THE ATTITUDES OF PRACTITIONERS AND PATIENTS TOWARDS REUSABLE METAL VAGINAL SPECULA AS A SUSTAINABLE ALTERNATIVE TO SINGLE USE PLASTIC

Introduction

Climate change impacts on sexual and reproductive health worldwide¹ and health systems contribute significantly to global emissions.² Reducing reliance on single-use plastic has been identified as key to decarbonising the NHS.³ Reusable metal vaginal specula have a lower lifetime carbon footprint than disposable alternatives.⁴ We explored the acceptability of reusable metal specula amongst patients and practitioners in an integrated sexual health and contraception service.

Methods

Anonymous surveys were circulated to practitioners (band 5-7 nurses and doctors from FY2-consultant) and patients who had been examined with metal specula for intrauterine contraception over a 5 month period.

Results

31 practitioners responded. 22(73.3%) had used metal specula previously. 25(83.3%) were happy to switch to metal specula if found to be more sustainable, with 5(16.7%) unsure. Concerns included difficulty of use (n=3), patient comfort (n=2) and increased workload from sterilisation (n=1). 40 patients responded. When asked whether happy to be examined with a metal speculum in future, 30(75%) answered yes, 7(17.5%) were unsure and 3(7.5%) answered no. 29/40 reported previous speculum examination. 16/29 preferred examination with a metal speculum, with 4 citing sustainability as the reason. 4/29 preferred plastic specula, as warmer (n=3), or for non-specific reasons (n=1).

Discussion

Metal specula were highly acceptable to both practitioners and patients. Only asymptomatic patients were surveyed some of whom had not had prior speculum examination, a limitation of this study. Some staff were inexperienced in using metal specula, and may require brief training eg warming metal speculums before use. We plan to increase reusable specula use in our service.

References

Women deliver [online]. The link between climate change and sexual and reproductive health and rights: an evidence review. 2021. Available from: https://womendeliver.org/wp-content/uploads/2021/02/Climate-Change-Report.pdf Healthcare without harm [online]. Healthcare’s climate footprint. 2019. Available from: https://noharm-global.org/sites/default/files/documents-files/5961/HealthCaresClimateFootprint_092319.pdf NHS [online]. Delivering a ‘net zero’ National Health Service. 2020. Available from: https://www.england.nhs.uk/greenernhs/publication/delivering-a-net-zero-national-health-service/ Donahue et al. A comparative carbon footprint analysis of disposable and reusable vaginal specula. Am J Obstet Gynecol. 2020; 223(2): 225