Patricia says her pain was dismissed to prioritise fertility. Is this 'medical misogyny'?

Women with sexual and reproductive health conditions are being "disempowered" in a health system that doesn't treat their pain seriously, according to an inquiry. Women with disabilities can go undiagnosed altogether, an expert says.

A woman lying on a couch behind a glass of water on a table

Women from diverse backgrounds confront different barriers within the health system and are calling for immediate reforms. Source: AAP / Diego Fedele

Key Points
  • Patricia experienced pain as a result of polycystic ovaries but says her comfort "was second to the baby factory".
  • An inquiry found that women generally experience more recurrent, severe and longer-lasting pain than men.
  • Stigma remains around menstruation and women's reproduction, an expert says.
When Patricia was 15 years old, she began experiencing ovulation pain and painful periods, before polycystic features were identified in her ovaries.

When she went to see a gynaecologist, she was asked when she wanted to have children.

"It was less about symptom management and more about ," Patricia, which is not her real name, told SBS News.

At 19, Patricia went through an ovarian drilling procedure, which she describes as a laser "poking a whole pile of holes in that polycystic ovary". It allowed her to preserve fertility for later and gave some symptom control, she added.

"It was like the comfort was secondary to the baby factory," she said.
Following the birth of her first child, Patricia experienced severe pain once again. With that came a similar sense of dismissal, even causing her to question her own experiences.

"I found the sonographer very dismissive, very challenging. She was like, 'Everything looks fine, you're ovaries aren't even that bad,'" she recalls.

Patricia says health practitioners claimed she knew too much and was essentially over-diagnosing herself.

"You can't win. You go in with not enough knowledge and you're told, 'I'm the expert, you're the layperson, you don't have the knowledge to understand what I'm explaining to you,'" she said.

"And if you go in with a high level of knowledge, you're treated as if you know too much."
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Victoria is examining women's pain: why isn't everyone? image

Victoria is examining women's pain: why isn't everyone?

SBS News

11/02/202415:19

Women's pain ignored

An inquiry into women's pain led by the Victorian government's Department of Health found that women generally experience more recurrent, severe and longer-lasting pain than men.

The insights prompting the inquiry came from the experiences of over 1,700 respondents to the Women's Health survey in 2023.

It found that 46 per cent of participants received or mostly received the care they needed, but one-third of participants also expressed concerns around service delays and a lack of connected care.

And when it comes to chronic pain, two-fifths of women reported this experience.

Around 50 per cent of women surveyed reported that sexual and reproductive health conditions, like , affected their health and wellbeing.
A woman holds a water bottle to her stomach.
Many women presenting with endometriosis "feel very disempowered in the health system", Kat Stanley, the director of EndoHelp Foundation, says. Source: Getty / Charly Triballeau/AFP
Kat Stanley, the director of Endo Help Foundation, said .

"They feel very disempowered in the health system," Stanley said.

"They talk about going in and having invasive tests and not really feeling like they have power or autonomy over what's happening."

Stanley says the stigma around menstruation and women's reproduction means many don't even have the language to describe what's going on in their own bodies.

"And when you already have the trauma history of going to get the help and not being believed, it's even harder to discuss those personal things that are going on for you."

'You're asking people to live in pain'

Issues for women in the health system have historical roots, dating back to the very concept of a hysterectomy.

"The history of the word hysterectomy is that we used to remove the womb of women who were hysterical and it wasn't that long ago that we were doing that," Stanley said.

"It's going to take a long, long time for that deeply-entrenched sexism to be removed completely from healthcare."

Patricia, who has considered the option of a hysterectomy to no longer experience constant pain, says it's often seen as a last resort by health practitioners.
In her experience, giving birth was prioritised over her health and wellbeing.

"I'm not going to be in pain every single day to overburden a population just because you think I might want [a child]," Patricia said.

"But there is a lot of reluctance to do things because of the thought that women might change their mind about where they stand.

"Yes, it's a huge operation, yes, there are inherent risks associated with it. But you are asking , in the off chance that they might change their mind."

Why it's more complicated for those of diverse backgrounds or with disabilities

Adele Murdolo, from the Multicultural Centre for Women's Health, said women from migrant or refugee backgrounds are less likely to use services at an early stage in their condition and are therefore over-represented in the acute sector, which is generally short-term treatment for a more severe problems.

This pattern of behaviour is clearly demonstrated in antenatal care. Murdolo says fewer women seek antenatal care early and then witness poor outcomes in birthing.
Back view of patient woman sitting on bed in hospital ward, looking away at window
Fewer women from migrant or refugee backgrounds seek early antenatal care. Source: Getty / Boyloso/iStockphoto
At the same time, health conditions for people with disabilities can go undiagnosed because they're seen as part of their overall disability, says Nadia Mattiazzo, the chief executive officer of Women with Disabilities.

"This is not just about someone who is in pain, this is about the things that chronic pain impacts on, which is pretty much access to daily life," Mattiazzo said.

"Access to employment, access to community, getting out of bed can sometimes be a really huge barrier. And if you can't get out of bed you experience a lot of isolation."
For women like Patricia, the inquiry is part of what she feels is like a "day of reckoning" for women saying enough is enough.

"There's a reason why you're hearing frequently this medical misogyny coming up, obstetric violence coming up.

"All of it is coming from treating women and their experiences as lesser than everything else when they are actually the key to it.

"If you want your babies to be safe, keep your women safe. I think the reason we have so many inquiries happening, with so many things that purely affect a women-based population, is because we are saying it's enough."

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6 min read
Published 12 February 2024 5:48am
By Catriona Stirrat
Source: SBS News


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