536 Health Care Skills
How to do a speculum exam
A speculum is useful for looking at the cervix
and vagina. If you have one, follow the steps
below and then continue with the exam on the
next page. If you do not have a speculum, you
can get much of the same information by following
the steps on the next page.
1. Be sure the speculum has been disinfected before you use it
(see page 527). Wet the speculum with clean water before
2. Put the first finger of your gloved hand in the women’s vagina. As you
put your finger in, push gently downward on the muscle surrounding the
vagina. (Work slowly, waiting for the woman to relax her muscles.) Use this
finger to find the cervix, which feels like the tip of the nose.
3. With the other hand, hold the speculum blades together between the
pointing finger and the middle finger. Turn the blades sideways and slip them
into the vagina. (Be careful not to press on the urine hole or clitoris, because
these areas are very sensitive. ) When the speculum is halfway in, turn it so
the handle is down. Remove your gloved finger.
4. Gently open the blades a little and look for the cervix. Move the speculum
slowly and gently until you can see the cervix between the blades.Tighten
the screw on the speculum so it will stay in place.
5. Check the cervix, which should look pink and round and smooth. Notice if
the opening is open or closed, and whether there is any discharge or bleeding.
If you are examining the woman
because she is bleeding from
the vagina after birth, abortion,
or miscarriage, look for flesh
coming from the opening of
the cervix. If you think she
may have an infection, check for
green or yellow discharge, or
bleeding from the cervix. If the
woman has been leaking urine or
stool, gently turn the speculum to
look at the walls of the vagina. Bring
the blades closer together to do this.
6. To remove the speculum, gently pull it toward you until the blades are clear
of the cervix. Then bring the blades together and gently pull back. Be sure
to disinfect your speculum again.
Where Women Have No Doctor 2012