Hesperian Health Guides

Hesperian Health Guides

Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb

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HealthWiki > A Book for Midwives > Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb


In this chapter:

A pelvic exam is a way to learn what is happening inside a woman’s vagina and womb. Doing a pelvic exam can help you learn:

  • if a woman is pregnant, and how many weeks she has been pregnant.
  • if she has an infection in her womb or vagina.
  • if she might have cancer of the cervix or womb.


You also must do a pelvic exam to insert an intrauterine device (see Chapter 21) or to do manual vacuum aspiration (see Chapter 23).

This exam is not difficult to learn, and with practice, most people can do it.

A different exam can tell you if a woman’s cervix is opening during labor. This chapter does not explain how to do that exam. Learn how.

Note: In some places, pelvic exams are done only by doctors — not midwives. But do not be afraid to try. With training and practice, midwives can learn this and other new skills. A midwife who learns to do pelvic exams can help women stay healthy throughout their whole lives, not just when they are pregnant or giving birth.


There are 3 parts of the pelvic exam

a speculum.
  1. The visual exam is a way to look for any signs of infection on the outside of the woman’s genitals.
  2. The speculum exam is a way to see inside the woman’s vagina and to test the health of her cervix. You use a tool called a speculum to do the speculum exam.
  3. The bimanual exam (2-hand exam) is a way to check the health of a woman’s womb and ovaries or to check the size of the womb in pregnancy. To do a bimanual exam, you feel the womb with the fingers of one hand inside a woman’s vagina and the other hand on her belly at the same time.

You do not always need to do all 3 parts of this exam.



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