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Really?! You have to look? Well check question.


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Our kids have had immunizations at the doctor's office, at a health clinic and at a county health department. They've never had to have exams first--let alone full body exams. So, no; not normal. Weird, if you ask me. :glare:

 

I've never heard of a child [girl] having to have a gynecological exam, except to look for signs of sexual abuse or having to do with illnesses/diseases specific to that area of the body. It isn't par for the course for a normal doctor's visit.

Edited by Abigail4476
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I actually tried to schedule a full exam for my daughter last year around her 16th birthday because that was when my mother took me to the gynecologist for the first time. I assumed it was a good thing to do. I was told that it was unnecessary unless she was sexually active or experiencing problems, so we skipped it. I'm still shocked that a pediatrician would suggest this. :001_huh:

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Quote from medscape:

 

"In older females, the focus of the examination is to evaluate the cervix and internal genital structures but with the prepubertal female, the external visualization of the genitalia can diagnose the majority of the problems that will be discussed later in this chapter. Rarely is there a need to perform an internal examination unless specific problems such as vaginal bleeding, recurrent or unresponsive vaginal discharge, suspected foreign body, or suspected vaginal tumor require further evaluation. The preferred means to evaluate these problems is to do an examination under anesthesia using a fiberoptic vaginoscope, hysteroscope, pediatric cystoscope, or endoscope with irrigating properties."

 

I would consider calling your county health department and asking them about the normalcy of such a request.

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Is it normal for a pediatrician to *require* a full body exam (if you know what I mean) on a child before they will give immunizations? I just can't imagine a 9 or 11 year old girl practically in stirrups for a well check. Tell me this isn't normal with all docs please! I was told by a pediatrician that they will NOT give immunizations otherwise. :ohmy:

 

I'd be looking for another pediatrician.

 

That sounds VERY odd to me!

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Our most recent pediatrician does look at my children "from head to toe". At first, I was kind of surprised by that, but since it didn't seem to phase either of them, I let it go. Nothing internal, just a quick check. I wasn't sure why she was doing it, but now I believe it is to determine which stage of puberty they are in. If it had bothered either of them, I would have refused the exam but I can't imagine their doctor would have refused to give immunizations. Actually, I can't imagine a pediatrician refusing to give immunizations but that's for another thread.

 

Lisa

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Is it normal for a pediatrician to *require* a full body exam (if you know what I mean) on a child before they will give immunizations? I just can't imagine a 9 or 11 year old girl practically in stirrups for a well check. Tell me this isn't normal with all docs please! I was told by a pediatrician that they will NOT give immunizations otherwise. :ohmy:

 

I don't know what you mean. An "internal exam" wouldn't be "practically in the stirrups", they would be in them. A glance for an imperforate hymen in someone approaching the age of menarche isn't so odd.

 

Require is odd. Either odd in the head or terrified of lawsuits/censure. Perhaps this doc didn't report sexual abuse he didn't pick up from the behavior, and he is terrified of getting in trouble again. Our state disciplinary board has had its troubles, including taking a disgruntled employee's word on things. Once they get your scent, they are all over you for years and years.

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Is it normal for a pediatrician to *require* a full body exam (if you know what I mean) on a child before they will give immunizations? I just can't imagine a 9 or 11 year old girl practically in stirrups for a well check. Tell me this isn't normal with all docs please! I was told by a pediatrician that they will NOT give immunizations otherwise. :ohmy:

 

I don't know what you mean. An "internal exam" wouldn't be "practically in the stirrups", they would be in them. A glance for an imperforate hymen in someone approaching the age of menarche isn't so odd.

 

 

 

There are clinics that do immunizations, but it is fairly standard for both adults and children to have a well check up if you are signing on to a full service pediatric clinic. It even has a billing code, new patient exam.

 

The clinic my children go to, only sees their patients. If someone just called because their child had an ear ache or needed an immunization, they would not see them.

 

When we moved here and signed on at the clinic my son's first appointment was a full well child exam. It is also included about a 20 min. chat with the doctor about my son's medical history. The plus side, is my kids doctor knows who they are. If we call with a problem, they have the chart...but they also know us.

 

My best friend on the other hand has never had her kids signed up with a pediatrician. She goes to urgent care, immunization clinics. It is just what she does. I like the continuos care from someone who knows my kid.

 

So, internal exam, run screaming. A full well child exam to sign on with a new pediatrician, standard. If they want to check under the underwear, ask why. If you are not comfortable with the answer you say no to that part.

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Ours does a quick glance-over and uses it as a moment to teach about private parts. So during the exam, after feeling the belly, she'll say something like "I need to look in your pants to make sure everything is ok with your private parts. But first I have to ask you and your mom if it's ok." She then turns and asks each of us. My kids have never minded, so far. If they declined (or seemed like they wanted to) I'd see if I could get a minute alone to talk about it with my kid, but would never force the issue. After all, that's what we're trying to teach them: that receiving permission is essential.

 

Your post brought up something else for me too. At some point, we're not going to know whether or not our children are choosing to be sexually active, and to what extent, especially not if I let her know I strongly disagree with that decision. She's only 9 right now, but I'm already trying to point to her pediatrician as a good source of information (as in: "I'm not sure about the answer to that honey, but let's ask at your next check-up") and have found her very helpful with that. At some point, I imagine my dd might like some privacy during those visits, but then what if she does talk about being active and needs an internal exam? I would want to know about it, for sure!

 

This is such a big part of why I'm terrified of my daughter becoming a teenager!

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Ours does a quick glance-over and uses it as a moment to teach about private parts. So during the exam, after feeling the belly, she'll say something like "I need to look in your pants to make sure everything is ok with your private parts. But first I have to ask you and your mom if it's ok." She then turns and asks each of us. My kids have never minded, so far. If they declined (or seemed like they wanted to) I'd see if I could get a minute alone to talk about it with my kid, but would never force the issue. After all, that's what we're trying to teach them: that receiving permission is essential.

 

Your post brought up something else for me too. At some point, we're not going to know whether or not our children are choosing to be sexually active, and to what extent, especially not if I let her know I strongly disagree with that decision. She's only 9 right now, but I'm already trying to point to her pediatrician as a good source of information (as in: "I'm not sure about the answer to that honey, but let's ask at your next check-up") and have found her very helpful with that. At some point, I imagine my dd might like some privacy during those visits, but then what if she does talk about being active and needs an internal exam? I would want to know about it, for sure!

 

This is such a big part of why I'm terrified of my daughter becoming a teenager!

 

 

Exactly what our ped does. At this last visit he asked he she would like to switch to a female dr for next visit. She gave an emphatic yes. Completely oblivious me hadn't even thought of that :001_huh:

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Ours does a quick glance-over and uses it as a moment to teach about private parts. So during the exam, after feeling the belly, she'll say something like "I need to look in your pants to make sure everything is ok with your private parts. But first I have to ask you and your mom if it's ok." She then turns and asks each of us. My kids have never minded, so far. If they declined (or seemed like they wanted to) I'd see if I could get a minute alone to talk about it with my kid, but would never force the issue. After all, that's what we're trying to teach them: that receiving permission is essential.

 

Our pediatrician has always done the above for every well child visit from birth. I consider it part of the annual physical. If it was an internal examination, yes, I would wonder at its purpose, but if it was an external look, I wouldn't think anything of it.

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Our pediatrician has always done the above for every well child visit from birth. I consider it part of the annual physical. If it was an internal examination, yes, I would wonder at its purpose, but if it was an external look, I wouldn't think anything of it.

 

:iagree: There's a big, BIG difference between a pelvic exam and an external check of the genitals. An internal exam isn't necessary unless the child is having problems or is sexually active, but our pediatrician always takes a peek in the underpants during a well child visit.

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:iagree: There's a big, BIG difference between a pelvic exam and an external check of the genitals. An internal exam isn't necessary unless the child is having problems or is sexually active, but our pediatrician always takes a peek in the underpants during a well child visit.

 

 

My ped's have always done a quick external look after asking my permission and my child's permission on both my sons and daughters. Nothing internal, just a quick look to make sure everything FROM THE OUTSIDE looks good.

 

My ped also told me that my daughter, now 16, does not need an internal exam unless she was sexually active or having issues with her period. If she needed one she would send her to a gynecologist, not do it herself in the ped's office.

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Is it normal for a pediatrician to *require* a full body exam (if you know what I mean) on a child before they will give immunizations? I just can't imagine a 9 or 11 year old girl practically in stirrups for a well check. Tell me this isn't normal with all docs please! I was told by a pediatrician that they will NOT give immunizations otherwise. :ohmy:

Yeah, that would happen over my dead body. :boxing_smiley:

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Is it normal for a pediatrician to *require* a full body exam (if you know what I mean) on a child before they will give immunizations? I just can't imagine a 9 or 11 year old girl practically in stirrups for a well check. Tell me this isn't normal with all docs please! I was told by a pediatrician that they will NOT give immunizations otherwise. :ohmy:

 

No, you're being really vague and I don't know what you mean. Why speak in codes instead of just plainly communicating what you're trying to say?

 

Are you talking about a head to toe once over- listen to the heart and lungs, glance in the underpants, etc? Or are you talking about a pelvic exam?

 

Head to toe? Normal practice, IME. Pelvic exam? No way and I have a hard time imagining any pediatrician suggesting one on a 9-11 year old girl unless the child was having a specific gynecological issue that needed addressed .

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Another thought: If nothing else, I would hope that a doctor would give a child a yearly head to toe just to watch out for suspicious moles or other indicators of a possible skin cancer. I say this as someone who, as a teenager, had to have numerous precancerous moles removed including one on my labia. I was mortified, of course, but glad that it was caught early. As a matter of fact, my 4 year old daughter has a check-up next week and I'm going to insist on a quick head to toe on her just to make sure a couple of moles and birthmarks that she has are okay.

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An internal or external exam? What is a "full" exam?

 

Our pediatrician does look at the kids' entire bodies when we bring them in, yes. Skin cancer rates in kids are rising too. :(

 

He's also looking for any weird bruising, or puckering, or whatever of the skin. It's our largest organ. :D

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My kids' pediatrician's office won't schedule immunization appts, apparently, if the kid is overdue for a checkup, which normally includes a brief external exam of genitalia but not a pelvic exam. However to actually see a female's genitalia, one does need to touch and open things up a bit, not just quickly glance at the outer regions.

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Our most recent pediatrician does look at my children "from head to toe". At first, I was kind of surprised by that, but since it didn't seem to phase either of them, I let it go. Nothing internal, just a quick check. I wasn't sure why she was doing it, but now I believe it is to determine which stage of puberty they are in. If it had bothered either of them, I would have refused the exam but I can't imagine their doctor would have refused to give immunizations. Actually, I can't imagine a pediatrician refusing to give immunizations but that's for another thread.

 

Lisa

 

Yes, it is this. There is NO internal exam done to young girls in a peds office, unless there is a specific problem. It is an external check. And yes, in the peds office I worked it, patients could not come in for vaccines unless they had had a well-check sometime during the previous year. If you just want vaccines...that's what the health department is for.

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My DD's ped does the quick head to toe, including in the underpants check, and always asks permission. I'm guessing that at some point, DD will want me to start leaving the room during exams, and one reason why I picked a female pediatrician for her is that I want her to feel comfortable talking to her doctor as a teen.

 

Having said that, there is a perinatologist at the high-risk pregnancy clinic that I used in my pregnancy with DD who's practice is focused on teen and PRE-TEEN girls. There's nothing like sitting in the waiting room for your biophysical profile with an 11 yr old, her mother, and the planned adoptive mother of her baby. And I assume she would do full pelvic exams on her patients.

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No, you're being really vague and I don't know what you mean. Why speak in codes instead of just plainly communicating what you're trying to say?

 

Yeah. People in the thread jumped to the conclusion that this meant a full gyn. exam, which does seem a little weird. But I'm not sure what the OP meant.

 

As for "requiring" it being fishy - if it's a private practice, they can set their own requirements for vaccinations. Our ped. won't do them if the kids are slightly under the weather, though they'll do the well check. I'm guessing that if you got a vax from the health dept. they wouldn't ask if your kid had a cold.

 

:iagree: There's a big, BIG difference between a pelvic exam and an external check of the genitals. An internal exam isn't necessary unless the child is having problems or is sexually active, but our pediatrician always takes a peek in the underpants during a well child visit.

 

Yep. That's what our ped does too - for my boys that is. And thank goodness she does a look because one of my boys turned out to have a hernia he needed an operation for at one point.

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As much as I tend to want my kids to have their privacy, their genitalia needs to be healthy too, so, just like I want their ears and throat to be checked periodically, yes, I do think it's appropriate to check at least with younger kids. Maybe at some point a kid is old enough to know if there is a problem, but I am not sure a 4 year old does. It's easy for things to go unrecognized once a kid is toilet trained and a parent stops seeing the child naked many times a day.

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I did ask the pediatrician exactly what he meant and he said girls have to lay with only a gown on the table with their knees bent so he could spread them open to look. Not an internal exam but I just can't imagine a male Dr. touching my daughter down their at every well check. The ped. before didn't do this so it took me by surprise is all. I can see now that this is normal for some pediatrician well checks. I will not be going there. I tried to be discrete in my original post because of the nature of the topic. Thanks for all the replies....

 

Our doc has always done that during dd's yearly visit. Of course, she's still young. But it is a part of the body, and things can just as easily go wrong there as anywhere else. I wouldn't want my dd not to have a full exam just because it's somehow inappropriate. It's extremely quick, takes a split second for them to make sure everything is normal. If it bothers you, just find a female ped.

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I did ask the pediatrician exactly what he meant and he said girls have to lay with only a gown on the table with their knees bent so he could spread them open to look. Not an internal exam but I just can't imagine a male Dr. touching my daughter down their at every well check. The ped. before didn't do this so it took me by surprise is all. I can see now that this is normal for some pediatrician well checks. I will not be going there. I tried to be discrete in my original post because of the nature of the topic. Thanks for all the replies....

 

That is totally normal. They check for things like labial fusion. Perhaps you would like a female doctor better.

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I did ask the pediatrician exactly what he meant and he said girls have to lay with only a gown on the table with their knees bent so he could spread them open to look. Not an internal exam but I just can't imagine a male Dr. touching my daughter down their at every well check. The ped. before didn't do this so it took me by surprise is all. I can see now that this is normal for some pediatrician well checks. I will not be going there. I tried to be discrete in my original post because of the nature of the topic. Thanks for all the replies....

 

Before I got to this update, it occured to me that the issue isn't with "exam before shots" but that, in accepting a new pediatric patient, the Dr. feels it should be policy to have a full exam.

 

I can totally understand that.

 

OP, the "code" and "vague" in the OP and the level of anxiety about this issue is heavy. I'd support you in finding a way to get more comfortable with the topics related to intimacy and reproduction and biology. Children are *more* protected from sexual violence when the topic is discussed and a comfortable, expected part of family life.

 

The assumption of "something wrong" or "something fishy" in this thread is over the top.

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Before I got to this update, it occured to me that the issue isn't with "exam before shots" but that, in accepting a new pediatric patient, the Dr. feels it should be policy to have a full exam.

 

I can totally understand that.

 

OP, the "code" and "vague" in the OP and the level of anxiety about this issue is heavy. I'd support you in finding a way to get more comfortable with the topics related to intimacy and reproduction and biology. Children are *more* protected from sexual violence when the topic is discussed and a comfortable, expected part of family life.

 

The assumption of "something wrong" or "something fishy" in this thread is over the top.

 

I totally agree. The OP sounds like she is really uncomfortable with anything having to do with sexual organs and that will certainly make an impression on her daughter.

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I totally agree. The OP sounds like she is really uncomfortable with anything having to do with sexual organs and that will certainly make an impression on her daughter.

 

I think your post was really unnecessary Sheldon. It's amazing how some people always seem to turn threads ugly! We can move on now. Thanks everyone who left a kind reply.

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I think your post was really unnecessary Sheldon. It's amazing how some people always seem to turn threads ugly! We can move on now. Thanks everyone who left a kind reply.

 

 

I am sorry you view it as ugly. It was not intended to be mean spirited. The fact is that the original post and the follow up post has the hallmarks of someone that is very uncomfortable with reproductive body parts. Denying a full external physical to a child because the mom is uncomfortable will most certainly stick with that child later in life.

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