The National College of Gynecologists and Obstetricians (CNGOF) advises against the systematic use of pelvic examinations, which are often poorly experienced by patients.
- The pelvic examination is “less well experienced (anxiety, discomfort, pain, embarrassment, shame) in women with a history of violence than in women who do not have it”, underlined the gynecologist Xavier Deffieux during the conference of press.
- “Even though a pelvic exam is recommended, it is only offered to the woman, who accepts it or not.”
While several cases of accusations of violence against practitioners have been revealed in recent years, the National College of French Gynecologists and Obstetricians (CNGOF) now considers that the use of pelvic examination in gynecology and obstetrics should not be systematic.
Pelvic exams don’t always provide proven benefits
Pelvic examinations (under a speculum or by vaginal examination), like endovaginal ultrasounds, are now recommended in several situations for the purpose of detection and prevention. However, their use does not always offer recognized benefits, explained this Wednesday, January 25, the CNGOF during a press conference a few days before its annual congress, relayed by AFP.
For example, for a pregnant woman who does not have symptoms or a history of preterm delivery, routine measurement of cervical length by endovaginal ultrasound is not recommended since this examination is not linked to a reduction in prematurity in the scientific literature, indicates the college. In a pregnant woman without symptoms and having no risk factor for preterm delivery, the systematic use of vaginal examination during follow-up consultations is also not recommended because it is not linked to a reduction in complications. of pregnancy.
More and more women report obstetrical violence
In addition to this, the college advises asking patients about the occurrence of violence in the present or the past, including in the context of the consultation or the gynecological or obstetrical follow-up. These recommendations fall in a context where more and more voices are rising in Europe to denounce obstetrical violence. In 2018, the High Council for Equality had thus alerted to an increase in violence against patients. Several rights groups claim that women routinely experience denial of informed consent and rude and demeaning behavior from medical staff and, at times, unsafe practices.
Nevertheless, the CNGOF insisted on recalling that“a gynecological examination can be badly felt, can lack benevolence, but it cannot be equated with rape, otherwise gynecologists – already too few in birth rooms – will become even more rare, as long as the profession resents this assimilation”.
