title: From 'silent' to 'heard': professional mediation, manipulation and women's experiences of their body after an abnormal Pap smear.
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.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. karin.blomberg.1@ki.se
authors.forename: Karin
authors.initials: K
authors.lastname: Blomberg
authors.forename: Anette
authors.initials: A
authors.lastname: Forss
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Ternestedt
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000523:psychology; D001828:Body Image; D003452:Cryosurgery / Q000009:adverse effects / Q000523:psychology; D005260:Female; D006176:Gynecology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008495:Medical Oncology; D008875:Middle Aged; D065006:Papanicolaou Test; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012649:Self Concept; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000209:etiology*; D013548:Sweden; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D014626:Vaginal Smears / Q000523:psychology*; D055815:Young Adult