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Readers Respond: Reasons women avoid Pap smears: Is it fair to require them for birth control?

Responses: 181


Updated October 14, 2010

It's offensive...

The accepted thinking that women are not entitled to make their own health decisions and do not have the right to bodily autonomy is totally abhorrent to me. The women who also endorse that thinking should be ashamed of themselves - what did we fight for all those years ago? To accept that women have no say in penetrative vaginal exams for a rare cancer with a test that often leads to harmful and painful biopsies or cryotherapy for nothing is shameful. To make healthy women think their bodies are hazardous and need regular probing, scrapping and palpation is absurd and offensive. It is a sick way to think... The constant indignity, pain and suffering that flows from the regime called women's health is far more harmful than cervical or any other sort of cancer. The damage done "supposedly" to fight cancer, is nothing more than using women's bodies for financial gain. I protect my body from "women's health" - my chances are much better with cancer!
—Guest HE

Find the right Dr for you...

I've never agreed that women must do as they're told and are not to make their own decisions with healthcare. Informed consent is a principle of screening for a reason - risk to a healthy person. The actual facts seem to be suppressed when it comes to women and screening and the attitude is, do as you're told, even if it hurts and upsets you. I strongly disapprove of this attitude and think big changes are needed. Every woman should find a Dr who respects her as an adult - freeze out Dr's who treat women like children - let other women know to stay away from them. My Dr does not agree with screening at all and so his patients are free to choose - a nurse does testing for those who want it. I see a female dr who works in his practice even though I've rarely needed an embarrassing exam - I've had one urinary tract infection in my 37 years. I wouldn't put up with the pressure many women face, I'd find a more respectful Dr.
—Guest Berry

Its Horrible

I stopped having pap smears after my last one about 3-4 years ago. I cried in pain and screamed on the table. The doctor wouldnt stop and wouldnt make an effort to stop the pain. I bled and hurt for days. I havent had once since. I even stopped taking birth controll and resorted to having my husband get a vasectomy although its not what we wanted because they refused to give me pills without having a exam. Im uninsured and recently looked into applying to a free clinic and they told me pap smears were requirments for female patients - refusal meant no services thru them. Its horrible. The exams are painful, they are embarassing, and they are humiliating. We as human beings have a right to choose what we want done to us. Id consider forced exams a form of rape!! No matter how they are forced - withholding birth controll, mandatory for your place as a patient, or whatever else. Its wrong.
—Guest GuestK

I was asked...

Doctors got caught out in NZ years ago and informed consent became a huge issue and got lots of publicity. As a result, I think we get more information and doctors seem to have more respect for informed consent. You'll also see consent mentioned in the brochures released by the Govt Health Dpt. The reason screening was put under the spotlight - a Dr decided to conduct an experiment without telling women. Women are usually uninformed about this testing, so I suppose he thought it was more of the same. He treated some abnormal lesions and left others to see how many actually progress. (aware the majority don't need treatment at all and will regress) Well, over the years, a couple of women got cervical cancer and a huge outcry followed... As a result of the publicity, the information got out to women. You'll find articles here on informed consent and doctors actually ask whether you want the test. (mine did) I haven't decided yet, but I have risk information. It MUST be your choice.
—Guest Betty C

Not all Dr's agree

I can't agree that forcing preventative medicine on women is something we should be proud of or "for their own good". As I understand it, cancer testing should be something the woman decides for herself. I was given some of this information by my Dr. I strongly disagree with misleading women. This is my body and I want the whole story. We whitewash scary stories for kids, not for women. Forcing anyone, even pressuring, is stepping over the ethical line in my book. My Dr doesn't pressure her patients - she's a rare Dr and that's why her patients respect and admire her. She has told me she doesn't agree with the way cancer screening tests for women have been packaged...she does tell her patients the test is not 100% correct and might only be 50% correct and she told me about the fairly high risk of an incorrect test result and what a colposcopy entailed... I found out recently my Dr lectures in medical ethics at the Medical School - hopefully, she will make future Dr's think...
—Guest Victoria

Fear of cancer v fear of control

I have mixed feelings about this topic. On one hand, I'm terrified of cancer and will do anything to lessen the risk. I agree that women have few choices in their medical care. We are told rather than offered tests and we rarely play a part in the decision making. The bad thing about screening is the escalating control of our lives by doctors. You almost stop being a person and just hand over your body and have things done to it. I don't agree with doctors telling us half the story. I'm scared of cancer, but also hate hospitals and indignity. I would equally hate to have treatment unnecessarily. We all have a right to protect ourselves. If the risk is small and unnecessary treatment high, then we need those facts to make a properly considered decision. It's a bit arrogant to say we think you should take the risk, without telling us the risk we're taking...almost arrogant and unprofessional. I tend to avoid Dr's too, the control gets to me, it cheapens you as a person, a woman.
—Guest Dina

There is another way.

I think your healthcare is over the top anyway, so it doesn't surprise me that doctors flout the law and your rights. I found your doctors very difficult, arrogant and domineering. I live in a country where doctors work with their patients. They accept we will all make different decisions and sometimes go against their advice. Your doctors were one of the reasons we returned to Europe after living in the States for a few years. (with my American husband) When you are used to being treated as an equal and permitted to make your own decisions, it is impossible to accept the paternalistics ways in US womens health. We can collect Pills at our local pharmacist...none of our doctors would refuse a woman Pills only to find herself pregnant. I really have a hard time understanding how your doctors get away with treating women so badly and everyone seems so accepting of it. Here's hoping for reform. My poor MIL has had about 50 pap smears - it's just ridiculous.
—Guest YR

Some women can`t test...

I work with the victims of sexual assault and most don`t have smears. Even though the risk of this cancer is small, it disappoints me that women are still waiting for a non-invasive and reliable screening test. I don`t think the number of false positives and negative biopsies can be explained away when we`re talking about a very uncommon cancer. I don`t scare these women, they know the risk is small, but they are higher risk because of the assault/s. It concerns me that all the money made from treatment for false positives may dissuade doctors from finding or recommending something better and non-invasive. Sadly, the control this testing gives doctors over women and the money it generates...means alternatives will be unlikely for a long time. I had to find self-test kits for a couple of very high risk women...Dr`s just want to force women to test regardless of their history. Pills should never be held - pregnancy is a serious issue. What about the CSA blood test?
—Guest Anne W

You need change

I lived in your country for 3 years and was surprised how doctors seek to control women`s bodies. There is no need for this sort of control. I can understand why many women feel resentful and even assaulted. If you don`t feel you`ve consented to these exams, it has a serious mental impact. Your doctors tend to exaggerate and frighten women. Our Dr`s tell us the truth and we are encouraged to make our own decisions. If you don`t want testing, that is quite reasonable. The routine gyn exams are not recommended at all. My Dr doesn`t agree with screening for all women and tries to encourage high risk women to screen, but she`d never use coercion or hold Pills. I was told the risk of this cancer was low and the test often led to unnecessary treatment so low risk women should only screen 10 yearly, if at all. We don`t resent our doctors, but I`d resent your doctor`s. It`s bad what is happening to US women. You are people as well...with rights. It is never wrong to say No to testing!
—Guest DVanD

Free up the Pills

I probably shouldn't comment here. My ex-GF hated the exam so much she used to stockpile pills to make them last longer. I didn't mind using condoms but she was worried about one breaking and getting pregnant. It did make our sex life awkward and then she started avoiding sex altogether. She put sex and this test together and it became a negative thing for her. It's not only pap smears, her Dr required all sorts of revolting things. It is bad, women should be able to get Pills without all of that and enjoy their sex life. As I understand it, all of the exam is about preventative medicine and not really connected to the Pills. One of my friends had a vasectomy to get his wife off pills. She also hated the exams. It sounds like a common thing, I hear about it from my friends.
—Guest Max

It's a screening test!

It's always surprised me that women are expected to subject themselves to regular intimate medical scrutiny with not a peep of protest or any sort of scrutiny as to the risks and value of the test. It's sexism at it's worst. This test doesn't empower women, it enslaves them. I'm not anti-screening, just anti-bullying. We're all adults and make decisions every day - cancer screening is no different. To hold a woman's pills is low...doctor's were pillars of society...not any more. Unplanned pregnancy can have very serious consequences, medical, social & economic. I have no respect for the doctor's who take pleasure in the misuse of their authority. They deserve harsh punishment.
—Guest Violette

Sleeping Beauty Program to Pap Smears

At Uni I did a short extra subject on Women and Medicine and we talked about the "unpredictable female body that harbours disease". We covered mandatory pelvic exams for brides that were State mandated in America during the Cold War. It was felt a woman who coped with penetration during a vaginal exam was more likely to derive pleasure from intercourse and thus be a good wife. I don't think much has changed in medicine. We're still treated like objects or bodies with no rights, never willing and informed participants. We can be deceived, manipulated, coerced, used for financial gain, humiliated, dismissed & harmed and it's all "for our own good". Nothing changes... It's just called something different to "justify" regular intimate exams. Pap smears are the new mandated pelvic exam. Having more women present in the profession hasn't helped. We all need to demand for ourselves the rights that males take for granted. We're not diseases waiting to happen...treat us with respect!
—Guest Kathy

Please ASK us whether we want a pap test

Women resent being man handled and told what to do. Many women feel helpless in medical settings. I know a few women and the number is growing who have stopped testing altogether. That happens when women feel manipulated and used or hurt by the system. If these women had been involved in their health care instead of having "things done to them" they might have kept testing. Dr's must have all decided that forcing women was the best way to get great coverage, but it has backlashed on them. I think women have lost respect for doctors and are disillusioned with all this testing. We feel we've been lied to and forced into things that should be optional. It would have been better to be honest at the start
—Guest Bea

Part of being a woman - really?

Some of you may care to look at a fascinating article that shows how women have been "programmed" in an unethical and dishonest way to just "accept" smears as part of being a woman. It concludes that women don't give informed consent for smears even though it is a requirement, legally and ethically. It shows a profession that views women and what is acceptable for us very differently to the accepted ethical standards for men. Look at the risk information for men and PSA testing (a very common cancer) ...pap smears are just as unreliable and for a rare cancer and near silence on the subject. Different standards and attitudes are applied for men. To answer your Q: No, it is VERY unfair and more than unfair, illegal and unethical. Pap smears should be something offered without pressure and entirely a matter for each woman. "It's just part of being a woman" J Bush, Social Science & Medicine, Vol 50, Issue 3, Feb 2000, pgs 429-444 Thanks for asking anyway - even that is a rare thing.
—Guest Harriet W (UK)

Is a pap a screening test?

I didn't realize the smear was even a screening test like PSA testing or rectal exams for prostate cancer. Cancer screening is optional whereas I have always been made to feel that paps were mandatory, like a law. No doc has ever asked me whether I want one or given me any sort of choice. They were almost an order I guess... I cannot even think what would happen if I didn't want the test, my doc would be hysterical. I got the feeling this cancer was more common than lung cancer or breast cancer because doctors talk about it so much and we've all have abnormal paps and LEEP. I don't think the rules for cancer screening tests should be different for women. Doctors should not be allowed to make the choice for us or hold BC. Are we children who can be ordered about?
—Guest SMc

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