How To Have An Empowered Pelvic Exam | Lucy Rowett

Pelvic exams are part and parcel of being a woman or having a vulva and vagina. From smear tests (in the USA they are called, “Pap Smears”), to examinations, maternity, having an IUD fitted, or many other reasons, if you have a vagina, you are guaranteed to experience some sort of pelvic examination in your life time.

This is part and parcel of being responsible and empowered about your health, and as a sex coach, I highly encourage you to get your regular smear tests, get regular STI screenings, and get very familiar with your wonderful vulva.

However, there is something very vulnerable about stripping down from the waist, lying on your back, hoisting your legs in stirrups, and having a complete stranger examine your foof, let alone start prodding around inside, isn’t it?

At best, a pelvic exam is uncomfortable and pinchy, and at worst it can be re-traumatizing. It can all depend on who is doing the examination and whether they listen to you and your own internal resources.

The history of gynecology is pretty grim, and every woman/vulva owner has a horror story of a medical practitioner who was at best, clumsy and inconsiderate, and at worst, violating their body.

While modern medicine is a miracle, it is also skewed against women/womxn.

Every woman (especially women of colour) will tell you a story of being dismissed, disbelieved, and gaslit by a medical professional at some point in their life. Or at multiple times.

Research into women’s/gynecological health is shockingly underfunded and undervalued. There have been many lawsuits and counts of malpractice in women’s medicine, from the Essure sterilization procedure to vaginal mesh (please do not ever, ever, consent to this procedure), to the Dalkon shield, to violations of consent against women in labour, to the average time to be diagnosed with endometriosis to be between 7–12 years.

There seems to be little understanding or respect for a woman’s bodily autonomy, even in the most basic of health checks, the humble pelvic exam.

While for a medical professional it’s all in a day’s work, there seems to be little understanding or respect for the fact that your vagina is a sensitive area and needs to be treated as such.

It honestly does not have to be this way. You are not a body to be prodded and poked, you are a sovereign human being.

While a pelvic exam may not be something that gets you skipping with joy, you can absolutely turn it into an empowering experience where you feel like you are working together with the medical professional.

This applies whether you are having a general examination, an STI test, getting a smear test, an IUD/IUS fitting, to pre-natal, labour, or post-natal examinations.

Basically, any time somebody is going to be sticking their fingers and/or a speculum up your vaj, you get to be empowered.

For the purposes of this piece, I will use the term “professional” or “medical professional”, as an umbrella term to refer to whoever is doing the examination, whether it’s a nurse, doctor, gynecologist/OB-GYN, midwife, pelvic physiotherapist, doula, or somebody else.

Your body. Your rights. Your rules.

While medical professionals are highly trained and knowledgable, they cannot know what it is like to be inside your body, your trauma responses, or your tolerance for pain.

If it feels painful or unbearable for you, that is it, don’t let them convince you otherwise.

Nobody has the right to do anything to your body without your consent, including a medical professional.

Create an affirmation for this that reminds you that it is and always has been your body.

Mindset changes

How you think and feel about a procedure and your body is going to be the biggest factor in having an empowered pelvic exam. When you are afraid, stressed, or in a trauma response, it is inevitable that the procedure will be more painful for you.

So let’s flip the script and make this as empowering as possible for you, here are some things that can reframe the experience for you.

Medical professionals are actually on your side! Even if you have had bad past experiences with medical professionals, remember the vast majority of them honestly do want the best for you and want to make your health better.

Work with them. Medical professionals work best with people who know their health and ask informed questions. Think of this experience as a collaborative effort to work WITH them rather than something being DONE TO YOU.

You are doing this to take care of your health and your body- you rock star, you. Aren’t you an incredible person who is proactive about their health? You are an empowered womxn who is the mistress/empress/lord of their body, give yourself a High Five!

What if you could treat this as a chance to get insanely geeky about your body? Do research beforehand on the procedure, get swotted up on vulvar and pelvic anatomy and prepare questions to ask. I love the Atlas of Erotic Anatomy and Arousal, by Cyndi Darnell for extra sex-geek research.

Extra ninja skills: If you want to be even more informed about your body, you could ask the professional to take some pictures of your vulva and/or your cervix with your camera phone. Have you ever been curious about what you look like on the inside? Now is the chance!

What affirmations could you create for yourself that remind you that you are safe and in control?

Can you visualize how you would like it to feel?

Do a self vulva exam

If this is physically possible for you, I highly, highly, highly recommend you make a regular practise of looking at your vulva in the mirror. I get all my clients to do this and I do it myself. Most womxn do not have regular contact with their vulvas, but this is a key part of being empowered about your body.

Learn all the anatomical parts, get super familiar with yours. If you find this too emotionally difficult, then it’s time to get support. Learn more about working with me 1:1 here.

Before your appointment

Think about what you would need in place for this to be an empowering experience. Think about any potential roadblocks and then brainstorm potential solutions. For example, if you know that you dissociate or freeze, what would you need to happen or for somebody to do?

For example:

• Bring a support person/cheerleader/wing woman along with you
• If you’re feeling anxious, take some rescue remedy or do something soothing and grounding
• Or do some dancing to raise your energy
• If you anticipate it being painful (especially for an IUD/IUS fitting), take some painkillers beforehand
• Make any travel preparations such as getting a lift or a taxi
• Buy your favourite drinks and snacky treats. Chocolate all the way!

Make it a ritual

You don’t have to be particularly into the woo to make this a sacred experience for you. Think about how you could incorporate your own spiritual practise into it, or add some.

For example:

• Visualize yourself connecting with your vagina and cervix. Imagine sending love and healing to those areas.
• Put on some music and do some sensual dance
• Tao tantric qi gong to bring energy to your pelvic area
• Placing your hands on your heart, vulva, and/or wombspace and sending love there
• Creating a mini altar in your living space or buying a few sacred objects to honour your vulva/vagina. Or buy some fun merch like badges, earrings, stickers, or anything else that celebrates the vaj. Check out The Vagina Museum or look on Etsy.

At the appointment

When you arrive at the appointment, here are some really important things to remember.

1. Tell the practitioner you feel nervous and speak about any concerns you have, and especially any pain or trauma you experience so that they know. Tell them what you need from them if this happens, for example, “I will need you to stop or go slower”, “I will need you to reassure me.”
2. Especially tell them about any pain you experience and request that they go gently and slowly.
3. You can ask for a smaller speculum. If you are having an IUD/IUS fitted, you can also ask for gas and air and numbing cream. Not all medical facilities have gas and air, but as my mother always says, “If you don’t ask, you don’t get!”
4. You can ask for more lube. Ask for all the lube you need. If you have a particular sensitivity to a certain brand or type of lube, tell them and ask for a different one.
5. The most important thing of all: You can put the speculum in yourself. Yes, you can!
6. You can ask them to stop at ANY time. Don’t let them rush you, so take all the time you need.
7. You can keep your hand close to your vulva or just on your body. This helps remind yourself that it’s YOUR body.
8. Visualize your vagina and cervix opening and expanding, with the intention that you are ALLOWING them inside you.
9. Try and find the funny. Humour reminds you that this really isn’t the end of the world and you will survive it. Can you find something humorous in this? I bet you can. Crack a few jokes with the professional, find some silliness in the situation. Your legs in the air, you may feel like a plucked turkey, there may be random farts or queefs. Humour can be a sanity saver if you can’t stop the panicky thoughts and feelings.
10. Keep talking to the professional if you can. Ask questions about your body, ask them what they are seeing. Now could be the time to ask them to take a picture of your vulva and cervix for you to look at afterwards- because your vagina is a marvellous thing.
11. When it’s finished, put your hands on your body and give yourself a cuddle. YOU DID IT! Thank your vagina and your body for being an awesome person. Go on, give yourself a high five.

Emergency key phrases

Here are a few simple phrases to remember:

“Can you stop for a second?”

“Can we pause for a second?”

“I’m going to take a few deep breaths”

“Can you give me a minute?”

“Can you pull out of me, please?”

Afterwards

Celebrate! Have a dance, buy a luxurious hot chocolate, play your happy playlist. You did it!

When you get home you may want to do another vulva/womb meditation, or you may want to self-pleasure.

Know your rights

If you feel uncomfortable with a professional or they are not listening to you, you have the right to ask for a different one. You do not have to put up with any shit from anybody.

If a professional has been insensitive, has not listened to you, or you have had a traumatic experience, you have the right to file a formal complaint.

Your body. Your rules. Your choice.

To your happy and healthy vagina,

Originally published at https://lucyrowett.com.