Examining Ourselves: Exploring Assumptions about Teaching Pelvic Examinations in Midwifery Education

A time-honored tradition in many midwifery programs isthe “pelvic exam lab”: an opportunity for students tolearn how to do a thorough and competent pelvic examby examining and being examined by each other. Propo-nents of this educational experience feel that being apatient is a valuable experience for beginning practi-tioners. They also believe that the opportunity to providefeedback to one’s classmates during an exam provides asource of helpful information in the early stages ofestablishing one’s comfort and skill while performingpelvic exams. Recently, students have questioned thispractice, raising a variety of concerns. In addition to theinvasion of privacy represented by the “intimate exami-nation” of another person’s reproductive organs, con-cerns about the potential for harassment and battery havebeen identied. In our increasingly liability-consciousenvironment, it is time to reect on the usefulness of thispractice in contemporary midwifery education.The experience of genital self-examination was ahallmark of the feminist women’s health movement ofthe 1970s. This experience became a symbol of self-discovery for the activist women of this generation. Theopportunity to visualize one’s vulva, vagina, and cervixrepresented the ultimate reclamation of self-knowledgeand self-determination. As one feminist women’s healthadvocate expressed, “. . . the fact that this particular areaof the body that has been inaccessible to us is nowvisualized . . . It was so revolutionary! Just the simple actof putting a speculum in the vagina ourselves andbringing up that part of the body and being able to see itin the same commonsense way we look at our face everymorning.”