View source for A Book for Midwives:Before the exam

{{bctrail|segments=3|chaptitle=Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb}}
{{DISPLAYTITLE:Before the exam}}
{{SideSupplement|bookabbreviation=abfm|pagealt=is from page 375 of|chapterpdf=http://hesperian.org/wp-content/uploads/pdf/en_midw_2021/en_midw_2021_20.pdf|bookurl=A Book for Midwives|booktitle=A Book for Midwives}}
{{chaptertoc|In this chapter:|
<ul class{{=}}"noprint">
<li>[[A Book for Midwives:Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb|Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb]]</li>
  <li>[[A Book for Midwives:When to do a pelvic exam|When to do a pelvic exam]]</li>
  <li>[[A Book for Midwives:Before the exam|Before the exam]]</li>
<li>[[A Book for Midwives:The pelvic exam|The pelvic exam]]</li>
  <li>[[A Book for Midwives:The visual exam|The visual exam]]</li>
  <li>[[A Book for Midwives:The speculum exam|The speculum exam]]</li>
<li>[[A Book for Midwives:Cancer of the cervix|Cancer of the cervix]]</li>
  <li>[[A Book for Midwives:The bimanual exam (2-hand exam)|The bimanual exam (2-hand exam)]]</li>
</ul>}}
=== Help the woman relax ===
The pelvic exam is easier and more comfortable when the woman is relaxed and not afraid. 

Explain what you are doing and why you are doing it. Remind the woman to take deep breaths and to let her body relax. Go slowly, and stop if you are hurting her. If the woman is healthy, the exam should not hurt. Pain can be a sign of infection or a sign that you need to be more gentle. 

<div class{{=}}speechbub style="position:relative; clear:both;width: 280px; height: 240px; float: right;">
[[Image:MW_Ch20_Page_375-1.png|center|250px|alt=2 women sitting together and speaking.]]
<div style="position:absolute; left: 27px; top: 12px; width: 130px;">Tell me anytime if you feel upset or scared, and we'll stop the exam.</div>
<div style="position:absolute; left: 127px; top: 47px; width: 170px;">All<br> right.</div></div>

====Fear====
Some women are afraid to have pelvic exams, such as women who have never had pelvic exams, and women who have had exams that were painful. 

Women who have been abused sexually or physically may have an especially difficult time having pelvic exams. These women have been touched when and where they did not want to be touched. With all women, and especially with women who have been abused, ask before you touch. 

====Shame====
Pelvic exams are the examination of genitals and vaginas. Many women are embarrassed or ashamed of these parts of their bodies. They may not want to talk about them, look at them, or let other people look at or touch them.

You can show by the way you do a pelvic exam that these parts of the body are normal, and so is talking about them. Encourage questions. You may not be able to take away someones’s feelings of shame, but you can help reduce them.

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=== Ask the woman about her history ===
Before you do a pelvic exam, ask the woman when she had her last monthly bleeding, if she is pregnant, and if she has any signs of infection in her vagina or womb. [[A_Book_for_Midwives:Chapter_7:_Learning_a_pregnant_woman's_health_history|Chapter 7]] suggests other questions you can ask a woman about her health history. 

Also, explain to the woman what you are going to do during the pelvic exam and answer any of her questions about it.



{{Previous and next sections|When_to_do_a_pelvic_exam|The pelvic exam}}


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