I had a friend of a friend be forced to take (and pay for! Thanks America!) A pregnancy test when she had to go to the ER, despite her telling them she physically couldn't get pregnant because she is trans, I swear in some cases it's like they just don't listen to patients at all đ
This happens to me all the time. I got sick of paying for it so i started throwing a huge fit every time they start in on that pregnancy test bullshit. If i say "ive had a total hysterectomy" and they still insist that "maybe you just dont quite understand, we HAVE to make sure youre not pregnant" i just start saying "HYSTERECTOMY. HYSTERECTOMY. HYSTERECTOMY." over and over until they give up. I used to be super super nice to medical professionals, but after 10 straight years of them fucking up my meds and insurance both on purpose and on accident, wasting my fucking grocery money, denying me treatment, and (on one occasion) using a medical exam as an in to sexually assault me, i give them exactly ONE chance. Past that, they deal with the mean bitch version of me
Edit: oh my god the well actuallys are so annoying. Yeah, you can have a pregnancy without a uterus. Would it surprise you to learn that ive actually had a total hysto and bilateral salpingooophorectomy and i say that every time and i have proof and they still dont care? It's not about the technicalities, its about valuing liability above human dignity and above the fact that people need money to eat and cant be wasting it on hospital liability that has no bearing on reality
There is something to this actually. With a total hysterectomy, your ovaries remain. (A radical hysterectomy is where they take everything). If the surgeon happens to fuck up removing and closing off the cervical area, you could potentially end up with an abdominal pregnancy. Of course the actual likelihood of that is infintesimal and I assume there would be other concerning signs before you end up pregnant.
Yeah the likelihood that the surgeon doing that removal left a piece of the ovary reduces that infintesimal number even further. My only thought is that it's required by the insurance company for anyone who was born with a uterus between 12-55 which is fucking stupid.
Oh, is 55 the cutoff? I went through menopause a few years ago at about 47 and I've been wondering why I keep having to take pregnancy tests, and if 80-year-old AFABs have to deal with this too. (Also haven't had that kind of sex in about 20 years (lesbian)...)
A total hysterectomy is where they remove the cervix as well. Subtotal they leave the cervix. If theyâre going to take other organs (tubes, ovaries) they start adding words like salpingectomy (tubes) and oopherectomy (ovaries) (or salpingoopherectomy for both).
Total as opposed to partial, where the cervix is left. The ovaries and tubes aren't technically the same organ, just part of the same system, so their removals get their own names.
a total hysterectomy does take totally everything, uterus and cervix. hysterectomy means âremove uterusâ essentially.
there are other words for removing the fallopian tubes and for removing ovaries.
I think people in here are thinking the hospital staff are just being dicks, but they are following protocols because not following them gets them fired and can cause them to lose their licenses.
Nobody is coming to the defense of an RN who chose to be kind to a patient and listen to them say they had a hysterectomy, only to later find out they either lied or didn't know what they were talking about (both things very common). Especially if preventable harm then gets done and the hospital gets sued.
And screaming "HYSTERECTOMY!" over and over and acting a toddler to someone on their 10th hour is a GREAT way to discover the utter depths of pettiness at the nursing station. If you find yourself wondering why it takes 2 hours to get a blanket or they talk to you like you're an ignoramus, it's because you're a bitch. And if you get admitted, expect to get the bed straps. (I know this very well because my mom likes to get mouthy and temperamental over stupid things, and I usually have to go play peacemaker.)
well if the surgeon fucks up removing and closing off the cervical area then you have a lot more issues than an abdominal pregnancy like intestines coming out through the vagina and such.
I've heard one case of a woman having a total hysterectomy, and then getting pregnant and giving birth to a healthy baby. Even infinitesimal things can happen occasionally.
If you have ovaries, pregnancy is possible. Yes. Even without a uterus. Yes. It has happened. Yes. Itâs very rare. No. We donât want to miss it. If youâve had your ovaries removed, it is impossible. If youâre without ovaries, then itâs a great idea not to be pregnancy tested. If you have ovaries, then yeah, we want one done just in case, because a cheap dipstick and a few drops of pee can tell us if we have a five alarm fire happening.
Edit: Jesus, youâd think Iâm asking for a pound of flesh.
Iâm also a woman and uninsured, for all the lovely people making assumptions.
And to everyone who called me a bitch and/or told me to die in DMs: you are why nurses are perpetually tired and on edge.
Beyond the impacts to the patient's mental well-being which are much better handled by the other comments with that experience, I want to approach this from a different angle.
because a cheap dipstick and a few drops of pee can tell us if we have a five alarm fire happening.
That is also part of the problem too.
I just checked the charge master for the hospital near me. A urine pregnancy test will be billed at almost $300 and the cash uninsured cost is $98.
So, this is not a cheap test for many people (especially since the rest of the visit is likely going to be extremely expensive already).
Yes. Itâs very rare. No. We donât want to miss it.
While on its own this sounds good, there is a reason they don't recommend a lot of tests proactively. There are risks associated with the test including turning off patients from seeking care at all. There is no recommendation for monthly MRIs looking for cancers, no one is suggesting every visit should include a prostate exam, and while colon cancer is a leading cause of death, the current recommendations for colonoscopies is every 10 years after age 45.
Maybe the risk that someone without a uterus may have an abdominal pregnancy with zero symptoms isn't worth the additional stress on the patient to push for testing unprompted.
Elaborating slightly: the pregnancy test requirements absolutely destroy all trust between the patient and the care team. All of it, gone and not coming back.
I came in with an acute issue, you immediately completely ignored that, refused to hear out my symptoms and insisted pivoted to an impossible issue, asked me a bunch of intrusive questions about the issue you made up in your head, and then told me I was probably lying about both the imaginary issue and the real one and you wouldnât even pretend to care about the real issue until I tested negative for the imaginary one.
The fuck am I supposed to trust someone who is explicitly operating on the assumption that I am lying every single time I open my mouth? The fuck is the point in saying anything? The fuck is the point in not just signing myself out to go suffer at home, since thereâs obviously no way for me to convince the doctors that I have symptoms at all?
(Yes. Impossible. Iâm a fucking virgin, and Iâm not Catholic. Ramble on about whatever infinitesimal odds of an ectopic pregnancy you like, there still needs to have been a dick involved somewhere.)
God damn. I've only been to the emergency room once in my adult life, so I hardly have much experience, but I was treated as a person who's opinions and answers to their questions mattered, and who got at least a perfunctory say in what was going on.
Being a cis man is apparently a golden ticket in the healthcare industry, and everyone else gets to ride in steerage where they amuse themselves by slapping you in the face and calling it medicine.
Specifically a white and reasonably well-groomed cis man.
And itâs not universal, but the likelihood of being treated like shit is going to be at best 30-40%, rising to between 80 and 90% the more urgent you feel about your issue. And knowing that is going to massively impact how you interact with all healthcare, even the areas that are generally good to you. Youâre going to do shit like decide not to get swabbed for strep because your throat hurts and you donât want to spent ten minutes answering the same three useless questions at the local urgent care. Thatâs why the usual pro-call-all-women-liars argument pisses me off. Treating patients like liars massively increases the likelihood that they will simply stop seeking care altogether. Leave the hospital and not come back no matter what their symptoms are.
But they leave that out of the statistics when they try to justify it. It doesnât sound like youâre providing me evidence-based healthcare, it sounds like youâre ignoring the vital evidence of my words. Itâs nothing but a very, very good way to teach a person that their words donât mean shit to healthcare workers, so why waste them and your money?
The medical field has had a lot of blatantly moronic ideas that persisted a lot longer than the 3.5 seconds youâd expect it to take to call bullshit. Someday, calling all women liars and demanding pregnancy tests on hysterectomy patients who arenât even in for abdominal symptoms is going to be looked on as badly as insisting that Black women canât feel pain.
When people come in with symptoms, especially A+E, the first job is to rule out common serious pathology. This is why there are general questions about bowels, periods, pregnancy, urination, diet ect. It makes certain diagnosis less likely especially the ones which needs immediate attention such as appendicitis or an ectopic pregnancy.
Which then brings us to why pregnancy tests are important. It's not a matter of trust in you as an individual, it's a matter of statistics and likelihoods of a cohort. The truth is, pregnancy possibility is one of the things patients routinely are inaccurate on reporting in A+E when they're stressed or in pain, there are many many cases where patients swear to god they can't be pregnant and it then turns out they are.
This leads to the problem. It's not that they don't specifically believe you as a person, it's just that statistics and past experience show that a patients word isn't infallible. Hence the pregnancy test, because a missed ectopic can kill you, and it's a straightforward low invasiveness test. If it's negative, the diagnostic process can move on with one serious potential cause ruled out.
To contrast this, let's say as part of the history they ask you how often are you opening your bowels, and you say 7 times a day. No doctor in their reasonable mind is going to say "nope don't trust you, best monitor and count the times you go to the bathroom to make sure". People don't lie about things like that (outside of very very niche cases), hence doctors can take everyone at face value.
I hope this helps explain why pregnancy tests aren't people not trusting you.
to my face. You talked over me and called me a liar and refused to touch anything until I had proven you wrong, but you still continue under the assumption that I was lying, it just happened, coincidentally, to be true.
I have heard this line of reasoning before. It has only gotten more idiotic and misogynistic with every tiresome repeat. Itâs just wrong.
You are not giving the best care possible, because you are making it more likely that I, and every other woman who doesnât like being called a liar, will simply give up and seek no care and go experience severe complications at home. That is not the best care. That should be the worst case scenario that you shit your pants over. The patient in front of you is your only patient, and treating that patient as secondary to your imaginary friend is not good care and never will be.
They didn't believed in your ability to correctly assess that, not that they specifically think you're lying nor that specifically YOU are lying.
People lie all the time, people lie to their medical providers, people mistakenly think they cannot get that and so on and so on. It's in their job not to take everything on a word.
Surprise pregnancy is a thing. If doctor would just believe someone because they said something on that, and they would die in result, would it be better than not believing? I doubt so.
Doctors, in the end, are more about not letting you die than about building trust through believing you fully no matter the risks of doing so.
Are doctors assured in patient's awareness enough to believe that they didn't mistaken medical procedures (Hysterectomy by itself doesn't include ovary removal and thus doesn't necessarily prevent pregnancy), or there was no medical error, or anything alongside the lines? Or are they also expected to fully research everything and then double check for every patient, using much more invasive procedures?
Why would doctor want to risk be sued just so the patient would "have more trust that doctor believes fully" or to risk patient's life for the same reason?
So how are they supposed to know that you, specifically, are not a liar, when the statistics show that a good percentage of patients (of either gender are) are? You're taking this unnecessarily personally. Do you also refuse to show your drivers licence when pulled over by the cops, because the police should take you at your word that you have a valid one? Do you think you can get a job without providing references because the employer should just trust you about your previous experience?
Also, every test has a false negative and false positive rate and doing thousands of unnecessary tests increases the likelihood of false results, which in this case potentially skews diagnoses away from what is really going on. Iâm not aware of exact specificity and sensitivity of pregnancy tests (probably varies by brand) but no tests are 100% on both.
I agree healthcare is way too expensive. We still should do upregs. We do a bunch of proactive testingâthe whole bloodwork battery we usually do for most ED visits is proactive, after all. We run MRIs for symptoms that donât line up neatly with anything. We sometimes nasal swab for a host of viruses even when the pt doesnât look very viral. These are all good data points to have to build a clinical picture.
âCheapâ, I have watched them stick a 99 cent pregnancy test into my urine then turn around and charge my insurance company $300 for it.
Iâve had a bilateral salpingectomy done, I donât have fallopian tubes. My eggs get absorbed into my body. They still insist even though last time I checked only 4 pregnancies have ever occurred after that surgery were from left over pieces of fallopian tube. My tubes were fully removed. Iâm going to start bringing my glossy hi res photos of my tubes post op that my surgeon gave me (since they had to send them to pathology which meant I couldnât keep them) with me to procedures so they maybe stop scamming my insurance company into paying hundreds of dollars for an unnecessary and very cheap test.
I might be butting in here, but many people have to pay full (negotiated) price on these tests until they hit their deductible. And even if insurance is covering 100% of the costs, we should still care if wasteful things are being done because it drives up the cost for everyone else and contributes to our horrible system.
That said, I know some patients lie and some are idiots and a lot of medical professionals are jaded (and a lot lie or are also idiots), so it's a complicated line to walk.
And that sucks and insurance is evil. But itâs not wasteful to do a fast and simple and noninvasive test that knocks out some possibilities, plural, for whatâs going on. I can see a good argument for not putting everyone in a full body MRI for cancer prevention, but the dipstick hcg is so deeply not a waste of anything.
Itâs literally a waste of $299. And my time. And the healthcare workers time. And I have bodily autonomy up until the point where Iâve given a healthcare worker a reason that I shouldnât for a time, and this isnât that time.
Isn't it possible for the health insurance to not cover the amount in full and then bill you for the difference? I'm sure it would end up being a line item among a million other things, but still.
Yes. Insurance is evil. The upreg is still a good idea. But if the argument is âthe hospitals are charging my insurance too muchâ, then, like, ok? I hate insurance companies! Fuck em!
Well it happening once is nbd. But when it happens thousands of times it raises costs (legitimately or Ă la snickering robber baron) for everyone else.
I agree insurance is evil, but I promise you even ten thousand pregnancy tests a day more would not result in a legitimate insurance rate spike. They are so unbelievably cheap. It is literally only greed that makes them expensive and thatâs a greed problem and not a problem with the test.
Yes. But the greed is a problem and it must be taken into account. I agree itâs dirt cheap to conduct the test⌠ideally but the greed is still a problem.
Not to mention time is a resource as well. Five minutes taking the test is five minutes better spent elsewhere.
Because we force people to take a lot of unnecessary tests, if you only view them after they result. We donât know itâs not necessary until it proves itâs not necessary.
If the argument is: it costs too much! I agree WHOLEHEARTEDLY, but thatâs a system problem and not one I can do anything about. If the argument is: I donât NEED it, you donât know that. Your doctor doesnât know that. I donât know that. Itâs a good idea to do a fast, simple, noninvasive test that narrows down our options for whatâs going on.
Having access to a toy in the hospital doesn't mean it has to be used.
The majority of all medical tests in the United States are wholly unnecessary and are known to be such from the jump. We also do entirely too much treatment of the monitor and not enough treatment of the patient.
I've been working in emergency medicine for 6 years, and I've seen it happen. I've taken patients having a blood sugar emergency to the ED with a blood sugar of 500, instead of giving my patient a bolus of insulin and discharging them the patient was given an unnecessary ($1500) MRI to make sure their symptoms entirely explainable by known medical history wasn't a stroke. Their symptoms weren't stroke-like in presentation either.
I'm sure it's just a coincidence that it was a Medicaid patient they wouldn't have been able to bill as much for otherwise.
Man, Iâll be real, Iâd be annoyed, but Iâll never be mad at a hospital wanting to do MORE tests rather than less. Iâve seen them discharge my mom and had to physically hold her up as she nearly collapsed in the parking lot because they didnât do the tests they needed to do to properly diagnose the infection she had
The sheer unbridled confidence of âitâs probably nothing seriousâ is great up until the one time youâre wrong
That's not what I'm talking about. Tests are necessary when they're indicated, your mom had indications for testing that were ignored (which is negligence). I'm talking about blanket policies to mandate additional testing for every single patient (and passing the costs off to the patients because this is America) simply so the hospital can avoid liability that doesn't actually exist if they give their staff livable working conditions.
Alright, fair, but there are like two or three nested and entangled problems here, and the one youâre talking about is a symptom of the others
The for-profit, private insurance healthcare system in America, and the working conditions for staff caused by that system, those are the root causes of the thing, and those are the ones Iâd complain about before I complained about the hospitalâs policy on blanket tests, yâknow?
And man, again, speaking purely from personal experience and how my brain works: even with the cost, Iâd rather have the needless test. But Iâm willing to accept thatâs a me thing
(Alternative joke post: a man who orders an MRI on every senior is a fool every day but one)
When you're a patient being denied necessary treatment to receive unnecessary tests they're the exact same thing. But I guess a dipstick like you would wanna advocate for other dipsticks.
my vaginal cuff healed extremely well and is completely sealed. no i will not be pissing in a cup for you especially for an outrageous expensive price plus my insurance wonât cover it due to me having had a hysterectomy.
if one day my cuff happens to magically rip itself open so that semen has gotten into to abdomen and met an egg, sure iâll piss in a cup for you. otherwise, not gonna happen and iâll laugh in your faces. iâve had enough experience being a patient as well as a healthcare professional in womenâs health specifically, i know how my own body works.
It happens. Very rare but you can get fistula formation from the fallopian tubes which can form a connection to the vagina, which then present as an ectopic pregnancy. I think there's only ever been a handful of cases though.
A bit more common in subtotal hysterectomies though still quite rare.
Essentially impossible in bilateral oophorectomies though, nothing to fertilize.
Basically the blanket rule is, abdominal pain in women of child bearing age? Rule out pregnancy even if the patient swears they can't be pregnant. You'd be surprised the number of times people say they can't be pregnant then it turns out they are.
Though in general I'd agree, it's a bit of a hard sell in the cases of a documented hysterectomy since there are few cases of ectopics in those circumstances. It's such a low impact test though so I don't know why you'd be bothered by it though I suppose if you're charged for it might be different.
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u/mysocksareinsideout MakeshiftEmery Jul 31 '26
I had a friend of a friend be forced to take (and pay for! Thanks America!) A pregnancy test when she had to go to the ER, despite her telling them she physically couldn't get pregnant because she is trans, I swear in some cases it's like they just don't listen to patients at all đ