The return of our weekly roundup, looking back at sexism in women’s health over the last few weeks
Hysterical Women of the Week is back! Between work and life getting in the way, I let our weekly roundups slide a bit in January, so here’s a look back at what’s happened in the last week – plus a few stories I missed from the previous four weeks.
When Women Are Denied Pain Relief During Invasive Procedures
Jessica Furseth wrote for Broadly about her own and other women’s experiences of being denied proper pain relief during a hysteroscopy – an invasive procedure that examines the inside of the uterus with a small camera to explore heavy or unexpected bleeding, pelvic pain, fibroids, polyps, fertility issues, or diagnose uterine cancer.
As Jessica writes: “I figured it might be like a smear test, or maybe an IUD fitting. The hospital leaflet I was given prior to the procedure told me to expect period-like cramping. I took some paracetamol with codeine for the pain, and laid back with my feet in stirrups.” But the procedure was so painful that Jessica found herself hyperventilating, clamping down on the nurse’s hand, moaning in pain, and eventually crying out in agony.
Pain, it seems, is often a routine part of hysteroscopy. The dentist will give you a shot before starting to drill. So why does the National Health Service (NHS) routinely send women to have their wombs poked and prodded without anesthesia? And why, when women are in obvious pain, do some doctors ignore them?
Although it may seem astonishing that women are routinely being subjected to invasive and painful procedures without anesthesia, it shouldn’t come as a surprise: Historically, women’s pain is taken less seriously by doctors.
NHS guidelines state that the pain levels accompanying hysteroscopies vary: Some women feel “no or only mild pain,” but for others it can be “severe.” Although both local and general anaesthetics can be offered by NHS doctors performing the procedure, there’s no requirement for them to do so. Many women undergo the procedure without any anesthesia at all. The current guidelines from the British Society for Gynecological Endoscopy (BSGE), the body overseeing hysteroscopy, also acknowledge that it “can be associated with significant pain.”
Heart disease kills more women than anything else – so why do men get all the attention?
Dr Nishat Siddiqi writes for New Statesman: “As a cardiologist, I thought I would be the first person to recognise cardiovascular disease in myself, but I was wrong. When I was pregnant, not only did I fail to recognise the signs of severe hypertension (very high blood pressure) but so did my midwife and obstetrician… It was only when my life and that of my unborn son was at risk that the correct diagnosis was made.”
The staggeringly high death rate from cardiovascular disease in women reflects a worrying trend: women are less likely than men to recognise that they have symptoms related to heart disease, so they seek help later than men, their symptoms are more likely to be misinterpreted by health care professionals and up to 50 per cent of women with heart attacks are initially misdiagnosed.
Women have less chance of being investigated adequately: one study found that paramedics are less likely to perform a heart tracing to rule out a heart attack in women than they do in men. Another study found that the “door-to-balloon time” – the crucial time taken between the arrival in hospital of a patient having a heart attack to the opening up of the blocked coronary artery – is longer in women than in men. Even if women receive the correct diagnosis of heart disease, they are less likely to have the appropriate treatment.
Women present later, are under-investigated, under-treated and have poorer outcomes from all forms of cardiovascular disease when compared to men. Moreover, the prevention and treatment of cardiovascular disease has historically focused on men’s health. Typically, women are woefully under-represented in clinical trials that test treatments. The majority of new drugs are tested on Caucasian men and then rolled out to everybody.
Related: How One Woman Changed What Doctors Know About Heart Attacks – New York Times Well
I Was Pregnant and in Crisis. All the Doctors and Nurses Saw Was an Incompetent Black Woman
A devastating read by Tressie McMillan Cottom, for Time Magazine, on the death of her premature newborn baby, and the struggle to be taken seriously as a pregnant black woman in a crisis situation:
I have never felt more incompetent than when I was pregnant. I was four months or so pregnant, extremely uncomfortable, and at work when I started bleeding. When you are black woman, having a body is already complicated for workplace politics. Having a bleeding, distended body is especially egregious.
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When the doctor arrived, he explained that I was probably just too fat and that spotting was normal and he sent me home. Later that night my ass started hurting. Just behind the butt muscle and off a bit to the side. I walked. I stretched. I took a hot bath. I called my mother, The Vivian. Finally, I called the nurse. She asked me if my back hurt. I said no. It was my butt that hurt. The nurse said it was probably constipation. I should try to go to the bathroom. I tried that for all the next day and part of another. By the end of three days, my butt still hurt and I had not slept more than fifteen minutes straight in almost seventy hours.
I went to the hospital. They asked again about my back, implied I had eaten something “bad” for me and begrudgingly, finally decided to do an ultrasound. The image showed three babies, only I was pregnant with one. The other two were tumors, larger than the baby. The doctor turned to me and said, “If you make it through the night without going into preterm labor, I’d be surprised.” With that, he walked out and I was checked into the maternity ward. Eventually a night nurse mentioned that I had been in labor for three days. “You should have said something,” she scolded me.
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The assumption of black women’s incompetence —we cannot know ourselves or express ourselves in a way that prompts people with power to respond to us as agentic beings—supersedes even the most powerful status cultures in all of neoliberal capitalism: wealth and fame. In a 2017 interview, Serena Williams describes how she had to bring to bear the full force of her authority as a global superstar to convince a nurse that she needed a treatment after the birth of her daughter. The treatment likely saved Serena’s life.
In the wealthiest nation in the world, black women are dying in childbirth at rates comparable to those in poorer, colonized nations. The CDC says that black women are 243 percent more likely to die from pregnancy or childbirth-related causes than are white women. Medical doctors surely know about these disparities, right? Why, then, would a global superstar have to intervene so directly in her own postnatal care, and what does that say about how poorer, average black women are treated when they give birth?
Half of patients with chronic fatigue syndrome claim they are dismissed by doctors who say the illness is psychological
The Daily Mail reported on a study on 282 patients – predominantly women – with chronic fatigue syndrome (CFS), which found that 40 per cent avoid going to A&E in fear they won’t be taken seriously because of claims it’s ‘all in their heads’.
Almost half of people suffering with chronic fatigue syndrome (CFS) have been dismissed by doctors who claim their illness is psychological.
Scientists have warned there is a ‘profound’ lack of understanding of the condition, also known as ME, in hospital settings.
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It suggests the majority of patients are not receiving proper care, or being misdiagnosed with something else.
Only 30 per cent of patients reported receiving appropriate treatment in an emergency, according to the research.
And finally…
As I posted on Friday, the latest edition of medical journal The Lancet explores the way women are overlooked and undervalued in medicine. In news that will come as no surprise to regular readers of Hysterical Women, Reuters reported that the journal: “found medical research was skewed towards the needs of men, with almost three quarters of biomedical research papers failing to consider differences in outcome according to sex.”
“The evidence is clear: women are disadvantaged within science, medicine and global health,” Lancet executive editor Jocalyn Clark told the Thomson Reuters Foundation.
“Gender equity in science is not only a matter of justice and rights, but is crucial to producing the best research and the best care for patients.”
