During your pregnancy and postpartum, part of the care we offer as your midwives is general reproductive health care including cervical cancer screening and swabs for sexually-transmitted and vaginal infections. Do you dread Pap tests or avoid getting swabs for possible infections? Even if you don't dread them, we know they aren't everyone's favourite part of caring for their bodies! And, while important for your health, we certainly never hear our friends commenting how excited they are for their upcoming Pap tests. Furthermore, an increasing number of folks are without a Family Physician or Nurse Practitioner, making it challenging for them to access cervical cancer screening.
Self-screening program for prevention of cervical cancer
The BC Cancer Agency just launched a province-wide self-screening program for the prevention of cervical cancer. Instead of getting a routine Pap test, individuals can now choose to order a kit, take a sample in the comfort of their own home (or wherever they like!) and send it back. Check out the Q&A here: http://www.bccancer.bc.ca/screening/cervix/changes-to-cervix-screening
What causes cervical cancer?
The human papillomavirus (HPV) causes almost all cervical cancers. HPV can take more than ten years to progress to pre-cancerous cells or cervical cancer.
According to Immunize BC, every year in BC, about:
- 200 people will get cervical cancer, and 50 will die from the disease.
- 6,000 people will develop high-risk changes to the cervix, which are precancerous.
- Over 450,000 people will undergo Pap tests, and over 14,000 will need further follow-up.
HPV is very common and easily spread through any kind of sexual contact. Most people will get HPV at some point in their lives – often without knowing it. Usually, the body’s immune system removes the virus. But sometimes HPV does not clear on its own, and over time, certain types of HPV can cause the cells of the cervix to become abnormal.
You can read more about the HPV (human papillomavirus) vaccine here: https://immunizebc.ca/vaccines-by-disease/hpv
Pelvic exams at First Light Midwifery
We recognize that, for some, these aspects of health care can be uncomfortable while, for others, they may avoid them entirely, finding them incredibly invasive or overwhelming. And, unfortunately, pregnant folks are not eligible for the new self-screening. As your midwives, we are always looking for ways to support you being in charge of your health care. We hope that trauma-informed care increases the likelihood of you being able to access reproductive health care, including pelvic exams, in ways that feel safer for you.
Sometimes during your care, a pelvic exam may be recommended but, ultimately, you decide when, whether and how you want your exam done. During a pelvic exam or Pap test, did you know:
- You don't need to use the uncomfortable foot rests?
- You can place the speculum yourself? (speculum: instrument used to see your cervix)
- You can ask your midwife to stop, slow down or pause at anytime?
- You can ask for a mirror to see your cervix?
- We use anatomical terms as a default (vagina, cervix, etc.) but you can also let us know what terms you would like us to use when referring to your anatomy?
- You can invite support people to be with you for these exams or ask support people to leave the room for these exams?
Some things we do to try and make these exams more comfortable:
- Before the exam, we talk about what it will involve, the information you will (and won't) get and the reason for the exam as well as answering any questions you have.
- During the exam, we ask permission before touching your body & let you know what we are doing throughout the exam.
- We observe for non-verbal cues that you are finding it painful and pause to check-in.
- When using a speculum, we open it as little as possible.
- We have thick, cozy Turkish cotton towels large enough to go over your lap and cover all different sized bodies. (No uncomfortable little paper sheets!)
- Our exam table is on the far-side of the room from the door and points away from it.
- We have a poster of a sunrise above the table for you to look at. (The ceiling is so boring!)
- If you want or need sexually-transmitted and/or vaginal infection testing, you can choose to do self-screening. (Self-screening is where we explain how to do the swabs and you do them privately by yourself instead of having them done by your health care provider.)
And, just because cervices are awesome, feel free to check out: