534 Health Care Skills
How to Examine the Abdomen
If a woman has pain in the lower abdomen, first read the chapter on “Pain in the
Lower Abdomen” and ask the woman the questions on page 357.
Then examine her abdomen:
1. Ask her to undress so that you can see her abdomen from just below her breasts
down to the hair between her legs.
2. Ask her to lie flat on her back on a firm bed, a table, or a clean floor, with her knees
bent and her feet close to her buttocks. Ask her to relax her abdominal muscles as
much as she can.This may be difficult for someone who is in pain.
3. Listen for bubbling and gurgling noises
by putting your ear on her abdomen. If
you do not hear anything for 2 minutes,
this is a danger sign (see page 354).
4. Ask her to point to where it hurts most.
Then begin pressing gently on the other side.
Keep pressing gently as you move around
her abdomen to see where it hurts most.
5. As you press her abdomen,
feel for lumps. Also, see if her
abdomen is soft or hard, and if
she can relax it under your hand.
6. To make sure she does not have another problem like appendicitis, an infection in
her gut, or a pelvic infection (PID), slowly but firmly press on her abdomen on the
left side, just above where the leg joins the body (the groin). Press until it hurts a
little.Then quickly remove the hand. If a very sharp pain (rebound pain) happens
when the hand is removed, she may have a serious infection.Take her immediately
to a health center or hospital to see if she needs surgery. If she does not have
rebound pain, continue to examine her by looking at the outside of her genitals
for sores, discharge, bleeding, or other signs of sexually transmitted infections (STIs).
For signs and treatment of STIs, see page 261. If you know how, do a pelvic exam
(see the next page).
Where Women Have No Doctor 2012