Pap Smears I Have Known by Molly


IMG_0522Your body is your own. This may seem obvious. But to inhabit your physical self fully, with no apology, is a true act of power.”

–Camille Maurine (Meditation Secrets for Women)

“I used to have fantasies…about women in a state of revolution. I saw them getting up out of their beds and refusing the knife, refusing to be tied down, refusing to submit…Women’s health care will not improve until women reject the present system and begin instead to develop less destructive means of creating and maintaining a state of wellness.”

Dr. Michelle Harrison (A Woman in Residence)

One afternoon at the skating rink for homeschool playgroup, a few of my friends sit in a hard plastic booth and the conversation turns to pap smears and pelvic exams. Later, I read Michele Freyhauf’s post about her hysterectomy experience and the skating rink pap smear stories come back to me with vivid clarity.  Being a woman is such an embodied experience and we have so many stories to tell through and of our bodies. During my conversation with my friends, I warn them: watch for my new show–Pap Smears I Have Known. At the time, several other friends are preparing for a local production of the Vagina Monologues and I have a vision: The Pap Smear Diaries. But, really, how often do we have a chance to tell our Pap smear stories, our pelvic exam stories? Where are they in our culture and do they matter?

Three experiences come to mind as I talk with my friends…

1999. I am married, twenty years old, and a graduate student. I go to the student health center for my annual exam. As I walk up to the door and place my hand on the handle, I feel this intense, visceral reaction in my body of wanting to run away. For a few moments, I can’t open the door, instead I think only of fleeing. The thought comes to me: I’m going in here to volunteer to be assaulted. Having to undergo a routine pelvic exam and pap smear as a condition of having access to birth control pills feels like a routine humiliation, like a ritual of physical invasion and “punishment” designed to shame young women who dare to have sex.

This is MY BODY.

2003. In my Type-A way, I head to a doctor for a “preconception visit” before my husband and I begin to try to conceive our first baby. This appointment is at a birth center in which you wear flowery housegowns instead of paper dresses. When the doctor touches me (she asks permission first), I flinch and recoil slightly. She looks at me with surprise: “haven’t you ever had a pap smear before?” I am intensely embarrassed because I know what she is thinking. She is thinking I must have been sexually abused and she is probably writing that on my chart right now. I haven’t been sexually abused, though I’ve spent my formative late teens and early twenties working in domestic violence and sexual assault centers. I’m not sure why this feels so embarrassing to me, and I also still wonder, isn’t it actually more normal to flinch when a stranger pushes their hand into your body than to be totally cool with it? Later at this birth center, I give birth to my first son. In what will eventually be six pregnancies, I only experience a single pelvic exam ever while pregnant, during his birth immediately before pushing. This is good. I prefer hands kept outside my body. After his birth, clots form in my uterus and prevent it from clamping down properly. The doctor does a manual exploration of my uterus to remove the clots. I scream out at first with the pain of this invasion and then hum my Woman Am I blessingway chant in order to cope.

This is MY UTERUS. March 2014 082

2009. My third baby has died unexpectedly during my second trimester. I give birth to him at home alone with just my husband. The baby’s birth is surprisingly peaceful and empowering, but then the clots come, eventually the size of grapefruits. When I become unable to distinguish whether I am fainting from the unbelievable sight of so much blood or dying from the loss of it, I ask to go to the emergency room. The ER doctor tries to examine me to see if I am hemorrhaging, but she only has a child-sized speculum. She is unable to get her hand inside me because of the clots in the way. She puts the miniature speculum in over and over and it keeps flopping out because it is too small for me. I have never been so miserable. “This wouldn’t hurt so much if you’d stop moving around so much,” she says in an irritated voice. When she leaves the room, she leaves bloody handprints streaked along the sides of the bed and my blood in a puddle on the floor.

This is MY BLOOD. 

“…no woman is powerful, no woman has ‘come a long way baby’ when she’s made into medical mincemeat when giving birth. No woman is powerful when she lies on her back and flops her knees open for stranger’s fingers and casual observation.”

Leilah McCracken, Resexualizing Childbirth, quoted in Birthdance, Earthdance, master’s thesis by Nané Jordan (p. 58)

This February, I attend the local production of The Vagina Monologues performed by several of my friends before an encouragingly full theater in our small Midwestern town. One of them delivers a powerful portrayal of “My Angry Vagina.”  She is amazing and intense and angry as she stomps across the stage:

“…why the steel stirrups, the mean cold duck lips they shove inside you? What’s that? My vagina’s angry about those visits…Don’t you hate that? ‘Scoot down. Relax your vagina.’ Why? So you can shove mean cold duck lips inside it. I don’t think so.  Why can’t they find some nice delicious purple velvet and wrap it around me, lay me down on some feathery cotton spread, put on some nice friendly pink or blue gloves, and rest my feet in some fur covered stirrups?”

During my pregnancy with my daughter three years ago, I buy urinalysis strips on the internet and keep track of the protein, sugar, and leukocytes level in my urine. I monitor my blood pressure in the pharmacy section of the grocery store. I buy a Doppler and check her heartbeat myself. When I find myself continually worried about what I will do if she is not breathing at birth, I travel to a city several hours away and become certified in neonatal resuscitation. I buy a neonatal resuscitation bag and show my husband and mother how to use it. After she is March 2014 116born, breathing well, in wild, sweet relief into my own hands in my living room, I drink liquid chlorophyll to rebuild my blood supply and I ingest my own placenta dehydrated in little capsules prepared by my doula.

An acquaintance comes to me complaining that her insurance company does not cover her prenatal visits and she is tired of paying more than $100 for a five minute visit while they check her urine and the baby’s heartbeat. I feel a little nervous about it, but I pass her my Doppler and my leftover urinalysis test strips on the front porch of my little UU church. Later, she tells me how empowering it is to take care of these responsibilities herself, rather than going to the doctor for something she is perfectly capable of doing. Another friend borrows my Doppler several times to check heartbeats for other friends—sometimes with good news and sometimes with bad news—and in January of this year I have the honor and privilege of finding my brother and sister-in-law’s first baby’s heartbeat for the first time.

My friend asks to borrow my neonatal resuscitation equipment in case she needs it for a birth she is attending (it has already been to several other friends’ houses during their births). I tell her, “I love black-market health care,” and pass it to her furtively at the bowling alley.

Later, I reflect that it isn’t black-market healthcare that I love, it is women taking care of each other and themselves. I love empowered self-care. I love feminist healthcare, though it has yet to exist on a systemic level in this country, and I love the possibility and potential found in taking the care of our bodies into our own hands whenever we can.

I have yet to invest in any speculums, but maybe I should. And, purple velvet.

Molly is a priestess, writer, teacher, artist, and activist who lives with her husband and children in central Missouri. She is a breastfeeding counselor, a professor, and doctoral student in women’s spirituality at Ocean Seminary College. Molly and her husband co-create at Brigid’s Grove: http://brigidsgrove.com and she blogs about theapoetics, ecopsychology, and the Goddess at http://goddesspriestess.com.

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Categories: Body, Embodiment, Feminism, power, Women and Community

25 replies

  1. This is great, Molly! I’m sharing it with some of my young friends who are having home births and using a local doula. It’s time for women to reclaim our bodies!

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  2. I once cried out when the speculum was “shoved” in and then the doctor told me that if I couldn’t control myself not to come back. I was so traumatized I did not go back to any gyn for nearly 10 years. Luckily, my pap smear is fine now.

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    • Thanks for sharing :( The more I think about stories like this, the more horrified I am that this is normative care for women. I was going to go into more depth with this post originally in terms of academic musings on the body as a source of power, etc., etc. but then I decided that, for this one, the personal stories stood on their own without requiring “back up” from other sources.

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  3. Molly…you are inspiring me in such a different way with this post today. This is inspiration that is body centered, raw, and active. I’m having trouble expressing how emotional this post is for me. I can only say thank you for sharing it all. Thank you for being a Goddess sister in your words and actions. Blessings.

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  4. Brava! Is there a way for a million women to read this and take it to heart? To womb? That’s what needs to happen to this blog. (I make it a practice to keep female physicians as my physicians, not men.)

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    • Barbara, I wish that having female physicians was the answer, but both Molly and I have had female physicians that we would not return to. If men had to have this kind of exam, a non-invasive procedure would have become the norm a long time ago.

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    • Wow. Thank you for sharing and for starting the discussion. I have had a very different experience and it never occurred to me to talk about our stories. We always talk about pregnancy and birth. I have had endometriosis since I was 12. I guess I just became accustomed to frequent exams because I had so many problems. My doctor was great and never made me uncomfortable during a check up. Then at nineteen he informed me that I could not have children. My sons think he’s full of crap. It was devastating. All I wanted was babies. Both of my pregnancies were very high risk. I had preeclampsia and had to be closely monitored. No home birth for me. I had my kids at teaching hospitals. I joke that everyone in the hospital checked my cervix. Again they were all respectful and I was not uncomfortable. Everyone asked permission to touch me. I felt like it was important for them to have experience working with a woman in labor before they were on their own! I think my need for special care made me more comfortable with the care itself. I had to compromise a lot to get my kids. I don’t have a girl because I was counseled to stop at two, and in my heart I knew the midwife was right. I feel blessed to have both of my healthy beautiful sons. I also feel blessed to have had some very compassionate people taking care of me. I have a great doctor now that does my yearly exam. That’s all I need because I developed adenomyosis and I lost my uterus in 2006. I have felt powerful and I have felt like a failure as a woman. Our stories are all our own and we should share them and hold each other in our hearts. Blessed be.

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  5. I described how I felt the first time I prayed behind a woman in our make-shift eid mosque in terms of the relief I felt when I had my first pelvic exam performed by a woman (a caring, thoughtful woman who understood). All that time, I never realized I didn’t have to be humiliated to serve God/get reasonable health care.

    I tell some Muslims this story and they don’t understand the humiliation I felt in praying behind a man. I explain, it isn’t praying behind a male body…it is that a man, any man, has the right to lead me in prayer and I must follow him if I am to pray in congregation. I feel vulnerable to God in prayer. A man’s unquestioned right to mediate that vulnerability was humiliating to me. Likewise, a male doctor (or any doctor on a power trip) humiliated me because they given a presumed right over my body.

    All to say, this post resonated very deeply with me.

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  6. I used to belong to a group on facebook called Women Against Stirrups and I remember them talking about a blood test that tests for everything a pap smear does and it’s cheaper and more accurate but is not implemented because pap smears make more money.

    When I was 15 my abusive boyfriend forced me to have sex with him, unprotected, and I was scared of infection so I went to a women’s clinic two hours away (so no one would see me) to get testing done. I was raped by the gynecologist who administered my first pelvic and got pregnant as a result. I was lucky enough to notice early on and got a medical abortion, I always think about what would have happened if I had been too late. I think I might have killed myself rather than go through with a surgical abortion or pregnancy.

    Gynecologists are difficult for me now. I have had two pap smears since my first, one was great with caring medical staff and the other was awful. I can’t go back again willingly. I won’t have an annual exam. I am engaged now and want to have children so badly but I don’t know if I will be able to, mentally.

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  7. wow. Thank you for this powerful writing! As a woman on her own journey into midwifery, fueled by the furies of LACK of tru health care for women, I really enjoyed this very empowering read! I share you passion for a more respectful view of women and the power we hold through our ability and choice to birth to be found in our current society. I could cry thinking of all the injustices women have suffered along their individual path of life choices in the health care systems we publicly host and cry even harder thinking of the lack of knowledge that women have towards the injustices being served to them. This is such an honest sharing of your experiences and I hope many, many people read this and find a new light in them to work to create fruitful change in our society! Blessings to you!

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  8. Thank you so much for this powerful, resonant piece. Interestingly, the yearly pelvic exam seems a particularly American practice. It’s not done in the UK or the Netherlands, for example. We women *do* need to take our bodies back.

    Brava. I hope many women read your essay!

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  9. I am a nurse-midwife and have done hundreds of pelvic exams. I hope the women I have cared for have felt respected because I truly try my best to be gentle and respectful. I hope women are aware that current evidence does not support annual Pap smears. In fact, general recommendation is every 3 years starting no sooner than age 21 and stopping at 65.

    http://www.cdc.gov/cancer/cervical/pdf/guidelines.pdf

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  10. I remember many years ago a neighbor was planning to have her baby in her own home under the supervision of a midwife. The thing was, this was illegal in Indiana! The way she had to talk about it was like a drug deal was going down. She had a healthy baby in her own home, and no one found out. Don’t know if home births are still illegal in Indiana, but they are in many states in the USA- a sign of the ‘medicalization =$$” of birth.

    If women refuse to pay for pre-natal care, follow a do-it-yourself route, then the healthcare industry will have to change its ways if they want to stay in business.

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  11. My first pap smear, as a 19-year-old virgin attending a Christian college and about to be (ill-advisedly, I might add) married, was with a female doctor in a tiny southern-Missouri town later booted out after she was “outed”. She had lovely posters on the ceiling to read, explained everything she was going to do before she asked me to disrobe, was gentle and kind, and “diagnosed” me with a menstrual condition so my healthcare would pay for the pill. (A decade-and-a-half ago, it wouldn’t pay for the pill just as birth control.) A few years later, when I was not getting pregnant, the male doctor I went to removed his hand from my vagina, re-lubed his finger and without warning poked it into my anus. When I flinched, he said, “Most people are surprised by that.” Um, I would say so! Now I have a delightful male doctor, not from America, who is gentle and kind and believes in natural remedies and the least invasive care possible. (No speculum yet.) Thank you for a lovely article that makes women want to open up with their stories! It’s healing, isn’t it?

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  12. Molly…You inspire so many people. Great article. :)

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  13. Wow, what a great article and how thought-provoking! I imagine all of us have pap-smear stories to tell. I remember one in particular. I was newly-divorced and back in college when I decided to visit the college health clinic for my pap. I was uncomfortable when I got a male doctor, but I told myself that it shouldn’t bother me to be examined by a man since I was divorced, and not a virgin. Anyway, the doctor had a good-looking male medical student with him and the two proceeded to examine me, much to my embarrassment. They felt my ovaries and then the doctor asked me if I would like to put my hand on my abdomen and feel my ovaries and I quipped, “Why not, since everybody else has!” I told my female co-workers about it later and was astonished when 2 married women said they would have been uncomfortable in that situation. Then I realized I had a right to my feelings! I only went to female ob/gyns and nurse practitioners for my pap after that. Luckily I no longer need a pap!

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  14. Hi Molly —

    I’ve been out of town for a few weeks and this is the first chance I’ve had to read this powerful post. As a feminist for over 45 years, I’m both unsurprised (hey, we still live in a patriarchy) and shocked at your experiences in the new milllenium (Our Bodies, Ourselves was published in 1971, for goddess’ sake). One of the women in my second consciousness-raising group in 1971 soon became a Lamaze instructor and agitated for women to get women-centered health care in the early 1970s here in Madison. We have great women’s health care here, for e.g. Barbara O’Connell, my ob-gyn, worked with Christianne Northrup before she came to Madison. She has always used a warmed speculum, always asks permission before she touches the outside of my vulva, is incredibly respectful and compassionate. Since college graduation in 1969, I’ve insisted on female ob-gyn’s for my own care, and even though the first one was “one of the boys” in order to make it in the UW Hospital in the 1960s, I was able to work with her by being very clear and very insistent about my needs.

    When I gave birth in 1981, I looked for a midwife, but there weren’t any medically trained midwives in Madison at the time. My choice was between a midwife who had attended about 100 births and a group of doctors who had each attended more than 1,000. Since birth difficulties are fairly rare, I opted for the docs, since their experience was greater and I was almost 35. But I insisted on the least invasive birth experience, no drugs to knock me out, etc. Now there are midwives in several of the local hospitals, plus doulas who come in to assist.

    I’m now going through a new women’s health experience that is changing my view of mainstream medicine, in both positive and negative ways. I had breast cancer surgery 6 weeks ago and will be receiving radiation therapy starting this Wednesday (prognosis good, stage 1 cancer). I feel very confident in the people who are treating me, but sometimes I feel like I have become a medical object poked and prodded by doctors, nurses, aides, etc. However, when that happens, the staff makes the biggest effort to soften the experience. For example, I had to have a CT-scan last Monday, and when I gotto the room, there were 4 women scurrying around the big machine that I was going to be conveyed into, each doing something to/for me. One situated me with my arms above my head on the CT-machine conveyor belt, two tatooed me in four places (so my body will have the right orientation when I receive radiation), and one supervised. But they also gave me a warmed blanket, which felt really comforting. The people treating me are caring, they are interested in my opinions, and they want to help me to get well again. But it’s very technological medicine, big machines, etc. So it’s an ambivalent experience, although the staff are trying to soften the blow.

    And I’m singing a little ditty quite often these days: “My body’s nobody’s body but mine./ You run your own body, let me run mine.”

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    • Nancy, I could not resist coming back to this post to wish you well in your journey through breast cancer treatment. I am almost 2 years out from my 2nd BC diagnosis and 7 years from my first. I sailed through radiation therapy and pray that you do too. So happy that you are feeling cared for by your treatment team. So did I. And still do. We live in a time and a place where breast cancer is much less a killer and more a chronic disease. It will change your life but not necessarily for the worst.
      I am also of the “Our bodies, Ourselves” generation and it has inspired my practice as a women’s health care provider.

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      • Thanks, Deb. I believe that you’re right about Breast Cancer as less of a killer and more of a chronic diseases. Each time I tell my story, I hear another woman’s story and realize that she’s right in front of me, still breathing. But there are SO MANY of us who are going through this! Thanks for the support. It means a lot.

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  15. Interesting new research conclusion in light of these experiences and the perception that it was an exercise in “routine humiliation” rather than health care: “The pelvic exam has been a standard part of a woman’s annual checkup for decades — yet it serves no clear purpose and may do more harm than good.”

    http://talkbirth.me/2014/07/01/guest-post-pelvic-exams-need-rethinking/

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