Monthly medical exams for Handmaids

Monthly medical exams for Handmaids are a compulsory, state-mandated procedure in the Republic of Gilead, designed to monitor reproductive fitness and enforce the regime's control over female fertility. These exams, conducted by a specialist doctor once a month, subject the Handmaid to a dehumanizing process of testing, inspection, and surveillance, while also creating a space of potential danger and illicit opportunity.

Procedure and Surveillance

Once a month, a Handmaid is taken by a Guardian with a red arm band to the doctor's office in a modern office building. She rides in a red car, alone, without her usual shopping partner. The Guardian faces her in the elevator, and waits outside the office with other Guardians. Inside the waiting room, other Handmaids in red regard each other covertly, sizing up each other's bellies. A nurse records their names and the numbers from their passes on the Compudoc to verify their identity. The nurse, a man of about forty with a diagonal scar across his cheek, sits typing, still wearing his pistol in a shoulder holster. When called, the Handmaid goes into the inner room, which is white and featureless except for a folding screen covered with red cloth, on which is painted a gold Eye with a snake-twined sword upright beneath it. After filling a small bottle left ready for her in the little washroom, she takes off her clothes behind the screen and lies down on the examining table on a sheet of chilly, crackling disposable paper. A cloth sheet is pulled up over her body, and at neck level another sheet is suspended from the ceiling, intersecting her so the doctor will never see her face. He deals with a torso only. She reaches her hand out to pull a small lever, which rings a bell elsewhere.

The Doctor's Proposition

The doctor, who is talkative despite the rule that he is not supposed to speak to her except when absolutely necessary, begins with a casual "How are we getting along?" He lifts the sheet, and a cold, rubber-clad, jellied finger slides into her. He pokes and prods, then the finger retreats and enters otherwise. He pronounces, "Nothing wrong with you," and calls her "honey." Her breasts are fingered in a search for ripeness or rot. Then, very softly, close to her head, he whispers, "I could help you." He claims to have helped others. When she asks how, he says, "How do you think?" and his hand, now ungloved, slides up her leg. He tells her the door is locked and no one will come in, and that they will never know it isn't his. He lifts the sheet, his lower face covered by a white gauze mask. He says, "Most of those old guys can't make it anymore. Or they're sterile." He has used a forbidden word: sterile. Officially, there is no such thing as a sterile man anymore, only women who are fruitful or barren. He tells her, "You want a baby, don't you?" She admits it is true. He says, "You're soft. It's time. Today or tomorrow would do it, why waste it? It'd only take a minute, honey." He is offering himself, his services, at some risk to himself. He murmurs that he hates to see what they put her through, and his eyes are moist with compassion, but his hand is moving on her nervously and with impatience. She refuses, saying it is too dangerous, that the penalty is death. His hand stops. He tells her to think about it, that she doesn't have a lot of time left, but that it is her life. She must leave the impression that she is not offended, that she is open to suggestion. He takes his hand away, lazily, lingeringly, and pats her thigh before withdrawing behind the hanging sheet. He says, "Next month." The knowledge of his power hangs in the air: he could fake the tests, report her for cancer or infertility, have her shipped off to the Colonies with the Unwomen. She puts on her clothes behind the screen, her hands shaking. She is frightened not because she has crossed any boundaries, but because of the choice itself: a way out, a salvation.

Context and Significance

The monthly exams are part of a broader system of medical surveillance that includes urine tests, hormone tests, cancer smears, and blood tests. This system is obligatory, a stark contrast to the voluntary medical care of the time before. The exams are a ritual of power, reducing the Handmaid to a torso, a set of organs to be tested and inspected. The doctor's proposition reveals a hidden economy of fertility within the regime, where some men exploit their positions of authority to offer illicit services. The Handmaid's refusal is not a moral choice but a calculation of risk, a recognition that the doctor's power to condemn her is as real as his power to help. The exams thus become a site of both extreme vulnerability and a dangerous, fleeting possibility of agency.