Many women suffer anxiety about pelvic examinations, especially if it is the first time, regardless of where they were born and grew up.  Having such an examination, for women who have experienced a prior negative or traumatic situation, such as female genital mutilation and cutting (FGM/C) is partly the cause for them to avoid visits to a physician.

There have been several hair-raising stories from post-FGM/C patients, telling their experiences when they visited gynecologists.  In most of those cases, the gynecologists and their healthcare workers were not informed about the women’s previous traumatic experiences.  These experiences can cause women to avoid prenatal care and regular gynecological check-ups.  The first person the patient encounters at a clinic, hospital or doctor’s office is the receptionist, who gathers information.  If that first encounter is not familiar with the needs of the patient and is not sensitive to cultural differences, the visit could take a downhill direction from there.

According to the National Institutes of Health, they elicit specific details in a gentle manner when patients confide to them their prior negative experiences.  They make all efforts to strategize together in order to minimize any discomfort to the patient. They also claim to educate the patient prior to examination.  They find that when the patient is in a reclining position on the examination table while she is still clothed helps to ease the patient’s anxiety.  It is suggested that having a chaperone with the patient during examination when anxiety is present could be helpful.  In some parts of the world, having a chaperone during examination of a patient is a requirement.  Based on a research study of emergency room patients, more than forty percent of female patients preferred a chaperone during examination by a male gynecologist, as compared to about twenty-six percent in examinations by a female physician.

Although these concerns and anxieties exist among women, they are encouraged to seek regular OB/GYN check-ups.  It is understandable that post-FGM/C patients could very well relive the trauma suffered in previous years; scheduling regular check-ups, pap smears and prenatal care are of utmost importance to your health and survival.

A pap smear, also called a pap test is a screening procedure for possible cervical cancer. Having pap smears helps to detect the presence of precancerous or cancerous cells on the cervix.  In a pap smear, the test looks for any changes in the cells of the cervix that show cervical cancer or conditions that could develop into cancer.  According to an article in Women’s Health, pap smear screenings should begin at the age of 21.  Routine screening is recommended every three years in women between the ages 21 through 65.  When your pap smear detects abnormal cells, your doctor will take immediate steps to figure out what is behind these changes and treat the condition before it turns into cancer.  That is the importance of having your pap smear done.

Seeking early and regular prenatal care is wise, and is most definitely helpful for a healthy pregnancy.  When you have regular prenatal care you will help reduce the risk of complications during pregnancy as well as at the time of delivery.  By having regular prenatal care, your physician will be able to control any conditions you may have, such as high blood pressure, diabetes, and other illnesses.  It is advised that from the fourth week of your pregnancy until week twenty-eight, you should visit your OB/GYN once a month.  If not, your first prenatal care visit should occur about eight weeks after your last menstrual period.

According to OB/GYNs, your second trimester commences in fourteen to twenty-seven weeks of your pregnancy.  This is the period when you should see your physician once every four weeks.  If you have a condition or complications, then your check-ups should be more frequent.

In your third trimester, according to medical advice, you should have a prenatal visit every two weeks until week thirty-six of your pregnancy. After week thirty-six, you should make weekly visits to your OB/GYN.  If you previously experienced FGM/C, you may need to have a C-Section delivery as opposed to vaginal delivery.  Your regular check-ups and prenatal care will prepare you for that.

There are five benefits of having prenatal care.  1) Your health and your baby’s life depend on it.  2) You will receive accurate and nutritional information during your pregnancy.  3) You will keep track of the development of your baby, as it grows in the womb.  4) You will know when to schedule various tests and exams.  5) You will know your delivery date and will be informed about what to expect when you go into labor.

The importance of having knowledgeable frontline healthcare workers in the U.S. is to avoid possible demoralization of post-FGM/C patients by uninformed healthcare workers.  Knowledge and information also involve cultural sensitivity and being aware of the cultures of the patients.  There may be problems in having pap smears or even regular pelvic examinations, if the patient has experienced type three of female genital mutilation and cutting, which is infibulation.  It is found that majority of the patients that shy away from prenatal care and OB/GYN exams are those that have been infibulated.  Physicians and healthcare providers need to be mindful of the various types of FGM/C.  Types one and two could very well cause cysts, keloids and heavy scar tissues.  Those could also cause difficulties in administering pap smears or simple pelvic exams.

Do not be afraid to have your examinations and tests done.  There are now more knowledgeable and informed physicians and healthcare workers in female genital mutilation and cutting, here in the U.S. and other parts of the western world.  When you search for an OB/GYN, inquire if that doctor knows about FGM/C, and to what extent his or her knowledge is in it.  It is your right to ask those questions.  If you need assistance in finding an appropriate OB/GYN, Global Woman P.E.A.C.E. Foundation has a list of such physicians that are knowledgeable in post-FGM/C medical care, and they will refer you to one of them.

Send all comments and questions about the preceding article to info@globalwomanpeacefoundation.org or call (703) 818-3787.