The speculum exam
A speculum is a tool for looking
inside a woman’s vagina. The
speculum holds the walls of the
vagina open. When it is in the right
position, you will be able to see the
cervix, test for infection or cancer,
insert an IUD, or empty the womb.
Practice opening and closing a
speculum a few times before you
use one for an exam so that you are
comfortable with how it works.
(you do not
need to use
work well on
Some midwives let a woman look
A smaller speculum may work best for
at a speculum before they give her an
exam. This can help the woman
understand the exam.
young women, women who have never
had sexual intercourse, older women who are
in menopause or who are not having regular
sexual intercourse, or women who have had
1. Help the woman relax by
FGC (see page 367). A larger speculum may
touching her leg, asking her to
breathe, and by being gentle
work best for women who have had many
and slow. Remind her to tell
you if the speculum hurts and stop the exam if you hurt her.
2. Warm the speculum with clean warm water,
or by holding it in your gloved hand.
3. Ask the woman if she is ready to start. When she is
ready, gently open the lips of her genitals with one hand
so that you can see the opening of her vagina. Make sure
to explain everything you are doing as you do it.
4. Hold the speculum with your other
hand. Turn the handle to one side,
and slide the closed bills into the
vagina. If you are gentle, the bills
will slide downwards into the vagina
and should not hurt the woman.
As you put the speculum in, turn it so
the handle is down. Be very careful
not to pull her skin or hairs. Gently
push the speculum all the way in. The
handle should rest against the skin
between the vagina and the anus.
A Book for Midwives (2010)