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Your Smear Your Way

During sexual health awareness week there have been a lot of conversations around smear tests with women sharing their top tips to encourage women to attend their appointments. This is such an important topic to discuss yet often there is a lack of awareness and understanding about the barriers for many women – particularly those who have survived sexual violence.

Most women find the idea and experience of a smear test anxiety provoking, or at the least really unpleasant. Yet for many women who have survived sexual violence the thought of going for a smear test, whilst necessary, can feel like another invasion of what is a very sensitive and vulnerable part of our body, triggering memories and feelings (emotional and physical) of past abuse.  This can include bodily responses such as to freeze, be hyper-vigilant, anxious and panic attacks to name a few.

Women and survivors shouldn’t be the ones having to do this work alone. So much more awareness, support and improvements are needed around the way in which smear tests are carried out. We believe this can start with every health care practitioner having access to specialist sexual violence training, which explores the impacts and responses to sexual violence, including how to best support someone before, during and after any medical procedure. This can be as simple as asking someone if they are worried about having the smear test and is there anything they need to feel more comfortable.

Here at RASASC we have worked with thousands of women over the past 34 years who have survived all forms of sexual violence and who have had to go through such health and medical procedures. We asked them about their experiences and what they would want to share with other survivors around asking for support and take care before and during the procedure.

  • Ask for what you need. It’s your body and your smear and you have the right to time, space, privacy and support. This could include asking for a double appointment and to do as much of the procedure yourself, like inserting the speculum.
  • Self-testing is currently being piloted on the NHS in some areas of London. In the meantime there some companies who sell self-testing kits that you can do at home if you want to and can afford to.
  • Know you can and have a right to change your mind at any point during your appointment and ask for the procedure to stop.
  • I always prefer and choose a female health care practitioner. You might have to be more flexible when making the appointment but you can insist.
  • I have found that speaking to the nurse beforehand has helped me. Just saying that previous experiences have been painful and caused me anxiety – and if she could be mindful of this. My last smear was a better experience as the nurse kept asking me if I was comfortable – her tone was gentle and calming. I also focused on the beach picture that was on the wall and this put me at ease helping the procedure to be less stressful.
  • For me it is all in the breathing; getting myself into a place where only my breathing matters. Low and slow, in through my nose and blow out through my mouth. I try and stay relaxed, and I keep my eyes closed.
  • A steam, sauna or a warm bath before can help to relax both mentally and physically – including your vaginal area.
  • I’ve always found it beneficial to wear a skirt to the appointment then you can just remove your underwear and lift your skirt up. You’re also covered immediately as soon as you stand up at the end and not left to put underwear and trousers back on awkwardly.
  • Taking a friend and someone you trust to wait with you can be supportive. Offering to go with a friend can also be a huge source of support.
  • I find smears triggering and my body can feel exhausted afterwards from being tense. I’ve found eating something sweet after helps keep my sugar levels up.
  • Try to focus on breathing through your anxiety and deep into your stomach. Taking a sensory box with you, with something to touch (e.g. stone), smell (e.g. perfume in cotton wool), taste (e.g. peppermint), listen to (e.g. music), see (e.g. photo) can also help to feel more grounded and present to manage flashbacks.
  • It’s okay to cry. And it can be really hard not to just sob.
  • I believe it’s a choice all women have the right to make for themselves, whilst being aware of the potential consequences – both of going and of not going.
  • So often we’re told that it’s over in minutes, yet those 10-15 minutes is a day’s work – and I tell myself that is all the work I have to do that day – and that really is enough. Giving it the value and the weight it deserves is important in validating your own experience and your own body.
  • Practice self-care and decide what works for you; it could include booking the day off, planning something nice afterwards or booking in a phone call with someone with you trust.

Resources and Support

If you’re a healthcare practitioner and would like to know more about our sexual violence training courses for you and your team, please get in touch with our Training and Prevention Coordinator.

Rape Crisis England and Wales and Jo’s Cervical Cancer Trust recently won an award at the BMA Patient Information Awards 2019 for their ‘Cervical Screening after Sexual Violence’ resource.

My Body Back offers specialist health support to women who have survived sexual violence, including STI and smear tests.

@AtYourCervix_x offers online peer support for women who find cervical screening difficult & raises awareness of barriers people face.

Support Documents

Click here to view our support documents. Each document is available as a PDF download.

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