Smear test after chilldbirth

[nuggles]

I've just had my reminder through to book my smear. I'm 4 months postpartum. Been reading that if you're exclusively breastfeeding then to delay it as it can alter results. So not sure what to do.

Does it hurt more after birth too?

I don't know about the breastfeeding link, sorry.

But I had my first smear when I was around 2-3 months post partum and I can honestly say I didn't feel a thing. Might be to do with the 3rd degree tear though

I've not heard that breastfeeding can alter results. I had a smear 4 months pp and it was fine, just the same at the one four years previously.

I had my first ever smear at 12 weeks PP after my first. I originally went at 8 weeks but was told to come back after 12 weeks as being PP can skew results. I was never told about a breastfeeding link though. This was 6 years ago though now.

As it happened, I did have to go for follow up treatment but as it was my first one, I don't know how long any abnormal cells had been there IYSWIM.

Thanks ladies. Looks like everyone near me seems to be having their smears at the moment. Have to wait 5 weeks for an appointment which is not so bad. Pretty sure cervix etc will have returned to normal by then - or whatever normal is after two births

It's to do with your hormones - your cervical cells change and can give false positive results (and sometimes false negative results too). Best to wait 3 months post stopping BF. It's weird as the cells look like those of an 80 year old - pregnancy does weird stuff to your body (I used to work in cellular pathology)

Oh wow thanks for that advice. Never knew that about cells and breastfeeding. I plan on bf until he's about 15 months so not sure if it's wise to delay a smear for another year or not. Something to consider I guess

I've never delayed a smear for breastfeeding nor been asked too. Didn't find that hit hurt more after childbirth either.

You need to wait until at least 12 weeks post delivery but with the newer liquid cytology method the results are accurate even if breastfeeding.

There's no reason why it should hurt after childbirth if you have healed well.

with the newer liquid cytology method the results are accurate even if breastfeeding.

This isn't actually true - the amount of cells will be adequate, so the sample will not be rejected as insufficient, but cellular changes will be present.

The following images give an idea - 1st is normal cyclic woman, 2nd is post menopausal woman, 3rd is breastfeeding woman and the 4th is a 'borderline' equivocal result that will result in 3 6 month follow ups. It is quite difficult to distinguish between the last 3 and women may end up with false positives and the associated worry until they get a subsequent clear one. Also the endocervix which protrudes in women who are cyclic, becomes internalised in women who are breastfeeding (and postmenopausal) making it more difficult to sample the correct area, risking false negative results.

I'm not saying that it is impossible to determine the difference, but it is so much easier (and thus safer) when women are cyclic.

The sample takers are not well versed in the intricacies of the lab side of things - for example they can take smears with lubricant which can cause issues with making cells fall of the slide during preparation, they don't tell women not to have sex for a few days before the test which can result in sperm obscurring the cells, they also don't advise not to use talk for a few days before, which can also interfere.

And an 'borderline' abnormality

Not heard about the breastfeeding thing. I def had my test while bf

Really interesting, Stepping.

My midwife told me to wait 3-4 months PP, although I understood that to be comfort-related. She didn't mention the bf issue though.

Thanks Stepping, interesting to see those slides.

At my last update we definitely had some slides but none relating to breastfeeding! They explained why to wait until 12 weeks post-delivery, and the lab side of info was explained - for years we've been told not to use lubricant. The 'no sex' thing is more difficult as I don't think the invitation letters stipulate that and the receptionists (understandably!) don't tell them when they phone to book.

That's really interesting, thanks.

Over two children, I've currently been breastfeeding for nearly 7 years ( I've never thought about it like that before!) but obviously frequency of feeds and duration has varied greatly during that time.

I would guess that a 4 year old feeding every bedtime or every other bedtime would affect the cells less than an exclusively BF 4 month old, is that right? I know that the breastmilk itself changes over time, which presumably is also hormone based.

SteppingOnToes- thanks so much for the detailed info and slides. I am 6 months post partum EBF. Sounds like I should I wait to do my smear as a false positive would just mean waiting anyway?