Before going into your first appointment, people usually describe Pap smears to first-timers as uncomfortable. "It's uncomfortable," they say, "but it doesn't hurt." However, for many, the opposite is true.
In truth, the real saying should be: "It should not hurt to get a Pap smear," as 33-year-old midwife Pamela Boatner pointed out in a now-viral video.
"Hey sis," Boatner said while tapping on the screen to get viewers' attention. "This is your midwife talking. It should not hurt to get a Pap smear. Pay attention, because this is what you need to do to make sure that your next annual exam goes smoothly."
"First thing you need to do is ask for a smaller speculum, because 9 times out of 10, they're using that big birther speculum, and unless you've had a 15-pound baby or have a pelvic disorder, you probably don't need that," she said.
Secondly, Boatner suggested asking "for plenty of lubrication on the speculum, because we're not jamming it in there all raw. We don't have time for that today."
You can also "change your position," she said. "Sometimes, laying on your back with your feet up in those little stirrup things is not what's most comfortable for you. Ask them if you can change your feet and put them in a different position. This might be better for you."
And finally, "When they find your cervix, tell them to tell you exactly what position it's in — left, right, or back — so you can remember and tell them for your next Pap smear to make it easier."
Throughout Boatner's comment section, there were two general tones: those who had no idea Pap smears weren't supposed to hurt, and those who didn't know they had options when it came to advocating for themselves in these situations.
To learn more about keeping comfy during Pap smears, I talked to Boatner, who, in addition to her role as a certified nurse midwife, also serves as cofounder of Prepared Pregnancy, an online educational prenatal tool for pregnant people and their families.
When asked why she believes so many people are surprised by the fact that they can ask for a smaller speculum or other methods of comfort during a Pap smear, Boatner told BuzzFeed: "Unfortunately, the medical model of care often focuses on the disease or condition and NOT the patient. It is easier for the provider to use a bigger speculum, less lubrication, or keep the patient in one standard position. However, the midwifery model of care centers the woman/patient and her needs. This factors in comfort, education, and past trauma, to name a few."
If you do find yourself experiencing pain during a Pap smear and wish to try one of Boatner's tips, she said you can change your position by "laying on your back with fists under your pelvic bone or laying on your back with both feet on the edge of the table rather than in stirrups, and sitting slightly up on the exam table — not fully extended or reclined."
And knowing the location of your cervix can help avoid a painful search: "Just like how most people have hair but the color or texture of the hair can be different, birthing bodies have a cervix but its location is not always in the same position," Boatner said. "For most, it is located directly in the center and posterior of the vagina, and for others it can be displaced slightly off to the right, left, down, or up. This is a variance of normal and is expected to change from person to person."
Knowing your body and being able to advocate for yourself is a necessary part of healthcare, especially today. "In a world where women are losing their voice, rights, and choices, healthcare should not be the venue where people remain silent. It is your body and deserves to be respected," Boatner said. "Learning to self-advocate helps ensure you have pleasant healthcare experiences and ultimately decreases the incidence of healthcare avoidance based on fear or trauma. Better healthcare experiences lead to better outcomes."
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