Before the exam
For example, to find out if a woman has an infection in her womb, start by asking
her if she has any signs of infection (see page 325) and by taking her temperature.
You can also try pressing on her belly, just above her pubic bone. If she has a womb
infection, this will be very painful. These are safe ways to find infection because you
do not have to put your fingers into a woman’s vagina to do them.
Before the exam
Help the woman relax
The pelvic exam is easier and more comfortable when the woman is relaxed and
Explain what you are doing and why you are doing it. Remind the woman to
take deep breaths and to let her body relax. Go slowly, and stop if you are hurting
her. If the woman is healthy, the exam should not hurt. Pain can be a sign of
infection or a sign that you need to be more gentle.
Tell me anytime if
Some women are afraid to have pelvic exams, such
as women who have never had pelvic exams, and
you feel upset or
scared, and we’ll
stop the exam.
women who have had exams that were painful.
Women who have been abused sexually or physically
may have an especially difficult time having pelvic exams.
These women have been touched when and where they did
not want to be touched. With all women, and especially
with women who have been abused, ask before you touch.
When you do a pelvic exam, you are examining a woman’s genitals and vagina.
Many women are embarrassed or ashamed about these parts of their bodies. They
may not want to talk about them, look at them, or let other people look at them.
These body parts are an important part of being a woman. When you do a pelvic
exam, encourage the woman to ask questions, and explain that these parts of her
body are healthy and normal. You may not be able to take away a woman’s feelings
of shame, but you can help reduce them.
Ask the woman about her history
Before you do a pelvic exam, ask the woman when she had her last monthly bleeding,
if she is pregnant, and if she has any signs of infection in her vagina or womb.
Chapter 7 suggests other questions you can ask a woman about her health history.
Also, explain to the woman what you are going to do during the pelvic exam and
answer any of her questions about it.
A Book for Midwives (2010)