So, you need to make your first OB/GYN appointment. You are undoubtedly a little nervous and your head is probably spinning with lots of questions. This is completely normal. Going to the doctor for such personal and intimate needs as your reproductive health can feel awkward and overwhelming, especially when you don’t know what to expect or where to even start. To help you get started, I have outlined a few key things everyone should know before her first appointment.
Making the appointment
You know you need to go to an OB/GYN but you aren’t sure where to even start.
If you are able to use insurance and parental consent is not an issue, you can call your family doctor. Your family doctor may be able to perform the exam or recommend the right person for you to see.
If you can’t use insurance or don’t want to tell your parents – don’t worry, you have options! All teens in Texas can consent to STI or pregnancy tests without telling their parents. In addition, any teen in Texas can get confidential birth control and reproductive health care at a Title X clinic without having to get parental consent. Title X clinics also provide reproductive health care at a reduced or no-cost rate depending on your individual income. A common family planning clinic is Planned Parenthood, but not all Planned Parenthoods can see you without parental consent. Visit this link to find a list of Title X clinics near you. If you are already on Medicaid, you should be able to receive birth control and reproductive health care without parental consent wherever you go. However, to be sure I would recommend calling a Title X clinic.
No matter who you call, you should be able to request to see a male or female doctor depending on what makes you feel most comfortable.
Bring a friend or go alone
Now that you have your appointment, who should you take with you or should you go alone? The choice of bringing someone with you is completely up to you. You can bring someone and ask them to stay in the waiting area, ask them to come to the exam area, or go by yourself. For my first appointment, my two best friends were there for me in the waiting area. And it was comforting knowing they were there to support me.
Remember the first day of your last period
You can always expect that the nurse or doctor will ask you for the first day of your last period, how often you have them, and about how long they last. If, like me, you aren’t the best record keeper, ask to look at a calendar to jog your memory. You can also start using a period tracker app to help you keep track. They also may ask you a lot of questions about your sexual history, such as have you had sex with men, women, or both, do you use birth control, and do you experience bleeding or pain during sex.
These questions may feel overly personal but remember they aren’t asking to judge. It is their job to get the best sense of your medical history to offer you the best care possible. If you identify as transgender or non-binary, you can ask the doctor to use anatomical language that makes you feel most comfortable.
Most information is kept private
HIPAA is a federal law that protects patient confidentiality. Dr. Veronica Ades, MD, MPH, and Assistant Professor of Obstetrics and Gynecology at the NYU School of Medicine, explains “that means that doctors cannot release protected health information to anyone other than the patient without the patient’s permission. However, it’s important to know that this may be a little different for minors, whose parents may have access to their medical information.” Dr. Ades advises teens worried about their privacy to ask what will be kept confidential when they call to make the appointment, and again with the nurse or doctor at the start of the appointment. “Ask whether their records will be shared with their parents or kept private. Even if the medical record isn’t shared, the bills may go to the parent’s house if the child is on the parent’s insurance, so it’s important to think about all of this in advance,” recommends Dr. Ades.
You can call the insurance company to ask about their privacy policies and you can also contact your local Planned Parenthood clinic or any Title X to ask about free or low-cost services they offer to avoid using insurance.
Your appointment may include physical exams
Some visits, like some STI tests or birth control consultations, may not require any physical exam. But if you are having a pelvic exam or a pap smear, this is how to prepare. Before the exam, the nurse will ask you to take off your clothing including your underwear and put on a hospital gown or robe. They will give you privacy when you change. Once you are changed, the doctor will return to the room and begin the physical exams, which could include a breast exam, a pap smear, and a pelvic exam. The doctor may check your ears, throat, and neck and perform a breast exam. During the breast exam, the doctor will lift one side of your robe and gently press your breast in a circular motion to check for small lumps or abnormalities. The doctor may ask if you perform your own monthly breast exam. Monthly self breast exams are a good habit to start and you can ask her to explain how to do the breast exam if you don’t know how.
The doctor will then ask you to put your feet on the metal stirrups to begin the pap smear and pelvic exams. A pelvic exam is the term used to describe the part of your appointment that includes physically examining your reproductive organs. To do this, she may use a tool called a speculum to open the walls of the vagina. You may have heard that this tool is cold but often doctors try to make it more comfortable by running warm water over it before using it. The speculum enables the doctor to see your cervix and perform the pap smear. The pap smear is the exam the doctor performs by rubbing your cervix with a long cotton swab to collect cells used to test for abnormalities and screen for pre-cancerous or cancerous indicators.
As part of the pelvic exam, your doctor will also place two of her fingers inside your vagina and press your stomach to check your internal organs to ensure you’re healthy. You may feel a little pressure and pinching during the exam but overall it is only mildly uncomfortable. Speak up if you feel any pain, since this shouldn’t hurt.
Ask as many questions as you need to
This is your time with the doctor or nurse and you are completely expected to ask as many questions as you need to. A great tip for not forgetting something important is to write down all the questions you have before your appointment and bring that list with you to share with your doctor. Also, remember the doctor won’t be surprised if you don’t know a medical term. If you are confused by anything the doctor tells you or if you don’t understand a term or phrase, ask them to explain it to you.
A Pap Smear is not the same as an STD test
A common misconception is that if you have had a pelvic exam and pap smear you have been tested for STDs. A pap smear is not a full STD test and you have to request to be screened for STDs. In my experience, the nurse or doctor will ask if you want to include these screenings. If an STD test is something you want done, be sure you ask if you aren’t prompted to do so. No matter what clinic you go to, minors in Texas can consent to STD testing without parental consent.
Your first OB/GYN appointment is the right step in beginning a lifetime of healthy habits. I won’t lie, you won’t look forward to it every year, but taking charge of your health will help you lead a happy, healthy life.
