Our bodies ourselves Specialists claim medical profession patronises women

Press, 27 October 1982, Page 10

Our bodies ourselves Specialists claim medical profession patronises women

A return to natural birth methods and mistrust of doctors, felt by many women, is a result of the medical profession being too distant from the patient and too overbearing, top British and Dutch obstetricians have told the World Conference on Gynaecology, in San Fransisco.

Professor Denys Fairweather of the University College, London, said that the medical profession had “got its just desserts” in the natural birth backlash. “Poor communication and an attitude of ‘do what I tell you because I know better’ - has meant a mistrust of hospitals," he said.

In the last few years, better education, communication and the realisation that women have a right to refuse advice, has led to a healthier atmosphere in maternity wards.

At his hospital the wards used to be very clinical, but now there was wallpaper, carpets, and pictures to make it more like a home delivery occurring in a hospital.

Professor Tom Eskes of Nijmagen, the Netherlands, said: “Birth is a perfect thing and if you interfere with it, you have to have a reason. Husbands should be present, too. It takes two to make a pregnancy so it takes two to complete it. If the husband isn’t there, something is wrong.” With more than 40 per cent of babies born at home, the Netherlands still had one of the world's lowest baby death rates, he said. Britain, with only one per cent of deliveries at home, had a higher peri-natal death rate. Teen-age pregnancy

The conference was told that many teenagers failed to realise that sex could lead to pregnancy, and were forced into early sex by social pressures ’

Dr Pramilia Senanyake, a leading family planning expert, said adolescents needed to learn to say "no” and mean “no." Dispensing contraceptives with less than adequate information was next to useless, and the pill should not be recommended for young women within two years of their first period.

Of the 60 million women who had become pregnant in 1975 around the world, 13 million were not yet adults. Young women who were not emotionally or psychologically mature enough for pregnany resorted to late abortions. Moralising might alienate teenagers and contraceptives might confuse them.

Family life education needed to help young people build self-confidence and self-esteem, she said.

Dr Senanyake dismissed the view that better sex education led to promiscuity. She emphasised the role of the family in providing information and a stable environment in which teenagers could learn to value emotional relationships.

Adolescents needed to feel part of their society and not an intrusion upon its wellbeing.

Research in the Netherlands had shown that the most suitable contraceptive for young girls was a combined oral contraceptive consisting of ethinyl oestradiol and norgestrel, taken as a “morning after” pill.

Dr Adrian Haspels of Utrecht recommended two pills — the "morning after" and another two 12 hours later, to prevent pregnancy. These pills, known as eugynon 50, were effective contraceptives and were not as likely to cause nausea and vomiting as other contraceptives, Dr Haspels said. But more could be done to encourage proper contraception earlier, and young women seeking contraceptive

advice. should be treated in exactly the same way as older women.

“Teenagers welcome the beneficial side effects of oral contraception." he said, "including the regularisation of their cycle, the reduction of blood loss, and pre-menstrual tension, and one of the blights of teen-age life - minor skin problems such as acne.” Infertility Women who are unable tc have children because of a new form of brain tumour have new hope, thanks to an improved diagnostic method and better drugs, the conference was told.

Disorders of prolactin — a female hormone involved in fertility and breast feeding, and which is disturbed Dy tumours of the pituitary gland in the brain, can result in infertility. But now, thanks to the C.A.T. scanner — an X-ray machine that lets doctors look at slices of the brain — these tumours can be spotted more accurately. According to Dr Howard Jacobs of the Middlesex Hospital. London, C.A.T. scanners have been the major advance of the last five years. Ordinary X-rays were very inaccurate. The availability of blood tests for the hormone prolactin meant that those women who would respond to drugs could be isolated.

The drugs used included a bromocriptine, one of a series of compounds made from the wheat, fungus ergot, but now a whole new collection of synthetic variants existed, including Schering's lisunde. which was 10 times more potent.

The ergot drugs worked by shrinking the brain tumours which caused the initial hormone problem. Dr Jacobs said as many as 60 per cent of affected women could become pregnant and need not take the drugs for an extended period of time.