WOMENS-HEALTH Messages for October, 1998: Re: Patients with previous elective abortion

Re: Patients with previous elective abortion

From: William D. McIntosh, MD (anonymous@obgyn.net)
Wed, 28 Oct 1998 20:14:13 -0600 (CST)

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At Wed, 28 Oct 1998, Marna wrote: >
>Dr. McIntosh-
>
>I understand the reasoning behind this, but can you tell us *why*? Can you
>give us an example of why this would be important.
>
>I like many women are not proud of the choices I have had to make, and I too
>have had comments made to me and to my partner about a previous termination
>of pregnancy.
>
>While I realize how important it is not to omit anything, it just makes it
>difficult, when a patient is felt they are discriminated against and treated
>differently for a choice they made.
>
>Thank you for your time.
>
>--
>Marna D. E. Gatlin
>Doula/SNMW
>

The first, and best, reason is that this is an extremely bad idea in principle. There are any number of factors in a medical history that might be embarrassing, but hiding them from your doctor is a bad idea. An abortion is just one of many.

Possible complications of an abortion that might effect a current pregnancy include Rh isoimmunization, intrauterine scarring from the D&C, cervical incompetence from the D&C, uterine perforation from the D&C, and so on. I realize that these are rare, but why tie one hand behind your doctor's back, so to speak?

I hope there is not any physician that would treat you differently due to any possible factor in a medical history. I am sure there are, but there is no reason that you have to go see them. If you have had an abortion, or an STD, or a psychiatric condition, I can sympathize with your desire to keep that reality private, but hamstringing your medical care is a bad alternative.

I once treated a patient of severe, abnormal bleeding. Despite everything I tried, we could not get her bleeding under control, and finally, I counseled her that surgery was necessary. The patient consented, the surgery was scheduled, the the day had arrived. The patient's mother was present in pre-op, and asked me if her daughter could take her medicine that night as usual. I was not aware that she was taking any medicine, so I was very concerned. It turned out that she was taking a medication for depression, she was ashamed, and so she hid it from me and from the anesthesiologist. One of the side effects of this medication is menstrual irregularities. No surgery was necessary, just a simple medication change.

The point is that she didn't know. Well, that's what she pays me for, to know things that she doesn't. It's my burden to put all the pieces together and create a treatment plan. It is the patient's burden to give me ALL the pieces, so that she gets the treatment she deserves.

-- William D. McIntosh, MD Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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