Ciara Lawrence is currently an Engagement Lead at UK Learning Disability charity Mencap and has worked for them for 20 years. Ciara is a Get Lippy Ambassador for The Eve Appeal and Jo’s Cervical Cancer Trust to help raise awareness of the barriers that women with learning disabilities face in having cervical screening. She wants to raise awareness of the signs and symptoms of gynae cancers and to empower women in her community to look after their health and go for their cervical screening.

For me as a person who has a learning disability, I was quite embarrassed to talk about having a cervical screening (smear test) when I was first invited to go and did not want to go. I felt that it would be uncomfortable. I didn’t think I needed the test. I did not feel it was right for me and I either ignored or binned the letters. It sounds really awful. I felt that the test just wasn’t for me.

There were a few reasons I decided to go and have a cervical screening test. Over the past few years some of my relatives have passed away who had different types of cancer. I saw them in good times and I saw them struggling. In December 2018, a very dear relation to me died from cancer. She was only 48 which was heart-breaking.

It showed me how important cancer awareness is and that cancer screening is important. She is not here to tell people to go, but I am here and in her memory, I want to do something positive about it and I know she would be proud of me. I decided to put my big girl boots on and got on the phone to book my first cervical screening test. I went for it!

Before my test, I felt very nervous because I did not know what to expect. What was lovely was that some of my colleagues here at Mencap told me about their own experiences of visiting a clinic for cervical screening and that helped me. I also watched an NHS YouTube video of what would happen and what I should expect. Once I had all the information, I felt prepared.

When I arrived for my appointment, the nurse called me into her room. She invited me to sit down. She asked for my name and details. She then asked me, if I knew what the test process was. I answered yes, because I had spoken to colleagues, and watched videos on YouTube. She then asked if I would like her to talk me through it face to face. I said yes. She then brought over the instruments that were going to be used during the test.

What was interesting about that moment was she gave me a choice, she said if you are happy we can do it now, but if you are unhappy or have any worries we can delay, the ball is in your court, and I said ‘no, I am here, I want to go through with it now’.

Then she took me over to the medical bed. She pulled the blind around me and asked me to take off the lower part of my clothing. Once I said I was ready, she came over and began the test. Whilst she carried the test out, I talked about nice things like my work at Mencap and I found that helped me a lot. I even laughed with her and that helped me to feel relaxed.

Before I knew it, the test was over. Afterwards, we sat down and talked. She told me that once the swab came back from the lab with the results, I would get a letter in the post at home. She told me it could take a few weeks.  I felt very proud of myself afterwards.

During the whole appointment, the nurse took a bit of extra time with me. She made sure I understood exactly what was going to happen. She did this slowly and clearly. She made reasonable adjustments. This is a good example of what we are asking healthcare professionals to do for patients with a learning disability in hospital through Mencap’s Treat me Well health campaign.

I was really lucky to have a positive experience, although not everyone will have the same experience as me. It is vital that all women whether they have a learning disability or not, get the same support and care. It was helpful that I could talk to people who had their test before me about how I was feeling without feeling embarrassed. Watching a YouTube video of somebody having the test also helped. I felt that I had every choice in front of me and I was able to feel ok about it.

I also found resources on the website of Jo’s Cervical Cancer Trust which were also useful because it explained in easy stages what would happen and when and that was really good to have. I could then visualise the process from beginning to end.  Quite a few different things helped me to feel confident. Having people around me who understood was amazing. That afternoon I had a nice text from my mum saying ‘good luck I’m proud of you, I hope it goes ok’ so that gave me a lovely boost.

I was relieved that my test result came back and was normal, but if the results had come back and I had to go and see another doctor then I know I would have good support to do that because it would be a scary experience like anyone else goes through.

The nurse had a lovely attitude towards me so it couldn’t have gone better. I left the surgery feeling empowered. Next time I am invited to go for a test, I won’t feel as nervous. On the way home, I decided to make a video with the hope of changing at least one person’s idea of cervical screening, I wanted to help encourage other women to go for theirs. My video has now had 149,000 views!

Even if one person has seen my video and gone for a test, I have done what I set out to achieve.

Before I went for the test, I actively went and searched for information about what would happen. There is lots of Easy Read information on the internet now, but it shouldn’t be down to the person to find it themselves. I want the NHS to send people an Easy Read letter and a link to the NHS video I found on YouTube. As someone who has a learning disability, it was a big thing for me to go and do. You can do it with the right support like I had. You can take someone with you to support you, but I decided to go independently as I felt this was right for me.

Having a cervical screening test is very important, because it might help to save your life.

Tips for a cervical screening appointment

Ask Questions about what will happen

You can have an appointment before your screening to talk to a nurse or doctor about what to expect

Get more time

Ask for a double appointment to have more time with the nurse/doctor

You can ask for a woman

You can ask for a female nurse or doctor if you would feel more comfortable

Ask to bring someone you trust

A friend, family member or carer can come along with you for support

Practice the body position at home

This will help you get used to the position- lying on your back, legs bent and knees apart

Listen to music or a podcast

Listening to something during your screening might help you relac

Practice saying the words you need

You will hear words like cervix, speculum, vagina during your appointment, so you might want to practice saying these words before your appointment

You are in control

You can ask the doctor or nurse to stop at any time for any reason.

It is okay if you can’t go through with the screening the first time

Wearing comfortable clothes

Wearing a long dress or skirt (if you wear them) can help you feel more comfortable

Get more help

You can contact The Eve Appeal for free help on nurse@eveappeal.org.uk or 08088020019

Mencap has information and advice on mencap.org.uk/treatmewell