Vaginal examination
Vaginal examination in practice
Vaginal examination surprises young girls and still troubles a majority of women. It must be said that this concerns a part of the body of women which is very intimate, the sex and that the so-called “gynecological” position is particularly uncomfortable and adds to the embarrassing side of the visit. It can be performed by the gynecologist, midwife or general practitioner.
But as with any examination, it should only be done after obtaining your consent, which you can withdraw at any time.
As a patient, you have the right to say no to vaginal examination, as with any examination, depending on the Law of March 4, 2002 (known as the Kouchner law).
Lying on your back on the examination table, thighs apart and legs resting on the stirrups, you don’t necessarily feel good, nor very comfortable. After an interview and several observations, the practitioner examines us using a speculum *. Again, the feeling is quite unpleasant insofar as this examination involves the introduction of a foreign and cold body into the vagina. Perhaps he takes the opportunity to do a smear, using a small brush, an examination which is used to detect abnormalities of the cervix. The vaginal examination usually takes place at this stage of the consultation …
Placed next to us, the practitioner puts on a glove which he coated with lubricating liquid and introduced two fingers into our vagina. At this stage, we relax (well we try …). If one is relaxed, (and if the practitioner is delicate enough), the vaginal examination is not painful ! If we dread and contract the muscles, it can hurt us. The watchword: relax as much as possible!
The practitioner assesses the condition of the cervix (length, consistency, degree of dilation) and the bottom of the vagina. Then, while palpating the abdomen, he examines the uterus, ovaries, tubes.
What is vaginal examination for?
The functions of vaginal examination are numerous, especially during pregnancy.
During classic consultations, vaginal examination allows the practitioner to ensure the general good condition of our genitals. During pregnancy, it is also used for many specific tests.
At first, vaginal examination contributes to pregnancy diagnosis and makes it possible to determine whether it is an ectopic pregnancy, or to detect certain gynecological diseases.
During pregnancy, vaginal examination is used to carry out regular monitoring and to look for, in particular, the threats of preterm birth.
But some practitioners completely abandon this examination, which they consider invasive and which can bring unwanted germs into the vagina and then into the uterus. There will then be no vaginal examination during the entire pregnancy, unless there is a suspicion of a particular pathology (or if you do not ask for reassurance about the baby’s position).
During the last prenatal visit, vaginal examination is performed to make a number of observations that will help in the choice of the type of delivery (upper or lower route, for example). The presentation of the fetus, the condition of the membranes which block the opening of the cervix, the shape and strength of the bones of the pelvis as well as the genitals are studied during the examination.
During labor, it is a means of monitor cervical dilation, as well as the position and progression of the fetus in its mother’s pelvis.
In France, vaginal examination is very often performed during prenatal visits, but less systematically than a few years ago. The usefulness of this examination is starting to be questioned by a part of the French medical profession… partly carried by the requests of the patients.
* Instrument intended to remove the edges of certain openings of the human body (anal, rectal, vaginal speculum).