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Self-care note: This information talks about sexual violence and cervical screening. We use the term ‘survivors’ throughout, but understand not everyone relates to it. This information also includes quotes from survivors of sexual violence. If you find this information too distressing, remember you do not have to read it at all or in one go. We have a section on getting support that may be helpful.
Many people find being invited for and having cervical screening (a smear test) uncomfortable and distressing. But if you have experienced sexual violence, you may find it particularly traumatic or distressing.
If you feel this way, you are not alone. We recently did a survey with survivors, where almost half said they had not attended cervical screening because of their experience of sexual violence.
Cervical screening can feel both intrusive and intimate because of the physical position the test is done in and the medical equipment used. This means it can trigger flashbacks of the things you have been through, or evoke physical and psychological responses, like a panic attack, dissociation, or freezing. Many survivors are anxious about having to disclose their experience to a healthcare professional.
Remember that these are all normal, reasonable responses and there is support available. We list some of the organisations who can help you at the end of this page.
Getting the letter inviting you to cervical screening can be upsetting and make you feel very anxious. You may react by simply throwing the letter in the bin. If you feel able, talking about your feelings with someone you trust could be a first step to dealing with any issues or concerns the letter might be bringing up.
You might want to talk to your partner, a friend, relative, doctor or nurse. If you are currently getting mental health support to deal with your experiences of sexual violence, you might prefer to speak to your Rape Crisis counsellor, Independent Sexual Violence Advocate (ISVA), or another support professional.
If thinking about cervical screening is too much, you can ask your doctor to take your name off the cervical screening automatic invitation list until you feel stronger. Please be aware that you may be asked why you want your name removed.
Above all, try to remember that the violence you experienced was not your fault, and that you are deserving of care, safety, and dignity. It is also important to remember it is your choice whether to go for cervical screening and, if you do go, you are in control of the test.
Feeling that you are not in control of your cervical screening appointment may remind you of past violent or abusive incidents. You can begin to take back that sense of control by making some decisions about how you want the appointment to go:
You may find disclosing your experience of sexual violence very difficult or you may have never disclosed. You may also deny it when asked. All of these feelings and reactions are normal.
There is absolutely no pressure to disclose anything during your appointment. But it might be helpful to let the nurse know that you are feeling uneasy. If they are aware, it may help them better understand how to help you through the appointment. You may find it helpful to:
If you would prefer your nurse to know about your history, try practising this conversation beforehand with someone you trust. Alternatively, you can take a trusted person with you, who can be your voice if you lose yours. Or it might be easier to write it in a note that you can pass to your smear taker.
If you are worried about stress responses kicking in, coping with these, or what your nurse might think, it may be a good idea to let your nurse know before the test. For example, you can tell them “I might cry” or “I might not be able to answer your questions”. You do not have to explain why you might react this way.
If you feel able, you and your nurse can agree a plan of action. It may include a word or signal that lets them know you need to stop the test immediately. It could be an agreement that you will insert the speculum yourself, to help you feel more comfortable or in control.
If your distress or anxiety starts rising, some self-care techniques may help:
Remember that if you feel unsafe, uncomfortable or distressed, it is your right to stop or pause the test at any time – whether you simply want a short time to collect yourself, or you would prefer to leave altogether.
It is absolutely fine if you don't go through with your cervical screening on the first attempt. You can always try again on another day or with another nurse. Be patient and gentle with yourself, and remember that your nurse's main concern is your health and wellbeing. They are not there to judge, and should be respectful of your emotional need to move forwards at your own pace.
Likewise, once you have had your cervical screening, give yourself the time and compassion you need to deal with any difficult feelings it may have brought up.
Waiting for your results can be an anxious time. Try to remember that most of us (9 in 10) will have a clear result.
If you do have cell changes (abnormal cells) on your cervix or a high-risk human papillomavirus (HPV) infection, it may bring up lots of feeling or memories about what you have been through. Going for further tests or treatment may feel impossible or too upsetting.
You don’t have to cope with these feelings alone. If you feel able, speak with your doctor or nurse about your results and ask for more emotional support if you need it. They can refer you to an NHS counsellor or you can find a private counsellor who suits you. Remember that private counselling does cost money.
You can also call our free Helpline on 0808 802 8000 to speak with one of our trained volunteers.
We have lots of information about cervical screening that you may find helpful, including a blog with useful tips. We also have support services, including:
There are also other expert organisations that may be able to help:
Provides information and support to survivors of sexual violence, sexual assault and sexual abuse across England and Wales.
Freephone 0808 802 9999 (12 to 2.30pm, then 7 to 9.30pm, every day)
Provides information and support to survivors of sexual violence, sexual assault and sexual abuse across Scotland.
Freephone 0808 801 0302 (6pm to 12am, every day)
Offers free counselling for people who have experienced sexual violence, sexual assault and sexual abuse across Northern Ireland.
Offers support to women to reclaim control of their body after sexual violence. Runs specialist cervical screening and sexual health clinics offering cervical screening and STI testing in London and Glasgow for women and trans men who have experienced sexual violence.
Offers support to adult survivors of childhood abuse, including a free support line and email support service.
Support line 0808 801 0331 (10am to 9pm, Monday to Thursday, and 10am to 6pm on Friday)
Provides confidential, independent advice and support for LGBT+ survivors of sexual violence, sexual assault and sexual abuse.
Sexual Assault Casework and Support Service 0207 704 2040
A national umbrella agency for 130 specialist organisations in the UK that offer support to people who have experienced sexual violence, sexual assault or sexual abuse. It has a free, confidential helpline.
Helpline 0808 801 0818
A survivor led group for women who, as female children or teens, experienced sexual violence, sexual assault or sexual abuse by a member of their immediate or extended family.