Reproductive Healthcare Shouldn’t Be Painful
Content Warning: Distressing experiences receiving medical care
*While the term “women” is used in this piece, this essay refers to people of all genders who have uteruses.
A few years ago, I was set to have my first pap smear. I’ve had obstetrics and gynecology (OB/GYN) appointments before, but this would have been my first time having the pap smear exam done. I was a bit nervous, not knowing much about the procedure outside of basic knowledge, but I still felt ready and prepared to move forward with what was needed to care for my health and wellbeing. The appointment started off fine with the general health check-ups and questions, and I felt at ease. Then came time for the pap smear itself.
No matter how hard I tried, I could not go through with it. The doctor tried their best to make me feel comfortable, telling me to focus on my breathing and trying to distract me with talking. However, nothing could distract me from the excruciating pain I was feeling, to the point where I started crying. I felt extremely embarrassed, finally admitting that I could not go through with the complete pap smear. I left the medical office confused, defeated, and ultimately ashamed. “Why couldn’t I go through with getting my pap smear? Why couldn’t my body handle it? Millions of other people get pap smears every year – why can’t I?” These questions raced around my head the rest of the day and for days after. I did not want to have that experience ever again, but I decided to try one more time.
About a year later, I went back to my OB/GYN office, nervous but ready to try again to get my pap smear. However, the same sequence of events took place – I felt somewhat confident at the beginning of the appointment, but by the end, I was crying and couldn’t complete the procedure. That day, I vowed to never attempt to get a pap smear again, even if it meant risking my health. I didn’t know that my uncomfortable experiences associated with routine pap smears were emblematic of a larger issue of ignoring women’s pain in healthcare. Ignoring women’s reproductive health-related pain, especially Black women’s pain, is normalized in healthcare as seen by the experimentation on Black women’s bodies for gynecological research, the historic treatment of women in healthcare spaces, and the societal culture of not believing women.
Ignoring women’s pain has unfortunately become normal in healthcare. There are multiple studies proving that women’s pain is more likely to be ignored by medical providers, particularly when it comes to reproductive health concerns. Thousands of women have stories attesting to the dismissal of their pain, this leading to a heightened risk of developing diseases or medical complications, along with the psychological impact of being gaslit by medical professionals for years.
Moreover, when we bring race into the frame with gender, we see that there is a particularly long history of ignoring Black women’s pain in healthcare, including relating to the creation of the speculum (the device used in pap smears). The history of medical misogynoir stems back to the Transatlantic Slave Trade. Many people know of the so-called “Father of Gynecology” J. Marion Sims, but few know of his horrific work purchasing enslaved women in Alabama for the sole purpose of performing medical experiments on them. Sims conducted these experiments with no anesthesia or pain management despite it being readily available during that time period and its usage with white women (in his surgeries on white women, he gave them anesthesia).
Sims’ 1840s experiments were done with the goal of correcting “vesico-vaginal fistula,” or an opening between the vagina and bladder that can occur after prolonged labor and vaginal birth, with this condition was most likely being due to enslaved women becoming forced breeders for slave owners. Based on these experiments, he developed the device that would today be known as the speculum.
This creation did not come without the extreme price of the pain and torture of Black women, three of whom are remembered as Anarcha, Betsey, and Lucy. Anarcha, who was 17 years old at the time of her first procedure, had over 30 experiments done on her body. To add on, J. Marion Sims was not the only person enacting this violence on Black bodies – there were unfortunately many other people before and after him enacting the same pain via experimentation on Black women’s bodies. This persistent ideology is what has led to the real-life consequences of pain disparities.
I can’t help but note the connection between the fact that my ancestors’ pain led to the creation of the speculum, yet that very device has caused many other people and I so much pain. While there are concrete steps that can be taken to combat these systemic issues of pain disparities, such as educational campaigns addressing disparities in pain management and policy changes in the medical field, it is also important for patients, especially marginalized patients, to know how to advocate for themselves in healthcare settings. Sharing our stories can push the medical field to prioritize patient safety and comfortability. Everyone deserves comprehensive, full-spectrum healthcare free from pain – we owe it to our ancestors, each other, and ourselves.
Nadia L (she/her) is a reproductive justice and health equity advocate born, raised, and currently based in Northern New Jersey. She is a Spring 2024 graduate …
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