Smear Campaign

Pearls of wisdom

CW: Child Sexual Abuse, Pregnancy Loss


This year, European Cervical Cancer Awareness Week falls from January 28th. As a result, the past few days have seen my Twitter feed full of reminders that smear tests save lives; that cervical cancer is an awful way to go; that it is preventable; that a few minutes’ of (unnecessary) embarrassment and (minimal) discomfort are worth it if they save your life; that you really don’t want to be one of the 70 women in Ireland who dies as a result of cervical cancer this year.

I chose to believe this piece of research that instructed me that there is a statistically significant number of false positive results. I decided to nod in agreement with pieces like this from The Guardian. Never mind that it’s nearly 15 years old. I liked what I read.  I also had a look at the academic journals and read the ones that would confirm my existing bias. As a full-time researcher in the social sciences, I know better; but I decided to suspend my natural and professional critical interrogative proclivities in order to tell myself I was making an informed decision. Hey! I wasn’t going to be publishing my findings, and I wasn’t going to be harming anyone (except, maybe, myself) if I was wrong.  I also had a quick look at this website and decided I didn’t tick enough boxes to be anything other than ‘low risk’.


So, for the 16th year running, I won’t be having a smear test. Head-in-the-sand? Definitely. I wouldn’t normally be so reckless about screening (I had my first mammogram at 27 – before I’d even had kids), but a smear test is a slightly different screening exam to most, and the reason for my aversion is – sorry to say – rooted in my experiences of child sexual abuse, and subsequent sexual assaults as an adult. I want to feel empowered as much as, and as often as, possible. Smear tests aren’t really empowering.


All of that said, however, I think there might be a solution. I am not the only woman in Ireland with a history of sexual assault. There are thousands of us in the ‘smear test age bracket’ who have been sexually abused, and I think it might be a good idea if we were facilitated with a bit of compassion / understanding.


I’m reminded, very much, of the last time a health professional went faffing around at my nether regions. It was four years ago last week, and I was losing a pregnancy. This had not been an easy pregnancy to achieve, and I’d used donor sperm for a variety of reasons (that’s a whole ‘nother blog post). Anyway.


Losing this baby* was devastating. Not least because I didn’t have a partner to hug me and tell me it would all be all right, but because accessing healthcare was difficult for me. I decided to do what I could to take ownership of my own care, and empower myself as best I could. The first thing I did was drive an hour out of Dublin (passing, literally, by two maternity hospitals on my way) to Mullingar. I’m a doula, and although I rarely practice any more, I am still in contact with many members of the birth community; and I hear things, and I know things. One of the things I had heard was that I could expect to find more compassion in Mullingar than in the Dublin hospitals (for a variety of reasons).


In Mullingar, I was treated with kindness and compassion by the young male doctor in A&E who drew blood and tried to be as reassuring as possible. I was invited (and I choose the word deliberately) to return for further blood tests and a scan at the Early Pregnancy Unit. I thought about it. I wasn’t keen, but I steeled myself and showed up. When I was registering that morning, I noticed that the nurse (Deborah) wore a name-tag which indicated that she was attached to the SATU (sexual assault treatment unit) in the hospital. Ten minutes after sitting down, waiting to be called, I decided to take my treatment in my own hands, ignored the voice that said I was ‘being dramatic’ and ‘attention seeking’ (my abusers used to toss this at me any time I got upset about how I was being treated) and I approached this nurse. I disclosed that I had a history of sexual abuse and explained that I found trans-vaginal ultrasounds immensely difficult.


The amount of compassion and understanding I bumped up against was instantly reassuring. Deborah asked what I needed, how she could help, offered me choices (I didn’t need to have a trans-vaginal ultrasound if I didn’t want one, and could opt for the ‘old-fashioned’ way of drinking litres of water and having an abdominal scan instead). She literally held my hand throughout the procedure and did her absolute best to make sure that I felt empowered, comfortable and heard at all times.


I can honestly say that hearing the dreaded words ‘I’m really sorry – there’s no heartbeat’ was made that bit easier by the way I had been treated with compassion and dignity every step of the way.


Now, I know that having a miscarriage and having a smear test are different – but in many ways, they’re not that different. So what I’m wondering is if might be possible to have some additional consideration for women who have a history of sexual assault? Is there any chance, for example, that we could have our smears done in one of the SATUs around the country? Or – given that I know how over-stretched the SATUs are – could we have HCPs undergo additional training to make them more aware of the issues  faced by abuse survivors? Is there any possibility that we might have trauma-informed care around smear testing? Honestly, if I were to re-consider my position, that is the one thing that would make me do so; and I don’t think I’m the only one.


This is one of those times when I’m going to say ‘do as I say, not as I do’ and encourage you – if you live in Ireland and own a cervix – to check here to see if you’re due a smear test. And if you are, to go and have one.


*Lookit, I know it wasn’t really a baby, but it was in my head, because I desperately wanted it to become one. 







Published by

Hazel Katherine Larkin


Please feel free to share your thoughts and comments!

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s