How I came to love my annual exam

Annual Pap Exam

Karen Loughlin, Owner and Administrative Director of Denver Center for Birth and Wellness discovered the breadth and depth of midwifery by way of well-women care. After years of dreading annual exams and frustration with how rushed her visits felt, she found reprieve in her first visit with a midwife. Read on to learn about how her journey led to the founding of our birth center. 


When most people hear “midwife”, they think babies, home births, and maybe even bathtubs.

What many women don’t realize is that a midwife can be woman’s healthcare provider, partner in wellness, and a caring, compassionate option for pap smears and routine exams. This is how I was introduced to the midwifery model of care.

I’ll admit, I can be a bit of a planner. So when I decided to start trying to get pregnant with my first, I had already watched “The Business of Being Born”,  and researched my birth and care options. After learning about the incredibly poor outcomes our medical model has for maternal outcomes in the US and that we rank behind more than 30 other countries, I knew I wanted to explore midwifery as an option. I was also due for an exam and wanted pre-conception counseling to review some irregularities with my cycle, so I decided to “test” my prospective midwife by scheduling an appointment with her for my regularly scheduled pap smear.

Pap smears are not my favorite. I’m probably not alone in this. Just seeing an exam table makes my toes curl. Thinking back on my annual exam experiences conjures images of cold rooms where you sit in a paper gown for WAY too long after having sat in a waiting room for WAY too long, being hastily interviewed by a physicians assistant or nurse with regards to my basic history and having answered my most deeply personal questions in 10 second checklists. Then you look forward to having a doctor briskly whir in to maybe make an effort at two sentences of small talk while ignoring the paper gown attire, an uncomfortable procedure with this strange person, then being just as hastily left to re-clothe. I typically breeze by the front desk as I hurry out to recover the lost 3 hours of work time that was spent in the waiting process. All the while, there was likely no discussion around sex-life, hormone balancing, or any concerns beyond whether or not I had access to a prescription for some kind of birth control.

Sound familiar? hopefully not. But in my heart I felt like I must not be alone in my disappointment around these experiences. Not knowing what to expect, I optimistically hoped for something different from my first appointment with a midwife. I definitely got it.

To start with, my appointment wasn’t spent in the waiting room. After a few minutes, I was greeted by the midwife and taken into a comfortable room in the local birth center. Situated in plush chairs, she and I engaged in conversation about my life, my health goals, my history, my charts, my cycles. I think we probably even touched on favorite foods and current events. She cared about getting to know me and making me feel comfortable. How refreshing!

...women really can have access to providers that care, take time, and give them the respect and attention that they need and deserve about such an important aspect of their physical and mental well-being.
— Karen Loughlin, Administrative Director and Owner of Denver Center for Birth and Wellness


Next came the actual exam. We went into a room across the hall that did have an exam table, but instead of harsh lighting and cold floors there were more comfortable chairs, a pillow on the exam table, and a warm feeling. So far, so good. After getting situated on the table, I was surprised as she started dictating each of her next moves. “I’m going to use the smaller speculum. I’m just going to apply some gentle pressure here for a moment and let you relax. Go ahead and breathe.” She actually watched and waited for my ques that I was relaxed, ready, and participating. Interesting. Then she started telling me what she was observing. “Your cervix looks great. Since you haven’t had any babies, the opening is round. It looks like your uterus may be tilted a bit to one side. Has anyone ever mentioned this to you? No? Would you like to see? Here’s a mirror.” Over the course of my hour-long appointment, I learned a lot about my own body that no one had ever taken the time to explain or explore. I learned how to really do a self-breast exam. I learned about my uterus, I got recommendations for things I could do to help my body balance out, both chemically and symmetrically, that could also help me achieve my pregnancy goals. And most of all, I left feeling happy, calm, empowered in my own health and body, and heard. What a difference.

That exam, in hindsight, was actually a life-changer. It led me not only on a path to a beautiful, natural labor and waterbirth, but also sparked in me a new hope. A hope that women really can have access to providers that care, take time, and give them the respect and attention that they need and deserve about such an important aspect of their physical and mental well-being.

It was that hope and belief that ultimately led to the opening of Denver Center for Birth and Wellness, with a mission of providing that kind of experience to all women seeking care they want and deserve, whether it be for babies, breast exams, or just that *formerly* dreaded annual exam. So next time you are due, go ahead: consider seeing a midwife! You just might be surprised to find that you can actually look forward to your annual visit!

Karen Loughlin