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A little while back I posted on my Instagram page the things I am asked by non-midwifery people. I think the most common one is “aren’t you grossed out by touching vagina’s” or “don’t they smell horrible”?
If I’m honest, I was petrified of looking at the most intimate part of a woman when I first started studying, let alone touching that area!

Firstly, do you know the difference between the vulva and the vagina? Most people just refer to the outside as the vagina (or fanny if you’re chatting to your mates), but the outside is the vulva. This is made up of the labia majora, the labia minora, the clitoris and the opening of the vagina.

The vagina is the muscular tube part which let’s be honest, other than being where the period flows out of the body, it’s where the penis goes for sexual intercourse.

I was petrified of doing a vaginal examination (VE) at first. Not because I was grossed out, but because I was worried I was invading a woman’s personal space at a time when she was possibly in pain. I was also nervous because it’s not every day you do this! Now having done it quite a few times I can honestly say I don’t even think about the fact I am inserting my fingers into a woman’s vagina. I’m thinking “am I hurting her”?, “am I going to find the cervix”?, “if I find the cervix am I going to get the dilatation correct”?, “am I going to feel the suture lines”?, “am I pulling my thinking face whilst I’m doing this”?

Every woman (or trans man pre full transition) you come across as a midwife has a vulva which leads to a vagina, to a cervix & then a uterus. It’s just skin! It’s just anatomy!

When preparing to perform a VE, after gaining consent of course, I wash my hands in accordance with the 7 steps due to it being one of the World Health Organisation’s (WHO) 5 moments. I then put on sterile gloves and apply lube to my index and middle finger. Before doing anything, I look at the vulva to make sure there is nothing out of the ordinary that I can see. I’m talking cuts, scars, signs of FGM, signs of infection, varicose veins, warts etc. I then again confirm the woman is happy for me to go ahead and before I begin, I announce that I am just going to touch the entrance to the vagina first so as not to shock her.

It is key that the woman is relaxed, so if she is contracting, I wait for a contraction to pass. I often ask her whether it is ok that I leave my fingers inside if she has another contraction so that I can feel what happens to her cervix. I then most definitely ensure she is aware that if she wants me to get out, I will do as she wishes immediately.

 

So, what does it feel like? I’m sure most of you have masturbated or inserted a tampon at some point, so you’re all aware that the vagina should feel moist and warm (but not hot). It’s not alien, it’s not weird, it just feels like you would expect a vagina to feel. The tricky bit is the cervix! If you have never seen one or how they change through the monthly cycle, have a look on The Beautiful Cervix. It’s great for you to visualise what you are feeling.

As for if they smell….. there is a distinct smell which comes with a labouring woman. It to me is the smell of labour. I’ve not quite worked out yet if it’s the amniotic fluid, the mucus plug, the general vaginal smell or a mix of it altogether. Probably the latter. Either way, it’s not horrible. No woman smells horrible! Each woman will know we all have our own scent which is completely & utterly normal!


Picture by Jamie McCartney for ‘The Great Wall of Vagina’.

 

As always, if you have any questions find me on Instagram @thelifeofastudentmidwife.