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Stirrupless Exams
It is my recommendation to do away with stirrups for most pelvic exams, unless the patient prefers it.
Both of the following examples give patients more power and control of the situation.
If you are using an exam table, you may just be able to use the extension part of your table, see pictures below from the Feminist Midwife.
http://www.feministmidwife.com/2016/11/02/empowering-gynecologic-exams-speculum-care-without-stirrups/#.X9QkYdhKg2w
If using a cart, such as many do in the emergency department, have the patient scoot toward the end of the bed and put 2 to 3 folded bath blankets under their hips. Depending on the size of the patient this should allow for plenty of clearance of the speculum handle. If you find you are needing more of a upward tilt of the pelvis ask the patient to move their feet closer to their buttocks.
There are also commercially available wedges that can be used in lieu of the stacked bath blankets.
Products
Named one of TIME's 100 inventions of 2020: Creek Women's Health has created a new reusable speculum that is much smaller than other speculums on the market and can help with providing a more trauma informed experience for the patients. They also sell one time use lights to use with it as well as other products.
https://ceekwomenshealth.com/
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