This was originally published on Pigletish.com on August 8th, 2019
The cervix is the opening to between the womb and vagina. A cervical smear exam (PAP test) is a health check that looks for HPV (Human Papillomavirus) and it’s one of the best ways for women to protect themselves from cervical cancer.
In 2015, shortly after my 25th birthday, I received the first letter inviting me to go for my very first smear. I binned it. According to Jo’s Trust, I’m not alone; with 1 in 4 women missing their appointments each year. But why?
For the longest time I was ashamed to talk about smear tests and especially afraid to admit that I hadn’t been yet and the reason why: I was sexually abused in an intimate relationship and the thought of being vulnerable, exposed and not in control of my own body was so scary that it crippled me.
Just talking or even thinking about having a smear test made me feel tense and shaky and, despite knowing the risks to my health, until very recently I didn’t believe I’d ever be able to do it.
It takes time to recover from abuse.
Healing from abuse is a long process and, despite the passing years, leaving the house is still hella scary. Slowly but surely, I’ve hit some pretty big milestones in my recovery: from the first time I spoke about the abuse to the first time I was able to walk my dog in the dark.
Earlier this year, I took a chance and started a new romantic relationship and, with his support* and reassurance, I started to realise that my life matters. It’s hard to explain to someone who hasn’t been through it, but the impact abuse has on your self worth is shocking and, to me, taking care of my body and health felt like an incredibly selfish and indulgent thing to do.
*of course, I am not suggesting that you need the help of a partner to reach this conclusion. I had done most of my healing before we got together, his love just adds to my own self love and amplifies it.
The longer I put off my smear, the harder it was to book.
Try as I might, I couldn’t stop thinking about my smear test. Every time I saw a social media post from someone imploring women to go for their cervical smear, I felt guilty. I worried that because I had put it off, the results would be terminal and the thought of hearing bad medical news made it even scarier to go. I was worried about having to explain to the doctor or nurse why I had put it off, I wasn’t ready to talk about the reasons. I was scared I’d cry the whole way through the procedure.
Something clicked on Monday and I called my GP’s surgery and made the appointment.
Even after booking it, I considered cancelling the appointment.
It was actually the second time I’d got around to booking my smear. The previous time I had booked it, I’m sorry to admit that I couldn’t face it and cancelled my appointment.
Knowing that I had the support of the mental health community on Twitter behind me, I tweeted my achievement. I hoped that publicly announcing the appointment would help me keep myself accountable. Here’s the tweet:
“I just booked my first ever smear test. It’s taken years of building up the courage. I’m 29 years old. I’m a sexual abuse survivor. Today something clicked and I managed to book the appointment. Group hug?”
Sometimes, when you least expect it, a tweet takes off and with over 2.5 million impressions and over 3,000 responses (many from women with similar fears to my own), boy was I surprised to find out just how “not alone” I really was.
They say it takes a village to raise a child and it took the population of a small country to get me to my smear test. Every time I felt like cancelling, I remembered that there were thousands of people rooting for me. I read and re-read your comments (although I still have a whole inbox full of messages of kindness and support) and I somehow found the strength to walk through the door.
I made it to the appointment. Here’s what happened:
The nurse sat me down and asked me whether or not I had received a letter inviting me for a smear exam and if I had ever had one before.
I explained that I hadn’t recently received a letter, but that I was 29 years old and, having ignored several reminder letters, I had never had a smear before. As per the advice of many many awesome ladies on Twitter, I told the nurse that I was a sexual abuse survivor and that I had been putting it off because I was afraid. I cried as I told her.
She was brilliant. She explained the procedure slowly and offered to show me the medical equipment (I declined). She asked me at every stage whether I was comfortable and whether I wanted to stop. She offered for me to have a chaperone if I wanted one (I declined).
Before having the cervical exam, I had to provide a urine sample for a pregnancy test because my cycle is irregular and I haven’t had a period for a while. It came back negative and so we were OK to proceed.
The nurse asked me to remove my shoes and “bottoms” and to lay on the bed. She let me undress privately behind the curtain and asked me to call her when I was ready. She also asked me whether I would prefer the door to be locked or unlocked and provided me with a paper towel to put over my lap.
I wore a skirt to the appointment so that I felt less exposed (I have the ladies of Twitter to thank for this tip too), so I removed my boots, tights and knickers and lay on the bed.
I took a moment to breathe deeply and gather myself. I called her in and closed my eyes.
She raised the bed and reassured me that we could stop at any stage if I wanted to. The little bits of control she allowed me to have went a long way to making me feel more comfortable.
Medical detail (trigger warning)
She asked me to put my heels together and relax my knees apart. I felt vulnerable, but less so than I had expected to. I deliberately wore a bracelet to the appointment, so I started focusing on fiddling with that.
She inserted a speculum (which is a smooth tube) into my vagina. I was finding it difficult to relax, so it hurt a little at first, but the feeling passed quickly.
She asked if I was OK to continue. I said yes.
She then opened the speculum so that she could see my cervix. This didn’t hurt at all, in fact, I only knew it was happening because she told me.
Apparently my cervix is high, so she asked me to put my fists under my bum and lift my hips so she could see. She then very quickly took some samples (using a small thin brush), removed the speculum and left me to get dressed behind the curtain.
The appointment was around 15 minutes, with the procedure itself taking no more than 5 minutes (probably a lot less).
I felt relieved afterwards.
So relieved, actually, that I cried again – I thought I was going to be sick.
A few of you have asked me how I gathered the courage to go and I wish I had an answer that was simple or easy to put into words. It took a lot of time, healing and talking about what has happened to me in order to normalise it enough that I felt I could go.
No, the procedure wasn’t painful or really uncomfortable. The nurse was nice and incredibly understanding. It didn’t take long and, yes, I’m glad I went. But to say those things and expect other victims of sexual assault, abuse and rape to feel that their concerns are all answered would be to do these women a disservice.
I think that most people who are afraid of having their smear test know that the test itself is nothing to be feared. I think most women out there know that the nurses performing the exam are kind and patient and will do their best to help us feel at ease.
And really all we can do is keep talking about this stuff; keep encouraging women to take power over their bodies and put their health first, but also to protect them while they are doing it.
If you are worried about your cervical screening, Jo’s Trust have a helpline you can call confidentially and they will be able to answer any questions you may have about your test or any concerns you may have. Most importantly, remember that you are in control of this appointment and that you can stop at any point if it gets too much for you.
If you have a friend or relative who is struggling to book their test or attend their appointment for any reason, please remember that nobody should feel shamed into talking about it and that, with your gentle encouragement, they will get there eventually.
Thank you to every single one of you who sent me a nice message on Twitter, I’m glad that I was able to go and I’m not sure I would have made it without you. Also a huge shout out to the women who messaged me saying that the tweet inspired you to get your own tests booked – I can’t explain how happy that makes me.
Love, always.
This is such an honest post. I work as a medical receptionist, and I am responsible for booking women in for their smear- and the amount of people who cancel or don’t want an appointment is large, I think just because of the nature of the procedure. But this has really given me some insight into why certain people may be even more apprehensive about their appointment- and I think this is something more people should be aware of, as it is important to go to the appointment, but we also need to address why people may not want to book theirs and remove the stigma around talking about it. I’m glad you had a kind and welcoming nurse as I think that must make all the difference. Thank you for sharing this insightful post x
Ah, thank you – I tweeted about my first appointment before I went and it had so many responses from others in the same boat. I think it’s definitely worth remembering how vulnerable sexual abuse survivors feel in these kinds of appointments. && not everyone is ready to talk about it or disclose either.