Not your mother's... pap smear? My walk through women's health after sexual trauma.
I shared a vulnerable video to Facebook before my annual wellness visit and pap smear this morning, but there are some details I wanted to get into that I think are better covered in writing. My intention is for this post to be helpful to all women- because honestly pap smears are never fun. They are super uncomfortable- and I remember dreading them even before I ever experienced a miscarriage or the trauma of rape.
So, let’s get into some tips for making pap-smears, colposcopies, and other invasive exams a little easier.
(Quick side note: if you’re looking for more emotional posts focused on the healing after rape or miscarriage, that’s not what this post is about but you may find what you’re looking for in some of my other posts, like these: the angry #metoo post, the one about true strength, and the one about miscarriage. Wherever you are in the journey to healing, know that you are not alone. It does get easier. You will be so much more than okay. You’re allowed to be really fuckin’ angry and hurt and numb and whatever else you may feel, and I’m sending you so much love. If you need someone to reach out to, I am here for you. There are so many support groups and safe loving spaces out there for you too. You don’t have to heal alone. Please take care of yourself.)
1 | You have a voice. You gotta use it if you’re gonna get through this (and you are).
I know Western medicine makes it really confusing and uncomfortable to deal with healthcare in general these days… but you DO have a say over what happens with your body. Speak up to your provider. If your doctor is a jerk with zero bedside manner or respect for your body or what you’ve been through, drop ‘em. Literally walk out that door. You have that choice.
I found a doctor who sees me as a whole human and who really honors and speaks to the emotions and pain behind what I’ve experienced, and when we do my exams she really is responsive to my requests. Every woman deserves that. If you don’t like something, say so. If someone isn’t right for you, say you’re just not comfortable and ask for a referral to another provider (or just walk out and do the research from home, I’m not gonna judge).
Honestly, that’s my best advice. The rest of this post is pretty much ideas for what you can use your voice about to make your exam more comfortable.
2 | Work with your doctor to improve your physical comfort during an exam.
Just ask your doctor or the nurse beforehand to do these things for you. If they can’t take the time to treat you like a human being, find another place to go. It’s worth absolutely nothing if you force yourself to go through this and it sucks so bad you never go back- you could end up really sick down the road! Even if you have to scrape up the money, it’s worth the investment to be selective about who’s going to be sticking their tools and hands up in your vagina, y’know?
Warm the speculum! No, I’m not kidding. Those cold things are evil- and how exactly does anyone expect a woman to relax her body while you stuff a cold metal beak in there and poke and scrape around?! It’s literally not possible to relax with a cold piece of metal in there, so get that speculum to a reasonable temperature docs.
My doctor has a warmer for hers, but you can also have the doc just run them under warm water (and remember to test the temperature first on the inside of your thigh to make sure it’s not too hot).
Ask your doc not to use the stupid stirrups. My doc doesn’t use these unless she absolutely has to for an exam and it’s such a relief. Most of the world doesn’t use those monstrous devices, it’s just something Western medicine decided was easier on the doc, never mind the woman’s comfort or dignity. What my doc has me do is place the bottoms of my feet together and relax my legs off to the side. This keeps me warmer and more comfortable and it feels much less vulnerable, all of which helps me relax and makes her job easier too.
Ask for support if you need it. This morning was the first pap smear I’ve had done since being raped where I didn’t need to ask for someone to hold my hand. Literally every single time, I’ve asked my doctor if there was a nurse available to hold my hand, or I brought my sister, mom, or friend along. I always tell my supportive hand-holder ahead of time that I’m probably going to cry a little, and just let them know that having them there really helps and that’s all I need. There’s no shame in asking for help, and the quality of support that comes from holding a loving woman’s hand while you’re in a vulnerable position as a woman yourself builds this feeling of safety and reassurance that I can’t even describe- this is true for me even when the woman holding my hand is a complete stranger who’s probably in med-school and feeling like woahhhh this wasn’t in the job description. It’s beautiful in its own way too though, it brings the humanity back into the work and I know very few people who don’t cherish those experiences.
Slow it down! If your doc wants you to just strip down to nothingness and throw on a glorified sheet before they’ll speak with you, remember that you can always ask them to do the talking portion of the exam first instead. This gives you a chance to get comfortable-ish with the person who’s about to be all up where you don’t want them, and it also teaches the doc to pay a little more attention to their patient (you AND lots of other women too) as a human with boundaries and dignity to be considered- something western medicine needs to do a better job of anyway. Also, it makes it so you’re not freezing by the time you actually need to be exposed for the exam- which again makes it easier to relax your muscles and therefore makes the doc’s job a little easier too. Win, win, win.
3 | Be considerate of your own comfort, just like you would for someone you love.
Plan your exam thoughtfully for yourself. For me, I know that 1) I’m not going to sleep well the night before and 2) I’m going to feel anxious and guarded the day of until it’s finished. I hate feeling like that, so I do my best to reduce the anxiety and also get it finished as early in the day as possible.
What I do is schedule my appointment first thing in the morning and set my alarm extra early- like early enough to avoid any human contact whatsoever because I know I’ll snap at people or burst into tears, and I don’t want to deal with either of those things. Normal human interaction can come after the big scary event, ya know?
I have a glass of water, put on music that feeds whatever needs I have that day (sometimes I need to feel badass to get through it, and I find myself the Girrlscout Spotify playlist. Other times, I want to relax into feeling safe and loved, so I listen to my own playlist made up of songs that soothe and inspire me (my Wild Writings playlist on Spotify, if you must know. I recommend making your own though!).
You can also plan some gently distracting physical activity before and after to help with nerves and get you out of your head. This time, I decided to walk to my appointment instead of driving, and it gave me a lot of time to really settle into the mindset I wanted to go in with. I decided how I wanted to feel during and after the exam (like, emotionally), and built myself up to that point with music and by planning my route so I could stop in a couple scenic places, treating myself to a coffee in the quiet coffee shop before it got busy…
After the exam, the walk home gave me the perfect opportunity to shake off the tension and I ended up feeling really genuinely happy. I feel resilient and strong and radiant, not like a victim anymore. I think it’s a natural process of healing and I went through some really ugly phases before I got to this point, but the healing really does come if you allow it and become a strong advocate for yourself. Seek out women and resources, situations, and states of mind that you want to bring to life.
Even if what you want to feel won’t quite click for you at first, appreciate the details that are what you want and allow yourself to continue the never-ending spiral of embracing yourself. Thank yourself for trying and for considering your own needs and desires. That’s a beautiful, powerful practice to have in place.
I hope this has helped at least a little bit.
But, one more thing:
It’s so important to take the time to really love and nurture yourself through these kind of things. Take as long as you need and do your best to be gentle with yourself, but also remember that while you didn’t choose what happened to you- you are responsible for your own healing. You don’t have to do it alone, but you are the one who takes responsibility for setting things in motion. If you need support, girl you gotta ask for it.
There’s anonymous support out there if you don’t know how to share this with “the real world,” and that’s a perfectly valid option. There are women’s advocate groups and support groups that can help you find whatever help you need, from professional medical and mental health care to kind and caring women in your community. There’s so so so much out there in the world and so many peoples’ hearts are in this mission of helping women to heal and rise up… but they can’t do anything for you if you don’t let them or if they don’t know you exist.
It’s up to you to start the healing. Maybe that means taking your wonderful body in to test for any STDs or other problems and starting with the physical healing. Maybe it means talking with someone you trust about what happens. Maybe it means writing angry poetry on the bathroom mirror. Maybe it means sitting in the corner and crying. Whatever it looks like for you, it’s time to begin allowing a little grace into this horrible experience. Embrace yourself in the ways you know how, thank yourself so so so much for all that you do and all that you are and all that you still have the strength and courage to feel each day. You are in this world to do so much more than merely heal… but you can’t move forward without taking the step right in front of you. Please take care of you, first.
I’m sending you so much love. You’re going to get through this. It’s allowed to suck and it’s allowed to be difficult, and it’s allowed to get easier with time. You’re allowed to heal when you’re ready, you’re allowed to enjoy life again. You’re allowed to be a complete emotional disaster for 3 months and still love yourself anyway (I did). You’ve got this. If you need support, reach out to me at firstname.lastname@example.org. I’m not a health care professional, I’m just a girl who’s been there. Now, go take good care of you.