A health care practitioner uses a vaginal speculum to help her inspect the vaginal canal and cervix during a pelvic examination. The Graves speculum comes in different sizes. It has two curved, rounded blades that fit more naturally inside the vaginal canal. The standard-sized Graves speculum is the speculum of choice for women who have had a child. Its wider blades help separate the looser vaginal walls. With practice, it is relatively easy to learn how to insert a speculum.
- Skill level:
Things you need
- Examination table
- Graves speculum
Have the patient disrobe from the waist down. Position her on the exam table so she is lying on her back with her knees bent and her feet in the stirrups. Have her slide down until her buttocks are hanging slightly off the edge of the table. Elevate the head of the table to maintain eye contact.
Cover her knees with a drape. This helps give her a sense of modesty.
Put gloves on. Make sure the patient does not have a latex allergy. If she does, use latex-free gloves.
Sit down and position yourself between the patient's legs. Adjust the light so you have a clear view of her genital area.
Run warm water over the speculum to warm it. Some health care practitioners keep speculums in a heated drawer.
Show the patient the speculum if she hasn't seen one before. Tell her you are going to insert it. Assure her it's all right to let you know if she's uncomfortable at any point. If you haven't warmed the speculum, tell her it will be cold.
Place the index and middle fingers of your dominant hand inside her vagina. Press downward and laterally to enlarge the vaginal opening.
Ask the patient to relax. It's not uncommon for a woman to tighten her pelvic muscles at this point.
Insert the Graves speculum into the vagina at a 45-degree angle. Always apply downward pressure during insertion.
Keep the blades closed.
Rotate the speculum to a horizontal position. Grasp the handles with your other hand. Insert the speculum until it is flush against the perineum.
Open the blades using the manual screw. Make sure you can see the cervix. Lock the blades in the open position.
Remove the speculum when the exam is cover.
Offer the patient tissues to clean herself. Help her sit up.
Let the patient dress before sharing your findings with her. If time is limited, discuss your findings after she sits up.
Tips and warnings
- The Graves speculum is available in a paediatric size. The paediatric speculum is used in very young children.
- Women who perform in-home self-examinations of the cervix and vaginal canal may use a plastic speculum. Wash it after each use to keep it clean and sanitary.
- Don't use K-Y Jelly, petroleum jelly or other lubricant to moisten the speculum. This could affect the integrity of a Pap smear.
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