A New Speculum, 150 Years Later

The first records of gynecology can be traced back to 1800 BCE, where the Kahun Gynecalogical Papyrus provides some of the earliest records of gynecological care. The earliest speculum was recovered from the ruins of Pompeii, dated 79 CE. Of the innumerable medical instruments that exist today, the speculum has always stood out to me. Not because it was cutting edge, but because it wasn’t. It was in the 19th century that the speculum became a staple of Western gynecology. This was due largely to Dr. James Marion Sims, often called the “father of modern gynecology.” In 1845, Sims designed a bivalve metal speculum to observe the cervix and perform surgical repairs. His invention allowed doctors to see inside the vaginal canal more clearly than ever before. However, Sims’s legacy is deeply controversial. Sims performed these experiments on enslaved Black women without anesthesia, most famously Anarcha, Lucy, and Betsey. In the 1870s, Edward Gabriel Cusco and T.W. Graves innovated the speculum, the design remains the same in medicine today, 150 years later. Now, the tool is usually made of stainless steel or hard plastic and inserted manually before being opened by a screw or ratchet system. This experience is often physically painful and emotionally unsettling. A 2020 essay in The Washington Post described it as “the single most anxiety-inducing part of a woman’s annual exam,” with many patients citing coldness, pain, and lack of control as major concerns. These discomforts are the reason behind many skipped vaginal exams, resulting in a large number of missed cancer diagnoses. Why do we ignore the pain and deaths of women while the science behind hair transplants is constantly evolving? We theorize about the reason behind these inequalities while the answer is simple: in the eyes of society, women’s lives are worth less. That is why innovations in “femtech” are so crucial, they move us towards a world where when a woman appears in a hospital, she has the same chance of leaving as a man.

In 2017, industrial designer Hailey Stewart, while working at the global design firm Frog, set out to change this outdated technology. After she and her coworkers experienced uncomfortable vaginal examinations, they banded together to create a solution to an easily resolved problem. Her project reimagined the speculum not as a mechanical clamp, but as a bloom. Named the bouquet speculum, her design features five petal-like silicone segments that open gently through inflation. The concept prioritized patient comfort, softness, and the providers’ control. “Design is not neutral,” Stewart told Dezeen. “A cold speculum says one thing; a blooming one says something else entirely." Though the bouquet speculum remains a conceptual prototype and is not yet FDA approved, it has spurred the conversation about women’s health that should have begun centuries ago. Media coverage in Wired, Dezeen, and The Washington Post praised the way Stewart’s design questioned the norms of medical tooling and championed the idea that care could begin with the object itself.

Jean M. Bouquet studied at the University of Chicago, and has 27 years of experience in family medicine. In 2023, researchers Bouquet and colleagues, inspired by Stewart’s conceptual design, engineered a multi-petal, silicone speculum that gently opens in overlapping segments. This adjustment of the petals reduces pressure points and improves visual access to the cervix. Their study, published in Medical Devices (Auckland), found that the petal system provided comparable visualization to a traditional speculum while minimizing pinching and discomfort during simulated exams. The bouquet’s design was built with polylactic acid (PLA) and silicone petals and incorporated a LED illumination system to improve visibility. While still early in clinical evaluation, the innovation represents a shift away from static metal tools and toward biomechanical sensitivity. In the words of the authors, the device aimed to “increase patient dignity” while preserving clinical utility. The device also eliminates many of the clinical issues associated with the two billed speculum. Due to the vertical opening of the two billed speculum, when it is opened it will often cause vertical vaginal stretching and vaginal wall collapse. Not only does this result in pain but it makes it increasingly difficult to collect a sample from the cervix, and to observe the vaginal opening. By using a five bladed speculum, the vaginal walls are opened from all sides, giving the doctor a clearer view of the vagina and cervix, and providing comfort for the patient.

Misogyny is so deeply embedded into the world of medicine, it is often overlooked due to how commonplace it is. From male mice being the only subjects of scientific research to the sole usage of male-dummies for car-crash tests, women have been excluded from the world of medicine. This systematic discrimination is not only deeply prejudiced, but puts the lives of all women in danger. By excluding women from medical care and research, we withhold critical knowledge from the next generation of doctors, and endanger the lives of women everywhere. The innovation of the bouquet speculum is an important step towards a more equal distribution of medical care. Scientists like Stewart and Bouquet represent a crucial group of doctors willing to challenge the norms of the medical field and make improvements in areas that are ordinarily overlooked. Medicine is about moving forward, yet this field has remained stagnant, innovations like the bouquet are what make medicine an ever-growing field, something immortal.

Works Cited

Bouquet, Jean M., et al. “An Innovative Design for the Vaginal Speculum.” Medical Devices Evidence and Research, vol. Volume 16, Sept. 2023, pp. 211–18. https://doi.org/10.2147/mder.s415558.

Geller, Amy, et al. “Overview of Selected Women’s Health Conditions.” A New Vision for Women’s Health Research - NCBI Bookshelf, 14 Feb. 2025, www.ncbi.nlm.nih.gov/books/NBK612403.

Miller, J. “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present.” Psychiatric Services, vol. 58, no. 10, Oct. 2007, pp. 1380–81. https://doi.org/10.1176/appi.ps.58.10.1380.

Pardes, Arielle. “The Speculum Finally Gets a Modern Redesign.” WIRED, 5 Oct. 2017, www.wired.com/story/the-speculum-finally-gets-a-modern-redesign.