Pelvic exams are common gynecological procedures with a complex history. They have been used to inflict extensive harm on communities & individuals, and the painful practices associated persist to this day. There is also a history of incredible pelvic care, including gentle practitioners and subversive practices.
As reproductive health care supporters and practitioners, we need to radically reimagine this common procedure. We need to learn to approach it with the utmost respect and care, being gentle and thoughtful in our approach.
Consent
Trauma Informed Care and Consent with Feminist Midwife Stephanie Tillman episode of Evidence Based Birth podcast.
Tema Mercado on Embodied Consent
The Wheel of Consent (Betty Martin) a nuanced look at consent in healing and caring professions and the give/take of relationships and procedures involving consent
Pelvic Exams Reflections & Writings
Art by Lisa Boivin: digital art and powerful explanations from Indigenous artist Lisa Boivin on the subject of bioethics and reproductive health
Questioning the Routine Pelvic Exam: breaks down the elements of a routine pelvic exam, how to improve upon them, and which may not be necessary
Public Privates: Gynecology from Both Ends of the Speculum (book) by Terri Kapsalis
The Politics of the Pelvic Exam: Practicing Applied Feminism: reflections on providing respectful pelvic exam care and its impact on people.
Prevalence of Potentially Unnecessary Bimanual Pelvic Examinations and Papanicolaou Tests Among Adolescent Girls and Young Women Aged 15-20 Years in the United States: a study looking at how often young women had pelvic exams in a gynecologist setting and how often those were actually necessary.
Feminist Midwife Scripts: Painful Cervical Exams During Labor & Post Scripts: specific language and tips around communicating with clients when cervical checks are painful.
Anatomy & Body Care
The Vulva Gallery: Anatomy gorgeous illustrations, inclusive language, and a look at the anatomy of the vulva
The Vulva Gallery: Useful Websites a look at common questions and variations around vulvas and where to find more information
Mapping the Yoniverse (Samantha Zipporah): a colouring book with inclusive, accurate, informative looks at the the vulva, vagina, and pelvic area.
Hot Pantz: Do-It-Yourself Gynecology zine
Supporting Your Microbiome: The Vag Edition zine by Ashley Hartman Annis
Women’s Anatomy of Arousal book by Sherri Winston with a revolutionary look at anatomy of sexual pleasure and pelvic organs
A New View of a Woman’s Body book with incredible illustrations looking to more deeply understand internal anatomy (out of print so can be hard to find).
How To: Pelvic Exams (on other people)
Empowering Gynecologic Exams: Speculum Care Without Stirrups: explanation with pictures about how to do pelvic exams on a gyne table without stirrups.
Table Manners and Beyond: The Gynecological Exam for Women with Developmental Disabilities and Other Functional Limitations includes adaptations, alternate positioning, and access suggestions. Uses often outdated offensive terminology, resource is included primarily for its illustrations.
Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb (Hesperian Foundation): a detailed set of instructions around pelvic examination
Pelvic Examination: chapter from Anne Frye’s “Holistic Midwifery” textbook.
Training in the Self-Help Approach: chapter from the Shodhini “Touch Me, Touch Me Not” book.
Pelvic Examination: chapter from Varney’s Midwifery Textbook
Speculum Exam: checklist step-by-step from “Practical Skills Guide to Midwifery” textbook
Empowering WomanCare Strategies for Pelvic Exam Anxiety: a video discussion around ways to help people feel more comfortable and supporting before and during pelvic exams
External and Speculum Exam: teaching manual in how to conduct pelvic exams
Pelvic Exam (Stanford Medicine): a look at conducting a pelvic exam from a medical perspective, includes video, photos of norma and abnormal findings.
Pelvic Exam: medical training video on a plastic model including pap smear and swabs
Cervical Self-Exam
Self-Examination chapter from “A New View of a Woman’s Body” with excellent illustrations by Suzann Gage
How to Give Yourself a Cervical Exam: a video detailing how to perform a cervical self-exam
How to Photograph Your Own Cervix: a video detailing how to do you own cervical exam and take pics of your cervix.
How to Do a Cervical Self-Exam: a written explanation of performing a cervical self-exam
Self-Exam: The Cervix Close Up: a look at cervical self exams (written instructions)
Cervical Self-Examination: written instructions and illustrations about self-exam
How to Do a Self-Exam: a look at self exam, and what you may see, what’s normal, etc.
Gynecology Teaching Associates (GTAs)
At Your Cervix: documentary film about GTAs and pelvic exam practice in medical settings.
I Made a Career Out of Showing People My Cervix: an article narrative by a GTA discussing the work of teaching pelvic exams with our own body.
Evolution of the Gynecology Teaching Associate: An education specialist: an article looking at the practice of working with GTAs in medical school.
Student response to gynecologic teaching associates: a study looking at how GTAs are received by students and their reflections of working with them.
The Rise of the Gynecological Teaching Associate: a look at history and practice of GTAs.
Speculums
Does the Vaginal Speculum Need a Redesign? an article looking at the history and modern innovations around the speculum.
Why No One Can Design a Better Speculum an article looking at the historical design of the speculum and arguing it is actually well-designed.
10 Artists/2000 Speculum: an art project depicting speculums and different depictions of what is found inside a vagina
Hegenberger speculum (designed for use while repairing tears after childbirth)
Gyn Punks 3-D printed speculum
Yona speculum
The Callascope
Inflatable “speculum”
My blog post Learning to Love the Speculum
Pelvic Exams and Trans Folks
Tips for Providing Paps to Trans Men: handout with helpful tips aimed at providers.
Guys Need Pap Tests, Too: A Trans Man’s Guide to Visiting the Gyno: an article about self-advocacy at the gynecologist for trans men.
Cervical Cancer Screening for Patients on the Female-to-Male Spectrum: a Narrative Review and Guide for Clinicians: a detailed look at trans-affirming pelvic care (with a special focus on pap smears)
Trans Cervical Health Primer: a look at common questions and nuances of trans pelvic care.
Trans Women and Cervical Cancer Screening: a look at cervical cancer potential in a neo-vagina or neo-cervix and screening options for trans women.
Trans Men and Cervical Cancer Screening: a look at cervical cancer potential with different kinds of surgery in trans men.
Context: Gynecology, Racism, Exploitation & Subversion
Medical Bondage: Race, Gender, and the Origins of American Gynecology (book) by Deirdre Cooper Owens
Lecture and transcription by Dr. Deirdre Cooper Owens about her book Medical Bondage
Remembering Anarcha, Lucy, and Betsey: The Mothers of Modern Gynecology an NPR podcast (27 min) about the enslaved women whose bodies were experimented on by a white doctor as he developed many methods and tools we use today in gynecology
Anarcha, Lucy & Betsey: website with campaigns to educate about and honour Anarcha, Lucy & Betsey with a statue (in place of J. Marion Sims), artwork, learning centre, etc.
The Art of Medicine: Listening to Black Women Saves Black Lives
Black Maternal and Infant Health: Historical Legacies of Slavery
Why No One Can Design a Better Speculum an article looking at the historical atrocities in the development of the speculum and its ongoing design.
Black Subjectivity and the Origins of Gynecology a look at the book “Medical Bondage” by Deirdre Cooper-Owens
Historian Uncovers Gynecology’s Brutal Roots on Slavery a look at the book “Medical Bondage” by Deirdre Cooper-Owens , an interview
Reproductive Justice, Health Disparities, and Incarcerated Women in the United States
The First Birth Control Pill used Puerto Rican Women as Guinea Pigs a look at the racist, eugenicist ideologies and practices behind the clinical trials of birth control pills
Social Workers Forced Indigenous Girls Under 10 to get IUDS, Canadian Lawyer Alleges a look at modern sterilization and lack of protection for Indigenous girls in foster care, as well as the legacy of forced sterilization of Indigenous women in Canada.
From Both Ends of the Speculum: Reflections of American Gynecology a personal look at gynecology and medicine in the USA from on OBGYN
She Had An Eye At The Tip Of Each Finger… a historical look at French Midwife and OB Marie Boivin who invented the bi-valve speculum still in use today
Gyn Punk: The Cyborg Witches of DIY Gynecology a look at a Spanish anarchist collective 3D printing custom speculums
Menstrual Cups in Museums? It’s Time a look at technology, design, and devices used for pelvic healthcare and support
Context: Medical Abuse
She Didn’t Want a Pelvic Exam. She Received One Anyway: NYT article on the experience of a woman receiving a pelvic exam she did not consent to while under anesthesia.
Pelvic Exams While Under Anesthesia Sparks Debate: a look at the practice of pelvic exams on anesthetized women.
Conversations We Shouldn’t Still Be Having: Pelvic Exams Under Anesthesia: a look at the practice of un-consented pelvic exams.
License to Betray: Investigative piece on sexual assault in medicine.
America’s Medical Profession Has a Sexual Assault Problem: a look at sexual assault and medical residents/students
Us, Too: Sexual Harassment within Academic Medicine in the United States: a look at which divisions of medicine had higher incidences of sexual harassment