The OB/GYN

So, I'm back now to discuss my appointment experience:

The process for getting in to see an OB/GYN is that I have to have a referral from Health Services to the doctor of their choice. If I chose to pursue my own care and choose my own doctor I would most certainly find myself waiting one to two years merely to get my first appointment.

So, due to this doctor shortage i find myself literally at the mercy of the choice that Health Services and the OB/GYN that they choose for me. (And of course, I am foolish and trust the choice of WLU health services- foolish indeed.)

It might have to do with the research I've been doing on childbirth and Western Childbirth Practices, but I really had high expectations of my first visit to the OB/GYN. However when I finally left I felt like less of a person, and it was clear/obvious that I wasn't an individual or a woman to be listened to, but an object to be directed. I had no say in what was happening, no outlet to ask any questions and didn't leave feeling like a free agent better equipped to help me make a decision about my birth control options. In short, I expected to leave feeling empowered and instead i left feeling violated and depressed.

So, I'll just start from the beginning of my day (because it certainly was a whole day):

When I stepped off the elevator onto the second floor, I walked around looking for the suite, and found it very quickly because the office was so full that one woman was actually sitting outside of the waiting room! Anyhow, she immediately informed me that her appointment was scheduled for 11am, yet here she was at 12:30pm still waiting to be seen. So, I'm thinking, this is going to be a long afternoon...

The waiting room was possibly the smallest room i could have ever been, there wasn't even space for me to fill out the paperwork required for a first visit. I felt like all eyes were on me and everyone was watching me fill out incredibly personal and revealing information. Watching me list off like it has no meaning the ins and outs of my cycle.

How often do you bleed?
How much do you bleed?
When was the last time you had your period?
etc etc
Like I was cataloging the habits of my uterus.
Not to mention that it was the first day of my period and the OB/GYN obviously didn't even take the time to read the degrading questions I was required to answer because she did not know that it was the first day of my period.

After I filled out these questions, I went and sat in the hall outside of the office because there was simply no more room in the waiting room for patients to sit.

So anyhow, as it turns out, even though my appointment was scheduled for 1pm I had time to leave and go to class from 2:30-4 and come back for my appointment (which is an indication right away that OB/GYNs are overworked, underpaid and are being bombarded with more patients than they can possibly handle.)

So, before i discuss the circumstances of my actual appointment, I feel the need to comment on the circumstances of the waiting room, which is not the fault of the doctor herself, but more the fault, I think, of Daulton McGuinty and our own health care system.

Many of the women waiting there at 2pm had scheduled appointments at 11am- some of these women were obviously pregnant and found themselves due to the shortage of OB/GYNs obligated to give up their entire day in order to submit to a 15 minute appointment which did nothing to preserve dignity or individual subjectivity. I have never seen so many pregnant women in one room before, it was intensely overwhelming and I certainly felt my anxiety level go up (I attribute this to the fact that I seriously thought I was pregnant last month and this was th first day of my period- I was still recovering from the prospect of housing and raising a child) However, anxiety aside, the overwhelming number of pregnant women just waiting to be called for their turn with this woman seriously gave me the impression of "baby mill"

As I sat in the waiting room I started to become very anxious because the "woman friendly environment" i had anticipated was quickly being overshadowed by the obvious clinical ideals of our Western medical system. I honestly don't know why I would have expected less, because the OB/GYN is still a division of traditional Western Medicine, however, I had high hopes considering that the practice is woman-centered.

Oh, how my feelings of "baby mill", "vagina mill" and woman as object were confirmed once I returned after class.

I'm not going to get into too many details of the actual appointment, but really I think question some of the principles behind what happened in that office.

In particular, I spoke to a nurse before i left for class and told her that my PAP was up to date, and yet, I was told I had to have another one. Why wouldn't Health Services have just forwarded a copy of my record over? If I had to sign a release I would have done so rather than endure my second one of the year. It almost served as a measure of power and control rather than something that done for my own wellbeing, in the way that it was performed and the way that it was treated. It seemed as though this doctor didn't see me as a person seeking educated information on contraceptives, but viewed me as someone to be lectured (and in the end she not only did that, but almost seemed to play some ridiculous mind game with me).

The part about this entire visit is that is seems as though she was intent on making me doubt what i wanted without really offering me options. She didn't seem interested in discussing what was best for me, or giving me an opportunity to ask questions. What really confused me was that she told me that I needed to have a pelvic ultrasound (which makes perfect sense to me) in order to make sure that the IUD would be ideal for me, and really i think, trying to send a moral message home by saying something to the nature of "Now, you may be in a monogamous relationship now, but this is really meant for the married woman" and the tone in which she said this to me really led me to feel that she was implying something, though I can't quite put my finger on it.

So anyhow, after this appointment, and she's really done her job to make me more doubtful and unsure of the choice I'm about to make, I go over to the counter to wait for the form that would refer me to get an Ultrasound, and what does she give me?... a prescription for an IUD.

I feel that my care has been compromised because of the culture behind Western medical practices in combination with the doctor shortage we are currently facing. Unforunately I am blogging from a friend's house so I am unable to cite literature re: the culture behind Western medical practices, but for immediate reference you can consult Foucault's "The Birth of the Clinic." and "Panopticism."

Anyhow, as a result of this dehumanizing experience, I went home feeling like some of my power had been taken away from me. The system is meant to disempower women and (intentionally or unintentionally?) makes women feel like less of a person.(I Personally lean towards intentionally considering the power structures are present in the hospital and clinical setting. It was a very odd experience and a far cry from the woman friendly/woman centered type of environment I had hoped and expected to enter. I think that the whole notion that I would be going to a doctor who specialized in gynecological related issues caused me have high hopes. It is unfortunate that I failed to consider sooner the context of the OB/GYN- it still remains within the one of Western medical care. Essentially, I failed to consider that OB/GYN is not necessarily synonymous with "pro-feminist, pro-woman perspective."

Really, how could it any different than any other clinical setting? It is difficult to find a traditional clinical setting that is empowering to anyone, never mind women within the context of an OB/GYN. It's getting late now, but I'm going to have to do my research on whether there is a different available option in the department of gynecological care.

In the meantime, since I'm toying in my head with the ethics of everything that I experienced at my doctor's appointment, here is an interesting link to a documentary coming out in the states called "At Your Cervix" which critically addresses the teaching methods and then ethics behind them currently used to train OB/GYNs in med school.

Another point I must make about what this doctor told me is that the IUD is typically meant for women who have had at least one child and who are done having children. For this reason (since its being marketed for the presumably hetersexual upper middle class white woman who is 'finished' procreating) they are only available in one size which may not be the right size for my uterus (which is why I am extremely confused as to why I was given a prescription if this is a possibility. Did she determine in my exam that my uterus was a suitable size? If the risk is so low that its not worth checking out? Was she just tired and thought she should just give me what I wanted? Then as if that wasn't enough, this woman just refers me off to another male OB/GYN because he's doing a clinical trial on the IUD, but a smaller size developed for women in my target demographic who have not yet had their first child and are currently waiting at least 5 more years to have children. This clinical trial would require me to submit to a third PAP for the year, blood work, and probably many follow ups for documentation of the IUD. This IUD is identical to the other one except that it is physically a smaller size. I don't know how I feel about all of this. As a result I have a doctor's appointment with my family doctor on Wednesday morning. More to come...