A Feminist Script for Painful Cervical Exams During Labor

This blog post aims primarily at medical providers, care seekers, and reproductive health workers. Midwife Stephanie Tillman, a doctoral student in Health Care Ethics, addresses how to navigate painful cervical exams during pregnancy. She describes what an exam might be like if we used a feminist approach to care.

First, a provider should acknowledge that in most cases, a cervical exam is not necessary. Additionally, a few factors may make an exam painful, such as a history of sexual assault or a condition like vulvodynia.

She begins the script by checking in with the birthing parent and their family. From there, she asks about their past experiences with cervical exams. What makes them painful? What can typically make them more comfortable? Next, she explains why a cervical exam may be helpful and what the consequences of not having one might be.

The birthing parent is then able to give consent for the exam, if they choose to do so.

Prior to the exam, it is important to talk the birthing parent through what will happen and give them the option to say "stop" or "out." Regularly checking in with the patient and listening to their bodies can help the birthing parent relax and reduce their level of pain.

A final note about my feminist approach to care: I never enter a room and say "It's time to check your cervix!" My approach is always to see how someone is doing, discuss how they are experiencing the labor, how their partner(s) and family are experiencing the labor, how I understand the labor to be going from a midwifery standpoint, and discuss where we might go together next in the plan of care, outlining all options. Sometimes that involves a cervical exam.

SOURCE: Feminist Midwife • AUTHOR: Stephanie Tillman, Feminist Midwife • LAST UPDATED: April 4, 2016