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.
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