Reference Manual - IARC Screening Group

Performing Breast and Pelvic ExaminationsFor right-handed persons, the hand placed in the vagina usually is theright hand. In these instructions, it is referred to as the pelvic hand. Thehand not in the vagina is referred to as the abdominal hand.Avoid placing your thumb on the woman’s clitoris because this isuncomfortable for her.Figure G-20. Inserting the Fingers into the Vagina• Follow the anterior vaginal mucosa until you feel the cervix (FigureG-20). Begin gently palpating the cervix.• A nonpregnant cervix will feel like the tip of your nose. Duringpregnancy the cervix is softer, larger and feels like your lip.• Feel the size, length and shape of the cervix. Note its position andconsistency.• The position of the cervix often indicates the position of thecorpus of the uterus. A cervix pointing up usually means theuterine body is directed posteriorly (retroverted), while a cervixpointing down usually means an anteriorly directed uterus(anteverted).• Move the cervix gently from side to side between your fingers. Itshould move 1–2 cm in each direction without causing thewoman discomfort or pain (Figures G-21a and b).Cervical Cancer Prevention Guidelines for Low-Resource Settings G-25