Feminist accounts of 1970s women's health activism in the Anglophone world highlight cervical self-examination as a means of reclaiming the female body from biomedical monopoly. Whilst cervical screening programmes have become part of health policy in the United Kingdom and other Western countries, cervical self-examination does not appear to be widespread, nor have many women seen their own cervix. Feminism has also drawn attention to the significance of biomedical imagery and discourse in the engendering of knowledge about one's own body, particularly through visualisation techniques. This paper presents interview material in which women describe the experience of cervical colposcopy and their responses to magnified images of their own cervix during this procedure. The data are used to consider how visualisation techniques shape bodily experience.
"Women's attitude towards the magnified view of their cervix, displayed on the monitor during the procedure, corroborated Howson's  observations of women's reactions to this sight. Her conclusion that the magnified view turns their cervix into a medicalised object, rather than providing reassurance for women was borne out with this group of women. "
[Show abstract][Hide abstract] ABSTRACT: The last comprehensive investigation of women's experience of the colposcopy service in the UK was conducted in the 1980's. It highlighted women's anxiety and lack of information, resulting in recommendations for improvements. Since then the colposcopy service has changed substantially. It is therefore time to re-visit women's experience of this service and reflect upon the success of service changes in improving experience and reducing anxiety. The aim of this study was to investigate women's experience of being referred for, and attending, colposcopy appointments, and identify potential service improvements.
Qualitative in-depth interviews were conducted with 18 women newly referred for colposcopy in the West Midlands, UK. The interviews were designed to elicit the experience of colposcopy from the patients' perspective.
The eight emerging themes were categorised as three overarching concepts, which were: feelings of emotional reaction, choices being accommodated and time delays. Women felt very apprehensive before their appointment, but when attending, appreciated being consulted about their preferences. Delays in referral and feeling 'rushed' by staff impacted negatively on women's experience.
Service changes in information provision and increased respect for dignity seem to have improved the experience that women have of colposcopy, however, this does not appear to have translated into decreased anxiety. Women still have strong emotional reactions to being referred for, and attending, colposcopy appointments. Staff taking time to explain the diagnosis fully, and discuss their preferences about aspects of their consultation can alleviate their anxiety.
BMC Women's Health 04/2011; 11(1):11. DOI:10.1186/1472-6874-11-11 · 1.50 Impact Factor
"Initial analysis involved the team each reading selected interview transcripts then identifying concepts for further analysis guided by the theoretical positions outlined in the introduction. Key concepts included the negotiation of medicalization through the lived body, how women move between different accounts of their body, the limits technology imposes on women's agency in the negotiation and the concept of a visualized body (Green et al., 2006; Howson, 2001). Analysis proceeded by constant comparison of all transcripts (Green and Thorogood, 2004), looking for similarity and differences between each respondent's transcript and those already analysed. "
[Show abstract][Hide abstract] ABSTRACT: Women's perspectives on breast screening (mammography and breast awareness) were explored in interviews with midlife women sampled for diversity of background and health experience. Attending mammography screening was considered a social obligation despite women's fears and experiences of discomfort. Women gave considerable legitimacy to mammography visualizations of the breast, and the expert interpretation of these. In comparison, women lacked confidence in breast awareness practices, directly comparing their sensory capabilities with those of the mammogram, although mammography screening did not substitute breast awareness in a straightforward way. The authors argue that reliance on visualizing technology may create a fragmented sense of the body, separating the at risk breast from embodied experience.
Health 11/2010; 14(6):653-68. DOI:10.1177/1363459310361599 · 2.10 Impact Factor
"This change in identity in the health care system is also coupled to the shift to dependence on professional interpretations of an unfamiliar part of one's body previously unaccessed. Howson (2001) discusses this phenomenon in detail in her feminist analysis of how bodily knowledge is affected through medical visualization processes, pointing out that allowing women to see their cervixes during colposcopy, as suggested by some (Juraskova et al., 2007; Walsh, Curtis, & Mylotte, 2004), does not address the objectification of the body that occurs. The increased awareness of the cervix and 'gynaecological interior' of the body is one indication of changes in how bodily boundaries were conceived. "
[Show abstract][Hide abstract] ABSTRACT: While there is a large body of research on cervical cancer screening, fewer studies address the experiences of women receiving abnormal Pap smear results after routine screening. Those studies highlighting such experiences tend to concentrate on resulting psychosocial distress, with an absence in the literature about women's experiences of their bodies during medical follow-up for dysplasia, and no studies were found that explore such experiences over time. In this article, we focus on bodily experiences over time during medical follow-up of an abnormal Pap smear among a group of women in Sweden. This qualitative analysis is based on interview data from a total of 30 women, and with in-depth analysis of the content of 34 transcribed interviews with nine women who were followed longitudinally. We found that medical follow-up involved an experience of both "having" and "being" a body, which changed over time. Women described a process that ranged from having a cervix that was neither felt, 'heard', nor seen, to having a body that became known to them first indirectly through professional mediation and later through direct experience after professional manipulation. The conceptualization of bodily boundaries appeared to change, e.g. through visualization of the previously unfamiliar cervix, pain, vaginal discharge, and bleeding, as well as linkages to the bodies of women in their extended families through the generations. Thus, bodily experiences appear to be an intrinsic part of medical follow-up of an abnormal Pap smear through which health, disease, and risks in the past, present, and future were reconceptualised.
Social Science & Medicine 02/2009; 68(3):479-86. DOI:10.1016/j.socscimed.2008.11.007 · 2.89 Impact Factor
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