What to Expect at Your Ob/Gyn Appointment
Thank you for choosing ColumbiaDoctors Department of Obstetrics & Gynecology for your Ob/Gyn care. Our goal is to provide you with information that will help empower you so that you can be proactive and engaged in your own healthcare – and so that you can raise any concerns. We want you to feel as comfortable as possible with the care that you will receive.
The first visit with a new clinician is primarily a conversation between you and your clinician, and your past medical history will guide the initial conversation. The first visit may also include a physical exam. Future visits may also include a physical exam, as well as other exams, tests, or procedures.
What Should I Expect at the Beginning of My Ob/Gyn Appointment?
Once you are in the exam room, a medical assistant may take your vital signs, gather your medical and surgical history, as well as other information, such as, any allergies and a list of medications that you are currently taking. The medical assistant may then let you know that the clinician will be with you shortly and step out of the room. When your clinician arrives, they will want to learn if there are any particular concerns that you want to discuss during your visit and will ask you some open-ended questions. You may have answered some of these questions already on a pre-visit questionnaire or with the medical assistant. The clinician may also ask specific questions about you, your family, your history, your health, and your experiences. Here are other common topics that your clinician may bring up or that you are welcome to bring up:
- Your general well-being and happiness
- Any physical developments that you have questions about, such as, a lump in your breast
- Your menstrual cycle history
- Past obstetric history, such as, number of pregnancies and any complications
- Past gynecological history, such as, abnormal pap smears, sexually transmitted infections, endometriosis, fibroids, ovarian cysts, cancer history, menopause/perimenopause transition
- Pelvic pain, vaginal and vulvar changes that you may be experiencing
- Bowel or bladder concern
- Sexual Activity (including vaginal, oral, and anal sex) and sexuality
- Contraception, reproductive plans, and fertility issues
- History of assault or sexual abuse
Some of these questions are very personal, and it is natural to be worried about sharing private information. Be sure to talk to your clinician if you have any concerns about confidentiality.
Depending on your individual history and concerns, a physical exam may be recommended.
Typical components of the exam are:
- General exam
- Breast exam
- Pelvic exam
What Happens During the Exam?
Before the exam, your clinician will step out of the room and give you privacy to change if you are not already in a gown. You will have a sheet to cover up your legs. Your clinician will come back into the room with a chaperone (or call one to the room if you are already in a gown), who will always be present during the physical exam. Your clinician will let you know what to expect before each part of the exam.
General exam
A general exam may include listening to your heart and lungs with a stethoscope, as well as assessing your head, neck, and abdomen.
Breast exam
Your clinician will manually palpate (touch with pressure) your breasts, feeling for lumps, thickening, or discharge. A chaperone must be present for the breast exam.
Pelvic exam
We understand that the pelvic exam can be uncomfortable, intrusive, and may cause anxiety. We are focused on your safety, comfort, and privacy at all times. If you are able to take deep breaths, you may experience less discomfort during the exam. A chaperone must be present for the pelvic exam.
You will lie on your back on an exam table with your knees bent and your feet placed on the corners of the table or in supports (stirrups). You will be asked to slide your body toward the end of the table and let your knees fall open. The pelvic exam usually consists of:
- A visual external exam where the clinician examines the clitoris, labia, vaginal opening, and anus.
- An internal visual exam, where your clinician will use a speculum to look at your vagina and cervix. A gel may be applied so that the speculum slides more easily into your vagina. When the speculum is inserted, it may feel a bit cold and will be gently opened so that your clinician can see your vaginal canal and your cervix. It is normal to feel a sense of pressure or discomfort. If you would like to insert the speculum yourself, please let your clinician know.
- A Pap test or Pap smear involves the clinician taking a sample from the cervix using a small brush. If you are having any unusual vaginal discharge, your clinician will take another sample to check for causes of discharge. For women ages 21-65, Pap smears are recommended every 3-5 years.
- A bimanual exam serves to check your internal female organs. Your clinician will insert one or two gloved, lubricated fingers into your vagina. With the other hand, they will gently apply pressure to the lower part of your belly. You may feel some discomfort when your clinician presses in certain places, but if it hurts, you should let your clinician know.
- Sometimes your clinician will also do a rectal exam. If your clinician conducts a rectal exam, they will insert one gloved finger into your anus. This is usually done at the end of the bimanual exam. If you feel any pain, you should let your clinician know.
After the physical exam, your clinician will announce that the exam is over. If you or your clinician has more to discuss after the exam, the clinician and the chaperone will leave the room so that you can get dressed, and your clinician will then come back when you are fully clothed and ready to discuss any issues discovered during the exam and/or care options for consideration. Alternatively, if your exam is normal and the appointment can conclude, the chaperone will remain in the room with the clinician for any closing thoughts or instructions and then the chaperone and clinician will leave the exam room together for you to get dressed and leave.
Questions You Might Have
Can I stop the physical exam if I feel uncomfortable?
Of course. It is your right to ask to stop the physical exam at any point. We want you to feel in control of your body at all times.
How should I prepare for my OB/GYN visit?
You can get ready for your visit by preparing a list of questions. It is also helpful for you to know about your own medical history, including any developments in your obstetric and gynecologic status, new or recurring.
Where can I report concerns?
If you have any concerns about the care that you received during your appointment, please reach out to our Quality and Patient Safety Team at cdsafety@cumc.columbia.edu or call the patient safety hotline at 212-305-8548. Concerns can also be reported (including anonymously) via the ColumbiaDoctors reporting intake website.
All reported information will be, to the extent feasible, kept confidential.
If I report a concern, will it impact my care?
No, making a report of any concerns or sharing feedback about your care will not impact your care. Members of the Columbia community are prohibited from retaliating against anyone, including a patient or a relative of a patient, who reports any concerns or who seeks guidance on doing so.