There are lots of posts and videos all over Facebook and Instagram at the moment about smear tests but as it’s cervical cancer awareness week (22nd-28th January) this isn’t a surprise really. In fact it is awesome that so many are behind it and sharing and encouraging others to have their smear test. What might be surprising is that whilst smear tests can be potentially lifesaving, there has been a huge decline in the uptake of smear tests over the last 10 years.
According to Jo’s Cervical Cancer Trust, cervical cancer is the most common cancer amongst under 35’s, smear tests prevent 75% of cervical cancers from developing, and yet 1 in 4 women do not attend when invited. In the age group of 25-29 year olds this figure drops to 1 in 3 not attending.
Smear tests are to detect abnormal cells in the cervix which could develop into cancer if left untreated. Since the NHS Cervical Screening Programme was introduced in 1988, the number of women getting cervical cancer in England has gone down from over 4,100 a year to 2,300 a year in 2010.
So, if a smear test can have such a significant impact on preventing cervical cancer why on earth are the rates declining?? Lots of posts have been shared about being shy or the embarrassment element of going for a smear and ‘tag someone to remind them to book theirs’. But surely it isn’t that simple? That isn’t the only reason is it?
Confession time – I haven’t been for a smear test in 6 years. I’m educated, informed and know that these are a bloody good idea but why had I been delaying? (For the record 2 weeks ago I finally made my appointment and it will take place next month so no need to nag me now!). I’ve been tested before (between having my eldest who is nearly 10 and my youngest who is 5) and it was no problem at all – it didn’t hurt and was quick and straightforward. So why was I ignoring every reminder that popped through my door? I’m sure there aren’t many women who are eager and happy to pop down to their doctors for the test but it is just something you do even though it is a bit unpleasant. If you asked me why I was missing it I couldn’t have given a reason – well I could have given some rubbish ones like no time, having really irregular periods so booking it was hard to plan, or that I was going to book it when things quietened down at work. But I hadn’t really thought about why I was avoiding it though.
It wasn’t until I saw a post earlier this week on Instagram by @drrebeccamoore (Birth Trauma expert) that struck a cord with me and really made me think more about this. She said “We should get smears done, we all know this. But what if it feels terrifying because of a birth injury, assault or trauma. Then going for a smear can feel impossibly difficult…..” I work with women postnatally who have experienced birth trauma and yet this isn’t something that I had really considered but of course it makes so much sense.
The Birth Trauma Association estimates that 10,000 women in Britain are treated for post-traumatic stress disorder as a result of birth each year. They estimate as many as 200,000 more women may feel traumatised by childbirth and develop untreated symptoms of PTSD. That is a lot of women and potentially a large group of them may find going for a smear test more challenging than most other women.
On her post @drrebeccamoore suggested the following ways that may help women who are struggling to go for a smear test find it more manageable (she acknowledges that these aren’t all the answers but it may help someone):
- Book a double appointment so it’s not rushed.
- Book your appointment for first thing in the morning as it is often quieter and so hopefully you won’t be kept waiting.
- Take control pre smear – talk or write to whoever will do the smear and tell them what distresses you and how you would like the smear to go. For example, you could sit up rather than lie down as it may feel safer. Do you want a running commentary or no talk?
Are certain words too triggering? Ask these words not to be used.
Some women hate being touched on their abdomen, ask not to be touched there.
Ask for the smallest size speculum.
Take painkillers beforehand.
- Take a friend.
- The smell of the room can be triggering, antiseptic etc, take a small bottle of essential oils to sniff or use Rescue Remedy spray.
- Ultimately be sure the person doing the smear will stop even mid procedure if you ask them too. Your body your choice.
And so, what has all this got to do with my reluctance for booking my smear? I didn’t have (what I would describe) as a traumatic birth with my son but when I made myself think about my labour undeniably the worst part was having to lie on my back just like you do when you have a smear test and having a speculum examination. I wouldn’t have said my labour with my son was painful – but that was. Being on my back and unable to move, having really intense contractions that were coming very close together and felt so painful and overwhelming. Being in a curtained cubicle and being able to hear people just on the other side of the curtain while I was so vulnerable further increased the intensity of these feelings.
If this experience had left me with a sub conscious desire to avoid a similar situation again then I can only imagine what the experience (or thought of the experience) may trigger for women who have experienced birth trauma or injury (or for those women who may have experienced sexual assault).
Of course embarrassment, not knowing what to expect, fear of judgement etc will all play into the reasons why some women feel unable to book their smear test but for some women it is a whole lot more complicated than that and we should be aware, and considerate, of that too.
So, my test is booked for the 12th February. I’ll be needing to use my relaxation and hypnobirthing techniques in the lead up to, and during it, but I know it will be ok. Not pleasant – but ok. If you are feeling worried about having your test please don’t continue to worry and not do anything about it. Access some help and support – either from friends, your GP, the practice nurse or some of the organisations below. If you have experienced birth trauma and it is affecting you please access support. I’m not saying it will be easy but this it is too important to not do something about.
Jo’s Cervical Cancer Trust – https://www.jostrust.org.uk/
Birth Trauma Association – http://www.birthtraumaassociation.org.uk/
Cancer Research UK – http://www.cancerresearchuk.org/about-cancer/cervical-cancer
A Guest Blog from Yvonne Hopkinson
Yvonne moved to Gloucestershire from Somerset in 2012 and immediately felt at home. Her Gloucestershire connection is a little older than this having moved to Cheltenham in 2000 to study for her degree. After graduation she was employed as a lecturer at the University of Gloucestershire and while she moved back to her home town of Taunton in 2003 to get married and eventually have her first child, she commuted to glorious Gloucestershire every day for years!
When Yvonne isn’t at the university she can be found teaching antenatal and hypnobirthing workshops for her business Relaxed Birthing or as part of the Nurture 4 Life team in Cheltenham. She is also ploughing her way through a PhD on the topic of exercise during pregnancy and so is keen to hear about any Mamans experiences! You can find her on Facebook at www.facebook.com/relaxedbirthing, drop her a line at firstname.lastname@example.org or give her a follow on Instagram .