this post was submitted on 16 Aug 2025
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She needs to make an informed choice. SHE. So tell her the scan (and perhaps some other aspects of treatment, like medication/anesthesia) has risks to a fetus and ask if she could be pregnant, even offer a test if there's a possibility.
And make sure that question is asked and answered in private!
But her cycle timing is not necessarily relevant. It's highly unlikely to get pregnant during your period, but possible since your ovaries alternate and can be out of sync. Meanwhile, someone who hasn't had sperm anywhere near her in six months isn't gonna be pregnant even if it's been three since her LMP.
What would you do if she were unconscious, refuse to treat in case it might harm a hypothetical fetus? You might say that's ridiculous but it's happening in 6-week ban states now. And when women are pregnant and miscarrying they've died of sepsis because there was still a fetal heartbeat.
Everything you said is accurate, with one caveat: patients are often ignorant about the mechanics of pregnancy. Reproductive health education is shockingly insufficient among the population. "Could you be pregnant?" is not a useful question unless you're sure that the patient understands how pregnancy works. Asking for the date of their last cycle is at the very least a data point that has some diagnostic value. "No, I can't be pregnant because my boyfriend always pulls out" is a statement that contains a lot of information, but none of it has diagnostic value. You would still need to ask all the questions related to possible pregnancy.
That said, you're right that the timing isn't necessarily informative, either. And double down on asking these, or any, questions in private.