The Speculum May Be Getting a Much-Needed Redesign
Anyone who has ever put their feet in the stirrups at an OB-GYN appointment is familiar with the torture device known as the speculum. If it seems like it should be a relic of medical history, it's because it is. We still use what is essentially the same design first used by Dr. J. Marion Sims 150 years ago.
Before Sims, in 97 AD, versions of a speculum were found in Pompeii. An 1821 version invented by Giuseppe Cannella involved a knife to amputate the cervix. Then, in 1825, Marie Anne Boivin invented a bivalve speculum that would be free of a doctor’s hands and could be screwed into place. Even though her work was applauded and awarded, the invention was overshadowed by Sims'.
The story of Sims comes with a complicated history. Not only is Sims a man, but he wrote in his autobiography, “If there was anything I hated, it was investigating the organs of the female pelvis.” Yet that is what Sims did in his professional career, as he is now known as the father of gynecology. What else did Sims do? He experimented by operating without anesthesia on enslaved women in Alabama in the mid-1800s. He would later use anesthesia on white women.
In 2017, professionals are still dimly utilizing this duck-billed device created by a man in the 1800s. Sure, we can choose from several women doctors and insert the speculum ourselves during a Pap; we have options. But why, in the world we live in today, in the literal future with talking phones and holograms of Tupac, can we not achieve a new tool for propping open the vulva?
Welcome the women at Frog Design, who have created Yona, a speculum prototype that will refine the pelvic exam experience. Yona was kick-started when the designers began discussing their experiences at the gynecologist. The anxiety; the cold, hard material; the cranking noise — it’s a dreaded experience entirely.
The team of women began interviewing: 1) women who had never been to the gynecologist and had their first exam 2) women who had HPV and 3) women who had given birth. The researchers coined the term “radical empathy” because they wanted to help individuals to build an understanding and awareness for their experience during a pelvic exam.
One interviewee told the crew about the invasive experience. “The speculum is metal and cold. It feels more like a weapon than something that’s meant to go inside of me.”
The team began to think of a vibrator shape, but after speaking with health care professionals, they learned what a doctor needs from a speculum and how they can incorporate this into a sensible and comfortable design. Ultimately, the look of the new prototype resembles the old speculum in many ways, but with a few adjustments.
What are the new adjustments?
- Yona is covered in silicon, which is similar to a vibrator material.
- The handle and the bill are angled from 90 degrees to 105 degrees, which means the doctor can be farther away during the exam.
- The bill is made of three leaves so the doctor doesn’t have to open the bill up so far.
Beyond the speculum is the entire experience in the doctor’s office. During their interviews, the designers found that the white paper dress was equally as uncomfortable for women. This led to them creating a more comfortable, wearable dress while also incorporating a “your butt goes here” graphic on the sanitary paper of the patient chair to avoid any more scooting once lying down.
The designers also hope to create an app, because why not? The application would include a medical questionnaire and a guided meditation. It’s important for the patient to be relaxed for themselves, but also for the doctor, as it creates a swift and easy visit.
Yona is still a prototype, and the team is seeking out partners and doctors who are interested in the design. However, the team is aware of the challenges. This isn’t the first time someone has tried to redesign the speculum. The medical field is known to resist change and challenges. Fran Wang, a medical engineer at Frog, told Wired that gynecologists think the current speculum is fine. She said, “It passes, but it’s not great.” She continues, “But we’re working on making it better. When you give [physicians] the option to choose a better one or a worse one, then they’re going to choose the better one. But they might not know that until they get that option.”
And honestly, after 200 years of uncomfortable, anxiety-ridden experiences during an exam, don’t we deserve a change?