“I will not go there any more, because I will hear that I am letting go”. The worst texts of gynecologists

– When the gynecologist told me to “pick up the * psko”, I thought: you can stand it, it won’t get any worse. I was wrong – recalls Ewa. What do Polish women hear in gynecologists’ offices? The list of words that should never be found there is really long.

1. 3 million Polish women go to the gynecologist less than once a year or not at all – many of them find the visits embarrassing. Unfortunately, they often hear unpleasant words from doctors, which increases their fear of regular examinations
2. Paulina went to the gynecologist for a prescription for birth control pills. She heard in the office that she looked slutty
3. Ewa, the doctor said that she had cancer and only a few months to get pregnant. She didn’t explain anything to her, she just dismissed her. Eve cried for three days
4. Julia wanted to give birth at home. The attending physician said that if he did, he would kill his child
5. You can find more similar stories on the Onet homepage.

A Polish woman visits a gynecologist

They can pin a chair with one text. You lie down with your legs spread, you can’t move, and panic in your head … Run away! But you grit your teeth and stay. Later, you ask questions and look for another gynecologist, but you are consumed by stress before each visit. You knock on the office door, silently pleading for reality to go smoothly this time.

Over 3 million Polish women go to a gynecologist less than once a year or not at all (a study conducted in March 2019 as part of the nationwide social and educational campaign “In the Women’s Interest”). Almost 15 percent treats the visit as a necessary evil, and 9,7 percent it is embarrassing (data from the report by Joanna Skonieczna “Gynecological care from the perspective of patients with particular emphasis on people aged 12-25, LBTQ and with disabilities” from 2015).

Women consider the most embarrassing moment of visiting a doctor:

1. lying on the gynecological chair (pregnant – 36,5%; non-pregnant – 32,5%),
2. gynecological examination (pregnant – 32%; non-pregnant – 30,4%),
3. preparation for the examination, i.e. undressing (pregnant – 24,8%; non-pregnant – 25,1%).

Source: “Views and expectations of women towards gynecological examinations”, Pomeranian Medical University in Szczecin, Katarzyna Szymoniak et al. 2016

I will not go there again, because I will hear that I am letting go

– I’m out of birth control pills – Paulina begins. – At that time, I was studying in the third year and went to the clinic in Krakowskie Przedmieście. The doctor was in his forties, it seemed that everything would go smoothly. I asked for a prescription and it started … First, an embarrassing question about the number of partners. Later, a statement that I look slutty to him. The doctor was clearly getting off the ground. He asked which field of study I was studying, and when I replied that for the conservation of monuments, he ordered: on my knees to Częstochowa, you sinner.

– You know, it was all serious – Paulina is starting to get nervous, although several years have passed since the visit she talks about. – He said: kneel on a kneeler. And do you even know what a kneeler is?

When asked if she got this unfortunate prescription, she answers in the affirmative. However, the incident in the office still arouses emotions in her. – Why did he convert me? To feel better? I should have complained then, but I did nothing. I was in a difficult life situation, and I left the office so exhausted that I did not have the strength to get down to it.

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I will not go there again, because I will hear that I will never be a mother

– I have counted, four years have passed – Ewa ponders. – At the end of 2017, I got very severe pains in the lower abdomen and around the ovaries. I tried to make an appointment with several doctors at the National Health Fund or privately, but in December there were no available dates. Even privately, I was not able to get to the gynecologist until the end of January of the following year. I thought I was lucky when the appointment fell free at the clinic. And when I saw a doctor in the office, I was even glad that there would be less stress.

According to Ewa’s account, the visit began as standard with an interview. She told about the pain that she was strong and that she could not function normally, because neither sleep at night nor work, and painkillers do not work. She heard: – Each of them thinks up so as not to go to work. What? You wanted to be vacated … The doctor ordered him to go to the armchair. When Ewa was lying in pain, she heard: – Come on, raise your d * dog.

I gritted my teeth because I knew I wouldn’t get to anyone else. She started the examination, then stated that she was already over the limit, but as an exception, she would give me an ultrasound. I didn’t even manage to get up from the couch when she asked if I was planning to start a family – Ewa starts talking faster and faster. – I confirmed, and she asks: Is there a partner? Me, that I just broke up … To what she: Then get down quickly, because you have to crack the brat. Everything is cut out here. You have a tumor on the inside of your uterus and you have several months to become pregnant. It’s a cancer. I will arrange the procedure for you to the hospital.

At that moment, Eve burst into tears. He mumbles he’ll report and leaves the office. – She did not explain anything to me, did not commission any research, did not rewrite anything – she ends her story. – I roared for two days and then started looking for someone to consult me. As a result, it turned out that the types of lesions she had were not excised, and the pain was caused by polycystic ovary syndrome. Ewa wonders if the gynecologist did not aim for a refund from the National Health Fund. Until now, the number of times he sees her at the clinic, she gets chills.

I will not go there again, because I will hear that I will kill my child

“Okay, I just got it out,” Julia says. – Relieved. If you want, you can use it, but it’s good to have such a text. The story she wanted to tell did not pass her throat, although her daughter will soon be four years old. So she wrote down what she considered important and sent it.

«I just wanted to tell you something that I decided to keep only for myself. So far. It’s about my doctor. Now I think it’s good that this would see the light of day. I really wanted to give birth at home and I was carefully preparing for it. However, the gynecologists did not like this decision. According to their position, I should, like any old woman, end up in the delivery room. When I announced that I was going home after my last ward check-up, they realized how determined I was.

The leader of the pregnancy started to scare me. She said that if I didn’t go back to the hospital immediately, I would kill the baby. With these words. I’d rather not hear it, you know. And the worst part is, she said so for no particular reason. Out of sheer fear of the doctor who had done the last test, and he was her supervisor. He took my card, read it and said: Oh, and Dr. Joanna X., she did my specialization at my place. I’ll contact her soon. This is the hierarchy, the hospital hierarchy. The patient doesn’t count. And yet the psyche in childbirth is so important. In my opinion, on par with biology.

Women must not be frightened! Despite the fact that I meditated a lot and distanced myself from various texts and stories, her words were alive in me (after all, it was my attending physician) throughout the entire delivery. And I was very afraid that something bad would happen. It is completely unnecessary. However, I know it had an impact on my extended pressure phase. And when Maja was born, the first thing I said was – she is alive! Look, she has everything in place … It still hurts me a lot, those words of hers. Besides, his too; he kept saying that I was old enough that I would not be able to give birth naturally. But it was her opinion that I would kill the child that stuck with me like a knife.

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I will not go there any more, because I would have smacked his face

“Now I have no problem with that,” says Kinga. – I was 23 when I saw this gynecologist. Young girls are stupid, now I’d slap his face. I was three months pregnant and my husband promised to find the best doctor. He learned from an American friend from medicine about a great specialist in Katowice. Then the guy was under forty and could pass for such a handsome bearded man. But you know, for me he was an old man … – starts to tell Kinga.

– I lie down in the examination chair, and he starts to get excited about me, tells me how beautiful I am and that it’s impossible to focus on such views. Overall, looking at me, he was still messing about. I interrupted this “examination” and went to my husband’s waiting room. Now I think I was a complete idiot because I didn’t tell anyone about it, but I was terribly ashamed. I remember that this doctor had a PhD in medical sciences and the visit cost a lot of money. God, how terrible it is, a gynecologist should be subtle and cultured. Shame!

I will not go there again, because I do not want to hear that …

«Your breasts are too small» – Gosia’s bust commented on the Warsaw gynecologist, to whom she went for a referral for a hormone level test in connection with acne. Gosia claims that when she was instructed to undress, he looked at her with obvious disgust and was sexualizing.

“What do you think I enjoy seeing your steps torn apart” – this is what Asia heard during the postpartum examination in the hospital. The midwife, who was present at the examination, laughed eagerly, adding a bit of a nuisance from herself.

“If he does not pay, let him tire” – Zosia’s friend from high school, working in the ward, where she also gave birth, replied. She asked him why the woman in her room was walking for the fourth day to induce labor.

“You can afford manicures and pedicures, and you save money on a condom” – Milena summed up her doctor, to whom she complained that the pregnancy was unplanned and she was not ready for another child. In fact, her nails were perfectly made, with rhinestones and decorations. Maybe she envied?

This counting could be dragged on for a long time. Hundreds or perhaps thousands of women would add to it a text that is impossible to forget, even if you wanted to. This post on one of the internet forums can be a good summary:

«Find a gin who is polite, outspoken (I mean he explains recommendations and diagnoses, not: writing a prescription without saying a word and won), not playing roasty (not making malicious pricks that too little sex, too much sex , too little contraception, too much contraception, too early for babies, too late for babies … etc is really not his job) and it relates to a human, not a mare, it’s a miracle. And when he finds himself, after a few visits he leaves the hospital because he didn’t get along with the director. And listen again about the fact that I am getting off my new gynecologist when I come for a prescription for pills (when the only reason I needed them at the time was because of severe hormonal acne). “

Code of Medical Ethics, art. 12 paragraph 1

The doctor should treat patients kindly and culturally, respecting their personal dignity, the right to intimacy and privacy.

In Poland, the language of pain reigns supreme in contacts between a patient and a gynecologist

Marta Boczkowska, a health psychologist, helps to highlight the problem and find solutions.

Monika Zieleniewska: The patient, after crossing the threshold of the gynecological office, enters a relationship with the doctor …

Marta Boczkowska, health psychologist:… The relation is by definition unequal. Patients are often undressed and therefore feel discomfort. Not all doctors have this in mind, and yet they are responsible for ensuring the well-being of women. Not only to carry out diagnostics, but also to make the patient feel like an equal partner in mental contact.

However, often the opposite is true. Why?

There is no single answer to this question, because both people are different and the environment is different. As a person working with doctors on a daily basis in a hospital ward, I know that the health care system in our country is extremely difficult. I also work with medical students and I perceive them as nice, willing, empathetic and really caring about the patient’s well-being. However, when we meet after a few years, I can see how they have changed. Research conducted in England shows that 12- or 24-hour on-call duty combined with under-eating reduces empathy by as much as 30 percent.

So the soulless system takes over?

Not really, because the medical staff eagerly uses training or the help of psychologists. Unfortunately, he has very little time for this, and knowledge flies quickly in the multitude of duties.

It’s interesting, and the next topic?

Sometimes this behavior is due to the lack of tools, underestimating the fact that communication with the patient is as important as diagnosis. When the patient is under stress, in pain, the doctor should establish a relationship with him based on trust and cordiality, otherwise he will not be informed. The patient will close in on himself, and when we measure his blood pressure, it turns out that it is higher than when the doctor showed empathy and understanding. Sometimes, but very rarely, I want to emphasize it, I notice that in young people the communication tools are downplayed. The last thing is personality problems. They can be found in all professions, but the medical profession gives a special field of activity. If we have complexes, low self-esteem, we can easily feel better: I put on an apron and suddenly become a superman. I am talking about a fraction of people, but I think each of us happened to meet a doctor who immediately set the report in terms of: I know better, and you, as a patient, do not need knowledge.

How, then, should a girl react when she comes for a prescription for birth control and learns that she’s letting go?

For example: your statement is vulgar. I do not wish to be treated in this way, and it is not your competence to judge me. I will report it to the head of the clinic. I believe that such behavior should definitely be stigmatized and punished. We need to speak out loud about how we have been treated.

And how is he to deal with Julia’s trauma, which the doctor frightened that if she decides to give birth at home, she will kill the child?

I was on the side of the doctors until I heard the doctor’s words. Such a message is outrageous and traumatizing at the same time. I understand the conservative approach of gynecologists, because home delivery is not popular in our country yet. The fear for the patient is obvious to me and I would not look for negative intentions here. However, this message could have been delivered much more gently. It would sound completely different: you are my patient, I am worried about you and your child. I understand that you have made a decision that you want to give birth at home, but I, as the conductor of the pregnancy, believe that you should stay in the hospital. The domain of Polish healthcare is the use of messages based on fear and aversion. Meanwhile, they do not work at all. They only leave a mark in the form of trauma, sometimes phobias or anxiety. If someone is afraid of something and we scare them additionally, they will be more afraid. Sometimes I hear from students that scaring might help, that it is for good intentions. We have the language of benefit and the language of pain, as Daniel Kahneman says. And this language of pain reigns with us – what can you lose, what bad will happen to you. The effects are short-term, because the patient will actually get scared, but in the long run this type of approach is ineffective.

I would call such behavior violence.

Agree, this is violence against the other person, absolutely unprofessional behavior.

How to proceed to avoid a painful violation of your self-esteem?

It’s worth calling a spade a spade. If we experience rude behavior, we need to address it. When the doctor speaks in a raised voice or screams, let’s use a technique called the camera technique. Let’s tell him: you yell at me, I don’t like it. I wish you would stop because I want information about my health. We are then in the position of assertive contact.

In a word, let us demand respect.

I see patients claim their rights more and more, but the pendulum is tilting towards the claims side. From submission and such “I do not know, I do not speak, it is not appropriate for me to ask”, in the direction “please tell me everything at once, I demand that now the doctor be only for me”. It is also not a balance, because in this situation doctors are the aggrieved party. However, I hope it will even out, that we are on the right track to learn assertive contact, talking about our needs. Let us communicate our feelings – I need the doctor to explain to me, and the last examination was painful, etc. I think that doctors lack feedback. They don’t know everything, maybe if they did, they would change their behavior. I would count on that.

So we change the language of communication, but for a patient who already has a fear of visiting a gynecologist, it will not be easy?

Then he can come to us, psychologists, and work through it. Although I believe that the responsibility for ensuring that patients do not feel anxiety lies with the specialist. It is he who must learn to effectively communicate to the patient that he is worried about her, that he sees contraindications, while paying attention to her hormonal, mental and physiological state. He should also give the patient the right to choose, give up his help and go to another doctor. Our task is to properly support the patient. Because it’s not the patients who have to deal with pathology.

We encourage you to listen to the latest episode of the RESET podcast. This time Kamila Wykrota, the resilience trainer, will tell us about what resilience is. How does the ability to adapt to changing circumstances and react to adversities affect our quality of life? You will find out by listening to the latest episode of our podcast.