At Your Cervix: Making Pelvic Exams Ethical, Consensual, & Pain-Free

Image courtesy of Amy Jo Goddard
Image courtesy of Amy Jo Goddard

Have you ever thought about HOW medical and nursing students learn to do pelvic exams? Who do they learn on? How do they get past their fumbling nervousness to a point where they can provide a comfortable exam for their patients? Is that even possible?

At Your Cervix is a documentary film that explores the connection between the way medical and nursing students are taught pelvic exams and the reality that most patients experience them as painful and disempowering. It comes directly out of the radical, revolutionary work of gynecological teaching associates (GTAs)–women who teach medical students how to provide safe, respectful, consent-based pelvic exams. The unique thing about the GTAs is that they use their own bodies to teach. Director & producer Amy Jo Goddard has had over 1,000 pelvic exams as a GTA and knows first hand that pelvic exams should not hurt when performed correctly. She and her partner on the film, midwife Julie Carlson, started At Your Cervix in order to change the negative experiences patients often have with gynecology—however their mission expanded as they researched and found out the affronting alternatives when students do not get to learn with trained teachers.

At Your Cervix uncovers the racist origins of gynecology and obstetrics and links that to the continued objectification of primarily poor women and women of color in current teaching practices. The so-called “father of gynecology” and still lauded Dr. Marion Sims learned to do procedures by experimenting on enslaved women without anesthesia. Even though anesthesia existed at the time, he had colleagues hold the women down while he cut into their genitals and organs in order to learn and “practice.” The filmmakers believe that this dark history of gynecology relates to the way it is approached today.

The filmmakers want to improve gynecological care and end unethical practices that are still used, often routinely, to teach medical students. Nursing students are often expected to learn on one another and there is a current case in Florida filed by two students who were told to undergo a vaginal ultrasound with their fellow (yet untrained) student colleagues. The most egregious way students learn is that they will often be told by instructors to “practice” pelvic exams on anesthetized patients without their consent. Many people consider this a thing of the past, but research and the interviews of the filmmakers show that it still happens. Just this week, a woman posted a powerful blog post about her experience as a patient who experienced a non-consensual pelvic exam, waking from knee surgery and finding iodine-stained gauze on her pelvis. She has experienced many consequences from this medical assault including PTSD. She is not an exception. Research has shown that up to 90% of medical students might learn this way. In 2012, medical student Shawn Barnes sent a letter to the journal Obstetrics and Gynecology detailing his experience doing a pelvic exam on a non-suspecting and non-consenting patient, saying he felt “ashamed.” They printed the letter.

This practice of students doing exams on anesthetized patients without consent is outlawed in only four states, but not if the filmmakers have anything to say about it. At Your Cervix has the potential to create massive social and systemic change. Already, during their fundraising campaign, the film is raising awareness, creating dialogue and activating people. This is an important documentary that sheds light on little-known areas of women’s health and gynecology.

After working on the film for years, the filmmaking team is raising finishing funds. Please join the movement and help them get this film to completion and end these practices. No amount is too small.

Please share this with your networks and support this movement!

At Your Cervix, A Student's Look
Image courtesy of Amy Jo Goddard

Other sources regarding Sims:

McGregor, D. K. (1998). From midwives to medicine: The birth of American gynecology. New Brunswick, NJ: Rutgers University Press.

Washington, H. A. (2006). Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. New York: Doubleday.

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