In order to see the inside of the vagina a bivalve vaginal speculum is used. The speculum can be made of metal or plastic and has two blades that are at right angles to its handle. The blades are inserted closed together but once in the vagina they are opened by means of a lever and hinge at their base. The examiner can then look between the blades as they hold open the walls of the vagina to see the cervix and vagina, and perform procedures or tests (eg. Pap smear).
In Australia, Canada and the USA a bivalve (two bladed) vaginal speculum is normally used with the woman lying on her back. In Europe, a single bladed Sims speculum is used to pull back the back wall of the vagina while the woman lies on her side facing away from the doctor.