BMJ 2014;349:g5759 doi: 10.1136/bmj.

g5759 (Published 17 November 2014)

Page 1 of 1

Filler

FILLER
Down thereyou know . . . whatchamacallit!
Michael Berry specialist trainee year 4, anaesthesia, Watford General Hospital
It never ceases to amaze me how the words vulva and vagina
make peoples toes curl. Female patients frequently use all sorts
of euphemisms to describe their genitalia, implying some sense
of shame associated with the anatomically correct terms. This
leads me on to the medical profession and its collusion with this
taboo surrounding the terminology of female genitalia.
Moreover, the specialty expected to be the pioneers in
appropriate nomenclature is probably one of the worst offenders:
obstetrics. Conceptionthat is, sexand stages of cervical
dilatation are all freely and proudly discussed. However, the
regular vaginal examinations are secretively disguised as an
internal examination or shortened to an acronym such as VE.
The comedy or tragedy depending on how you view it does not
end there. Delivery by forceps entails half a dozen healthcare
professionals peering intently at a womens vulva and repeated
examinations down below are loudly announced by obstetricians
of varying seniority. On more than one occasion has the rightly
concerned birthing partner turned to me and whispered: Where
are they going to examine?
Finally, after a delivery by caesarean section, the last steps of
the procedure always involve cleaning you down therethat
shameful abyss, which like Lord Voldemort in the Harry Potter
series is not allowed to be named. What a paradoxical situation

then, where looking at, examining, suturing, and cleaning are

all done on full display but the use of the word vagina or vulva
almost never occurs.

It is entirely acceptable for the general public to struggle with

anatomical terms, which probably should be, but for a variety
of reasons are not, in common usage. However, there is
absolutely no excuse for healthcare professionals to fall into the
same trap. We do not use terms up there, thingy or doo-da to
refer to other parts of the body.

Apart from using the correct terminology to accurately assess

patients it also empowers women to use the right words if they
are used freely and without shame by professionals. Thus, it
enables female patients to communicate openly about medical
problems and takes away some of the perceived embarrassment.
As healthcare professionals we owe it to our patients to promote
the view that every part of the body has a name and no part of
it is shameful or embarrassing.
Competing interests: I have read and understood the BMJ Group policy
on declaration of interests and have no relevant interests to declare.
Cite this as: BMJ 2014;349:g5759
BMJ Publishing Group Ltd 2014

Correspondence to: michael.berry1@nhs.net

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