maddybeauregard

[maddybeauregard]

It's Not Just Me, Right?

The first time I was dismissed by my doctor, I was 14 years old. My doctor had told me for months that I wasn’t getting my period because I didn’t weigh enough, despite my point that I’d never gotten it even when I was at a higher weight. I remember the sense that I was being viewed as crazy and the feeling of utter helplessness that came with that. The more I argued, the more irrational my doctor found me and continued to insist that if I continued to put on more weight, my period would magically appear. He mistook my frustration at his negligence as me just looking for a reason to get upset. With the help of my parents, I visited a new (female) doctor, who heard me out, ran some tests, and found out the issue was related to my hormones and not my weight. This instance, while luckily being pretty inconsequential, opened my eyes to the fact that doctors will not magically have the answer, and sometimes they will dismiss the knowledge you have about your own body. Unsurprisingly, like in most other areas of society, women’s opinions and ideas are more likely to be ignored. Once you realize that medicine isn’t completely unbiased and fact-based, it can leave you feeling on edge when going to seek care. But do we have to accept this version of medical care as the norm? Will ceasing to ignore that medical bias exists help us to better deal with it?

[maddybeauregard]

Recognizing the Problem

Thinking about my experience led me to wonder how prevalent this phenomenon is. A study done on when women get disease diagnosis shows the notion that women’s pain is ignored isn’t merely in our heads. While individually we may not be sure if we are receiving inadequate care based on gender, a population-wide analysis of disease diagnosis showed that women are in fact diagnosed later than men for 700 diseases on average. The scale of this data points to this being a systemic issue, not just a coincidence. This issue has been dubbed “The Pain Gap” by several news outlets. This pithy title has obviously caught a number of Americans’ attention to get coverage from outlets such as Forbes, but are we as a nation truly ready to grapple with this issue? Although it’s gotten coverage in the news, the Pain Gap doesn’t seem to be widely known about, and how are you supposed to solve a problem you don’t even know about? Conversation and sharing experiences is an important first step in overcoming an issue of inequality, and I’m ready to start the discussion. I hope you’ll join me.

[maddybeauregard]

Searching For a Solution

Gender bias is just one star in a larger constellation of medical stress American women face. Race, Class, Ability, Weight, and Gender Identity are all factors that can further affect the care we get. One factor I’d never fully considered is how rural communities face a huge disparity in medical resources, especially when it comes to reproductive care. In the past decade, at least 90 rural hospitals have closed, along with the maternity wards of other hospitals closing as well. Patients often have to travel long distances for care, which can be life-threatening, especially when it comes to reproductive care. It also can just be incredibly inconvenient, especially for people dealing with jobs and children. This information combined with the fact that these tend to be lower income communities make seeking appropriate care difficult in a way I’ve  never had to consider. However, many people have been thinking about solutions for dealing with this issue, and one of those solutions involves integrating reproductive care into family health care. A small number of doctors across the country are already providing this care at different levels. Seeing how comprehensive care is able to assuage the stress of women living in rural areas, you’d think there’d be a strong push among doctors to integrate it more widely, but only 3% percent of family doctors across the country have the capability to and will terminate pregnancies. Having a familiar face provide your abortion, which can be a difficult and stigmatizing procedure despite how common it is, can make the experience much more bearable. This rings true for me, especially amidst the current climate of increasing anti-abortion legislation.  

The Mabel Wadsworth Center, located in Bangor, Maine, offers primary, reproductive, and mental health care for people with uteri, all within the same building. Patients say the center thoroughly searches for the cause of their symptoms, unlike dismissive doctors they’ve seen in the past. A large part of the success of the center is that it was founded with the goal of counteracting incomplete healthcare that disregards the feelings of its patients. The fact that providers at Mabel Wadsworth are aware of the different factors in their patients life that affect their wellbeing coupled with the more personal nature of a small, private practice allows their patients to truly feel listened to and cared for. After wading through a sea of information about the issues within the American Healthcare System, discovering the Mabel Wadsworth Center felt like an idyllic haven; a perfect solution. And yet, it’s still not perfect. The center is located in the city of Bangor, with some patients from remote areas of Maine having to travel more than 25 miles for the nearest obstetric services. In order to see a nation-wide benefit from integrated health care like this, many more practices would have to open in areas currently lacking resources. On top of that, existing  family healthcare providers would have to battle legislation, regulations, and stigma that restrict them from being able to offer reproductive care. Still, changes like this could be major reliefs to women seeking care across the U.S. and have real potential to reduce the rising maternal mortality rate, which is currently 23.8 women per 100,000 births. That number grows even higher when you look at only Black or Native American women. A statistic like this should be cause for national concern and a wake-up call that we need to look at how women are treated in medicine. Many of these deaths are due to reasons like untreated complications or proximity to obstetric care, which makes expansion of easily accessible reproductive care look like a necessity. Luckily, we have the means to work on this, and expanding centers like Mabel Wadsworth is one of the most concrete, actionable plans I’ve found to improve care for women. It is a beacon of hope amidst the current tidal waves of uncertainty.

[maddybeauregard]

My conclusions

Initially, I was surprised at how much my research seemed to drift into reproductive care, as historically one of the ways women have faced medical bias is being reduced to their role in bearing children. However, it is such a large pitfall in our medical system, and it lets women down in so many ways. This is a consequence of men controlling medicine for centuries, writing women off, and putting them down. I came to the conclusion that it is crucial to focus on reproductive care when we talk about medical inequality, in order to reclaim the narrative on it, and to end women being spoken over about their own bodies. 

[maddybeauregard]

Until Gender Bias in medicine is addressed at a systemic level, here are some steps you can take to protect yourself and your health.

[maddybeauregard]

Works Cited

Johnson, Akilah. “In Rural America, the Crisis of Disappearing Reproductive Care Steals Lives.” The Washington Post, WP Company, 18 Nov. 2022, https://www.washingtonpost.com/health/2022/11/18/reproductive-care-access/. 

“The U.S. Finally Has Better Maternal Mortality Data. Black Mothers Still Fare the Worst.” NBCNews.com, NBCUniversal News Group, 30 Jan. 2020, https://www.nbcnews.com/health/womens-health/u-s-finally-has-better-maternal-mortality-data-black-mothers-n1125896. 

“Maternal Mortality Rates in the United States, 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Feb. 2022, https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm. 

Mabel Wadsworth Center, 13 Oct. 2022, https://www.mabelwadsworth.org/. WomensMedia. “Just Your Imagination? the Dangerous Gender Bias in Women's Healthcare.” Forbes, Forbes Magazine, 9 Nov. 2022, https://www.forbes.com/sites/womensmedia/2021/09/21/just-your-imagination-the-dangerous-gender-bias-in-womens-healthcare/?sh=25a4947c3e54.