Can a Pap smear during pregnancy cause a miscarriage?

Yes

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by Laura Kirk

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I'm not exactly saying yes, but I am amending the original question. Can a Pap smear PERFORMED IMPROPERLY cause a miscarriage? In April I was elated to be pregnant with my second child. At my first prenatal visit with my new "set" of doctors in this case, I was seen by a nurse midwife, received the most painful, most rough pap smear of my life, and miscarrried 2 days later. So before we start to belittle people for their lack of info, we need to consider the circumstances surrounding the question. Yes, I know that many things can cause a miscarriage, especially in the first trimester. I am finishing up my BSN right now, so I'm not exactly a layman. But I do know that in my first pregnancy I did not receive a pap until the 3rd trimester because I was up to date with my pap's, and I experienced no difficulty. I just question the technique by which the particular pap in question was performed. So opinions are great and all, but I would like to see some qualitative scientific research on the matter in order to say 100% "A pap smear is not dangerous during pregnancy." There are always exceptions to a rule, so let's not make people feel ignorant because maybe the question was posed because they knew of such an exception.
From a medical standpoint a pap smear is a highly effective tool for early diagnosis of cervical disease. EVERY woman should have a pap smear on a routine basis and probably every pregnant woman should have one during pregnancy, especially if they don't have them regularly. The main thing that a pregnant woman needs to be certain of is that she trusts her provider. I had moved after my first pregnancy, in which I had been seen by a single OB/GYN who handled all his cases himself in a small, friendly office where one felt comfortable to ask questions and knew that they would receive answers. After relocating, the only OB/GYN services in the area consisted of a couple of large groups of doctors where most care was provided by mid-level practitioners and you didn't even see the same person two times. There was an established protocol of prenatal care that gave the patient the impression that they were merely one of a herd of pregnant women being corralled from station to station. This, in my eyes, is not prudent care of a patient. I want a provider to know me without having to look at a piece of paper, to be able to bend and flex if needed in order to better provide my obstetrics care. My first OB drove through a blizzard, running stop lights in order to reach me in time for delivery. There is no way in hades that any of this second set would have done that for a patient. My first OB performed the pap himself so gently and quickly that I didn't even realize he had done it. The midwife who performed the pap in April was so rough that I experienced severe cramping and pain and prayed for the procedure to be over. So, in conclusion, the procedure itself, when performed properly, poses NO danger to a pregnancy. As far as in situations where the procedure is not performed correctly or is hastily perfomed with undue roughness by a provider crunched for time, I think that the outcome of miscarriage due to cervical trauma should not be immediately ruled out.

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