Two Cents: Modern Obstetrics and Gynecology

I happened upon an interesting self-ascribed feminist post about “medical rape” and the “medicalization of childbirth.”  I’m certain that I have written about being an empowered patient, since that is one of my goals as a childbirth activist – to help empower women to participate in their health care, ask questions, get second opinions, etc.

I’m not sure the original author has much knowledge of the socio-political dynamic in part responsible for the current state of modern medicine.  However, she makes some good points.  For instance:

But other interests come into play in a corporate system of medicine, and the patients’ best interests are unfortunately not at the forefront (for more reading, check out Paul Starr’s The Social Transformation of American Medicine). There are systematic and institutionalized incentives for the American Medical Association to promote hospital births and to keep childbirth squarely in the realm of a self-regulating medical profession. And there is a long history of a predominantly male medical establishment ignoring women’s concerns and knowledge about their own bodies.

The male medical establishment – even with female practitioners – tend to subvert women and suppress their decision-making ability, especially in the reproductive health sector.  Why?  Well, it is easiest to exert power over a woman when she is on her back with her feet in stirrups, her butt hanging over the edge of a paper-clad table, and a speculum shoved into her private parts.  Who hasn’t felt vulnerable and less powerful in that position?

I’m not suggesting that all obstetricians are bad or that men make sucky gynecologists, not any more than I’d suggest that cesareans are completely unnecessary, or that the safest place to have a baby is at home.  Then again, statistically about half of the cesareans performed in this country are not necessary (and don’t improve our infant mortality rate), and actually staying home is the best way to ensure that unnecessary interventions aren’t performed on you when you’re only 2cm dilated at the hospital.  Unfortunately, a growing number of women are dissatisfied with the services their obstetricians provide, are disgusted by medico-legal decision-making when it comes to women’s (and babies’) physical and psychological well-being during the childbearing year, and suffer poor childbirth outcomes.

Something has to give.

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