Has the Time Come to Discontinue Routine Pelvic Examination?

Ledbetter, Ann

doi:10.1111/jmwh.12886

Cited by 1 publication

(2 citation statements)

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“…Evidence recommending against the screening pelvic examination in asymptomatic patients is still very new for patients and health care providers. 42,63,64 Both patients accustomed to an annual external or internal examination and health care providers who may continue their preferred practice despite the evidence may struggle or disagree with possible changes to practice. Shared decision making is the posited standard of care, especially in such a circumstance when perhaps no perfect answer exists and when the decision regarding a plan of care is thus best made through sharing information and values.…”

Section: Clinical Contextmentioning

confidence: 99%

“…Evidence recommending against the screening pelvic examination in asymptomatic patients is still very new for patients and health care providers 42,63,64 . Both patients accustomed to an annual external or internal examination and health care providers who may continue their preferred practice despite the evidence may struggle or disagree with possible changes to practice.…”

Section: Clinical Contextmentioning

confidence: 99%

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Consent in Pelvic Care

Tillman

2020

J Midwife Womens Health

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Consent is a clear dialogue between individuals to engage in a specific activity. Expectations for consent to intimate examinations in health care should be equal to, if not exceed, expectations for intimate interactions in society. In reality, current definitions of consent in health care vary. These blurry definitions lead to individualized interpretation, incomplete fulfillment, and opportunities for misunderstanding by both patient and health care provider. If a patient does not believe they have consented to an examination or procedure, they are likely to rightfully identify with one of consent's antonyms, assault. Within the field of gynecology, a history of misogyny, racism, and classism illuminates abhorrent contexts of assault disguised as care. Similar practices persist in the modern application of pelvic care, ranging from overt sexual assault to coercion disguised as guidance. Health care providers and students who seek to improve consent practices can look to evidence-based frameworks such as trauma-informed care and shared decision making, both of which are embraced widely by professional organizations. These approaches often take precedence during the first pelvic examination; care for people who are lesbian, bisexual, queer, transgender, or nonbinary; and care for anyone with a known history of sexual assault; they can be easily extrapolated to all intimate examinations. Beyond obtaining consent for the examination itself, health care providers must also intentionally obtain consent to include students in care and openly discuss new universal recommendations for chaperone presence. Scripting for common procedures, such as bimanual examinations for pelvic care or cervical examinations in labor, allows health care providers to practice trauma-informed language, include evidence-based guidance, and avoid unintentional bias. Contemporary providers of intimate pelvic care must work to understand and strengthen the definition of consent and ensure its realization in practice.

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Section: Clinical Contextmentioning

confidence: 99%

Section: Clinical Contextmentioning

confidence: 99%