ensure you get it?"

...


I don't know how long ago this was, PP, but I've never had an OBGYN exam with a male practitioner that DIDN'T have a nurse there.


Come to think of it, me either. I just had an ultrasound for early pregnancy (so internal) and the Dr. at the office wasn't my Dr. but her partner (she was at the hospital) and DH was even in the room but we had to wait for the female nurse to come in. I assumed it was for note taking but, come to think of it, she just stood there!
Anonymous
Post 04/23/2015 13:10     Subject: First annual exam
Anonymous wrote:For another perspective, would you be willing to ask her if there's anyone she would wish to accompany her?

I had to have my first such exam well before I became sexually active, for medical reasons, but I was deeply uncomfortable being alone with the doctor in that situation and would have really preferred for either my mom, my closest friend, or at least a nurse to have been there with me. It would have made things much easier for me, honestly.

I wish my mom would have asked if I wanted her there; I would have said yes but was afraid it was too invasive and needy to ask her to come back with me since she gave the impression that obviously such an appointment SHOULD be private and maybe a little embarrassing to even have to drive me to. Asking is all about ensuring you know and respect someone's boundaries, provided your question is a question and leaves them a legitimate option to gracefully decline, so I wouldn't feel violated or upset by most any well-meaning question. Especially a question of the nature, "what if any support do you prefer to have for (something), and how can we ensure you get it?"

...


I don't know how long ago this was, PP, but I've never had an OBGYN exam with a male practitioner that DIDN'T have a nurse there.
Anonymous
Post 04/23/2015 11:18     Subject: First annual exam
Make it her choice.
Anonymous
Post 04/23/2015 10:50     Subject: Re:First annual exam
OP, I think this is very considerate of you. When you talk to your DSD about it, let her know that there are no right or wrong answers and that your intention is to support her through this, in whatever way that looks like and is most comfortable to her. Maybe have plans to go to lunch with her after, or have a comfort favorite of hers with you in case she just wants to go home. I think she'll appreciate the gesture.

Also, do your part to vet the doctor and nursing staff. Find someone with the beside manner that you think she'll respond to well, or ask if she wants to be involved in that process. I love the doctor I go to now, but she would have terrified me (she's a New Yorker -- very to-the-point, if you will) on my first visit; I remember being grateful that the doctor I went to was calm, made me feel welcome and valued (not like I was doing something "wrong" for being there for birth control as a teen), and genuinely seemed to care about me.

I think you have a lot of good things to sort through from previous posts, and no matter which route you go, know that it's great that you care for your DSD as much as you do.
Anonymous
Post 04/23/2015 09:34     Subject: First annual exam
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Frankly, I would feel violated if a mother (or mother figure) even asked me if I wanted them in the room!

She's having sex, OP. I think she can handle a speculum.


Maybe you're not as close with your mother as my daughter is with me. I've worked really hard to cultivate a relationship with her where she could view me as a part of her support system.


Actually, I am incredibly close with my mother. But I am also very private about my body, and once I was comfortable enough to have sex I was comfortable enough to visit a gynecologist alone (partly because my mother helped me take mature steps one at a time). I just fail to see why a sexual, young adult (almost) WOMAN would be so broken up about an annual exam that she'd need company. I think that is unusual.


It's weird to me too PP, but I think it's generational. The majority of young women I see have their mothers or a friend with them for their exam.