This guest post is written by Diane, a valued contributor to this blog.
Leading medical organizations state a pelvic exam/pap test is NOT medically indicated for women wanting birth control pills. However, some physicians continue to abuse women’s rights and violate the principle of informed consent by linking the two.
It’s bad enough that physicians are still routinely violating ethical principles and best practice guidelines without fear of reprisal from oversight bodies. It somehow feels worse when an organization such as Planned Parenthood permits such coercive practices as part of their service. Many of the young women and teenage girls served by Planned Parenthood do not have the resources or options to obtain help somewhere else. The ideas of Planned Parenthood – low cost, accessible family planning services and birth control – are commendable. The way Planned Parenthood behaves in practice, when it comes to Paps and pelvics, is not.
Planned Parenthood ostensibly has a HOPE program. HOPE stands for “Hormonal Option without Pelvic Exam,” and it’s supposed to allow patients to obtain hormonal birth control without exams. However, there’s a string attached: PP will only start you on birth control. After six months or so, they will not refill the prescription unless the patient submits to a full exam.
When I sought out Planned Parenthood in a major U.S. city, they refused to give me birth control without a full pelvic exam: Pap, bimanual exam, STD testing, breast exam. They tried to justify this by telling me, “we just need to see if you’re okay.” As per the World Health Organization, they really only needed to get a blood pressure reading to prescribe the Pill – there was nothing in a breast exam, Pap, or any of the other unnecessary procedures that would have told them about my ability to take hormonal birth control. I of course flipped them the finger and said “hell no.”
What happens to those who DO submit to Planned Parenthood’s demands? This is a copy of a letter that was sent to a Planned Parenthood patient who was referred for a colposcopy after having a Pap test at one of their clinics. She was under the age of 30, and the “changes in her cervix” that were found were mild and should have been left alone. Luckily, she decided not to have a colposcopy at Planned Parenthood. The patient’s personal information has been redacted from the letter:
“Dear ___:Your test results show some changes in your cervix that we need to look at more closely to know for sure what is going on. See attached sheet.
There is a way to do this called colposcopy – using a special microscope called a colposcope to view the cervix and vagina. Colposcopy lets us make a diagnosis of your condition and determine whether or not you need further treatment.
So, as soon as you can, please call the center at the phone number indicated, so we can schedule your appointment. Please refer to this letter when making your appointment.
If you already made this appointment, please disregard this letter.”
I don’t know what it is about Planned Parenthood, low income clinics and Medicaid: they assume their patients are illiterate, uneducated fools who need to be spoken to as if they were small children. This letter is written on perhaps a third grade reading level, it’s patronizing, and it’s grammatically incorrect.
In addition, note that this letter doesn’t give the patient a single bit of help in making an informed decision. Colposcopy is described as a “special microscope.” There’s no mention of the acidic solutions with which they coat the cervix during the procedure. Nor do they mention the numerous painful biopsies that are taken during a typical colposcopy.
There’s no information on what those “changes in the cervix” really mean, the person’s risk for cancer, or the cost/benefit analysis of doing a colposcopy.
Also, the directive to call “as soon as possible” makes it seem as though this is an emergency situation.What if this letter had told the truth? If it had said, “Your cervix shows ____.” There is a 99.9% chance that these changes mean nothing, especially since you’re HPV negative and under the age of 30. We could do a colposcopy if you’re very nervous about it, but 98% of them come back normal, and here’s a rundown of the risks versus the benefits….” would the response have been different?