NCHS Data Brief ■ No. 339 ■ June 2019

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Receipt of Pelvic Examinations Among Women 

Aged 15–44 in the United States, 1988–2017

Gladys M. Martinez, Ph.D., Jin Qin, Sc.D., Mona Saraiya, M.D., M.P.H., and George F. Sawaya, M.D.

Key findings

Data from the National 

Survey of Family Growth

● A decreasing trend

in the receipt of pelvic

examinations in the past 12

months among women aged

15–44 was observed from 1988

through 2017.

● A decreasing trend in the

receipt of pelvic examinations

among women aged 15–20 and

21–29 was observed from 1988

through 2017.

● During 2015–2017, receipt

of a pelvic examination 

in the last 12 months was 

highest among non-Hispanic 

black women, followed by 

non-Hispanic white women and 

Hispanic women. 

● During 2015–2017, receipt

of a pelvic examination in the

past 12 months increased with

increasing levels of education.

Pelvic examination has been commonly performed as part of a physical 

examination for women in the United States. However, the value of routine 

pelvic examinations has been questioned recently (1,2). In 2012, the American 

College of Obstetricians and Gynecologists (ACOG) recommended annual 

pelvic examinations for women aged 21 and over as part of the well-woman 

visit (3). In 2018, ACOG advised that pelvic examinations be performed 

when indicated by medical history or symptoms (4). Using National Survey 

of Family Growth (NSFG) data through 2017 for women aged 15–44, this 

report describes trends overall and by age since 1988 in the receipt of pelvic 

examinations in the past year, and differences by Hispanic origin and race, 

education, poverty status, and health insurance status for 2015–2017.

Receipt of pelvic examinations in the past 12 months 

decreased over time among women aged 15–44.

Figure 1. Receipt of pelvic examinations in the past year, by age and survey period: United States, 

1988–2017 

1

Significant decreasing trend in the receipt of pelvic examinations in the past 12 months from 1988 through 2017 (p < 0.05).

NOTE: Access data table for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db339_tables-508.pdf#1. 

SOURCE: NCHS, National Survey of Family Growth, 1988, 1995, 2002, 2006–2010, 2011–2015, and 2015–2017. Percent

80

60

40

20

0

1988

74.6

63.5

1

56.5

1

52.5

1

14.9

67.2

64.9

42.3

1995 2002 2006–

2010

2011–

2015

2015– 

2017

Total 15–20 21–29 30–44

Survey year

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 339 ■ June 2019

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● A decreasing trend in the percentage of women aged 15–44 who received a pelvic 

examination in the past 12 months was observed from 1988 through 2017 (Figure 1). In 

1988, a higher percentage of women received a pelvic examination in the past 12 months 

(64.9%) than at any of the other time points (52.5%–61.3%). 

● The percentage of women aged 15–20 who received a pelvic examination in the past 

12 months decreased over time: 42.3% in 1988, 36.7% in 1995, 31.8% in 2002, 24.1% 

and 21.8%, respectively in the periods 2006–2010 and 2011–2015, and 14.9% during 

2015–2017. 

● The percentage of women aged 21–29 who received a pelvic examination in the past 12 

months decreased over time: 74.6% in 1988; 69.1% in 1995; 63.8%–62.2% in the periods 

2002, 2006–2010, and 2011–2015; and 56.5% during 2015–2017. 

● The percentage of women aged 30–44 who reported receiving a pelvic examination in the 

past 12 months showed no statistically significant change over time. 

Receipt of pelvic examinations in the past 12 months varied by Hispanic 

origin and race during 2015–2017.

● Receipt of a pelvic examination in the past 12 months was highest among non-Hispanic 

black women and lowest among Hispanic women (Figure 2). Specifically, 59.5% of 

Figure 2. Receipt of pelvic examinations in the past year, by Hispanic origin and race: United States, 2015–2017

NOTES: Significant differences were seen between all Hispanic-origin and race groups (p < 0.05). Access data table for Figure 2 at: https://www.cdc.gov/nchs/

data/databriefs/db339_tables-508.pdf#2. 

SOURCE: NCHS, National Survey of Family Growth, 2015–2017. Percent

60

50

40

30

10

20

0

Hispanic Non-Hispanic white Non-Hispanic black

45.4

53.8

59.5
NCHS Data Brief ■ No. 339 ■ June 2019

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non-Hispanic black women, 53.8% of non-Hispanic white women, and 45.4% of Hispanic 

women received a pelvic examination in the past 12 months. 

Receipt of pelvic examinations in the past 12 months varied by 

socioeconomic status.

● During 2015–2017, receipt of a pelvic examination in the past 12 months among women 

aged 22–44 increased with increasing education: 51.5% of women with less than a high 

school diploma, 55.0% of those with a high school diploma, 60.7% of those with some 

college, and 68.7% of those with a bachelor’s degree (Figure 3).

● Women with household incomes 300% or above the federal poverty level were more likely 

to have received a pelvic examination in the past 12 months (60.0%) compared with women 

with household incomes below 150% of the federal poverty level (47.5% ) and women with 

household incomes 150%–299% of the federal poverty level (49.5%).

Figure 3. Receipt of pelvic examinations in the past year, by education and poverty level: United States, 2015–2017

1

Significantly different than other poverty level categories (p < 0.05). 2

Significant linear trend by education level (p < 0.05). 

NOTE: Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db339_tables-508.pdf#3. 

SOURCE: NCHS, National Survey of Family Growth, 2015–2017. Percent

80

51.5

55.0

60.7

68.7

47.5 49.5

1

60.0 60

40

20

0

Bachelor’s 

degree or higher

Less than 

high school

High school Below 150% 150%–299% 300% or 

above

Some 

college

Education2 Poverty level
NCHS Data Brief ■ No. 339 ■ June 2019

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Receipt of pelvic examinations in the past 12 months varied by current 

health insurance status.

● During 2015–2017, women without health insurance coverage were less likely to have 

received a pelvic examination in the past 12 months (38.9%) compared with women 

who had private insurance (56.2%), Medicaid (49.1%), or Medicare, military, or other 

government insurance (58.1%) (Figure 4). 

● Women with private insurance were more likely to have received a pelvic examination in 

the past 12 months (56.2%) than those with Medicaid as their health insurance (49.1%).

Figure 4. Receipt of pelvic examinations in the past year, by current health insurance status: United States, 2015–2017

1

Significantly different from those with Medicaid (p < 0.05). 2

Significantly different from those with private; Medicaid; and Medicare, military, or other government insurance (p < 0.05). 

NOTE: Access data table for Figure 4 at: https://www.cdc.gov/nchs/data/databriefs/db339_tables-508.pdf#4. 

SOURCE: NCHS, National Survey of Family Growth, 2015–2017. Percent

60 1

56.2

2

38.9

49.1

58.1

40

20

0

Medicare, military, 

or other government

Private Medicaid No insurance
NCHS Data Brief ■ No. 339 ■ June 2019

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Summary

This report describes trends in and characteristics of receipt of pelvic examinations in the past 

12 months among women aged 15–44 in the United States. Women aged 15–44 in 1988 were 

more likely to have received a pelvic examination compared with women at any later NSFG 

survey period. The decrease in the receipt of pelvic examinations among women aged 15–44 

occurred primarily among women aged 15–29. From 1988 through 2017, the percentage of 

women receiving pelvic examinations in the past 12 months decreased by 65% for women 

aged 15–20, 57% for women aged 21–29, and 6% for women aged 30–44. Women of lower 

socioeconomic status (lower levels of education and household income) were less likely than 

those of higher socioeconomic status to have received a pelvic examination in the past 12 months. 

Women without health insurance were less likely to have received a pelvic examination in the 

past 12 months compared with those with private; Medicaid; or Medicare, military, or other 

government insurance. These results could provide a benchmark for estimates of the prevalence 

of pelvic examinations before the 2018 ACOG-updated guidelines.

Definitions

Age: Respondent’s age at the time of the interview. The recode variable AGER was used. 

Education: Educational attainment at the time of the interview, indicating the highest degree or 

grade finished. Results are presented only for women aged 22 and over because many younger 

women have not completed their education. The recode variable HIEDUC was used.

Health insurance: A measure of health insurance status at the time of the interview. For this 

report, the categories are combined into four mutually exclusive categories: private health 

insurance only; Medicaid; Medicare, military, or other government; and uninsured (includes no 

health insurance or having a single-service plan). The recode variable CURR_INS was used.

Hispanic origin and race: This report used the NSFG recode variable HISPRACE2, which 

conforms with the Office of Management and Budget’s 1997 guidelines for the collection and 

presentation of race and Hispanic-origin data in federal statistics systems, allowing respondents 

to report more than one racial or ethnic origin (5). The categories shown separately in this 

report are Hispanic; non-Hispanic white, single race; and non-Hispanic black, single race. 

Non-Hispanic respondents of other races or those reporting multiple races are included in the 

overall estimates but are not shown separately in figures due to the diversity of this group. The 

shorter phrase “non-Hispanic white women” refers to non-Hispanic white, single-race women, 

and “non-Hispanic black women” refers to non-Hispanic black, single-race women.

Pelvic examination: NSFG asked respondents, “(In the past 12 months have you received) 

a pelvic exam—where a doctor or nurse puts one hand in the vagina and the other on the 

abdomen?” The description of the examination was added in 2011; previously, the question asked, 

“In the past 12 months have you received a pelvic exam?” The variable was PELVIC12.

Poverty level: A measure of the household’s income expressed as a percentage of the federal 

poverty-level threshold for a household of that size. The recode variable POVERTY was used.
NCHS Data Brief ■ No. 339 ■ June 2019

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Data source and methods

This report is based primarily on interview data from the 10,094 women aged 15–44 in the 

2015–2017 NSFG public-use data files. NSFG is a nationally representative survey of women 

and men aged 15–49 in the U.S. household population that gathers data on fertility, cohabitation, 

marriage, divorce, infertility, use of contraception, and general and reproductive health. More 

information is available on the NSFG website: https://www.cdc.gov/nchs/nsfg/index.htm.

The data presented in this report are bivariate associations that may be explained by other factors. 

For example, age differences between two groups could explain differences in the outcomes. 

Statistics for this report were produced using the SURVEY procedures in SAS software version 

9.4 and Proc Descript in SAS-callable Sudaan. Percentages were compared using two-tailed t

tests at the 0.05 level. No adjustments were made for multiple comparisons. A weighted leastsquares regression method was used to test the significance of trends that involved more than 

two time points or more than two age, education, or poverty groups. When this method was 

used, terms that refer to percentages that “increased” or “decreased” indicate that there was a 

significant difference over time or across groups. This report follows National Center for Health 

Statistics data presentation standards for proportions (6).

About the authors

Gladys M. Martinez is with the National Center for Health Statistics, Division of Vital Statistics. 

Jin Qin and Mona Saraiya are with the National Center for Chronic Disease Prevention and 

Health Promotion, Division of Cancer Prevention and Control. George F. Sawaya is with 

the University of California, San Francisco, Department of Obstetrics, Gynecology, and 

Reproductive Sciences.
NCHS Data Brief ■ No. 339 ■ June 2019

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References

1. U.S. Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, Curry SJ, Barry 

MJ, Davidson KW, et al. Screening for gynecologic conditions with pelvic examination: US 

Preventive Services Task Force recommendation statement. JAMA 317(9):947–53. 2017.

2. Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD, Clinical Guidelines Committee 

of the American College of Physicians. Screening pelvic examination in adult women: A clinical 

practice guideline from the American College of Physicians. Ann Intern Med 161(1):67–72. 2014.

3. Committee on Gynecologic Practice. Committee opinion no. 534: Well-woman visit. Obstet 

Gynecol 120(2 Pt 1):421–4. 2012.

4. ACOG Committee opinion no. 754: The utility of and indications for routine pelvic 

examination. Obstet Gynecol 132(4):e174–80. 2018.

5. Office of Management and Budget. Revisions to the standards for the classification of federal 

data on race and ethnicity. Fed Regist 62(210):58782–90. 1997.

6. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez JF Jr, et al. National 

Center for Health Statistics Data Presentation Standards for Proportions. National Center for 

Health Statistics. Vital Health Stat 2(175). 2017.
NCHS Data Brief ■ No. 339 ■ June 2019

Keywords: Hispanic origin and race • poverty level • education • 

National Survey of Family Growth

Suggested citation

Martinez GM, Qin J, Saraiya M, Sawaya 

GF. Receipt of pelvic examinations among 

women aged 15–44 in the United States, 

1988–2017. NCHS Data Brief, no 339. 

Hyattsville, MD: National Center for Health 

Statistics. 2019.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Jennifer H. Madans, Ph.D., Acting Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Vital Statistics

Steven Schwartz, Ph.D., Director

Hanyu Ni, Ph.D., M.P.H., Associate Director 

for Science

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