Understanding Pap Smears & HPV Screenings

A gentle, evidence-based guide to caring for your cervix

Many conversations in women’s health can feel clinical, rushed, or even a little intimidating; and Pap smears and HPV screenings often fall into that category.

But here’s the truth I want every woman to know: Pap Smears and HPV screenings are not just a “routine test.” They are powerful, preventative tools that protect your long-term health—quietly, effectively, and often before you would ever feel a symptom.

As a midwife, my goal is always to bring both clinical excellence and compassionate understanding into your care. So, let’s walk through what these screenings really are, why they matter, and what your body is doing behind the scenes.

As a midwife my training allows that I not only care for women during pregnancy, postpartum and birth but for a lifespan.  The preventive health appointments and screenings done at Well Woman appointments are powerful tools which save lives.  Pap Smear cervical cancer and HPV screenings are extremely important preventive screening tools available.  Breast Health exams and Education to perform monthly self-breast screenings at home.  Conversations and education on fertility awareness, mental health and basic health screenings are all done in a respectful, gentle environment focusing on the client.  Yet, I see time and time again how pap smear testing is so often misunderstood or delayed.  I’d love to give more information for you to have all the facts to make an informed decision on if receiving pap smears are relevant for you and remind you that your community midwife is available and accessible to help you with your well woman appointments. 

What is a Pap / HPV Screening?

A Pap Screening (or Pap Smear) is a quick test that collects cells from the cervix to look for abnormal changes. These changes are often caused by certain strains of HPV (Human Papillomavirus,) and can develop into cervical cancer over time if not treated.  For this reason, you can do either a standalone Pap Smear where you just test for cervical cell changes or also a HPV screening (same test sample - just two tests are run instead of one).  If your HPV screening does come back as positive it does not mean you have cervical cancer, but it does put you into a higher risk category.  If this is the case there are a bunch of natural methods you can do to help your body combat the HPV virus, think all your normal immune boosting supplements and lifestyle changes which rarely get highlighted if positive screening results are found. And if your HPV screening is positive, it would be recommended to re-screen again in 1 year vs waiting longer.  

The beauty of the HPV screening? It catches changes and helps your start to boost your body’s own immunity to lessen the chance of cervical cancer developing.

How is this Testing Done?

A speculum is gently inserted (by you or your care provider) to visualize the cervix.  Next a plastic brush is inserted inside the speculum and brushed against your cervix to collect cervical cells for examination at the laboratory.  The entire process takes just a few minutes.  You will get your results back in about a week. 

Many midwives offer in-home appointments so you can do this testing in your home where you are most comfortable. 

Who Needs Pap Screenings?

General guidelines recommend screening for:

• Anyone with a cervix starting at age 21, regardless of sexual activity history 

• Continued screening through age 65 (and sometimes beyond depending on history) 

• Those who have had a hysterectomy may or may not need continued screening depending on the reason and their prior results 

Even if you feel healthy, have no symptoms, or are in a monogamous relationship, screening is still important.  

How Often Should You Get Screening Done?

The frequency which you do the testing depends on your age and the type of screening you do:

• Ages 21–29: Pap test every 3 years 

• Ages 30–65: 

  • Pap test every 3 years, OR 

  • Co-testing (Pap + HPV) every 5 years 

Your provider may recommend a different schedule based on your personal history. Generally, HPV testing is not recommended for women prior to age 30 as there is a higher occurrence of an HPV infection seen in this age group that would naturally clear on its own. Having a positive HPV screen could lead to higher interventions which might not be necessary.  Again, each individual needs to discuss their own risk factors with their care provider and come up with an individualized treatment plan that works for them. 

Why Is Pap Testing So Important?

Cervical cancer is one of the most preventable and treatable cancers when caught early! The cancer generally begins when cervical cells begin to show cell changes such as high- or low-grade intraepithelial lesions. These lesions are not typically cancerous, and treatment can be started now to address the changes vs waiting until cancer develops  Generally there is no pain, no discomfort and very few warning signs seen with cervical cancer until it is quite far along. 

• Over 90% of cervical cancers can be prevented or successfully treated when detected early 

• The 5-year survival rate is about 92% when cervical cancer is found in its earliest stage 

• Unfortunately, that number drops significantly when it’s found later, which is why routine screening matters so much. 

Most cervical cancer develops slowly, often over years. That gives us a wide window to catch abnormal cells and address them long before they become dangerous. 

You can view current statistics and trends on cervical cancer here: Cervical Cancer Data

Argument for declining pap testing:  

A recent trend is pushing back against pap testing and citing the anxiety that positive HPV screening has on individuals as negative. My input would be that each person needs to evaluate the level of risk they are willing to live with.  The mortality rate for cervical cancer is extremely high and the sooner it is found the lower this rate drops. Besides this, by delaying HPV testing until the age of 30, the false positive levels have dramatically decreased. 

Helping make Pap Testing less uncomfortable: 

I agree that the pap test can be slightly uncomfortable, and many clients can find the experience difficult, especially if there is a traumatic event they have lived through in their past.  Please have open dialogs with your providers about these things so they can help make this as stress-free event as possible.  My best advice for this is to go see a midwife who has received trauma-informed care trainings.  Also, if you are not happy how your provider is performing your procedure have them stop and go see someone new. This is your exam and your provider can stop at any time.  Listening to comforting music, diffusing essential oils, homeopathic remedies to help ease stress are all very helpful tools. Many midwives (myself included) will offer home visits, and the testing can be done in the comfort of your own home on your timeline.  You can also insert the speculum yourself if this is more comfortable.  Many providers will offer their clients an elevated wedge pillow to help tip the cervix into a more forward position. And lastly find a provider you appreciate and respect to do this testing and appointment with. If you don’t want to go out to dinner with them and have a fun conversation, I would encourage you to look into a different provider for this visit. 

Reach out for more information:

If you have questions or want to talk through what screening looks like in a midwifery setting, I’m always here to help guide you. In my effort to make midwifery care more accessible to those who are delayed with this screening, I offer a limited number of free Well Woman office visit time slots monthly in my home birth practice and am available to home visits.  Please reach out through my website if you desire more information. 💜

Disclaimer: This is not medical advice and is for informational and educational purposes only. A Joy Birth Services, Inc. is not responsible for any actions readers may take based on the content provided, and following these tips does not guarantee any specific outcome. Please connect with your healthcare provider for any questions or concerns you may have regarding medical conditions.