Gynaecological violence: listen to women
Published 31 Jan 2019 • By Louise Bollecker
Whether you have a chronic disease or not, gynaecological examinations are a necessary and sometimes feared step for women. The year 2018 saw many voices speak out against questionable, offensive or dangerous practices, along with the #MeToo movement against harassment and sexual assault.
Gynaecological violence denounced
An intimate and regular appointment in a woman's life, the gynaecological examination is sometimes experienced as a source of embarrassment but can turn into a physically and psychologically difficult moment. The French general practitioner and writer Martin Winckler denounced this phenomenon in one of his books: "when a professional physically or verbally mistreats a patient and responds to her protests (or her signs of pain) with contempt, it is mistreatment, it is no longer a blunder". According to him, the most frequent form of abuse is the doctor's judgment of the patient's weight, her contraceptive choice, her sexual orientation, her willingness or not to have children...
>> 70% of patients have already lied to their doctor to avoid their judgment
"Silence, contempt, derision, threat, blackmail are commonplace, and they are unacceptable," continues Martin Winckler. You go to your doctor to be supported and understood, not to be judged. Violence sometimes goes beyond the psychological: many women have spoken out, particularly on social networks, to denounce deliberately brutal smears or vaginal examinations that are sometimes unnecessary and painful.
The situation is more or less regulated depending on the country: in the United Kingdom, strict rules of behaviour to which gynaecologists must comply have been laid down. Sufficient measures to limit problems?
Be understood and become the director of your health
Is it even possible for a woman to be completely in charge of her contraception, her childbirth, her medical choices? For example, social networks and women's magazines have raised the thorny issue of the introduction of a DUI (intrauterine device), which is very often denied to women who have never had children.
Childbirth is also a source of tension: refusal by health personnel to allow the expectant mother to move as she wishes or adopt the position she deems necessary, systematic episiotomies, lack of psychological follow-up... Many midwives have deplored certain comments that were too dependent, arguing that they cared more than anyone else for the well-being of women and that patients were not always aware of the medical requirements behind the decisions made, sometimes in an emergency, in the delivery room.
The media coverage of endometriosis has also influenced the debates: this disease, which affects 1 in 7 women, came out of the shadows only a few years ago. Many patients were not listened to by their doctors. Their pains, which are comparable to stab wounds in the stomach, were not taken seriously for years.
>> Talk about endometriosis here
The Balkan scandal
If the #MeToo movement had not initially operated in the Balkans, it would have had a delayed effect: after a Croatian MP's speech in Parliament on "15th century" medical practices in her country, many testimonials were broadcast from all over the Balkans.
In Croatia, one in three women reportedly did not receive anaesthesia during painful treatment such as curettage, biopsy, follicular puncture or episiotomy. "While they were immobilizing my hands, legs and head, the doctor said I was crying because I am a spoiled woman," told a woman who had undergone a curettage without anesthesia to a local association that relayed as many testimonials as possible. In total, some 400 testimonials were collected, read publicly in several cities across the country, and submitted to the Ministry of Health.
The Bosnian association Natural Childbirth collected testimonies from more than 300 women on painful gynaecological treatments. The same is true in Serbia where, according to an association, these painful and humiliating treatments are the cause of the drop in the birth rate. A survey in 2015 showed that 10% of Serbian women "do not want to have another child because of a traumatic experience in maternity hospitals during the first birth".
And what do you think of these testimonials?
Have you ever had a bad experience with a gynaecologist? How was your delivery, if you are a mother?
Do you have confidence in your healthcare professional?
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9 comments
After delivering my first child, 1996 - ventouse delivery with epistiomtomy - I was near jumping off the bed and screaming in pain as I was being stitched. I was told to keep still and be quiet. Then it was discovered that no one had bothered to give me a local anaesthetic. Stitching was halted for me to be given a local.
Without much recovery time, I was being chased into the shower room to wash, alone. Fortunately my sister bustled past the HCA’s and came to my aid just as I was about to pass out in the shower.
(UK, 1996)
These are minor compared to the other stories but I wish to add the following just for the record:
1. when I suspected I was miscarrying and rang the hospital, I was told it was Sunday so not to bother coming in. Take paracetamol and a nice cup of tea and present at the ER on Monday. Sat in incredible pain, bleeding, next morning but was not rushed through. Doctor picked up a fetal heartbeat and told me I was being ridiculous and go home and enjoy my pregnancy. Same doctor apologised perfusely when I was rushed back in and told that no heartbeat could be found. (2000)
2. Had sympathis pubis dysfunction (PSD) from 2nd trimester in next pregnancy. Midwives were quite dismissive of my pain. I could barely walk. Got laughed at during one ante natal appt and told I could request a Zimmer frame. During the labour, part of epidural didn’t work and I felt that the baby was trying to escape through my thigh! The block had failed to work on that area and all my contractions were felt in that area. Developed sciatica after delivery. (2001)
3. Next pregnancy had PSD again but not as severe. Advised to write in my care plan that I was not to have my legs in stirrups during labour and to try and keep moving as much as possible during labour. Kept being told to lie on my back on the bed when the time came but managed to stay off it and articulate my wishes until active labour. Despite telling medics ( and my mother telling them) I was placed in stirrups anyway. (2002)
4. Found myself in the horrible situation of being a single mum of 3, chronic depressive, unemployed and pregnant in my 30’s. The father and I had slept together once and it was a new relationship. He had made it very clear that he would not stick around. My children’s father was abusive and, though long split up, still harassed me. Had he found out he would have made life unbearable. He was already contesting custody. With a heavy heart and much weighing up, I decided to have a termination. It was weeks before Christmas, I was utterly alone in the hospital, desperately miserable, sad and full of guilt. The nurse taking me to theatre asked if I was looking forward to Christmas. I replied no and started to weep. She told me that I was a mum of 3 and had better look forward to Christmas for their sake and not be so selfish. She made me feel suicidal. (2006)
@WinterSky Thank you so much for sharing your stories, they sound so difficult and you're very brave to have come out the other side.
I had two easy births but my last birth was the worse I had to be rushed into hospital as my waters wasnt breaking they was just trickling and the pain was uncontrollable I was told to not push as he was lying wrong I had the flying squad there with heart monitors they asked my husband to choose from me living or my baby but he did chose me the doctors tried turning him but instead of him turning he spun and the cord was round his neck and as i was trying not to push he slipped down and he was transverse so they couldn't deliver him in the maternity hospital as they had no operating theatre there and they couldn't take me to another one because it was to far so they took me to the nearest one they had a bubble there for my baby and they had to do a transverse caesarian they had a two hour OP, but only had 20 mins to deliver him but they managed to get him out but he wasnt breathing so they were giving him cold warm baths and resuscitation but they never gave up he gave a little wimper and they put him in the bubble incubator he weighed 7 llb 1 oz and was taken to intensive care iwas put into intensive care away fro him I never saw him for 48 hrs but he and my self was ok now he is a great strapping lad and he will be 43 in August
