Who’s Afraid of the Ob/Gyn? Lack of Communication Between Women and their Doctors

By: Dani Nispel,  Program and Policy Intern
National Council of Women’s Organizations

The National Council of Women’s Organization’s Women’s Health Task Force held a panel discussion this past Tuesday called, Blaming the Victim: A Discussion about Diseases and Conditions Women Suffer From and Get Blamed For. This talk got me thinking about the various ways women do not feel comfortable talking with their health care providers about their own health issues. The panel brought up the important issues of shame, which keeps women from having these conversations, their lack of health insurance, and the role women play as caregivers (and therefore, let their own health issues come  second). When discussing shame, I was instantly drawn to ob/gyns. What other health care professional creates so much anxiety for women, while also being such an important part of our health and sexual well-being?

Sex is not something women talk openly about, at least that’s what we’re taught. Which is why it’s so problematic that women are expected to talk openly with their ob/gyns. When women do speak openly, as Sandra Fluke testified about the importance of birth control, the backlash is enormous. Fluke’s testimony prompted Rush Limbaugh to comment, “What does it say about the college co-ed Sandra Fluke, who goes before a congressional committee and essentially says that she must be paid to have sex, what does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex.” These types of attacks on women and their sexuality don’t encourage a dialogue to take place, and in honor of National Women’s  Health Week, I want to encourage women to be empowered and take control of their sexual health.

If sex is something women are constantly attacked for, how can we assume that conversations about sex will magically start taking place between a woman and her doctor? The general recommendation is for girls to first visit the ob/gyn between the ages of 13 and 15–a time when messages about the mortal dangers of sex tend to be very high. And if girls start off their experience with their ob/gyn having no idea how to talk about sex, how do we expect this to get better? It’s not going to be with help from the ob/gyns themselves. A Huffington Post article from March found that, “while two thirds of the doctors ask their patients how sexually active they are, only 40 percent inquire about sexual problems or dysfunction. Just 28 percent routinely ask about sexual orientation….only 29 percent of doctors make a habit of asking patients whether their sex life is satisfying.”

This lack of communication between women and their doctors is especially frustrating for me, because there are so few places that an honest discussion about sex and sexuality can take place. I firmly believe that a health care professional should be someone who provides a safe space to have these conversations. However, the evidence consistently shows that this doesn’t end up being the case. Doctors are not being trained in LGBT health issues, a study from Standford showed, not only making the doctor’s office a potentially unsafe location, but also limiting the personalized care an individual can receive. This past January, the American College of Obstetricians and Gynecologists announced that women should be screened for domestic violence, with the hope that doctors would be in the position to recognize the signs of intimate partner violence and provide help and resources. However, this also means doctors would need to both recognize the signs and be willing to take action, which previous studies have shown is not always realistic for doctors who don’t receive much training surrounding domestic violence.

In vilifying women and distancing them from their own sexuality, I think it’s only reasonable to then see the consequences. Ob/gyns are there to help provide preventative care and help deal with any problems that arise: but this doesn’t happen when women don’t feel like they can share any of their sexual problems. Even further, if women aren’t talking honestly about their sex lives they may not be getting the best advice about how to protect themselves from STIs and when they should be getting tested, putting themselves at greater risk.  Going forward, I think there are some major areas for improvement. First, doctors need to be trained in issues that are pertaining to women’s sexual health — including  LGBT health issues and signs of intimate partner violence–and doctors need to be comfortable talking about all of these things openly with their patients. Second, women of all ages need to be taught that sex is not something that should be full of shame and self-blame, but sexual health (which includes enjoying sex) is part of your general health. This isn’t to say that all ob/gyns have not been doing their jobs to the best of their ability, but there is certainly room for improvement.

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One Response to Who’s Afraid of the Ob/Gyn? Lack of Communication Between Women and their Doctors

  1. Jackson says:

    I’m not sure I believe the eupnqmeit line, since the weight limit they set is 200lbs. I’m fat, had all my three kids fat. My first was a c/s due to a failed induction, my next two were born at home. Sample size = 1. What concerns me, if this becomes more of a trend in medical practices, is what I saw happen in the VBAC world over the years. As it became harder to find an OB who would “allow” a woman to VBAC more and more of us stayed at home. At first, most of us opted to have skilled midwives with us (though my son decided not to wait for mine), and listened to our care providers when they risked someone out. Then over the years I watched as more and more woman totally opted out of the system, and UBAC (unassisted birth after c/s) became acceptable. Some had prenatal care. Some didn’t. I’ve heard of UBAC with twins. Woman started ignoring “risk outs” and deciding they’d just stay home. The limits were pushed, much further than I personally was comfortable with, and I pretty much severed most of my ties with the community.The thing is…. when the option of a respectful VBAC in hospital became difficult, woman found another way, and that way became more and more, imo, dangerous. If it becomes difficult for a fat woman, no matter her health status, to find a normal OB, will she opt for the high risk OB or will she decide to opt out of the model entirely? Of those who opt out, some will be fine, and will have healthy pregnancies and easy births. Some will not.

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