‘Too little’ done to combat obstetric and gynecological violence against women

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In the wake of #MeToo, France saw a flood of heartbreaking testimonies from women across the country speaking out about cases of sexual harassment or abuse they faced while in maternity wards or at the gynecologist. Now that a well-known practitioner is being investigated for rape, what is being done to stop the abuse? Jowharinvestigates.

In a sea of ​​purple banners, one of the colors used by suffragettes to represent loyalty and dignity, tens of thousands of protesters took to the streets of Paris to condemn violence against women on Saturday.

Among those who demanded more government action was Sonia Bisch, founder of Stop Violences Obstétricales et Gynécologiques (StopVOG), a feminist organization that fights against obstetric and gynecological violence. His presence in the march comes at a critical moment.

Since September, a total of seven women have filed official rape complaints against well-known Parisian gynecologist Émile Daraï, who stepped down as director of the endometriosis center at Tenon Hospital on October 8. In addition to the complaints, Stop VOG has received an avalanche. of testimonials from various women on their social media accounts.

But while a legal investigation is underway, little has been done to curb obstetric and gynecological violence in France.

Illegal

“Rape doesn’t just take place in a dark subway by a stranger holding a knife,” Bisch tells FRANCE 24. “It takes place in families, couples, and in gynecological offices or maternity wards by the doctors themselves … Unfortunately, medicine is not ‘Not being exempt from things that happen in society’.

Obstetric and gynecological violence occurs when a healthcare professional engages in conduct or practices that are not medically justified or consented to by the patient. “It can take place during an abortion, IVF procedure, pregnancy or childbirth, and it can be physical, psychological or verbal,” explains Bisch.

For Aurore, 32, it happened during her first visit to the gynecologist. She was 16 at the time and her GP told her to get a checkup after she reported that her skin was irritated and itchy. Already feeling nervous about being examined under such intimate circumstances, she was met with haste. “The gynecologist was visibly very upset because he hadn’t seen anyone before. When he came into the room, he said ‘Hi’ and immediately told me to undress, ”he said.

“I took off my pants, sat on the exam table and started crying,” she explained, remembering how scared and stressed she felt at the time. “He started and I squeezed my knees together, I didn’t want to continue. He examined me with a swab to take a sample and performed a vaginal finger exam. All the time he cried, shook his head and said no. I did not understand what was happening. I was not ready “.

The doctor continued despite repeated attempts by Aurore to stop the consultation. Years later, when she asked for her file, she discovered that he had also performed a vaginal ultrasound on her. “I was so shocked at the time that I didn’t even realize what was happening,” she said. It turned out that Aurore had a simple yeast infection and only years later did she understand that she could have bought medicine from a pharmacy. But more importantly, she understood that she had been raped.

According to the Kouchner Act of 2002, physicians must seek their consent from patients before performing any medical procedure. If they fail to do so and carry out an act of sexual penetration “by violence, coercion, threat or surprise”, this is considered rape in France, according to article 222-23 of the penal code.

A systemic problem

Obstetric and gynecological violence cases first made French headlines in 2014, when women used the hashtag # PayeTonUtérus to talk about the sexual harassment or abuse they faced during check-ups or procedures, in the wake of the #MeToo movement.

Three years later, the former Secretary of Equality Marlène Schiappa ordered a report on this type of mistreatment that was published in June 2018. The report found that violence committed by obstetricians and gynecologists in France was systemic and not limited to a few cases isolated.

Some ways were found to be more common than others, such as performing episiotomies (surgical incision of the perineum) without the patient’s consent, obtaining vaginal sutures without anesthesia, and using pressure on the fundus (applying pressure to the uterus) to speed up the process delivery, a practice that has been strongly discouraged by the French National Health Authority (HAS) since 2007.

The report also revealed a general disregard for women’s pain and a lack of communication for the procedures, something that Sandrine *, 40, experienced first-hand before the birth of her second child. As her due date was approaching and she still had no contractions, she began seeing her new gynecologist on a regular basis to check on the baby.

During one of these visits, Sandrine underwent a painful vaginal examination, without warning. “It hurt a lot,” she said, remembering a former midwife in Paris who always asked questions before having the procedure. Then the gynecologist continued with his exam and did something that Sandrine says “didn’t feel good at all.”

“He wiggled his fingers, trying to stretch things out, but he wouldn’t tell me what he was doing… he couldn’t really handle the pain and it felt like something was different. I told him to stop what he was doing and he did it right away, ”he said. Sandrine discovered that, without her consent or communication, the gynecologist had tried to remove the membrane to induce labor since her baby was late.

“I think the biggest problem is not asking women for approval and not mentally preparing them for the pain they are going to feel,” Sandrine said, echoing Bisch’s assertion that, in 2021, women in France should not stop. the doctors. practices or maternity wards feeling “tortured or raped”.

Too little too late

Since the 2018 report was released, the French government and other medical authorities have done little to combat obstetric and gynecological violence. To make matters worse, the Ordre des Médecins (French Medical Association), the body charged with drafting the code of medical ethics and processing complaints, was criticized in 2019 by the Court of Auditors for its disastrous handling of patient complaints.

“Three and a half years later, nothing has happened. It’s very little. There’s a letter and that’s it, ”said Bisch, referring to a good practice letter published by the French National College of Gynecologists and Obstetricians (FNCGM) in response to the allegations against Daraï.

When asked by Jowharif the institution plans to do more, its president, Dr. Isabelle Héron, said the letter was “only part of the answer.” The report aims to remind doctors how to perform a gynecological examination, putting “the notion of consent at the center of the consultation”, and will be posted in waiting rooms so that patients “know that this letter was published”, Héron said.

“But above all,” he said, the best solution was “to teach our young people.”

For Bisch, it is not enough. “If the violence could be stopped by sticking pieces of paper on the walls, there would be no need for (feminist associations) to campaign against femicide. All we would have to do is stick a piece of paper on the abusive husbands’ walls telling them not to kill their ex-spouses, ”she said.

“We need control of medical practices … We need medical professionals, students, police and lawyers to be trained in this matter, so that they can understand the consequences of this violence,” concluded Bisch. Talking is not enough. We need people to listen. When you don’t listen to the victims, it’s like they aren’t speaking at all. ”

* Name changed to ensure anonymity.