by Amanda M

(Lexington, NC)

I am currently 13 weeks along. I had my first doctor's appointment in January my husband and I want a natural birth for our baby.

My first visit in the doctor immediately wanted to do a pap smear and pelvic exam I was a little concerned about that.

I want to know what the risk is and why it's necessary to have those kinds of test performed.

Answer:

Hi Amanda,

Most OB's and some midwives will want to do a pap smear and a pelvic at the start of your pregnancy, or even when you enter their practice (so if you moved halfway through pregnancy, a new doctor might want to do them.)

They say that the point of this is to check for abnormal cells on the cervix and to check your pelvic dimensions for birthing. They also use the pap to screen for STD's or other infections.

I am not a fan of this “tradition” in obstetrics, however.

First, I think it's a horrible way to start your relationship with your patient – no matter how wonderful and gentle a provider is, being put up in stirrups on the first visit is just a little not the best thing for a woman.

It tends to make women feel inferior and you certainly don't want to feel that way with your care provider – you are the ones hiring them.

Secondly, I just feel uncomfortable with the thought of anyone doing anything with the cervix so early in pregnancy. I think a pap and pelvic exam, like so many other things, is supposedly “safe” during pregnancy.

But it can cause cramping and bleeding, and it's possible that that could lead to a miscarriage. Maybe not likely, but it's not a risk I feel comfortable with, personally.

Third – the cervix changes a lot during pregnancy! There's a strong possibility that if you have “abnormal cells” during pregnancy, a repeat pap smear after pregnancy will show those cells were a “false negative.”

In fact, the same thing is likely to occur at 6 weeks postpartum (another common time for a pap smear.) My midwife recommends you wait and have a pap 6 months postpartum, when the cervix will be pretty much back to non-pregnant “normal.”

If you've been in a monogamous relationship for a long period of time (generally a year is the stated “long period”) and you're comfortable foregoing the STD testing, the pap smear and pelvic exam are probably pretty unnecessary. Like everything it's good to research for yourself – but that's my opinion.

Good luck to you during your pregnancy Amanda, I hope you have a healthy and happy nine months!