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  • Writer's picturemisha

Well Care for Everyone!

Here at Amethyst we care care about your health and especially the health of your cervix!

Let's get real: when was your last Cervical Cancer Screening (PAP Exam)?

If you can answer yes to any 2 of the following questions, then it's probably time for you to have a PAP Exam:

  • Are you 21 years or older?

  • Has it been 3-5 years (or more) since your last PAP?

  • Has it been more than a year since your last abnormal PAP?

  • Did your mother/gestational parent take DES while pregnant with you?

We know, getting a PAP Exam is not fun and it can be triggering for some people. Midwife Michele strives to make the experience quick (or as slow as necessary) and efficient with as little trauma as possible. Michele takes the following steps to help make the experience as positive as possible (CW: mention of sexual assault and rape):

  • Currently, exams can happen in the client's home, or another safe, clean, and private space

  • Clients are encouraged to have a support person present for their exam, especially if past exams have been traumatic or there is a history of sexual assault or rape, including obstetrical violence/birth trauma & birth rape

  • A pre-exam history is taken, including questions about sexual health, followed by Midwife Michele explaining all parts of the PAP Exam (and Pelvic Exam if the client is having one performed at the same time), including showing clients each piece of equipment/instrument that will be used and explaining its purpose

  • Midwife Michele defaults to using standard scientific or medical names for genitals and reproductive organs (vulva, labia, cervix, vaginal walls, etc.), but if you prefer other specific terms be used or certain terms be avoided, please let Michele know and they will alter their language

  • Exams are performed without stirrups

  • Exams can be performed without a speculum for most people

  • Clients can insert the speculum themselves

  • Clients can wear their own clothing and only need to remove or move enough clothing to make the exam possible

  • Clients can control the environment: overhead lighting on/off, music on/off, chatting/no chatting during exam, fan/heater/blankets, etc.

  • Midwife Michele will maintain ongoing consent during the entire exam to make sure their client feels safe and is okay with continuing on with the exam

  • Two safe words are used: one to stop/pause what the midwife is doing and one to have the midwife remove their fingers/speculum/sampling tools and end the whole exam

  • Following the exam, there will be a quick post-exam conversation about any health concerns Midwife Michele has based on anything noticed during the exam (signs/symptoms of sexually transmitted infections, yeast infection, anatomical anomalies, etc.) and an explanation on when to expect laboratory results and how to follow up

PAP Exams and Pelvic Exams are NOT only for cisgender women! These exams are for trans men, trans masculine folks, nonbinary/genderqueer people, gender non-conforming individuals, and anyone else with a cervix (PAP Exam) or cervix, uterus, and/or ovaries (Pelvic Exam). Midwife Michele is genderqueer (trans nonbinary), is competent in providing basic genital and reproductive well care to queer & gender-diverse clients, and they have experience performing these important exams for many clients with different bodies, genders, and health histories.

If laboratory results for a PAP Exam come back "abnormal", depending on the nature of the results, Midwife Michele may be able to address the situation within their scope of practice. However, if a consultation and referral to a OB/GYN is necessary, their notes and the lab results will be given to the client to share with the OB/GYN and with any other care providers/people that the client deems appropriate. Midwife Michele does have a preferred, independent OB/GYN provider they refer clients to who is affirming for all people and who accepts most insurance including Medical Assistance, but clients are welcome to see any provider they choose.

Don't let a poor past exam experience or fear of a poor exam experience keep you from getting important healthcare and screenings. Contact us and schedule your exam today!


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