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Manual Examination
During a manual examination, the physician inserts one or two gloved fingers into the vagina. If his or her other hand presses the abdomen, it is called a bimanual examination. This examination is often performed during pregnancy to determine the degree of opening of the cervix.
A manual examination does not usually render a woman niddah, as it takes place entirely within the vaginal canal and generally does not cause bleeding. If there is a small amount of blood on the gloved fingers, this can usually be attributed to abrasion (scratching) of the walls of the vagina – especially when the vaginal lining is sensitive and likely to bleed with minimal cause, such as during pregnancy or certain phases of the menstrual cycle, while a woman is taking oral contraceptives, or after menopause.
Speculum Examination
A speculum is a metal or plastic instrument consisting of two rounded arms on a hinge. It is placed inside the vaginal canal and the arms are then opened, allowing the doctor to see the mouth of the cervix (the opening of the uterus).
Because the speculum does not enter the cervical canal, it does not make a woman niddah due to opening of the uterus.
A speculum examination does not usually cause any bleeding. If a small amount of blood is found on the speculum, it may be attributed to abrasion of the walls of the vagina – especially if the woman’s vaginal lining is sensitive or if the examination was performed without lubrication. (Gynecological examinations are often done with lubricating jelly; however, for a Pap smear only water is used, because the jelly can interfere with test results.) Such bleeding is non-uterine and does not make a woman niddah.
The woman does not need to ask the physician if blood is seen exiting the cervix. If, however, the physician does report blood exiting the cervix, the woman is typically considered niddah. A halachic authority should be consulted with any questions.
