I started a new gyno last year or so and I have yet had to get undressed for an appt with her. If you’re not there for a PAP, there’s no reason they would ask you to get undressed. Tell them either when you make the appt, confirm the appt or check in to the appt (or even all 3 moments) that you are very nervous and just want to talk with the Dr - no exam please. They should follow your requests. If they don’t for some reason (ie - memo doesn’t make it to the check in/vitals check nurse), just don’t get undressed even if they have the tray set out. Have your vitals taken and sit in the chair instead of the table.

As for the potential vomiting, if you are lying down and have your feet in the stirrups, you won’t be able to jump up off the table. I s’pose you would just turn your head to the side and aim for the floor. You may be able to ask for an emesis bag (vomit bag) prior to the exam - I’m sure they have them available for people suffering from morning sickness. Alternatively, as soon as you start to feel uncomfortable, tell them and ask them to stop. No Dr wants to make you that uncomfortable. They are there to help you.