By now, you’re probably used to the good old Pap smear. Typically part of your well-woman exam, a Pap test helps screen for cervical cancer by detecting abnormal changes to the cells of the cervix.
Fortunately, getting a Pap smear test regularly during pregnancy and in general helps your doctor find and treat any health concerns early.
Your age and history will determine how often you should have a Pap smear test. In general, women ages 21 to 29 should get one every three years. Women who are 30 to 65 years old should either get a Pap test every three years or a Pap test along with an HPV test (called co-testing) every five years.[1] Many women get Pap smears annually at their OB/GYN checkups.
You may also be given a Pap smear during pregnancy, frequently at the first prenatal visit, though it depends. Talk to your doctor about when and how often you’ll be getting a Pap test if you’re not sure.
Why Pap smears are done during pregnancy
If you’re pregnant and haven’t had a Pap smear in the last couple of years, your practitioner will probably recommend you get one during your first prenatal visit. They may require it as part of your routine prenatal tests and screenings regardless of when you’ve last had one.
If you have had all normal Pap smears and would be due during pregnancy, your practitioner may choose to do one in the second trimester or in the postpartum period.
Just as when you’re not expecting, a Pap smear during pregnancy can detect early on if there are any abnormal cervical changes. The screening also looks for some sexually transmitted and other infections.[2]
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How Pap smears during pregnancy are done
You’re likely already aware of how the Pap smear procedure goes. A Pap test during pregnancy is pretty much the same. You'll lie on your back with your feet in stirrups (not fun, but at least it's familiar) while a speculum is inserted into your vagina to give your practitioner a clear view of your cervix. Your practitioner will rub a brush over your cervix, gathering cells, which are sent to a laboratory to be cultured and analyzed.
Pap smears and sexually transmitted diseases
Because women sometimes don’t know when they have a sexually transmitted infection (STI), the Centers for Disease Control and Prevention (CDC) recommends all pregnant women be tested early on for various STIs, including hepatitis C, hepatitis B, HIV and syphilis, at the first prenatal visit. Many women are also tested for chlamydia and gonorrhea.[3]
Some STIs require a blood test to diagnose them in addition to the vaginal exam.
If you test positive for an STI, rest easy knowing that most are completely treatable, even during pregnancy.[4]
If you have a bacterial infection, such as gonorrhea or chlamydia, you'll take a pregnancy-safe antibiotic before giving birth, and your partner may also need to take antibiotics to avoid reinfecting you.
If you have genital warts when you’re pregnant that don't seem to be clearing up on their own, your practitioner can safely remove them with freezing, electrical heat or laser therapy.
If they're not impacting your pregnancy, they may want to wait until after you deliver to treat you. Warts very rarely affect your ability to have a vaginal delivery.
And don't worry — it’s highly unlikely that you’ll pass on human papillomavirus (HPV), which causes genital warts, to your baby.
What happens if a Pap smear during pregnancy is abnormal
If abnormal cells are found during a routine Pap smear at your first prenatal visit, try not to worry too much. A Pap test can sometimes be abnormal due to irritation, infections (like a yeast infection), polyps or benign cysts.[5]
The hormonal changes during pregnancy can also trigger an abnormal Pap result in some women.
If your Pap test isn't normal, your practitioner may opt to perform a colposcopy (an exam where your practitioner takes a closer peek at your cervix), but biopsies or further procedures might be delayed until after the baby is born.
Pap smear during pregnancy risks
You may have heard that a Pap smear can cause a miscarriage or some other problem with your pregnancy. Don’t worry: It’s perfectly safe to have a Pap smear while you’re pregnant and it doesn’t increase your risk of miscarriage.
Just so you’ll know in advance: Some women experience spotting or light bleeding after a Pap test. The same can happen after sex or a pelvic exam or during pregnancy. That’s because, during pregnancy, the cervix becomes tender and engorged, which means it’s very sensitive and can be irritated easily.
Usually, light bleeding after a Pap exam doesn’t mean there’s a problem. It can last for one to two days and should turn brown-colored quickly. For extra reassurance, check in with your practitioner.
Although a Pap test is probably one of those things you don’t look forward to, it’s worth the few minutes of discomfort. A Pap smear pregnancy exam, along with STI testing and the many other screenings for expectant moms, are all part of the routine prenatal care that will help keep you and your baby as healthy as possible.
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