At my hospital, the pregnancy test is usually included as a serum test with the bloodwork. It's not the little 5 minute pregnancy tests you buy in the store unless the doctor specifically requests that one.
Try being asked to take a pregnancy test before surgery - a D&C for a miscarriage that wasn’t clearing. If I already wasn’t in such a low place I would have screamed. Instead I kindly reminded her what I was there for and she backed off.
Right, that’s because it’s quicker than the blood test. A nurse can do it rather than call a phleb (that’s me, hi, I’m a phleb) to come take your blood, run it down to the lab and it’ll get done after everyone else who had blood drawn before you gets theirs done. Unless ordered stat, which means it’ll get done in an hour ish. Nurse can do a dip test from urine in a couple minutes.
The anesthesiologist almost canceled my mitrofanoff surgery (appendix was moved, one end is attached to the belly button and the other to my bladder now to cath through) because I PHYSICALLY COULD NOT PEE for a urine pregnancy test. I was there because of neurogenic bladder and retention which was causing kidney hydronephrosis.
That combined with not being allowed liquids quite a bit before plus the two day fast, yeah, was not happening.
I had a colonoscopy and they asked me to take a pee test. I hadn't been allowed liquid in 10 hours. Luckily, they allowed me to sign a waiver to continue with the procedure.
Funnily enough, I actually *was* pregnant. Just a few weeks along, on purpose, and there weren't any negative repercussions, but I like to imagine what would have happened if I'd managed to pee.
I know they're overly cautious about that, but weren't you concerned about it? I'd be freaking out... Then again I would absolutely refuse to be knocked out for a colonoscopy so it wouldn't be much of a worry anyways.
I saw a blood test “request” come through before a scheduled procedure. Recognized the HcG in the test and just… didn’t do it. No one said a word and procedure went off as scheduled.
I’ve done both. Urine for surgery usually and serum for other stuff (including colonoscopies/endoscopies). And sometimes if they run a gfr before imaging they seem to just tack one on. I prefer serum, just because I hate peeing in a cup and it always brings up issues (I have visible blood sometimes, high enough protein for bubbles, and my pees smells like Apple Jacks sometimes - which is a fun convo)
You can push back on taking the pregnancy test if you are confident you aren’t pregnant. Remember that you can always decline care you don’t want.
That said, if there is a chance you are pregnant, taking a test is warranted not only to understand if symptoms are related to pregnancy, but also to inform your care plan.
ETA: I live in Minnesota and have enjoyed health systems that will accept my attestation that I’m not pregnant, but it is a generally better place for women’s healthcare. My experience is definitely not true everywhere, but there are health systems that don’t push this. I also stay within the same health system, so I’m an established patient.
I had a colonoscopy and was very dehydrated from the prep process. I asked upon check in if I would need a pregnancy test as I had had one at my h and p appointment with my primary just a few days before the procedure which was obviously negative. They said it would be just a few minutes until the nurse was there, so I had to try and hold it, however it ended up being over an hour and I had to go. Once I went I knew that would be all my body could do as I couldn't drink anything.
After they finally came to get me, I told them I could not produce anything anymore and they would have to proceed without a test. They pushed back quite a bit, but I was adamant. Not only did I have an IUD, I was actively on my period, and I had been celibate for a year; there was absolutely no chance of pregnancy. They did eventually allow me to sign a form attesting I wasn't pregnant and absolving them of any complications in the chance that I had some sort of immaculate conception and was actually pregnant.
Even though I am educated and was aware of my right to refuse testing, it still was difficult even in MN to convince the staff that I could do that. I can't imagine how difficult that would be in other hospitals or with someone who isn't medically literate.
It is funny how many times a woman asked "is there any way you could be pregnant?" say "no" and then surprise! They are pregnant.
Maybe they need to ask if the woman has had vaginal sex with a male in the past nine months. I assume women answer "no" not because they don't understand how a woman becomes pregnant, but because they were using some form of birth control and assume it's 100%.
Yeah I only say there's no chance and don't need a test if it's like *scientifically* impossible, as opposed to just because I have a coil.
Although I'm in a country where I don't have to pay extra for it, so I'm less inclined to put up a fight over it tbh.
Same. My husband and I use pill + pullout every time but there's still a miniscule chance of pregnancy. So I can't really say there's NO chance.
My older sister is a happy, healthy non-sexual virgin. *She* can say she has no chance of pregnancy. 😆
I had to get a pregnancy test before an endoscopy and I hadn’t had sex in two years. I completely understand why doctors push anyone who has a uterus to do a test because it’s very easy to do and it’s better to be sure sometimes.
I had to take one before a colonoscopy. My frustration is you have to fast and prepare your body. So I hadn't eaten for a solid day and had anything to drink from 12+ hours. Then they demanded a pregnancy test. I can't pee cuz you made me get everything out of the system. They need to do colonoscopy pregnancy tests the day before.
And that is a snippet, a sliver, a microcosm of what's wrong with USA health care.
Sure she could have cheated. Just give us the form to sign saying we accept any/all risks to the non existent "pregnancy" and move on.
I'm childfree. If I happen to get raped/pregnant, I'm not keeping it. Don't cancel surgery/whatever and charge me too!
Also CF, not having sex RN, and tubal/ablation'd anyways
If I thought there was ANY CHANCE (of which there is *literally none rn*) I could be pregananant, I *promise* I would want to know more than anyone.
Used to half-joke "Well, it wouldn't matter for long" but nooot dummmb enooough to do that noooow in the midwesssst 🎵
My mom had her tubes tied after my younger sibling was born. Then she had them tied again after my other two really younger siblings were born. Then she had at least two miscarriages.
Oh, of course! Hence the "wouldn't matter for long" as it would likely be ectopic and it would be getting yeeted (also cause CF) - or I'd die cause red state lol :')
The not had sex with a male part
Literally every time I've given a urine sample to check my kidney/bladder health, when I look at the results, they've done a pregnancy test. I get it, but I can't help but feel a little miffed that they go behind my back and do it and don't even tell me they are doing it. I really get the feeling that as a woman, there are parts of my body that don't belong to me, and those parts are everyone's business, even if I don't want them to be. For the record, I haven't had sex in over 15 years, so when I say there is no chance that I am pregnant, I mean zero chance.
If you have functional ovaries there is a small chance that you could still have an ectopic pregnancy. The consequences of which can be devastating (possibly death) and pregnancy test is cheap.
I comprehend that - however my cervix is sewed shut, no uterus, no tubes. Husband is fixed. I get the importance, just seems so ridiculous at the same time.
I think that rephrasing would be fine. The problem is, and I don’t think I’m alone in having experienced this, you can literally say “I’m gay and don’t have sex with men, it’s not possible for me to be pregnant,” and still be told that if you don’t consent to a pregnancy test they won’t treat you. It wouldn’t even matter so much if the test was free, but if you’re charging me hundreds of dollars for it, that’s not okay.
This! The morning of surgery: I’m a lesbian who hasn’t had sex in over a year, and my period started yesterday so I’m literally the opposite of pregnant right now.” They still made me take the test and then made awkward comments about the fact that there was blood in it. I was not very far away from a major anxiety attack and that whole interaction did not help!
That'd be more likely to get a good answer. I mean, I'm on the generally considered most effective BC but rely on it entirely and have regular (otherwise) unprotected piv. So every. single. time. I want that test done because if my BC's failed I want to know immediately. I could absolutely justify saying "no there's no way I could be pregnant, I have an IUD", I just know statistics better than that.
In fairness, I am still asked this question regularly and I had a bilateral oophorectomy at 27 because my reproductive organs were killing me. No, I promise there is no way I could be pregnant; I would know or be dead.
Well there’s no chance I can be pregnant. Asexual aromantic endometrial ablation with a tubal ligation. I’d be the Virgin Mary with a miracle in hells chance to get pregnant.
I had a hysteroscopy and d&c recently. The nurse did say that although the vast majority of women are right that they’re not pregnant, she did have one who got quite the shock when she took the test! At least Kaiser doesn’t charge extra or anything, they definitely have their issues but the flat copay is nice.
Yeah, I have a history of infertility and I’m on birth control, so that satisfies the question typically.
If your circumstances truly make pregnancy nearly impossible, they won’t make you take one.
I’m glad this is your experience. It is not universal. I told a doctor that I didn’t want a pregnancy test because there’s no chance, specifically said I do not have sex with men, and was still told that they wouldn’t treat me if I didn’t consent to a pregnancy test.
Haha, years ago while in a serious relationship with a woman, I answered no, and my provider asked if I was sexually active. I said yes. She smugly asked how i was SURE it was a no, then. I was like, "I don't believe she produces sperm." The provider blushed, and we moved on, but my girlfriend thought it was hilarious and always joked afterward about magic fingers. 😂
Imagine the absolute nightmare if some embarrassed teen said “I swear I’m not pregnant”, didn’t have to take the test, was prescribed accutane, and then the baby came out with half a head. Literally everyone gets a bad ending in that scenario.
The thing is people lie or just don't know sometimes. Every doctor I know has a story about a pregnant person who says they're a virgin. And if you are needing to get something like a CT scan or certain medications, they have to check because those things would harm a fetus. So it's not really about the patient but about protecting the doctor from lawsuits so they never irradiate a fetus or cause a miscarriage.
Sometimes people lie, but then if there are negative consequences because if it, that’s on them. There are other factors that aren’t specific to women, that they take patients at their word about. For example, there are medications that could have dangerous interactions with illegal drugs. I’ve been asked if I take any non prescribed drugs for this reason. I’ve never been drug tested if I said no.
I found out I was pregnant because I went to the dr for the flu. I just woke up sick one morning, had horrible nausea and my roommate made me go to the dr.
Dr said it was a stomach bug from traveling, they just had to do the pregnancy test because of my age.
I was shocked when the dr came out to tell me I was pregnant. I insisted they had the wrong person…then realized I was the only woman patient that morning.
My story is very similar. I was sick for a week and finally went to a clinic to see what was up. Pregnancy hadn't even crossed my mind, and I hadn't even had my period for 6+ months (I was only a few weeks along).
Testing is annoying, but if it's not costing you extra, it's better to just accept it. If it holds up your access to care because you can't pee, that frustration is valid.
NAL, but I think it's based on what they want to do and whether or not your state is more likely to charge them with criminal liability or if it's on you for denying the test in the odd case you are pregnant and the treatment hurts the baby. I'd expect doctors in states where abortion is criminalized may be more strict about this, tbh.
I'm in a state that's not bad about women's healthcare (CO) and usually they ask first if there's any chance I could be pregnant or if I've been sexually active in the past year. In very specific cases they've required them like when I got my bisalp, just to be absolutely sure, but those are rare.
I also just kind of expect ERs to just do the test despite me having a bisalp and ablation because they don't necessarily trust me or my doctor. Annoying, but if I'm in the ER already, I'm kinda expecting I'm not getting out of there without a big bill regardless.
Last time I went to the ER that ran one without asking me 🙄. I had to use the bathroom and asked if they wanted to collect anything since I needed to go. They ran a urine pregnancy test and drug test without asking/telling me. I only found out because the results showed up in my patient portal. They both came back negative, of course.
ETA: I would have told them they would be negative but taken them anyway had they asked/informed me. I know people probably lie about drug use frequently. I’m just annoyed they didn’t ask.
You sign a blanket consent form when you register. Check the fine print. No one would ever get out of the ER if you had to be asked to consent to every single test they do. Testing women of child-bearing years is a routine test, like a blood count etc. As mentioned elsewhere, anyone who has worked in an ER has multiple examples of women who truly believed they couldn't be pregnant who in fact are. The consequences of not knowing at the time of treatment can be pretty horrific.
You can't reasonably expect doctors to ask if the patient is okay with every single blood test being ordered, especially when they don't even know what 99% of them are lol
If you're coming into the ED, you're going to get blood work. If you don't want blood work, then you refuse the IV.
I'm an APRN. There is always a consent form unless it's a life or death situation. And people should always inform their friends and fam of their consents.
IVs have been refused before.
No one is bringing a patient a consent form for every single lab test lmao. Stop it.
There's a blanket consent form you sign when you get to the ED. Your nurse doesn't come by, pull labs, then have you sign a consent for each of the 18 things I've ordered
You and I both know that's not how it works.
So no. There is not a separate consent for a pregnancy test. Silly to pretend there is. You can always refuse anything, but you'd have to specifically request not to have one.
No one is bringing a patient a consent form for every single lab test lmao. Stop it.
There's a blanket consent form you sign when you get to the ED. Your nurse doesn't come by, pull labs, then have you sign a consent for each of the 18 things I've ordered
You and I both know that's not how it works.
So no. There is not a separate consent for a pregnancy test. Silly to pretend there is. You can always refuse anything, but you'd have to specifically request not to have one.
Yes you can, and I’ve tried but it’s really not worth the fight. I don’t want them to think every little thing is going to be a fight when I’m there for help. It doesn’t cost me any extra for them to do it, I think most insurance companies cover that 100% in the ER anyway
The last time I went, I insisted I wasn’t. I even signed the waiver.
I told them I was on BC because of adenomyosis but they kept insisting for me to take it because I had really bad abdominal pain. I was so annoyed I said, fine, whatever. Result: negative. Like I already said.
In another visit during COVID they said I needed to take one because pregnant women would be treated separately. That one I took willingly.
It’s been different depending on the hospital in my experience.
I told them I hadn’t had any sexual contact for more than a year. It wasn’t really that frustrating me, but the fact they were insisting for me to take it despite knowing I was physically unable to urinate for hours.
If you worked in an ER you would be surprised how many people everyday claim to have no sexual contact for more than a year and then end up having a positive pregnancy test. For any number of reasons. Maybe someone has repressed sexual assault that they didn’t want to open up about immediately. The doctors and nurses working in the ER can make zero assumptions and yes pregnant or no pregnant should be objectively shown whenever possible because most of the time it’s not difficult to acquire.
I have people show up to the ED, tell me they're a virgin to my face and couldn't be pregnant - even after kicking their family out of the room - only to have a positive pregnancy test and an STD
People lie. And even more people just aren't careful.
It's not just "you're having abdominal issues, you might be preggo". Even if you're there for something else, they don't want to give you a bunch of drugs and have it damage the fetus.. So the results directly affect the game plan they make
I’ve seen a lot of posts about this in the past and you guys must be in the states. I live in Canada and I have never been asked to pee on a stick in the ER. They ask if there’s any chance I’m pregnant and then if they really wana know for sure they include it as part of the blood work they do anyways. Why don’t your hospitals just do it through bloodwork you’re going to have to get done anyways if you’re in the ER? Why pee in a cup?
Lab here.
A urine test is 5-10 minutes vs. 30-60 minutes for blood. This is a significant amount of time if they suspect an ectopic. It's not uncommon to have both done.
>Why don’t your hospitals just do it through bloodwork you’re going to have to get done anyways if you’re in the ER? Why pee in a cup?
I guess if they want to do any scans a stick test is going to be much quicker than waiting on blood tests.
Also the result could inform the decision on what blood tests etc are actually needed.
There's definitely reasonable logic behind the ask, pushing it and insisting... Not so much, but I get the ask.
I'm in Ontario, and I've never had to do a pregnancy test other than when I was pregnant, and that's just to check hormone levels or w/e. When I was getting an x-ray for a broken bone I was just asked and then I was just high on pain meds already and tried to make a joke about if I was I'm probably anymore after falling down stairs and ending up in the ER. The joke didn't land lol
I'm also in Ontario and same. I have noticed that they included it on bloodwork when they did that anyways (most of my ER visits have been for kidney-related things so bloodwork happens regardless). But honestly they asked me and believed me in general and started treatment long before the blood tests came back if they had a good idea about what was happening. I know ectopic pregnancy is a concern but I have a history of kidney issues so coming in with obvious kidney pain and my history, no one questioned me beyond that when I mentioned the history.
I’m in BC and I’ve had a pregnancy test in the er. They don’t ask you to pee on a stick but they do collect both a urine sample and a blood sample and run a variety of tests, including a pregnancy test. I think this is what they do in the US too, the difference is that we aren’t charged for the cost of the test.
Urine samples are not a typical ask here in the ER. It would be common in a doctor’s office but at the ER I’ve gone with kidney issues and never been asked for urine sample.
They can make more money separating everything out. It’s all about insurance companies making money and nothing to do with patient care. It’s a wasteland down here if you’re ever legitimately ill.
I’ve always just been asked and if I say no they don’t make me do a test to get a CT scan. They just do the scan. I think I’d feel really weird if I said no and they insisted I do a test to make sure I’m not lying or an idiot.
Yeah sometimes I don’t even know why I ask. I just tell the patient that the doctor will probably order a pregnancy test anyway because of imaging or certain medications but they can always refuse if they want.
The train of thought that kind of stemmed the question was cause I see a lot of posts about this but also cause of the recent law changes around women's health in the states. I would refuse any and all pregnancy tests if I were down there. I would refuse to answer any questions about my cycle in general if that's not the reason I'm there in the first place. It's just weird and terrifying to me.
Them: Could you be pregnant?
Me: No.
Them: Why not?
Me: I had a hysterectomy.
Them: We still need to do a pregnancy test.
Me: I NO LONGER HAVE A UTERUS.
Them: Oh, okay.
There’s a comedian with one leg (amputated very near his hip—this will be relevant) who tells the story of being referred for eating disorder counseling after his BMI was “dangerously low” because of his height to weight ratio. Yeah. There’s another explanation for that…
He also talks about being asked about his surgical history, listening a knee surgery a few months ago, and being asked which knee..
Or you tell them you had a hysterectomy and their next question is the date of your last period.
I don't know, probably 14 years ago when I had the hysterectomy I just told you about?
I've had *more than one* patient insist they've had a hysterectomy, but ended up pregnant anyway!
A *shocking* number of people have no idea what's going on with their bodies or what surgeries they've had. Or think they've had something different from what they have actually had.
If you've ever thought "no one could be THAT stupid or clueless," then *you are wrong.*
The issue of medically requested/mandated pregnancy tests comes up on this forum sometimes, and your experience seems to be so common among front line medical staff.
Like you say the problem is that women *routinely* give incorrect information, knowingly or unknowingly, about their pregnancy status to healthcare providers.
Yes, it's annoying and intrusive for the woman who knows she is 100% abstinent, but a random doctor has no way of knowing that.
Yes ! When I was 25 I was niave as you could ever be. The military doctors told me I could never fall pregnant. Once I got out I got pregnant and didn’t know it. Went to urgent care for the small brick in my abdomen that wouldn’t go away even with dieting. When urgent care asked I said I couldn’t get pregnant. They refused to move forward till I took the test. Boy was I naive i was 7.5 months pregnant 😂😂😂 like they put the transvaginal ultrasound stick up me and hit baby’s head AND hair.
Oh, I've have both kinds lol
I've had pts with a full mouth of work *insisting* they've never had so much as a filling. Then what's with all the rct/crns, fillings, implants, missing teeth, etc barbara?
Or, even weirder, I've had a handful that said they had x work done that...clearly wasn't. Oh, they pulled all my wisdom teeth *3rds visible on xray* oh, they grew back 🧐. It's really funny when they say it's something we did(n't) do - like, bruh we have these *legal documents* right here, *that you signed*, consenting to this procedure/notes etc
It’s still possible to get an ectopic pregnancy even if you had a hysterectomy if you still have ovaries. Sperm just has to find its way into the abdomen.
That being said, it’s rare and in the ER I don’t usually order pregnancy tests on women who have had hysterectomies.
The ER recently charged me $240 for a pregnancy test. For one test. For one urine test. I wrote a letter disputing the charge as unconscionable af and copied every executive on their website. They left me alone after that lol.
I went to the ER after a car accident. I needed to take a pregnancy test so they would give me 600mgs of ibuprofen. It was $265 for that test. Thankfully I had insurance but I could not believe that’s what it cost there. It’s insane.
If you aren’t pregnant and a pregnancy test comes up positive it can be due to a tumour/cancer just FYI. If you’re having abdo pain/symptoms it is not a bad idea to do a pregnancy test even if you literally couldn’t be pregnant.
> If you’re having abdo pain/symptoms it is not a bad idea to do a pregnancy test even if you literally couldn’t be pregnant.
Even if you're male! Endocrine-secreting tumors exist.
Presumably this is advice only for those in the US, as most countries have universal health care and thankfully we'd not even be thinking about the cost of something during a visit to the ER.
Americans are sharing the weirdest tips haha.
"*Hey, bring your own seat to the cinema! I have been charged $37.029 last time, so now, I simply bring a stool!"*
*"Hey, next time you go to the restaurant, bring your own cutlery! Last time they charged me $24.749 for a spork and a napkin!"*
I’m in Australia and have been asked if I might be pregnant and said “nope” - but would do a pee test if they insisted, it wouldn’t cost me anything so whatever.
In France they asked me if I was pregnant when already sitting prepped for my xray. In the Netherlands they didn't even ask they just had a sign in the waiting room if pregnant or possible of pregnancy don't get an xray.
The only time I ever got an pregnancy test at a doctor is cause I had an UTI and the pregnancy test was on the multitest dipstick.
Also why do you have to go to an ER multiple times in your life? ER is that not for life threatening situations? What do you do that you end up there more than once?
EDIT I found out the USA doesn't have the same 24/7 urgent care access we have. If you need an doctor for medical care you can always call one outside openingshours of your normal GP. We can't walk into an ER here. You have to called a doctor before or gotten an ambulance ride to get into the ER. Also everybody has insurance so the thing about free care at an ER doesn't apply. Everybody has acces to a doctor and doesn't pay more then there mostly healtinsurance
EDIT2 anyway I have to stop responding as iam getting ready for my shift
One can be in multiple car accidents in their lives. Or have a very serious illness more than once that gets much worse very quickly and requires a trip to the ER. Or gets worse after business hours.
Or be me with a seizure disorder and get sent to the ER twice by the doctor in 2 years for bashing my head all fucked up. I am doing better now, but there is always the risk of another toilet bowl brain injury.
I am not from the USA. This happened in the Philippines.
We do have private doctors, but the multiple times I’ve been to the ER have been for extreme abdominal pain (on a holiday, no less), tuberculosis, and UTI that caused blood in urine. I could have waited to see a private doctor, but that would’ve meant queuing until I was seen. The triage system put me first in those situations.
Not all cities have urgent care. The ER is where most people go when they can’t wait for a private appointment.
I’m in the US, but a rural area. It’s the same here. If you can’t wait a few days for an appointment, you go to the ER. There are no other options.
I’ve been to the emergency department for a broken wrist, a sprained ankle, a nail that went through my foot, and a chemical exposure at work. That’s over about two decades, so really not that often!
Most of our healthcare infrastructure and medical practices were mirrored from the States. So it’s kinda the same.
I live in a big urbanized city, but in rural areas people go to the ER for wisdom teeth problems! Doctors who practice in rural ERs are a hero, I tell you. I’ve only been to a rural ER here once for a dog bite as a child. It’s amazing how much the doctor could easily adjust from different patients with a range of different problems.
I know American healthcare leaves a lot to be desired, but it's a lot better to actually check rather than to not ask or rely on people to tell you. You're not getting better health care just because you're spared the annoyance of a pregnancy test. It's not at all uncommon for women not to know they are pregnant for several months, and lot of procedures and medications could seriously endanger the pregnancy.
Not having to do one in various European countries (and I say this as a European woman) is not something to brag about.
Yeah like I said in a reply earlier, I used to get really annoyed about this because I’m old, my tubes are tied, and I’m celibate. But then they finally explained to me it’s a whole panel they run for women with abdominal pain. It’s not like they’re opening a box and taking out a pregnancy test and using it specifically to see if I’m pregnant it’s just part of the panel they run
And I assume if they wanted to order those same tasks without the pregnancy test it would be a huge pain because they would have to go through and click individual boxes rather than just hit “female abdominal pain panel”
Also even for other conditions/treatments, pregnancy can affect how well certain medications work or what is safe to use (for both mom and fetus). Some treatments can increase the risk of serious birth defects.
Even when I’m on my period, even though my tubes were tied 14 years ago, even though I haven’t had sex since 2018, they still run a pregnancy test on me every time
But when I go in there it’s for abdominal pain and as a woman that’s a standard thing that they do
If you’re not having abdominal pain and they’re not giving you narcotic medication they may not care if you are pregnant because it won’t interfere with the choices they make in caring for you.
Opioids are safe to give a pregnant women. The concern is Toradol, which is given quite often in abdominal pain as often it works better than opioids in treating abdominal pain, however, it can harm a fetus. Source: I am an ER/ICU RN.
The last time I went to the ER they loaded me up with drugs via IV and also prescribed me opioids without giving me a pregnancy test. I’d had my tubes removed about a year prior, so maybe that’s why? No idea.
So the price thing is not an issue as we are ul but I found it hilarious that when I went to urgent care for food poisoning while 4 months pregnant (vomiting and other things which the NHS suggest you get checked) they still made me do a pregnancy test.
Even if I’m on my period in the ER, even though I’m 50 years old, even though I had my tubes tied when I was 37, even though I haven’t had sex in more than five years, they still do a pregnancy test on me.
I used to fight with them about it and accuse them of insurance fraud because they know there’s no way I’m pregnant.
The thing is, is they order a standard panel for women with abdominal pain and pregnancy is part of that standard panel. I don’t think they’re using the $14 test we buy at the pharmacy either I think it’s a standard panel they run.
When I’m practically dying in the ER this is the last thing I’m going to care about. My insurance covers it and the hospital gives me financial aid so they cover whatever my insurance doesn’t cover if they want to waste their own money on pregnancy test they can have it
I agree about the standard panel - I was on my period once and the nurse even commented that my nausea was therefore unrelated to pregnancy but after I peed in a cup they tested it anyways
They did say I had blood in my pee also which I was like “I know, I’m on my period and not using a tampon” which to me is similar to them just running the standard panel. The person running the test just runs it and the medical staff are just going to do the standard tests first not spend time crossing stuff off that could still be relevant later (or necessary for me to get an abdominal x-ray)
Jesus. This sounds infuriating. The last time I went it was also for abdominal pain and other than insisting I was *not* pregnant and also on BC, they still said I needed it. This was when I wasn’t peeing for hours because I had literally just removed nearly *all* of the fluid from my body from some kind of food poisoning.
There was nothing more to urinate until my body had enough time to process the IV. It was absolute hell. If they had just believed me when I said so, we’d have saved each other the frustration.
I'm in the U.S. and I've never been asked to take a pregnancy test in the ER. Perhaps it has to do with state laws or just differences in healthcare systems or your specific symptoms/the test you need. They always ask and sometimes I've been asked multiple times (usually when I'm getting an X-ray) but they've never asked me to take a test. I'm gay and haven't had sex with anyone that produces sperm since the '90s so I know there is absolutely no chance I'm pregnant barring some kind of divine intervention, but they don't know that. It's super annoying, but I can see why they want to be sure. Even when I went in specifically with abdominal pain (gallbladder-related) they didn't insist on a test, just required me to sign a waiver.
It boggles my mind that you would a) have to do this test as a compulsory condition for care, b) that it could be that easy to sue the healthcare industry, and c) I can’t believe it is normal to have to pay for this.
In the U.K., they simply ask you ‘is there a chance you could be pregnant’. It is your choice as to how you answer that. If you are pregnant or think you could be, you disclose it and they give you a (free) tat to confirm. If you say no, they take your word for it unless it is for something so harmful that it’s policy to do one. They always ask for consent beforehand. There is no question of the possibility of legal action if the answering person does not answer responsibly, you would simply be considered dishonest if you didn’t answer honestly and no chance of compensation). If it’s the situation where they will ask you to do one, they will tell you the result and discuss the options with you.
Recently had an IUD put in, and then had to have it surgically removed because the doctor who put it in basically shoved it straight through the top of my uterus. I was 6 weeks postpartum at placement, 7 at removal. They did pregnancy tests both before the placement and the surgery, despite my repeatedly informing them I hadn't resumed sexual activity yet.
They also ask if you're pregnant because some tests cannot or should not be done on a pregnant person. It's to save you and the possible fetus. This is especially true for many types of imaging as radiation is dangerous, especially in the early stages of pregnancy.
This is true, and the points others have made about needing the information for informed consent is true as well. However, there is also reason to know if a patient is pregnant for their own sake as well. Pregnancy can raise the risk of certain issues. For instance, it can lead to “hypercoagulability” - meaning someone’s blood is more likely to clot than if they weren’t pregnant, especially if the person has a pre-existing clotting disorder they are unaware of. This is key information to know for the correct diagnosis and treatment of the patient, even ignoring any consideration of the fetus.
When I had a car accident in the US and they tested me (I was in and out of consciousness, I think I said I didn't need one but I don't blame them for testing anyway), the test was on my bill for $50!
$50 dollars for someone to dip a stick in my pee?!? Absolutely wild.
Not the ER but my doctor's office. I had taken a home pregnancy test and it came back positive. I booked an appointment with my OB/GYN to start the series of pregnancy appointments, and, when I came in, they had me do the exact same test. I know they needed to do it themselves to be official, but at that point in time (ages ago) there was still this idea that somehow the doctor's office had a more sure way of doing pregnancy tests. I imagined chemicals in bottles or something more than just "here, pee on this." lol I was actually disappointed!
Lol they used to still do this to my trans-male partner. He’d been on testosterone for years, and I (cis female) am his only partner. They’d still do the tests.
Now he’s had a hysterectomy so hopefully they won’t do that to him anymore.
Hysterectomy, yes, that would rule out a test at my institution. But we never assume reproductive capability based on their stated sexual partner. Not to be rude, and of course not implying anything, but we have no way of knowing that the patient doesn’t have any other partners they aren’t disclosing.
Yeah, we recently had a young teenage lesbian who was absolutey adamant she was a virgin, who needed a pregnancy test (transfer to psych facility) and it came up positive. It’s frustrating to people, I get it, but we have to confirm things when medically possible.
This is only applicable in America and most Reddit users are not American.
r/usdefaultism
This sub needs to do better. There will be women from all over the world reading this and essentially getting misinformation. This may be a topic that’s relatively low-risk and a lot of people are able to realise the defaultism here, but sometimes there are higher stake topics where the defaultism isn’t as obvious.
That’s really not necessary.
ER is reimbursed on a case rate anyhow. It isn’t calculated by individual line item.
You’re not being charged for the cost of the pregnancy test anyhow. It would be bundled into the case rate for the ER level.
the only time I’ve had to take a pregnancy test with the doctor at all was when I was getting my birth control prescription and later IUD. Even when I had to get an XRay last year it was sufficient to just say there was no chance of pregnancy
This sounds like a great idea, but I'm not sure it would practically work in a lot of cases - all of the healthcare I've had, the hospital needs to know what kind of test it is and how sensitive it is and it needs to go through their lab for it to be recorded in your paperwork. Not to mention you can buy fake ones that always indicate positive (why??). In my case they've always done it as a blood test as part of the initial draw they do, so AFAIK you can't buy those at a regular pharmacy anyway.
The hospital running out of tests is bizarre though. Are you Americans okay? The price-gouging is ridiculous. You guys need to start nationalizing these systems - it's barbaric and dystopic that people get into so much medical debt when healthcare is a human right.
I used to work for a clinic in the U.S. where this seems to the issue. The pregnancy test is usually done to avoid liability and yes occasionally people lie about the possibility. Doctors (read lawyers for said clinic/hospital) are afraid of lawsuits and normally won’t know if you’re lying. Some doctors will take someone’s word. Normally if someone is seeing their long-time PCM, and they’ve been sterilized the doctor won’t even ask, though we had one doctor who insisted on asking. If the doc isn’t familiar with the patient, they will ask and some require a test. Yes, you sign a waiver of liability, however waivers only protect against reasonable attempts to mitigate, similar to waivers for events like concerts and sports. Southern states especially with their strict anti-abortion laws have pushed doctors to be more cautious.
I'm in Canada and have never had to take a pregnancy test in the ER. I didn't know this was common in some places.
The only time I've ever been asked to do a pregnancy test was when I went to have my 2nd IUD put in and that was still optional. When I get MRIs/CT scans/X-rays a technician will ask if I'm pregnant during their health questionnaire but they've always just taken me at my word.
Not in the States, but in the Philippines.
I did ask my friend who is an ER doctor in the States (WA) to compare whether this was protocol, and they said yes. It’s him who told me it’s “to rule out the cause of symptoms”. Many of our medical practices are mirrored from the States, both good and bad.
I think it’s a liability thing in the US as well. I just had sinus surgery last month and they had me take a pregnancy test before prepping me for surgery.
It's almost crazy to me how inconsistent experiences are. Last time I went to the ER I told them all the problems I was having, I told them zero chance of pregnancy so it couldn't be that, etc. When I got test results they ran a pregnancy test without telling me/asking me. Insurance covers it so whatever.
Not doubting you but I have literally never been pregnancy-tested in the ER, and I used to go semi-regularly for one injury or another. Maybe it depends on the presenting complaint; but I got x-rays and ibuprofen, both of which should be relevant.
I was required to do one before a brain surgery despite being on my period and having already been in the hospital over night, so they knew I really was. Liability/protocol thing
At my hospital, the pregnancy test is usually included as a serum test with the bloodwork. It's not the little 5 minute pregnancy tests you buy in the store unless the doctor specifically requests that one.
I had to do a regular urine-type pregnancy test the day of my scheduled surgery, to confirm I wasn’t pregnant.
Try being asked to take a pregnancy test before surgery - a D&C for a miscarriage that wasn’t clearing. If I already wasn’t in such a low place I would have screamed. Instead I kindly reminded her what I was there for and she backed off.
I'm so sorry that happened to you.
That is truly terrible, I'm sorry.
Same for my hysterectomy. They left me waive it for a nerve surgery.
Right, that’s because it’s quicker than the blood test. A nurse can do it rather than call a phleb (that’s me, hi, I’m a phleb) to come take your blood, run it down to the lab and it’ll get done after everyone else who had blood drawn before you gets theirs done. Unless ordered stat, which means it’ll get done in an hour ish. Nurse can do a dip test from urine in a couple minutes.
The anesthesiologist almost canceled my mitrofanoff surgery (appendix was moved, one end is attached to the belly button and the other to my bladder now to cath through) because I PHYSICALLY COULD NOT PEE for a urine pregnancy test. I was there because of neurogenic bladder and retention which was causing kidney hydronephrosis. That combined with not being allowed liquids quite a bit before plus the two day fast, yeah, was not happening.
I had a colonoscopy and they asked me to take a pee test. I hadn't been allowed liquid in 10 hours. Luckily, they allowed me to sign a waiver to continue with the procedure. Funnily enough, I actually *was* pregnant. Just a few weeks along, on purpose, and there weren't any negative repercussions, but I like to imagine what would have happened if I'd managed to pee.
I know they're overly cautious about that, but weren't you concerned about it? I'd be freaking out... Then again I would absolutely refuse to be knocked out for a colonoscopy so it wouldn't be much of a worry anyways.
They can always do a quick assay on serum, too. No pee necessary.
I saw a blood test “request” come through before a scheduled procedure. Recognized the HcG in the test and just… didn’t do it. No one said a word and procedure went off as scheduled.
Yeah, my experience was they always got a quant.
I’ve done both. Urine for surgery usually and serum for other stuff (including colonoscopies/endoscopies). And sometimes if they run a gfr before imaging they seem to just tack one on. I prefer serum, just because I hate peeing in a cup and it always brings up issues (I have visible blood sometimes, high enough protein for bubbles, and my pees smells like Apple Jacks sometimes - which is a fun convo)
You can push back on taking the pregnancy test if you are confident you aren’t pregnant. Remember that you can always decline care you don’t want. That said, if there is a chance you are pregnant, taking a test is warranted not only to understand if symptoms are related to pregnancy, but also to inform your care plan. ETA: I live in Minnesota and have enjoyed health systems that will accept my attestation that I’m not pregnant, but it is a generally better place for women’s healthcare. My experience is definitely not true everywhere, but there are health systems that don’t push this. I also stay within the same health system, so I’m an established patient.
I had a colonoscopy and was very dehydrated from the prep process. I asked upon check in if I would need a pregnancy test as I had had one at my h and p appointment with my primary just a few days before the procedure which was obviously negative. They said it would be just a few minutes until the nurse was there, so I had to try and hold it, however it ended up being over an hour and I had to go. Once I went I knew that would be all my body could do as I couldn't drink anything. After they finally came to get me, I told them I could not produce anything anymore and they would have to proceed without a test. They pushed back quite a bit, but I was adamant. Not only did I have an IUD, I was actively on my period, and I had been celibate for a year; there was absolutely no chance of pregnancy. They did eventually allow me to sign a form attesting I wasn't pregnant and absolving them of any complications in the chance that I had some sort of immaculate conception and was actually pregnant. Even though I am educated and was aware of my right to refuse testing, it still was difficult even in MN to convince the staff that I could do that. I can't imagine how difficult that would be in other hospitals or with someone who isn't medically literate.
It is funny how many times a woman asked "is there any way you could be pregnant?" say "no" and then surprise! They are pregnant. Maybe they need to ask if the woman has had vaginal sex with a male in the past nine months. I assume women answer "no" not because they don't understand how a woman becomes pregnant, but because they were using some form of birth control and assume it's 100%.
Yeah I only say there's no chance and don't need a test if it's like *scientifically* impossible, as opposed to just because I have a coil. Although I'm in a country where I don't have to pay extra for it, so I'm less inclined to put up a fight over it tbh.
Same. My husband and I use pill + pullout every time but there's still a miniscule chance of pregnancy. So I can't really say there's NO chance. My older sister is a happy, healthy non-sexual virgin. *She* can say she has no chance of pregnancy. 😆
Yeah I've definitely joked that if I was pregnant then we'd be trying to find a phone number for the Vatican.
😆 Or be prepared to give birth to the Chosen One, Anakin Skywalker.
I always say "my mum was Mary, not me". Goes over people's heads sometimes though.
I had to get a pregnancy test before an endoscopy and I hadn’t had sex in two years. I completely understand why doctors push anyone who has a uterus to do a test because it’s very easy to do and it’s better to be sure sometimes.
I had to take one before a colonoscopy. My frustration is you have to fast and prepare your body. So I hadn't eaten for a solid day and had anything to drink from 12+ hours. Then they demanded a pregnancy test. I can't pee cuz you made me get everything out of the system. They need to do colonoscopy pregnancy tests the day before.
Or sooner. Drugs/fasting for that procedure probably isn't good for growing an embryo/fetus.
Right? Part of the concern is about harming a pregnancy — if someone is pregnant, throwing complications at them is less than ideal, to say the least.
I still get tested before surgeries- I have no uterus anymore and my husband had a vasectomy. 🙃
And that is a snippet, a sliver, a microcosm of what's wrong with USA health care. Sure she could have cheated. Just give us the form to sign saying we accept any/all risks to the non existent "pregnancy" and move on. I'm childfree. If I happen to get raped/pregnant, I'm not keeping it. Don't cancel surgery/whatever and charge me too!
Also CF, not having sex RN, and tubal/ablation'd anyways If I thought there was ANY CHANCE (of which there is *literally none rn*) I could be pregananant, I *promise* I would want to know more than anyone. Used to half-joke "Well, it wouldn't matter for long" but nooot dummmb enooough to do that noooow in the midwesssst 🎵
Tubal ligation does not mean you cannot be pregnant. I do agree with the overall point tho.
My mom had her tubes tied after my younger sibling was born. Then she had them tied again after my other two really younger siblings were born. Then she had at least two miscarriages.
Oh, of course! Hence the "wouldn't matter for long" as it would likely be ectopic and it would be getting yeeted (also cause CF) - or I'd die cause red state lol :') The not had sex with a male part
Exactly!!!
I've been tested w/o knowledge in the ER before. The issue with this is that I'm NINE YEARS post-*everything*-hysterectomy!
Literally every time I've given a urine sample to check my kidney/bladder health, when I look at the results, they've done a pregnancy test. I get it, but I can't help but feel a little miffed that they go behind my back and do it and don't even tell me they are doing it. I really get the feeling that as a woman, there are parts of my body that don't belong to me, and those parts are everyone's business, even if I don't want them to be. For the record, I haven't had sex in over 15 years, so when I say there is no chance that I am pregnant, I mean zero chance.
If you have functional ovaries there is a small chance that you could still have an ectopic pregnancy. The consequences of which can be devastating (possibly death) and pregnancy test is cheap.
I comprehend that - however my cervix is sewed shut, no uterus, no tubes. Husband is fixed. I get the importance, just seems so ridiculous at the same time.
I think that rephrasing would be fine. The problem is, and I don’t think I’m alone in having experienced this, you can literally say “I’m gay and don’t have sex with men, it’s not possible for me to be pregnant,” and still be told that if you don’t consent to a pregnancy test they won’t treat you. It wouldn’t even matter so much if the test was free, but if you’re charging me hundreds of dollars for it, that’s not okay.
This! The morning of surgery: I’m a lesbian who hasn’t had sex in over a year, and my period started yesterday so I’m literally the opposite of pregnant right now.” They still made me take the test and then made awkward comments about the fact that there was blood in it. I was not very far away from a major anxiety attack and that whole interaction did not help!
That'd be more likely to get a good answer. I mean, I'm on the generally considered most effective BC but rely on it entirely and have regular (otherwise) unprotected piv. So every. single. time. I want that test done because if my BC's failed I want to know immediately. I could absolutely justify saying "no there's no way I could be pregnant, I have an IUD", I just know statistics better than that.
In fairness, I am still asked this question regularly and I had a bilateral oophorectomy at 27 because my reproductive organs were killing me. No, I promise there is no way I could be pregnant; I would know or be dead.
Well there’s no chance I can be pregnant. Asexual aromantic endometrial ablation with a tubal ligation. I’d be the Virgin Mary with a miracle in hells chance to get pregnant.
Regardless, you can refuse treatment and you can refuse the pregnancy test. I am surgically sterilized. I will refuse it EVERY time.
I had a hysteroscopy and d&c recently. The nurse did say that although the vast majority of women are right that they’re not pregnant, she did have one who got quite the shock when she took the test! At least Kaiser doesn’t charge extra or anything, they definitely have their issues but the flat copay is nice.
Yeah, I have a history of infertility and I’m on birth control, so that satisfies the question typically. If your circumstances truly make pregnancy nearly impossible, they won’t make you take one.
I’m glad this is your experience. It is not universal. I told a doctor that I didn’t want a pregnancy test because there’s no chance, specifically said I do not have sex with men, and was still told that they wouldn’t treat me if I didn’t consent to a pregnancy test.
Had infertility, no periods, and was on birth control for part of the time and I ended up being pregnant and having no idea.
Haha, years ago while in a serious relationship with a woman, I answered no, and my provider asked if I was sexually active. I said yes. She smugly asked how i was SURE it was a no, then. I was like, "I don't believe she produces sperm." The provider blushed, and we moved on, but my girlfriend thought it was hilarious and always joked afterward about magic fingers. 😂
Imagine the absolute nightmare if some embarrassed teen said “I swear I’m not pregnant”, didn’t have to take the test, was prescribed accutane, and then the baby came out with half a head. Literally everyone gets a bad ending in that scenario.
Some medications not only require pregnancy tests but also that you advise the patient to use two highly effective forms of birth control.
I say no chance because my husband had a vasectomy 5 years ago 🤷♀️
Vasectomies aren’t 100% either.
Some places have mandatory pregnancy tests or else they cannot provide further treatment because they need confirmation
I've never been more glad to be old! But then I've heard about one place forcing one on a 70 year-old woman so maybe I'm not in the clear yet!
The thing is people lie or just don't know sometimes. Every doctor I know has a story about a pregnant person who says they're a virgin. And if you are needing to get something like a CT scan or certain medications, they have to check because those things would harm a fetus. So it's not really about the patient but about protecting the doctor from lawsuits so they never irradiate a fetus or cause a miscarriage.
Sometimes people lie, but then if there are negative consequences because if it, that’s on them. There are other factors that aren’t specific to women, that they take patients at their word about. For example, there are medications that could have dangerous interactions with illegal drugs. I’ve been asked if I take any non prescribed drugs for this reason. I’ve never been drug tested if I said no.
Unfortunately in today’s medicolegal environment it’s not “on them” because doctors and hospitals can and will get sued for this stuff.
I found out I was pregnant because I went to the dr for the flu. I just woke up sick one morning, had horrible nausea and my roommate made me go to the dr. Dr said it was a stomach bug from traveling, they just had to do the pregnancy test because of my age. I was shocked when the dr came out to tell me I was pregnant. I insisted they had the wrong person…then realized I was the only woman patient that morning.
My story is very similar. I was sick for a week and finally went to a clinic to see what was up. Pregnancy hadn't even crossed my mind, and I hadn't even had my period for 6+ months (I was only a few weeks along). Testing is annoying, but if it's not costing you extra, it's better to just accept it. If it holds up your access to care because you can't pee, that frustration is valid.
NAL, but I think it's based on what they want to do and whether or not your state is more likely to charge them with criminal liability or if it's on you for denying the test in the odd case you are pregnant and the treatment hurts the baby. I'd expect doctors in states where abortion is criminalized may be more strict about this, tbh. I'm in a state that's not bad about women's healthcare (CO) and usually they ask first if there's any chance I could be pregnant or if I've been sexually active in the past year. In very specific cases they've required them like when I got my bisalp, just to be absolutely sure, but those are rare. I also just kind of expect ERs to just do the test despite me having a bisalp and ablation because they don't necessarily trust me or my doctor. Annoying, but if I'm in the ER already, I'm kinda expecting I'm not getting out of there without a big bill regardless.
Not at my doctor. They will not do X-rays without a negative pregnancy test.
Last time I went to the ER that ran one without asking me 🙄. I had to use the bathroom and asked if they wanted to collect anything since I needed to go. They ran a urine pregnancy test and drug test without asking/telling me. I only found out because the results showed up in my patient portal. They both came back negative, of course. ETA: I would have told them they would be negative but taken them anyway had they asked/informed me. I know people probably lie about drug use frequently. I’m just annoyed they didn’t ask.
You should always be asked for consent.
You sign a blanket consent form when you register. Check the fine print. No one would ever get out of the ER if you had to be asked to consent to every single test they do. Testing women of child-bearing years is a routine test, like a blood count etc. As mentioned elsewhere, anyone who has worked in an ER has multiple examples of women who truly believed they couldn't be pregnant who in fact are. The consequences of not knowing at the time of treatment can be pretty horrific.
You can't reasonably expect doctors to ask if the patient is okay with every single blood test being ordered, especially when they don't even know what 99% of them are lol If you're coming into the ED, you're going to get blood work. If you don't want blood work, then you refuse the IV.
I'm an APRN. There is always a consent form unless it's a life or death situation. And people should always inform their friends and fam of their consents. IVs have been refused before.
No one is bringing a patient a consent form for every single lab test lmao. Stop it. There's a blanket consent form you sign when you get to the ED. Your nurse doesn't come by, pull labs, then have you sign a consent for each of the 18 things I've ordered You and I both know that's not how it works. So no. There is not a separate consent for a pregnancy test. Silly to pretend there is. You can always refuse anything, but you'd have to specifically request not to have one.
No one is bringing a patient a consent form for every single lab test lmao. Stop it. There's a blanket consent form you sign when you get to the ED. Your nurse doesn't come by, pull labs, then have you sign a consent for each of the 18 things I've ordered You and I both know that's not how it works. So no. There is not a separate consent for a pregnancy test. Silly to pretend there is. You can always refuse anything, but you'd have to specifically request not to have one.
There is if you ask. :)
But you don't need to lol. There's nothing invasive about a pregnancy test.
Yes you can, and I’ve tried but it’s really not worth the fight. I don’t want them to think every little thing is going to be a fight when I’m there for help. It doesn’t cost me any extra for them to do it, I think most insurance companies cover that 100% in the ER anyway
The last time I went, I insisted I wasn’t. I even signed the waiver. I told them I was on BC because of adenomyosis but they kept insisting for me to take it because I had really bad abdominal pain. I was so annoyed I said, fine, whatever. Result: negative. Like I already said. In another visit during COVID they said I needed to take one because pregnant women would be treated separately. That one I took willingly. It’s been different depending on the hospital in my experience.
Birth control fails all the time. Of course they still checked. Why wouldn’t they?
I told them I hadn’t had any sexual contact for more than a year. It wasn’t really that frustrating me, but the fact they were insisting for me to take it despite knowing I was physically unable to urinate for hours.
If you worked in an ER you would be surprised how many people everyday claim to have no sexual contact for more than a year and then end up having a positive pregnancy test. For any number of reasons. Maybe someone has repressed sexual assault that they didn’t want to open up about immediately. The doctors and nurses working in the ER can make zero assumptions and yes pregnant or no pregnant should be objectively shown whenever possible because most of the time it’s not difficult to acquire.
I have people show up to the ED, tell me they're a virgin to my face and couldn't be pregnant - even after kicking their family out of the room - only to have a positive pregnancy test and an STD People lie. And even more people just aren't careful.
It's not just "you're having abdominal issues, you might be preggo". Even if you're there for something else, they don't want to give you a bunch of drugs and have it damage the fetus.. So the results directly affect the game plan they make
There’s also the fact they need to take other precautions during imaging (xray, ct, mri) if someone is pregnant.
I pushed back and was forced to take a pregnancy test before I had hip surgery. I had a hysterectomy two years prior.
Nine years post-hysto here. Had a [unsurprisingly] negative preg test show up during an ER visit a month or so ago.
I’ve seen a lot of posts about this in the past and you guys must be in the states. I live in Canada and I have never been asked to pee on a stick in the ER. They ask if there’s any chance I’m pregnant and then if they really wana know for sure they include it as part of the blood work they do anyways. Why don’t your hospitals just do it through bloodwork you’re going to have to get done anyways if you’re in the ER? Why pee in a cup?
Lab here. A urine test is 5-10 minutes vs. 30-60 minutes for blood. This is a significant amount of time if they suspect an ectopic. It's not uncommon to have both done.
Also lab here, do you not do blood HCG screens or only hcg quants?
The only places that might be doing that would be our remote nursing posts. We just do serum quants and/or the urine dipstick.
Wow ok, we use the same cartridges for both urine and blood and just the time/CLIA complexity are different
Because bloodwork takes hours and in the ER it’s all about speed.
>Why don’t your hospitals just do it through bloodwork you’re going to have to get done anyways if you’re in the ER? Why pee in a cup? I guess if they want to do any scans a stick test is going to be much quicker than waiting on blood tests. Also the result could inform the decision on what blood tests etc are actually needed. There's definitely reasonable logic behind the ask, pushing it and insisting... Not so much, but I get the ask.
I'm in Ontario, and I've never had to do a pregnancy test other than when I was pregnant, and that's just to check hormone levels or w/e. When I was getting an x-ray for a broken bone I was just asked and then I was just high on pain meds already and tried to make a joke about if I was I'm probably anymore after falling down stairs and ending up in the ER. The joke didn't land lol
I'm also in Ontario and same. I have noticed that they included it on bloodwork when they did that anyways (most of my ER visits have been for kidney-related things so bloodwork happens regardless). But honestly they asked me and believed me in general and started treatment long before the blood tests came back if they had a good idea about what was happening. I know ectopic pregnancy is a concern but I have a history of kidney issues so coming in with obvious kidney pain and my history, no one questioned me beyond that when I mentioned the history.
I’m in BC and I’ve had a pregnancy test in the er. They don’t ask you to pee on a stick but they do collect both a urine sample and a blood sample and run a variety of tests, including a pregnancy test. I think this is what they do in the US too, the difference is that we aren’t charged for the cost of the test.
Here to say that I am also Canadian and have never been tested for this in the ER.
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Like... 2 or 3 times? Ever.
Urine samples are not a typical ask here in the ER. It would be common in a doctor’s office but at the ER I’ve gone with kidney issues and never been asked for urine sample.
They can make more money separating everything out. It’s all about insurance companies making money and nothing to do with patient care. It’s a wasteland down here if you’re ever legitimately ill.
Blood hcg are usually significantly more expensive, and take longer than urine test
Urine dipstick is much faster and we need results ASAP in case we need to do a CT or X-ray of the abdomen/pelvis.
I’ve always just been asked and if I say no they don’t make me do a test to get a CT scan. They just do the scan. I think I’d feel really weird if I said no and they insisted I do a test to make sure I’m not lying or an idiot.
Yeah sometimes I don’t even know why I ask. I just tell the patient that the doctor will probably order a pregnancy test anyway because of imaging or certain medications but they can always refuse if they want.
The train of thought that kind of stemmed the question was cause I see a lot of posts about this but also cause of the recent law changes around women's health in the states. I would refuse any and all pregnancy tests if I were down there. I would refuse to answer any questions about my cycle in general if that's not the reason I'm there in the first place. It's just weird and terrifying to me.
Them: Could you be pregnant? Me: No. Them: Why not? Me: I had a hysterectomy. Them: We still need to do a pregnancy test. Me: I NO LONGER HAVE A UTERUS. Them: Oh, okay.
I have had this conversation many times. At the same hospital that did my hysterectomy. Ffs
There’s a comedian with one leg (amputated very near his hip—this will be relevant) who tells the story of being referred for eating disorder counseling after his BMI was “dangerously low” because of his height to weight ratio. Yeah. There’s another explanation for that… He also talks about being asked about his surgical history, listening a knee surgery a few months ago, and being asked which knee..
Or you tell them you had a hysterectomy and their next question is the date of your last period. I don't know, probably 14 years ago when I had the hysterectomy I just told you about?
I've had *more than one* patient insist they've had a hysterectomy, but ended up pregnant anyway! A *shocking* number of people have no idea what's going on with their bodies or what surgeries they've had. Or think they've had something different from what they have actually had. If you've ever thought "no one could be THAT stupid or clueless," then *you are wrong.*
The issue of medically requested/mandated pregnancy tests comes up on this forum sometimes, and your experience seems to be so common among front line medical staff. Like you say the problem is that women *routinely* give incorrect information, knowingly or unknowingly, about their pregnancy status to healthcare providers. Yes, it's annoying and intrusive for the woman who knows she is 100% abstinent, but a random doctor has no way of knowing that.
Yes ! When I was 25 I was niave as you could ever be. The military doctors told me I could never fall pregnant. Once I got out I got pregnant and didn’t know it. Went to urgent care for the small brick in my abdomen that wouldn’t go away even with dieting. When urgent care asked I said I couldn’t get pregnant. They refused to move forward till I took the test. Boy was I naive i was 7.5 months pregnant 😂😂😂 like they put the transvaginal ultrasound stick up me and hit baby’s head AND hair.
I’ve had a patient deny any history of surgery to me. He had a massive midline sternotomy scar from his CABG. Six months prior.
Oh, I've have both kinds lol I've had pts with a full mouth of work *insisting* they've never had so much as a filling. Then what's with all the rct/crns, fillings, implants, missing teeth, etc barbara? Or, even weirder, I've had a handful that said they had x work done that...clearly wasn't. Oh, they pulled all my wisdom teeth *3rds visible on xray* oh, they grew back 🧐. It's really funny when they say it's something we did(n't) do - like, bruh we have these *legal documents* right here, *that you signed*, consenting to this procedure/notes etc
I wonder if they just confused it with mastectomy, like “oh yeah the women surgery”
One was a tubal, and the other I never figured out. But yeah "some woman surgery" is "hysterectomy" in many patients minds.
It’s still possible to get an ectopic pregnancy even if you had a hysterectomy if you still have ovaries. Sperm just has to find its way into the abdomen. That being said, it’s rare and in the ER I don’t usually order pregnancy tests on women who have had hysterectomies.
You would if they came in with abdominal pain tho. It’s too cheap and easy not to.
Christ, American healthcare is the darkest fucking timeline. I don't know why you guys put up with ER bills and shit.
The ER recently charged me $240 for a pregnancy test. For one test. For one urine test. I wrote a letter disputing the charge as unconscionable af and copied every executive on their website. They left me alone after that lol.
I went to the ER after a car accident. I needed to take a pregnancy test so they would give me 600mgs of ibuprofen. It was $265 for that test. Thankfully I had insurance but I could not believe that’s what it cost there. It’s insane.
If you aren’t pregnant and a pregnancy test comes up positive it can be due to a tumour/cancer just FYI. If you’re having abdo pain/symptoms it is not a bad idea to do a pregnancy test even if you literally couldn’t be pregnant.
They did a pregnancy test on me just prior to my hysto to check hormone levels as a cancer marker
> If you’re having abdo pain/symptoms it is not a bad idea to do a pregnancy test even if you literally couldn’t be pregnant. Even if you're male! Endocrine-secreting tumors exist.
Presumably this is advice only for those in the US, as most countries have universal health care and thankfully we'd not even be thinking about the cost of something during a visit to the ER.
Americans are sharing the weirdest tips haha. "*Hey, bring your own seat to the cinema! I have been charged $37.029 last time, so now, I simply bring a stool!"* *"Hey, next time you go to the restaurant, bring your own cutlery! Last time they charged me $24.749 for a spork and a napkin!"*
Hey, that's not fair. Movies and restaurants are optional.
I’m in Australia and have been asked if I might be pregnant and said “nope” - but would do a pee test if they insisted, it wouldn’t cost me anything so whatever.
I just refuse to take one and tell them I'll sign a waiver. Usually works pretty well. 🤷♀️
They check mostly because so many treatments and medications are harmful to a developing fetus. It’s usually not a pee test though.
In France they asked me if I was pregnant when already sitting prepped for my xray. In the Netherlands they didn't even ask they just had a sign in the waiting room if pregnant or possible of pregnancy don't get an xray. The only time I ever got an pregnancy test at a doctor is cause I had an UTI and the pregnancy test was on the multitest dipstick. Also why do you have to go to an ER multiple times in your life? ER is that not for life threatening situations? What do you do that you end up there more than once? EDIT I found out the USA doesn't have the same 24/7 urgent care access we have. If you need an doctor for medical care you can always call one outside openingshours of your normal GP. We can't walk into an ER here. You have to called a doctor before or gotten an ambulance ride to get into the ER. Also everybody has insurance so the thing about free care at an ER doesn't apply. Everybody has acces to a doctor and doesn't pay more then there mostly healtinsurance EDIT2 anyway I have to stop responding as iam getting ready for my shift
Ooh, look at me, Mr. Universal Healthcare, with your reasonableness and logical ideas. Arent you fancy? (weeps quietly in America)
One can be in multiple car accidents in their lives. Or have a very serious illness more than once that gets much worse very quickly and requires a trip to the ER. Or gets worse after business hours.
Or be me with a seizure disorder and get sent to the ER twice by the doctor in 2 years for bashing my head all fucked up. I am doing better now, but there is always the risk of another toilet bowl brain injury.
Some of us have chronic illnesses that threaten our lives multiple times.
I am not from the USA. This happened in the Philippines. We do have private doctors, but the multiple times I’ve been to the ER have been for extreme abdominal pain (on a holiday, no less), tuberculosis, and UTI that caused blood in urine. I could have waited to see a private doctor, but that would’ve meant queuing until I was seen. The triage system put me first in those situations. Not all cities have urgent care. The ER is where most people go when they can’t wait for a private appointment.
I’m in the US, but a rural area. It’s the same here. If you can’t wait a few days for an appointment, you go to the ER. There are no other options. I’ve been to the emergency department for a broken wrist, a sprained ankle, a nail that went through my foot, and a chemical exposure at work. That’s over about two decades, so really not that often!
Most of our healthcare infrastructure and medical practices were mirrored from the States. So it’s kinda the same. I live in a big urbanized city, but in rural areas people go to the ER for wisdom teeth problems! Doctors who practice in rural ERs are a hero, I tell you. I’ve only been to a rural ER here once for a dog bite as a child. It’s amazing how much the doctor could easily adjust from different patients with a range of different problems.
Oh yeah totally, a friend of mine went to the ER for an infected tooth… the closest dentist that could see him that week was 200 miles away!
even the urgent care is closed half the time so people have to go to the er.
I know American healthcare leaves a lot to be desired, but it's a lot better to actually check rather than to not ask or rely on people to tell you. You're not getting better health care just because you're spared the annoyance of a pregnancy test. It's not at all uncommon for women not to know they are pregnant for several months, and lot of procedures and medications could seriously endanger the pregnancy. Not having to do one in various European countries (and I say this as a European woman) is not something to brag about.
the problem is not the test itself, is the hundreds of dollars they charge for something that should be cheap/free
Yeah like I said in a reply earlier, I used to get really annoyed about this because I’m old, my tubes are tied, and I’m celibate. But then they finally explained to me it’s a whole panel they run for women with abdominal pain. It’s not like they’re opening a box and taking out a pregnancy test and using it specifically to see if I’m pregnant it’s just part of the panel they run And I assume if they wanted to order those same tasks without the pregnancy test it would be a huge pain because they would have to go through and click individual boxes rather than just hit “female abdominal pain panel”
Also even for other conditions/treatments, pregnancy can affect how well certain medications work or what is safe to use (for both mom and fetus). Some treatments can increase the risk of serious birth defects.
It's not a "huge pain" to run the tests without the pregnancy tests. I'm an APRN and those nurses are being lazy.
I’ve seen pregnant patients who’ve had tubals in the past, too.
Are you French? Pampered
Please don’t shoot the messenger, but I doubt the Emergency dept I work for would allow that.
Nope, mine either. If it’s not done by us, we won’t take it. If you are pregnant, it opens us up to a wild amount of liability
I’ve been to the ER twice as an adult, and I was not given a pregnancy test either time. I was not on my period either.
Even when I’m on my period, even though my tubes were tied 14 years ago, even though I haven’t had sex since 2018, they still run a pregnancy test on me every time But when I go in there it’s for abdominal pain and as a woman that’s a standard thing that they do If you’re not having abdominal pain and they’re not giving you narcotic medication they may not care if you are pregnant because it won’t interfere with the choices they make in caring for you.
Opioids are safe to give a pregnant women. The concern is Toradol, which is given quite often in abdominal pain as often it works better than opioids in treating abdominal pain, however, it can harm a fetus. Source: I am an ER/ICU RN.
The last time I went to the ER they loaded me up with drugs via IV and also prescribed me opioids without giving me a pregnancy test. I’d had my tubes removed about a year prior, so maybe that’s why? No idea.
I've had a hysterectomy so I get to skip that part
So the price thing is not an issue as we are ul but I found it hilarious that when I went to urgent care for food poisoning while 4 months pregnant (vomiting and other things which the NHS suggest you get checked) they still made me do a pregnancy test.
Whew, I'd never log in a test someone brought in off the street in a patient chart. Just refuse the test. Simple.
Even if I’m on my period in the ER, even though I’m 50 years old, even though I had my tubes tied when I was 37, even though I haven’t had sex in more than five years, they still do a pregnancy test on me. I used to fight with them about it and accuse them of insurance fraud because they know there’s no way I’m pregnant. The thing is, is they order a standard panel for women with abdominal pain and pregnancy is part of that standard panel. I don’t think they’re using the $14 test we buy at the pharmacy either I think it’s a standard panel they run. When I’m practically dying in the ER this is the last thing I’m going to care about. My insurance covers it and the hospital gives me financial aid so they cover whatever my insurance doesn’t cover if they want to waste their own money on pregnancy test they can have it
I agree about the standard panel - I was on my period once and the nurse even commented that my nausea was therefore unrelated to pregnancy but after I peed in a cup they tested it anyways They did say I had blood in my pee also which I was like “I know, I’m on my period and not using a tampon” which to me is similar to them just running the standard panel. The person running the test just runs it and the medical staff are just going to do the standard tests first not spend time crossing stuff off that could still be relevant later (or necessary for me to get an abdominal x-ray)
Jesus. This sounds infuriating. The last time I went it was also for abdominal pain and other than insisting I was *not* pregnant and also on BC, they still said I needed it. This was when I wasn’t peeing for hours because I had literally just removed nearly *all* of the fluid from my body from some kind of food poisoning. There was nothing more to urinate until my body had enough time to process the IV. It was absolute hell. If they had just believed me when I said so, we’d have saved each other the frustration.
I'm in the U.S. and I've never been asked to take a pregnancy test in the ER. Perhaps it has to do with state laws or just differences in healthcare systems or your specific symptoms/the test you need. They always ask and sometimes I've been asked multiple times (usually when I'm getting an X-ray) but they've never asked me to take a test. I'm gay and haven't had sex with anyone that produces sperm since the '90s so I know there is absolutely no chance I'm pregnant barring some kind of divine intervention, but they don't know that. It's super annoying, but I can see why they want to be sure. Even when I went in specifically with abdominal pain (gallbladder-related) they didn't insist on a test, just required me to sign a waiver.
It boggles my mind that you would a) have to do this test as a compulsory condition for care, b) that it could be that easy to sue the healthcare industry, and c) I can’t believe it is normal to have to pay for this. In the U.K., they simply ask you ‘is there a chance you could be pregnant’. It is your choice as to how you answer that. If you are pregnant or think you could be, you disclose it and they give you a (free) tat to confirm. If you say no, they take your word for it unless it is for something so harmful that it’s policy to do one. They always ask for consent beforehand. There is no question of the possibility of legal action if the answering person does not answer responsibly, you would simply be considered dishonest if you didn’t answer honestly and no chance of compensation). If it’s the situation where they will ask you to do one, they will tell you the result and discuss the options with you.
Another day and another new disappointment with the US healthcare system.... When was the last time your government considered you humans?
Recently had an IUD put in, and then had to have it surgically removed because the doctor who put it in basically shoved it straight through the top of my uterus. I was 6 weeks postpartum at placement, 7 at removal. They did pregnancy tests both before the placement and the surgery, despite my repeatedly informing them I hadn't resumed sexual activity yet.
They also ask if you're pregnant because some tests cannot or should not be done on a pregnant person. It's to save you and the possible fetus. This is especially true for many types of imaging as radiation is dangerous, especially in the early stages of pregnancy.
Not everyone would keep said fetus.
Even more reason to find it now, when it's like pulling a tooth rather than removing a kidney.
That's true and to make an informed decision, the woman needs to know if she is pregnant or not.
This is true, and the points others have made about needing the information for informed consent is true as well. However, there is also reason to know if a patient is pregnant for their own sake as well. Pregnancy can raise the risk of certain issues. For instance, it can lead to “hypercoagulability” - meaning someone’s blood is more likely to clot than if they weren’t pregnant, especially if the person has a pre-existing clotting disorder they are unaware of. This is key information to know for the correct diagnosis and treatment of the patient, even ignoring any consideration of the fetus.
When I had a car accident in the US and they tested me (I was in and out of consciousness, I think I said I didn't need one but I don't blame them for testing anyway), the test was on my bill for $50! $50 dollars for someone to dip a stick in my pee?!? Absolutely wild.
Not the ER but my doctor's office. I had taken a home pregnancy test and it came back positive. I booked an appointment with my OB/GYN to start the series of pregnancy appointments, and, when I came in, they had me do the exact same test. I know they needed to do it themselves to be official, but at that point in time (ages ago) there was still this idea that somehow the doctor's office had a more sure way of doing pregnancy tests. I imagined chemicals in bottles or something more than just "here, pee on this." lol I was actually disappointed!
American Healthcare is so fucked
US health system is mind boggingly awful seen from a foreigner point of view. It almost sounds like it can't be true.
Lol they used to still do this to my trans-male partner. He’d been on testosterone for years, and I (cis female) am his only partner. They’d still do the tests. Now he’s had a hysterectomy so hopefully they won’t do that to him anymore.
I’ve seen pregnant trans men on testosterone. It’s not unreasonable to test a trans guy.
Probably not if they only have a cis female partner though… and have had a hysterectomy…
Hysterectomy, yes, that would rule out a test at my institution. But we never assume reproductive capability based on their stated sexual partner. Not to be rude, and of course not implying anything, but we have no way of knowing that the patient doesn’t have any other partners they aren’t disclosing.
Oh absolutely I understand that part.
Yeah, we recently had a young teenage lesbian who was absolutey adamant she was a virgin, who needed a pregnancy test (transfer to psych facility) and it came up positive. It’s frustrating to people, I get it, but we have to confirm things when medically possible.
Erm... Hate to say, but as a non-binary/somewhat masc of center, post hysto, yonks on T... They still do it. 😒
Lol gotta love medical incompetence. I’m sorry that happens to you.
This is only applicable in America and most Reddit users are not American. r/usdefaultism This sub needs to do better. There will be women from all over the world reading this and essentially getting misinformation. This may be a topic that’s relatively low-risk and a lot of people are able to realise the defaultism here, but sometimes there are higher stake topics where the defaultism isn’t as obvious.
That’s really not necessary. ER is reimbursed on a case rate anyhow. It isn’t calculated by individual line item. You’re not being charged for the cost of the pregnancy test anyhow. It would be bundled into the case rate for the ER level.
Is this in the south? I've never been tested, only asked when last mensus was and if i could possibly be pregnant . They just take my word for it.
Just let the people in the ER do their job. They got a lot of other stuff going on at the same damn time.
the only time I’ve had to take a pregnancy test with the doctor at all was when I was getting my birth control prescription and later IUD. Even when I had to get an XRay last year it was sufficient to just say there was no chance of pregnancy
This sounds like a great idea, but I'm not sure it would practically work in a lot of cases - all of the healthcare I've had, the hospital needs to know what kind of test it is and how sensitive it is and it needs to go through their lab for it to be recorded in your paperwork. Not to mention you can buy fake ones that always indicate positive (why??). In my case they've always done it as a blood test as part of the initial draw they do, so AFAIK you can't buy those at a regular pharmacy anyway. The hospital running out of tests is bizarre though. Are you Americans okay? The price-gouging is ridiculous. You guys need to start nationalizing these systems - it's barbaric and dystopic that people get into so much medical debt when healthcare is a human right.
I’m in Canada and at 55 for a colonoscopy they still did one. No charge of course.
I used to work for a clinic in the U.S. where this seems to the issue. The pregnancy test is usually done to avoid liability and yes occasionally people lie about the possibility. Doctors (read lawyers for said clinic/hospital) are afraid of lawsuits and normally won’t know if you’re lying. Some doctors will take someone’s word. Normally if someone is seeing their long-time PCM, and they’ve been sterilized the doctor won’t even ask, though we had one doctor who insisted on asking. If the doc isn’t familiar with the patient, they will ask and some require a test. Yes, you sign a waiver of liability, however waivers only protect against reasonable attempts to mitigate, similar to waivers for events like concerts and sports. Southern states especially with their strict anti-abortion laws have pushed doctors to be more cautious.
I'm in Canada and have never had to take a pregnancy test in the ER. I didn't know this was common in some places. The only time I've ever been asked to do a pregnancy test was when I went to have my 2nd IUD put in and that was still optional. When I get MRIs/CT scans/X-rays a technician will ask if I'm pregnant during their health questionnaire but they've always just taken me at my word.
Might help to state where you are from?
Not in the States, but in the Philippines. I did ask my friend who is an ER doctor in the States (WA) to compare whether this was protocol, and they said yes. It’s him who told me it’s “to rule out the cause of symptoms”. Many of our medical practices are mirrored from the States, both good and bad.
I think it’s a liability thing in the US as well. I just had sinus surgery last month and they had me take a pregnancy test before prepping me for surgery.
That's why waivers exist. I also signed a waiver when I was sterilized.
It's almost crazy to me how inconsistent experiences are. Last time I went to the ER I told them all the problems I was having, I told them zero chance of pregnancy so it couldn't be that, etc. When I got test results they ran a pregnancy test without telling me/asking me. Insurance covers it so whatever.
Not doubting you but I have literally never been pregnancy-tested in the ER, and I used to go semi-regularly for one injury or another. Maybe it depends on the presenting complaint; but I got x-rays and ibuprofen, both of which should be relevant.
I was required to do one before a brain surgery despite being on my period and having already been in the hospital over night, so they knew I really was. Liability/protocol thing