THE Missing Ingredient in Obstetric Training
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| (Picture found here.) |
Anyhooo-
So I am reading tonight and I just start laughing uncontrollably and slapping my hand against the table. My husband is like, "Say what?" and I read this too him:
(The author and midwife is talking to an OB she works with who she says is extremely gentle and kind to all his patients. She asks him WHY he is so different than his peers. He describes some of the women who trained him, Jamaican midwives and part of his "training.")
"Oh, it goes back to those Jamaican midwives in my residency, I guess. They were set on humbling me, mostly because they could. I want to think it was because they liked me. They used to make me do nurses' work. One day they said they wanted to teach me what it was like to be a woman patient. They told me to go into the exam room and remove my pants and get up on the exam table with my feet in the stirrups. I lay there for what seemed like an eternity, although it was probably twenty minutes or so. Then a a beautiful female medical student came in , nodded to me briefly, snapped on a latex glove, and did a cursory rectal exam. Then she said something unintelligible to me, distractedly patted my knee, and walked out of the room. I lay there staring at the ceiling, my face burning with embarrassment. Then I hear all the laughing outside in the hall. They were right, those crazy women. It was a lesson I will never forget."
Ladies, if this isn't required to graduate as an OB, then gosh dang it, it SHOULD BE.
Hope that brightened your day. It sure did mine.
Peace out-
(Carol Leonard did not pay me to write this blog post. But if she wants to be my friend, I am all ears.)
Comments
Carol Leonard is wonderful. I have an autographed copy...lucky me:)
So, I may be reaching a little….but these are the things that ramble around in my brain…
I’m shocked at how many woman apologize for what they look like ‘down there’. Most of us were taught to be private, but where does that shame come from? Providers who are embarrassed and display that discomfort as lack of eye contact, change in communication/comfort level, right down to being ‘all business’ and lacking gentleness – how does that affect a woman’s concept of her normal physical body. Does she read that as there is something wrong with her? Does her fear that she is somehow different or abnormal increase her tension, which in turn increases the unpleasant nature of the exam? Just as a lot of labor pain is the anticipation of discomfort – how much of the stigma of the gyn exam is actually the awkwardness of the interaction. The idea of the unnecessary rectal exam was the exposure to ‘what is’ – neither bad, nor good, nor dirty or clean – awkward, yes, unpleasant, sure – but doesn’t have to be abhorred and frankly isn’t any different than anyone else and shouldn’t be painful. There is a ‘dance’ of sorts to help through the strangeness without instilling shame or fear – as a provider it is learned…probably more from being a patient rather than actually watching or doing exams. Our bodies require a certain level of maintenance and we (patients) need to feel more comfortable with those professional that are there to serve us (that should be the mindset of providers) – and as practitioners we need to respect our patients and their bodies with open, sensitive and gentle care. This exercise is less about the physical experience of the exam (although, quite frankly, I do believe providers need to experience the physical impact of certian kinds of touch!) and more about the awareness of the interaction between provider/patient.
As a woman...the exam was the physical part that was necessary - but the "brief nod, latex snap, unintelligible murmur, distracted pat, curt exit & then hallway laughter" would be what I would remember and would 'color' the whole experience.
Is this necessary sometimes? Yes.
Can it be done in a respectful way? Yes.
I literally got HUNDREDS of responses about this from women who were hysterical because they had the EXACT same treatment. This isn't about punishment. It is about teaching some respect. This is an everyday procedure for an OB, but it is potentially humiliating for a woman and should be done in a professional and yes, compassionate way. And it CAN be- this experience taught this doc what it felt like to be HIS FEMALE PATIENT. Lesson learned, but not by many.