Experience of the first pelvic examination

To analyze women's experiences of the first pelvic examination and identify positive and negative components. To learn lessons, and build on and incorporate the positive components into a model of good clinical practice.

The open, cross-sectional study was carried out in community family planning and young persons clinics. A self-administered questionnaire was offered to all women under 25 years of age who attended a family planning or young persons clinic during the study period. The questionnaire was constructed to determine how experience compared with expectations and which components showed a significant trend towards a positive or negative effect. It also aimed to find what women considered to be important aspects of an internal examination.

A total of 167 evaluable questionnaires were completed in which experience of the first pelvic examination was reported from family planning clinics (41%), general practice (39%) and hospital/genitourinary medicine faculties (20%). These first pelvic examinations occurred at a mean age of 17.3 years (range 11-23 years). Significant trends of a positive experience were found when the examination was conducted by a female doctor (p = 0.02), when it was conducted in a family planning clinic as opposed to general practice (p = 0.04), after permission was sought (p = 0.001) and with increasing age at first examination (Mann-Whitney, p = 0.003). There were no significant differences in outcome with offer of, or presence of, a chaperone.

A friendly, female doctor who seeks permission before the examination, which should be uninterrupted, were considered to be important aspects for an internal examination.