Support For Survivors
Why Bother With A Smear Test?
Smear tests are probably not most women’s idea of a “Fun” experience but for Survivors of sexual abuse or sexual violence they can be especially upsetting so why bother to go at all? Statistics tell us that the NHS cervical screening programme – which can detect abnormal, pre-cancerous cells – saves around 5,000 lives every year. However, Research published in 2018 by Jo’s Cervical Cancer Trust found that nearly half of Survivors don’t attend cervical screening tests as a direct result of their experience. It may sound dramatic but this could lead to a life threatening illness. If you are a Survivor it is important to remember that you are so worth good preventative healthcare. However, while going for a smear test will probably always be difficult there are things that both you and your GP/Nurse can do to make the screening process as stress-free as possible.
Here are some tips we have put together to make the process more manageable:
What Is The Worst?
Take some time to consider what about the test you might find most difficult or triggering, and how you might address that. If there are particular words or positions you find tend to trigger memories or flashbacks of your abuse ask the test taker to avoid them or find alternatives.
You Don’t Have To Talk About It
Whether or not you choose to disclose your history is entirely up to you. Some women prefer not to, while others find it helps their GP or nurse to be more understanding about the difficulties they’re facing. If you decide to disclose, you do not need to go into any detail, it’s your choice. If you want them to know but don’t want to say yourself how about taking a friend with you who can explain on your behalf.
Think About Comfort
Think about what might make your test more easy on yourself. See if you could request a double appointment so you know you won’t be rushed. Can you bring someone with you to wait outside (or inside if you don’t mind them being there) Can you bring in your phone and listen to music or use a calming App during the session?
Knowing what is going to happen can make you feel more in control.
- Ask as many questions as you can with your GP or Nurse about what is going to happen and when – do this before the appointment. Being informed can help you to feel more powerful.
- Ask them to talk you through the test beforehand and show you the speculum and brush.
- Tell them what words or phrases you prefer or are comfortable with, to help them avoid any language that may be distressing.
- Tell them how heavy or light their touch should be, or not to touch certain areas if possible.
- Ask whether you can insert the speculum yourself, if that would feel more comfortable.
Think about practising some grounding techniques during the test: Breathe and use your senses:
Breathe Deep: Be aware of your breathing. Count if that helps four counts in and six counts out.
Look: Look at something on the wall or look at some calming pictures on your phone
Listen: Bring your phone with you and listen to music or focus on the noises outside
Feel: Touch hold onto a soft scarf or even a (small!) teddy
Taste: Bring in something sweet to suck or perhaps some chocolate
Smell: Bring in a small bottle of aromatherapy essential oil to sniff on
Remember: Clear thinking – It will be over quickly
Think Kind Afterwards
Plan ahead what you will do after the appointment. It may be better not to rush back to work. You may like to meet a friend for a coffee, or for some people just having some space on their own could be the best way to recharge and relax.
Celebrate And Be Proud!
Finally, acknowledge the achievement of having been through the test. Mark it in some way – perhaps by rewarding yourself with a small gift.
My Body Back Cervical Screening Clinic
My Body Back (www.mybodybackproject.com) is a service specifically for Survivors of Sexual Violence that offer support and smear tests in both London and Scotland. They run clinics especially for women and trans men who have experienced sexual violence, where women who have experienced sexual assault or abused are able to access cervical screening, STI checks, and coil fittings and removals.
The clinics are in direct response to requests from women Survivors to give them a space in which they feel in control and their needs are met, regardless of when they were sexually assaulted.
The London clinic is based in the Mile End Hospital in London and serves all UK residents, while the Glasgow clinic is in Sandyford and only serves Scottish residents. You don’t have to be referred by a medical professional and it’s open to all women and trans men.
On the website they describe their unique approach to smear tests:
“All the female staff are trained to work with women who have experienced sexual violence. We’ll discuss your needs with you, and how to ensure you are comfortable throughout the smear test. For example, if there are certain body positions you don’t like, places you don’t want to be touched, or phrases you would prefer are not used during the test – then these will not be used. We can also discuss grounding techniques to make the test easier for you, breathing exercises, and optional aromatherapy services as some women have reported this helps them feel calmer during testing. You don’t have to have the smear taken in one go, and can use a series of sessions to work up to the actual smear. For example, you or the nurse can insert the speculum at the entrance of the vagina in the first session, then a quarter of the way in during the second session, half way in during the third session, until you are ready to have it inserted the whole way and have the smear taken. You are welcome to insert the speculum yourself if this makes you feel more comfortable. Before and after the test, we’ll offer you tea and cake, to ensure you feel calm and in a good frame of mind. After your smear has been taken, we will process the results and send them on to your GP. They will then know you’ve had your smear taken, so they can stop sending you letters asking you to take a smear test. We will send your results to your GP as the relevant NHS Trust rather than using our clinic name, so your GP won’t know you’ve used a My Body Back clinic. This is because we understand not everyone wants their GP to know of their past experiences, or for it to appear on their medical records”.
Source: https://patient.info/news-and-features/how-to-prepare-for-your-smear-test-as-a-survivor-of-sexual-violence by Sarah Graham Published 31-Aug-18
Into The Light provide counselling, support and resources for Survivors of sexual abuse and those that support them. For more information about our services: see www.intothelight.org.uk