Hesperian Health Guides
When to do a pelvic exam
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HealthWiki > A Book for Midwives > Chapter 20: The Pelvic Exam: how to examine a woman's vagina and womb > When to do a pelvic exam
It is safe and useful to do a pelvic exam when:
- the woman wants to know about the health of her cervix, womb, and ovaries. You should certainly do this exam if the woman has signs of infection or cancer. But women can have infections or cancer in the cervix or womb and have no signs. So if possible, women should have this exam every few years — even if they have no signs of problems.
- the woman is pregnant and you need to know how long she has been pregnant.
- the woman wants an IUD.
- the woman is having problems after a miscarriage or abortion, and needs an MVA.
WARNING! It is not safe to do a pelvic exam when:
- the woman is in labor. It is not necessary to do a visual exam, a speculum exam, or a bimanual exam when a woman is in labor. If you must check her cervix to see if it is opening, see how.
- the woman has broken waters. If the woman is pregnant and her waters are broken, this exam can spread an infection into her womb.
- the woman is in late pregnancy and is bleeding from the vagina. If the woman is bleeding from the vagina in late pregnancy, she may have placenta previa. Do not do a pelvic exam — or you could make the bleeding worse.
- the woman gave birth in the last few weeks.
Making the pelvic exam safe
The pelvic exam is usually safe, but it can have risks. When you do a pelvic exam, you must be sure not to put any germs into the woman’s vagina. When you do a pelvic exam:
- always wash your hands well, before and after the exam.
- always wear very clean or sterile plastic gloves.
- always use clean tools.
If you cannot wash your hands or wear gloves, it is not safe to do the exam.
There may be other ways to get information about a woman’s health if you cannot make a pelvic exam safe, or you do not know how to do a pelvic exam, or the woman does not want a pelvic exam.
For example, to find out if a woman has an infection in her womb, start by asking her if she has any signs of infection and by taking her temperature. You can also try pressing on her belly, just above her pubic bone. If she has a womb infection, this will be very painful. These are safe ways to find infection because you do not have to put your fingers into a woman’s vagina to do them.