She Didn’t Want a Pelvic Exam. She Received One Anyway.
Janine, a nurse in Arizona, checked into the hospital for stomach surgery in 2017. Before the procedure, she told her physician that she did not want medical students to be directly involved. But after the operation, Janine said, as the anesthesia wore off, a resident came by to inform her that she had gotten her period; the resident had noticed while conducting a pelvic exam.
“What pelvic exam?” Janine, 33, asked. Distressed, she tried to piece together what had happened while she was unconscious. Why had her sexual organs been inspected during an abdominal operation, by someone other than her surgeon? Later, she said, her physician explained that the operating team had seen she was due for a Pap smear.
Janine burst into tears. “I started having panic attacks trying to figure out what had happened,” she recalled in an interview. “I have a history of sexual abuse, and it brought up bad memories.”
She felt especially unnerved as a medical professional: “Patients put such trust in the medical profession, especially on sensitive topics such as going under anesthesia.” (Janine asked that she be identified only by her middle name. The hospital declined to comment on its policies regarding informed consent for pelvic exams.)
Pelvic exams necessitate physical inspection of the most sensitive areas of a woman’s body. The exams are typically conducted while the patient is awake and consenting at a gynecologist visit, to screen for certain cancers, infections and other reproductive health issues.
But across many U.S. states and medical institutions, physicians are not required to obtain explicit consent for the procedure. Sometimes the exams are conducted — by doctors or doctors-in-training — while women are under anesthesia for gynecological and other operations. Often the exams are deemed medically necessary, but in some cases they are done solely for the educational benefit of medical trainees. At some hospitals, physicians discuss the procedure with patients beforehand or detail its specifics in consent forms, but at others the women are left unaware.