I am so glad about this research. I just want to share a small text
of an event that changed the practice of an obstetrician, and mine...
The try was worthed.
BMJ 2000;321:1454 ( 9 December )
Putting women in control: A doctor who changed my practice
As a research registrar in obstetrics and gynaecology I was
moonlighting and gaining extra experience doing family planning and youth
clinics. Unlike most of my previous
training I was expected to sit in and then be observed by a senior doctor.
It was my great fortune to work with Fay Hutchinson, the medical director
of the Brook Advisory Service, because she completely changed my approach
to patients.
Many of the women coming for contraception, pregnancy testing, and
abortion advice were young and had never had vaginal examinations or
smears. They would be prepared on the couch as usual and then they were
given a speculum and asked to "put that inside, please." As if it was the
most natural thing in the world that a doctor would ask a woman to insert
a speculum! And most did so with no fuss. I was so shocked. I was shocked
by the strangeness of what I was seeing and the topsy-turvy relationship
between doctor and patient.
This had been a stressful and complex procedure for me to learn as a
medical student and senior house officer. Why did Fay do it? Because
"women know best where their vaginas are. They put tampons, fingers, and
penises in."
She was absolutely right. It's easy for women to insert a speculum,
except for those who have come to expect the doctor to do it or who find
"down there" distasteful. It is a particularly valuable technique for
"difficult examinations" on women who are frightened or who have had bad
experiencesfor example, abuse or coercive sexor painful gynaecological
examinations. The women determine when they are ready, control the
insertion, and cannot adduct their thighs or clamp their legs closed.
They relax and it never hurts.
I have never had a problem since that day. Why had I never heard,
seen, or even read about self insertion in my years of training? Because,
Fay opined, "Male gynaecologists find it very hard to give up control."
Having since resisted and yet reviewed many other aspects of my basic and
routine practices I think she's wrong. All doctors find it hard to give up
control, both sexes and all specialties. But sometimes it's beneficial for
patients. Try it. Susan Bewley, consultant obstetrician.
I do Pap test in an ordinary bed in my Birthing Center for 10 years
now. No problem with the quality of specimen.
Rapid Response:
putting women in control
I am so glad about this research. I just want to share a small text
of an event that changed the practice of an obstetrician, and mine...
The try was worthed.
BMJ 2000;321:1454 ( 9 December )
Putting women in control: A doctor who changed my practice
As a research registrar in obstetrics and gynaecology I was
moonlighting and gaining extra experience doing family planning and youth
clinics. Unlike most of my previous
training I was expected to sit in and then be observed by a senior doctor.
It was my great fortune to work with Fay Hutchinson, the medical director
of the Brook Advisory Service, because she completely changed my approach
to patients.
Many of the women coming for contraception, pregnancy testing, and
abortion advice were young and had never had vaginal examinations or
smears. They would be prepared on the couch as usual and then they were
given a speculum and asked to "put that inside, please." As if it was the
most natural thing in the world that a doctor would ask a woman to insert
a speculum! And most did so with no fuss. I was so shocked. I was shocked
by the strangeness of what I was seeing and the topsy-turvy relationship
between doctor and patient.
This had been a stressful and complex procedure for me to learn as a
medical student and senior house officer. Why did Fay do it? Because
"women know best where their vaginas are. They put tampons, fingers, and
penises in."
She was absolutely right. It's easy for women to insert a speculum,
except for those who have come to expect the doctor to do it or who find
"down there" distasteful. It is a particularly valuable technique for
"difficult examinations" on women who are frightened or who have had bad
experiencesfor example, abuse or coercive sexor painful gynaecological
examinations. The women determine when they are ready, control the
insertion, and cannot adduct their thighs or clamp their legs closed.
They relax and it never hurts.
I have never had a problem since that day. Why had I never heard,
seen, or even read about self insertion in my years of training? Because,
Fay opined, "Male gynaecologists find it very hard to give up control."
Having since resisted and yet reviewed many other aspects of my basic and
routine practices I think she's wrong. All doctors find it hard to give up
control, both sexes and all specialties. But sometimes it's beneficial for
patients. Try it. Susan Bewley, consultant obstetrician.
I do Pap test in an ordinary bed in my Birthing Center for 10 years
now. No problem with the quality of specimen.
Céline Lemay
Competing interests:
None declared
Competing interests: No competing interests