Guidelines for gynaecological examinations and procedures
The gynaecological examination of women is a formal process and potentially intimidating to women, some of whom may have suffered various degrees of physical or sexual abuse during their lives.
Doctors should consider the information provided by women, listen and respond sensitively to their questions and concerns.
According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Guidelines for Gynaecological Examinations and Procedures C-Gyn 30:41
Awareness of cultural or religious factors is essential when discussing and offering gynaecological examination.
Where examination is indicated, doctors should ensure that:
- an adequate explanation is provided about the nature of an examination and the information that it will provide
- the patient has the opportunity to decline examination
- permission is obtained, especially for breast and/or pelvic examination
- privacy is provided for disrobing
- suitable cover is provided during examination, for example, gown or cover sheet
- a chaperone is available to attend any patient undergoing physical examination when requested, irrespective of the gender of the doctor.
- the patient must be made aware in advance of the presence of medical students and the right to decline their attendance at any examination
- it may be appropriate to delay examination until a follow-up appointment.
With respect to examination of young women and children, see the Royal Australasian College of Physicians (RACP) policy Genital Examinations in Girls and Young Women: A Clinical Practice Guideline.
In addition to these RANZCOG guidelines, it is recommended that patients watch the examination with a mirror to assist their understanding of the anatomy and what constitutes normal.40
The doctor should refrain from using language that is judgemental, expresses surprise or can be construed as derogatory when performing the examination.
Reproduced with permission from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) College Statement C-Gyn 30. Melbourne: RANZCOG; 2004.