title: Using a wrap skirt to improve the pelvic examination experience.
abstract: BACKGROUND
  The study aims were to analyze the experience of women and their physicians of nakedness when moving between changing room and examination chair and during pelvic examination itself, and to assess the protective benefit of a wrap skirt in alleviating the associated discomfort and vulnerability.
  
  
  METHODS
  We offered 1000 women a wrap skirt for pelvic examination and asked them to complete a post-procedure questionnaire. Physicians were invited to complete a similar but separate questionnaire. Data were analyzed using chi-squared contingency tables.
  
  
  RESULTS
  A total of 425 women (43%, age 15-78 years) completed the questionnaire; 51% felt uncomfortable and embarrassed during the examination, Muslim women significantly more so (p < 0.001). Most women (n = 255; 58%) rated the wrap skirt a significant improvement; 69% requested it for future examinations, significantly more so if the physician was male rather than female (66% vs. 54%, p = 0.003). Even the one-third of women experiencing no discomfort reported improvement. Most examiners (n = 45; 56%) found the wrap skirt beneficial; 31 (38%) were unconvinced.
  
  
  CONCLUSIONS
  Pelvic examination as practiced in many countries, on women naked from the waist down throughout, causes unnecessary embarrassment. A simple protective measure, such as a wrap skirt, significantly alleviates the discomfort and sense of vulnerability associated with nakedness.
authors: Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors: Lilian R
authors: http://orcid.org/0000-0002-4903-2818
authors: LR
authors: Neuhaus
authors: Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors: Elza
authors: http://orcid.org/0000-0001-9498-1724
authors: E
authors: Memeti
authors: Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors: Marie-Kristin
authors: http://orcid.org/0000-0001-6929-819X
authors: MK
authors: Schäffer
authors: Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors: Roland
authors: http://orcid.org/0000-0001-7062-5063
authors: R
authors: Zimmermann
authors: Department of Obstetrics and Gynecology, University Hospital of Zurich, Zurich, Switzerland.
authors: Leonhard
authors: http://orcid.org/0000-0001-8272-7761
authors: L
authors: Schäffer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D058869:Gynecological Examination / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D057240:Patient Preference / Q000706:statistics & numerical data; D011481:Protective Clothing; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Discomfort; intimate area; pelvic examination; protection; sense of vulnerability