Editor—I have had examinations with and without stirrups in the United States and United Kingdom.1 Before my move to the US, smears had always been done without stirrups, and it was just another examination—no more uncomfortable than having teeth drilled.
When I needed a routine cervical smear by my (lovely female) general practitioner in the US, I was in for a shock. I was supine, and stirrups were used (objective). I was flat on my back with my bottom on the edge of a cliff and my legs held up over the edge (subjective). As for choice, she would not take the smear unless I had stirrups.
Back in the UK, skip forward to a referral to a consultant gynaecologist. I had stirrups, and it was great—as far as having a strange man looking at your intimate parts can be positive. I was still supine, but the stirrups were placed lower, and my bottom was not on the edge of the bed. It felt as if they supported my legs to give me a bit of a rest.
In my experience, use of stirrups is not the issue. My female general practitioner used them: I hated it, feeling out of control and extremely vulnerable. I almost didn't go back. The male consultant, whom I didn't like, used them: no problem.
If the experience is not neutral or positive, women will not be examined, and you cannot quality control a nonexistent sample. As with other things in life, it's what you do with it that counts.
Competing interests: None declared.
References
- 1.Seehusen DA, Johnson DR, Earwood JS, Sethuraman SN, Cornali J, Gillespie K, et al. Improving women's experience during speculum examinations at routine gynaecological visits: randomised clinical trial. BMJ 2006;333: 171-4. (22 July.) [DOI] [PMC free article] [PubMed] [Google Scholar]