The bimanual exam
8. Feel the ovaries.
Finding and feeling the ovaries can be very difficult. It takes a lot of practice.
Put both your inside fingers on one side of the cervix and lift up the ovary.
Move your outside hand to the same side of the woman’s body as the inside
fingers and slide your outside fingers down her belly. When you press hard,
you can feel her ovary slip between your fingers.
You must push down deeply with
your outside hand, so ask the woman
to take a deep breath and let it go
before you feel her ovary. Stop
pushing if she is in pain!
An ovary is usually about this big.
After checking one side, move your hands to check the other ovary.
If you feel something bigger than 3 centimeters long and 2 centimeters wide,
or if this exam hurts her a lot, she might have a growth on her ovary, or she
might have a tubal pregnancy (see page 113). Get medical help.
Note: It is normal for a woman’s ovary to get bigger and smaller every
month. If you are not sure of the cause of a large ovary, try checking
again in 6 weeks. It may be small again.
9. Take your fingers out of her
vagina. Hold the lips of her
genitals open and ask her to
cough or push down as if she
were passing stool. Watch her
vagina to see if anything bulges
out. If it does, she could have a
fallen womb or bladder, or part of
her bowel could be bulging into
the vagina. Get medical advice.
a fallen bladder
After the bimanual exam, give the
woman a clean cloth or paper to wipe off the jelly. Explain to her that she will
have some extra discharge (the jelly) or a little blood after the exam.
Tell the woman what you found during the pelvic exam. Make sure to answer
any questions the woman has.
A Book for Midwives (2010)