Doing the MVA
4. When the woman tells you she is ready, follow the
steps on page 384 to do a bimanual exam. Feel
the size of the womb. The womb should be the
right size for the number of weeks the
woman has told you that she was pregnant. If
her womb is very big, she might have been
pregnant for longer than she thinks. Do not do
MVA for a woman who is more than 3 months
pregnant, unless she is having serious problems from an
incomplete abortion and you have no other way to help her.
5. Take off your gloves, wash your hands, and put on new, sterile gloves.
This will allow you to keep all the tools for the MVA sterile as you do
6. Gently insert a speculum
(see page 377).
7. Dip a piece of sterile gauze held with
the ring forceps, or a long swab,
into antiseptic. Use the gauze or swab
to wash the cervix.
8. Ask the woman to breathe deeply and relax. When she is ready, grasp the
cervix with a tenaculum or a ring forceps. Close the tenaculum and pull it a
little to straighten the womb. This can be very uncomfortable for the woman,
so be gentle and tell her what you are doing.
A Book for Midwives (2010)