Why Must a Pap Smear Be So Awkward?

Pap smear. The very phrase can make a vagina break out in a cold sweat. It’s not that a pap smear is the worst thing that could happen to a vagina, but it’s certainly not the most pleasant, either.

First of all, there’s the paper gown with the gap in front. It’s hard to call that couture. But then insult is added to injury when the paper sheet comes out so that you can cover yourself from the waste down. Hey – if someone is going to be all up in my vagina, I want to see what they’re doing.

Second, I hate scooting to the end of the table. “Just a little closer. You’re not quite there yet.” It always feels like I’m ready to fall off of the table, but the doctor is always telling me, “just a bit more.” There has to be a less awkward way of doing the pap smear, one that doesn’t require me to confront my fear of falling.

Then there’s the stirrups. My doctor politely covers the stirrups with oven mitts so that patients don’t have to touch cold metal. But there’s still something a little off-putting where oven mitts and my vagina are concerned. I’m not a cake coming out of an oven. Do we have to use the stirrups?

Last, but not least, is the dreaded speculum – those metal pliers that look like duck lips. They spread your labia apart so that the doctor can get a real good luck up inside your vagina. But is a speculum really necessary?

It turns out that none of this is necessary. My partner has gynecological issues. And when he started seeing a new vagina doctor, the doctor told him that she didn’t need a speculum to insert the swab to do a pap smear. She used her fingers to spread the labia (as so many of us do when we are participating in other vagina-related activities). This is what is called a “blind swab.” In fact, clinical studies in Europe have shown that pap smear tests from blind swabs are just as reliable as swabs that are taken using a speculum. (see source citation below) Why, then, are doctors still using a speculum?

I also found out that stirrups aren’t necessary. In cases where the patient has had sexual trauma, or is developmentally delayed, doctors can perform a pap smear without requiring the patient to get all uncomfortable up in the stirrups. Why isn’t that the norm? I’ve been sexually assaulted, but I shouldn’t have to tell my doctor that to get a pap smear without the stirrups.

Why aren’t women and transmen demanding that doctors eliminate the awkward, and usually uncomfortable, use of the speculum and the stirrups during a pap smear? Largely because most of us don’t know about it. I know I was surprised to find out that a speculum was unnecessary – I just thought that it was a unfortunate, but necessary, part of having a vagina. You get your naughty bits examined once a year, and that’s just the reality of life. But once I started researching, I found out that there was a lot (like the stirrups factor) that I didn’t know about a pap smear.

Moreover, the general opinion in this country is that vaginas are made for penetration. We just assume that stuff goes up in there. As feminists, we tell folks that they are the owners of their bodies, and that no means no. But how many of us have the ovaries to disagree with a doctor when they tell us that something is necessary, even if it makes us uncomfortable? If you have a history of “normal” paps, then a doctor doesn’t need to go spelunking up inside your vagina. I can see where a speculum might be necessary if there was a concern about lesions or an inflamed cervix. But for you average, run of the mill pap smear, all of this insertion and leg spreading seems totally uncalled for.

So let’s start advocating. Vaginas of the world unite. Down with the speculum! No more stirrups! Will you join me?

Source Citation: D. John Morgan, et al. “Comparison of Gram-stained smears prepared from blind vaginal swabs with those obtained at speculum examination for the assessment of vaginal flora,” BJOG: An International Journal of Obstetrics & Gynecology, Volume 103, Issue 11, November 1996, Pages: 1105-1108.

Comments

  1. Someone PLEASE help me out here- back in july of this yr, my gf&i had been together(8+yr relationship)off&on since losing apt.I had started wrking for 2mo @the time, and she chose to live in parks, but had been @times stayed w/me for anywhere frm few days-wk or 2(during time both had not seen/been with anyone and kinda went back to “exclusive”, but a daily wrk in progress). After staying w/me close to 2wks, she basically “disappeared”, not calling, answering phn, and i had been terrified at knowing she was outdoors, i chked hospitals,jails, etc-nothing. On a random lucky guess i found her walking to free lunch center. She seemed distant, and strange not even returning hug i gave due to SEEING she was alive! Said had to “talk”to me, but not bfore i went to wrk cause it would “not be good esp i just started&she knew it’d have bad outcome”. So i waited, and finally was told she suffered a miscarriage

  2. I have no children and at time was 33(now 34) and i didnt know how to even comprehend the extent of damage, let alone how SHE mustve felt. Shortly after our unplanned run-in, (about 4-5 days) she came to live with me at hotel i was staying until i had saved the $ needed to again have a “real” place to call home. She made it VERY clear that she coudnt couldnt be intimate, which i respected. Then at end of sept, she again went on own(this was her way of getting me to see that she was unhappy&only way she said to get my attention). This lasted over 3 months, and she again lived in a park up until a week ago. Now, this is where i am lost/hurt/etc- she had me look for notebook& where she said it was, i found the copy from planned parenthood THE DAY I FOUND HER IN JULY… it had all the procedures/labs,etc on it& only what she was seen for checked- depo shot, preg test& LAB FOR CHYLMIDIA.. I asked her about it and was 1st accused of lying- then after showing her, she DENIED being tested saying”i dont know what they did!” I know enough to know that 1-no tests are done for no reason 2-ive seen that they DO test for all stds on yearly exams, but never in 8yrs had she not shared all info w/drs with me, as i did same. Then, after asking if we stop in and ask she had no problem. By time we were there they closed& due to being fri, just left it to deal with monday. Until i was accused of “possibly”seeing other people(she was in bthrm&i had just got into rm, so she didnt know i heard her). A arguement ensued, & i asked if she was being honest with me re:all id been told to point… i saw in her face that SOMETHING was left out-6mos later im told that 1night i didnt answer phn she met guy& he invited her to his place&said he knew me(so she claims&i asked who& she has avoided ques)anyway, she said while there that he put his penis on her leg,& that she didnt leave immediately, but when she did she supposedly tried to come to rm i had rented, but @timeline given i wasnt even there yet. Can ANYONE PLEASE help shed light on this as i have loved her more than anything, but now w/new(or OLD info& just hearing of it)+ if the miscarriage even in fact was true-if she didnt get std&needed to wait for it to be treated….i dont know& given long relationship& was thinking of taking next step, i MUST know/get others input. i TRULY appreciate anyone taking time to listen, & help me. Thank you all very much-

    • OverItAll says:

      William: Odds are, she didn’t know what she was being tested for. 99% of women don’t know what tests are being run or even why. The 1% who do know, don’t do OBGYNs anyways. I quit seeing OBGYNs 4 years ago (at age 20) and I have no idea what they tested for (they’re illegally refusing to give me copies of my medical record). Most of the time, if a woman does ask, the doctor will either vaguely answer or not answer at all.

      • That’s total BS. You have every right to request a copy of your medical records. I can totally understand why you stopped seeing the gyno – but you also deserve to demand your records – they belong to you.

        • OverItAll says:

          I agree Serena, you’d think that was true! I’ve been demanding my records every 2 weeks for 4 years and have paid THREE times due to them “losing” payment. In my 23 years I’ve seen a total of 28 OBGYNs (25 between 19 and 20, and 3 for backup on my successful homebirth).

          You’d be shocked at the “tests” the 25 OBGYNs ran at 19-20 and how often. (In 18 months I had 10 transvaginal, 10 abdominal and FULL MONTHLY pelvic exams and I don’t know what tests were done on the PE’s). Then, I had what was supposed to be a pelvic ct scan (ended up being full-body because the doctors thought I was lying about the severity of my painful periods. Turns out, I was born with 1 kidney, which causes endometriosis). I kept requesting a laprascopy and was denied, thus the reason for 25 OBGYNs in 18 months.

          I was also told that I would never get pregnant (and if I did, I had a 99% risk of miscarriage or stillbirth or the baby getting bilateral renal agenesis). Well, I just had a homebirth that saved my son’s life, he’s almost 3 months old now and perfectly normal/healthy.

          Doctors misdiagnosed me and “missed” my son’s life-threatening condition. I trust no doctors.

          • Wow! That’s intense. I’m so glad your home birth went well. I gotta say – I trust a midwife much more than a doctor.

  3. I’d sure love an at-home test, but until I can find one available for sale in the U.S. – and a lab that will process the results – I think I just might ask for a CSA blood test instead. I don’t care how infrequently I’m supposed to *need* a PAP test -as I get older, I’m more uncomfortable with those things, no matter the gender of the doctor, the equipment used, or how their beside manner is. I’m just sick of it; and surely there must be some better way to do this. It seems crazy that there’s no better way to do this test after 60-some years, when we’ve advanced on so many other levels… And yes, I think we owe it to ourselves as women to figure out or find out what that may be. or it will never change!

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