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This sort of thing has been common practice since long before Dobbs. And it is usually motivated by the doctor's fear of getting sued over birth defects, especially if there is an alternative prescription that is not known to be associated with birth defects. And there almost always is an alternative.
I'd love to see some kind of citation or a medical professional's opinion. this seems like bullshit but I'm willing to read supporting evidence if you have any.
if the patient isn't pregnant, tests not pregnant, and says they won't get pregnant, and if they happen to get pregnant, abort the fetus, what the fuck is your problem? this woman asserted all this to the medical 'professional' and was still treated like a child who needed someone else's permission to receive the treatment she needed.
Ever had a migraine?
Comparing it to Thalidomide? FUCK YOU. The drug company knew it had multiple issues with pregnancy and still put it out. Docs warned each other. This is not the same thing, but you're trying to scare people into thinking there's an equivalence. https://www.bmj.com/content/362/bmj.k3415
Lol imagine writing this
I am, indeed, in the US.
Yeah fuck toxic masculinity. That has nothing to do with being a man. Toxic masculinity isn't manhood, it's the cultural distortion caused by generations of males trying to wear the costume of being a man, while being fragile themselves.
ah it's always that way huh? dirty patients lying to their docs?
get fucked.
hopefully you get a migraine this weekend to remind you to be humane to others.
Another poster already mentioned the issue with Depakote, aka valproate:
valproate should be avoided, if possible, in women of childbearing potential because of teratogenicity
See also:
In 2018, the European Medicines Agency introduced new restrictions on the use of valproate in girls and women of childbearing potential to avoid exposure during pregnancy
And yes, valproate is also used to treat cluster headaches, so it could easily be the drug that the woman in the article can't obtain.
so if anything can go wrong it shouldn't be prescribed?
Tell that to the millions of men who have high blood pressure but pop viagra all the time. Women get a double standard of treatment and it's bullshit. This woman didn't want children and affirmed she would seek an abortion if she became pregnant despite birth control. Docs still put her through this garbage.
Viagra is pretty safe, as drugs go. Are you thinking of Vioxx? That stuff was taken off the market.
taking viagra with a heart condition is dangerous. but these dr's apply two sets of rules, one for potential breeding stock and one for the rest of humanity. people are not breeding cattle, these docs need to stay in their fucking lanes and practice medicine, stop injecting their religious opinions onto patients healthcare.
Most people who take Viagra have hypertension, because hypertension is the main cause of ED. That doesn't mean Viagra is dangerous, but you shouldn't combine it with certain other drugs.
There is a world of difference between valproate and Viagra. Valproate causes birth defects and cognitive delay in 30-50% of pregnancies, which is astonishingly high. If Viagra caused permanent harm to even 5% of users, it would already be off the market.
so patients should be allowed to use drugs even if there are risks involved.
huh, it's almost like you're asserting that people should have agency. like the woman in the article, except her docs decided for her that even though she wasn't going to have a baby either way, so no risk to pregnancy, they wouldn't put her on that med because...? it's disgusting.
If you go to a doctor and demand a course of antibiotics for a viral infection, they have been trained to refuse. Because antibiotics do not treat viruses.
For that matter, if you actually do have a simple bacterial infection and immediately demand a last-resort antibiotic like vancomycin, doctors have been trained to refuse. Vancomycin may work on you, but using it may create bacterial resistant strains that will put others at risk. Resistance is especially a threat if you don't complete your course of antibiotics.
So doctors will offer you a different antibiotic instead, with less risk of creating a resistant strain. Even if you promise to complete your antibiotics, "you get what you get so don't get upset".
People have agency, but so do doctors. Doctors are not supposed to be dispensaries who simply give patients whatever they ask for. Doctors have the right to refuse to provide a prescription that is not in keeping with the standard of care, and offer a different prescription instead. You have the right to find a different doctor, or not see a doctor at all.
High blood pressure. Viagra can lower your blood pressure. If you’re taking medication to treat high blood pressure, taking Viagra could cause your blood pressure to drop even further. In some cases, this could make you feel dizzy or lightheaded or cause you to faint. And if you have high blood pressure that’s not controlled (measuring higher than 170/110 mmHg), your heart may not be healthy enough for sex. If you have high blood pressure, talk with your doctor about whether Viagra is right for you. If you’re able to take Viagra, your doctor will usually prescribe a dosage for you that’s lower than the typical dosage.
Oh and this one: Potential for cardiac risk with sexual activity in patients with preexisting cardiovascular disease; therefore, treatment for erectile dysfunction generally should not be instituted in men for whom sexual activity is inadvisable because of their underlying cardiovascular status.
Yup. Common practive with anti-epileptics - some have worse implications for babies than others which is why those said others are used first.
I just noticed this in the article:
Nearly all hospitals have long required pregnancy tests for some things, like getting a CT scan (which involves radiation exposure). And if the test is positive, the doctor is supposed to consider alternatives.
You cut the quote off, that's just part of what was said. That quote in full doesn't just talk about a pregnancy test, but that on top of and as well as sterilisation, before being allowed to take a necessary drug.
Exactly. It's not a "where do we draw the line" thing here, the line is already drawn as you allude to. It's not just CT scans as well, some actual medications need pregnancy tests or at least active contraception use. Roaccutane, methotrexate and other DMARDs etc - everything in medicine is a risk vs reward thing and I'm sure many patient would prefer not to be on a drug that messes up their fetus whether they're planning to keep it or not in the case they get pregnant. You'd rather just avoid the risk of that situation occuring altogether.
What birth defects would there be in this case?
I don't know, because the medication in question hasn't been identified.
But in general, if a medication causes any birth defects (or, more often, miscarriages) in lab animals then it won't be used at the equivalent dose in pregnant patients. It would be unethical to try to find out what it does to a human fetus.
that is not the case here at all. READ THE GODDAMN ARTICLE. SHE WASN'T EVEN PREGNANT.
But she could become pregnant while taking the medication, which would likely lead to birth defects. Why are you struggling to understand this so badly?
even though she said she'd abort if she did, and was not attempting to get pregnant, and may have been on birth control?
It's not a danger to the baby if you're already committed NOT TO HAVE A KID. what part of this are YOU struggling with so badly?
Do you think we should ban women from extreme sports once they reach child bearing age? After all, it'll put a hypothetical foetus at risk, right?
This is such a faulty line of reasoning as to be laughable. The doctor didn't offer contraception or an alternative medicine as the WHO gives guidance on, instead he made inappropriate enquiries about her sex life and the quality of her partner.
Pragmatism is giving a patient all the information they need to make a decision, not gatekeeping access to meds because you can't view women as anything other than a foetus factory.
So the woman was pregnant?
From the text in the original post, I assume she was not.
She's not pregnant, but doctors try to avoid long-term prescription of teratogenic drugs to patients who might become pregnant while taking them.
Which is super not ok. You get that, right?
No, I don't get that. If a drug might result in birth defects, it should only be used as a last resort. And that's not just me or some random NY docs saying it, it's the WHO and European Medicines Agency
Do you see the problematic thinking in that line of thinking, though? You are saying a woman can't be trusted to use a medication if it might cause a birth defect. She can't be trusted not to fall pregnant, she can't be trusted to think for herself. She can't be trusted to keep up with birth control. She can't be trusted when she says she doesn't want kids ever. What the first consideration is for, is the *possible child, foremost. Not the person, the actual patient. And you're quoting American healthcare?
I'm quoting the World Health Organization and a European agency, neither are American health care.
This is a universal approach taken by health care in the US, EU, and across the world. Doctors in general are pragmatists, and only concerned with outcomes. Which means acknowledging that no matter how often patients say "Trust me", they know a certain number will have a bad outcome. The doctor's job is to reduce that number.
It's the same reason why doctors increasingly urge their patients to not keep firearms at home. Even when the patient says they can be trusted with a firearm. It's not a matter of trust, it's a matter of statistics.
Firearms and medication aren't even slightly in the same ballpark. What you are arguing for is that all women of child baring age should never be allowed to mitigate their own risks. And the *potential possible for a fetus, has more consideration that the actual person. If you want to talk firearms. Firearms aren't banned outright. This drug has been completely and utterly denied to a person because of the *potential to crate another human. So if you compare that to firearms, that's like saying only women can't be trusted with firearms, even if they have safe measures to keep them at home. Like a gun safe. I live in Australia, we have guns here, I can go and buy a gun, and there's safety measures I have to abide by. That's not what's happening here. That's not what you're arguing. It's problematic to assume that one gender is incapable of mitigating risks, at all. She can prevent herself getting pregnant while on the drug and says she's child free, never wants kids. The potential for that to fail is still held in higher regard than the actual harm be caused an actual person, not an imaginary person that doesn't exist (if you want to call a cluster of cells a person, spoiler it's not). This would be like you going to the doctors and the doctor won't give you medication to relieve agonising pain to the extent it commonly causes suicidality, and the doctor says, no you just have to suffer in this pain when nothing else is helping, because you might cause a pregnancy in a woman, and you tell he doctor you promise to use protection and that you're gay and don't even sleep with women, and he still doesn't care, because the potential for damage to someone who doesn't even exist is more important than you and your actual lived existence. There is a medical rule that has caused people who it applies to harm, and those people are speaking out. You aren't able to imagine or consider their situation. This is an issue in the USA. So using medical advice from other sources doesn't really apply. This is happening because of the medical issues in that region specifically, the banning of essential health care for women, which is having huge roll on effects.
Doctors are expected to mitigate risks, too. Valproate-induced spina bifida is a real problem, and doctors share a responsibility to prevent it when it won't harm their patients. They share this responsibility because they previously tried making patients entirely responsible for mitigating their risk, and that approach has failed.
Nobody said the woman in the article "has to suffer". They didn't refuse to give her any medicine, they refused to give her a particular medicine. There are plenty of alternatives, and in fact the doctor in this article wrote the woman a prescription for a different medicine. But of course, some people only want what they can't have.
Despite what patients often think, doctors are not drug dispensaries. It's not their job - and never has been - to give patients the latest drug they read about online, or the drug that worked for their friend, or the drug that someone said "ask your doctor" about. If there is a less risky drug that can treat the patient, they will prescribe that instead of what the patient wants.
To take another example, vancomycin is an antibiotic of last resort. Bacteria have not yet developed widespread resistance to it, so it is reserved for patients who have antibiotic-resistant infections, like MRSA. If it is used too much, theoretically bacteria can finally develop resistance to it. And theoretically, people in the future with MRSA may suffer.
Next time you get antibiotics, try telling your doctor "No, I want a vancomycin prescription". You will be disappointed. They are going to give you what they think will get the job done without incurring unnecessary risks, for you or other people.
It is okay if there is a non teratogenic alternative that treats the targeted disease. Why risk teratogenicity when you can altogether avoid it?
You are assuming a few things, you're assuming she hasn't tried anything else and jumped straight to the deep end. And you're assuming that it's ok to say to one group of people they're incapable of mitigating risks for themselves, and need that to be decided for them. Taking away their autonomy entirely. She's been to many doctors. She's tried everything already. This causes people to feel suicidal because of the levels of pain on a frequent basis. And she's told she just has to live with the pain, her pain is inconsequential in comparison to an imaginary non existent person.
I don't think so. But if a med is not to be used in pregnant patients, then it's only used as a last resort for patients who could become pregnant while taking it.
Again, this is not about religious beliefs, it's standard CYA for health care providers.
In the case of valproate, there are even European regulations against using it in women during childbearing years.
NOT IN THE ARTICLE. not sure what bullshit this thread's asserting