Q for midwives re: sexual abuse and pap smears

[mysticmomma]

At 19 I was diagnosed with CIN3, and had a LEEP procedure done. All susequent paps have been normal. I haven't had one in 3 years due to anxiety over past sexual traumas. I have had several abusive, violent encounters. I know I need another pap. I no longer have a midwife, but do have a CRNP that will do the exam for me. I've looked into obtaining my own samples, but there doesn't seem to be enough research on the reliability of that. I don't know what to do. I'm considering asking for a valium before hand to help. I have a 3.5 month old, and will be waiting until 6 months PP for the pap I think. Please offer advice!
Trisha

[pamamidwife]

YOu might ask if teh CRNP does paps in a left side lying position - or in a more upright position. Sometimes it can be tricky, but it makes a huge difference to not be lying flat. A mirror can help, too - a large, stationery one, though - so you can see what is happening.

Valium is contraindicated during breastfeeding, but something like Xanax might be an option. Definitely talk to the CRNP about her experience with abuse survivors.

Good luck, mama.

[Robinna]

I'm not a mw or doula hon but I had a clinical phobia on this front too. I went 10 years without any kind of pelvic or pap, and the only reason I had one THEN was because I was pg and my MW was very concerned that I hadn't completed a colposcopy protocol when I quit going and was now pg. It was awful. I was having panic attacks at my telemarketing job at the time just from having to phone a Dr.'s office to find out about their office lease.

Anyway I went for hypnotherapy and I beat the thing blind. I also did hypnosis for childbirth which was fantastic for birthing, but the hypnotherapy to deal with my ob/gyn phobia may be the best thing I've ever done for myself. It doesn't motivate me to go have a pap smear by any means, but at least I can tolerate the idea now and had my MW do one after dd was born too. I don't know that I'll ever have another... I don't do the yearly physical thing... but I know now that if I have to, I can, without needing to be sedated.

I completely understand how you're feeling and want you to know that if you want to, if you're ready, you CAN make it go away. Please PM me any time if you want to chat about it.

peace
Robin

[mysticmomma]

Originally Posted by pamamidwife

Valium is contraindicated during breastfeeding, but something like Xanax might be an option. Definitely talk to the CRNP about her experience with abuse survivors.

Good luck, mama.

Dr hale's info is promising for a one time usage with a 6 month old.

[CMcC]

Originally Posted by mysticmomma

At 19 I was diagnosed with CIN3, and had a LEEP procedure done. All susequent paps have been normal. I haven't had one in 3 years due to anxiety over past sexual traumas. I have had several abusive, violent encounters. I know I need another pap. I no longer have a midwife, but do have a CRNP that will do the exam for me. I've looked into obtaining my own samples, but there doesn't seem to be enough research on the reliability of that. I don't know what to do. I'm considering asking for a valium before hand to help. I have a 3.5 month old, and will be waiting until 6 months PP for the pap I think. Please offer advice!
Trisha

Don't have a lot of advice for ya. I still have yet to have a pap smear done without being pregnant. (Gearing up for the first one in a couple of weeks.) I like the PP suggestion of hypnotherapy. I work with a hypnotherapist that says she has great success rates with people dealing with all kinds of issues. I would suggest having a trusted, encouraging, and supportive person go with you into the room while they are doing the procedure. Perhaps this person can also let the CRNP (or whoever) know about your circumstances (and make sure that person is sensitive to the situation). They don't have to tell the full story, just that you have anxiety (rightly so) over past sexual traumas. Make sure to let them know of any "triggers" that might "set you off". (I liked the suggestion of possibly using a different position, also.)

[dancindoula]

You may also be able to do the exam yourself with the CRNP there to assist. Some women find this really helps since they are actually in control of the procedure.