Monday 2 December 2013

The O&G Battle: The Push for Female-Only O&G Staff in the Labour Room

There has been a huge movement recently in the Malaysian community towards pushing for more female practitioners in O&G, especially with regards to boundaries for Muslims. The original petition here.

While I agree that every patient (not just in the specialty of obstetrics and gynaecology) has a choice regarding their doctors, I do not agree with the hardline stance that male doctors be banned from the labour room, fully qualified or otherwise. I wonder if the individuals behind this petition truly understand the way that our hospitals work, and I write this in hopes that the public is more understanding behind the policies that we hold.

That said, this is written purely on a personal basis and reflects no official stance from any party whatsoever.

1.      Government Practice
The government sector, whilst there has been improvements in previous years, is often limited in the choices of our staff. Staff are rostered on based on a shift and oncall system, and whilst you have more doctors during the day, you may have limited doctors at night.

Please bear in mind that doctors are rostered on based on area as well (dependent on the size of hospital) – for instance, a doctor covering the labour room may also have to do the emergency caesarean section, in which case, the labour room might not have a doctor during this time.

Please also bear in mind that not all labour rooms have the privacy of the more modern facilities.

Also please bear in mind that all male doctors are not allowed to attend female patients on their own – they need to be chaperoned by a female member of staff. It is in your right to request this.

2.      Aurat and Modesty
It is your luck as the patient if the doctors rostered on during the time of your delivery are male or female, and please understand that we doctors stand by a code of ethics: of professionalism, and justice, and benovelence.

In Islam, it is permissible to be examined by a doctor of the opposite sex. It is also the responsibility of the doctor to put the patient at ease by explaining the examination and what the purpose of the examination is. It is a very personal thing for women in labour to expose their private parts, but do remember it is also considered within the boundaries of aurat for females to expose these parts to other females – so please do not use the excuse of aurat for this issue.

Similarly with modesty, when a woman is in labour, she is at her most vulnerable – but it is crucial for staff to be able to monitor the progress. At times like this, naturally there is an element of embarrassment to have strangers examine the vaginal opening – but this is a necessary process to monitor the progress of the baby’s descent, and modesty has to be put aside for what is necessary.

What we do in the labour room is out of necessity, and not for fun. All staff are meant to carry themselves in a professional manner, and if they do not, as a patient, you have every right to complain.

3.      The Push for Only Female O&G Doctors
Whilst there are many more doctors currently in service, it is not necessarily the case within specialties. In Malaysia, where there is a preference for women to play a more passive role at times, it is difficult for some to go out into the field and face these very real challenges – the need to stay overnight at the hospital, leaving their families at home, and the physical challenges of operating.

That said, I have also similarly heard many hypocritical statements where the very same individuals who only want female obstetricians prefer male surgeons. Please bear in mind that the job of an O&G doctor also involves the operating theatre.

4.      Denying the Education of Male Medical Trainees in the Labour Room
Please understand that junior doctors and house officers need to be trained to deal with all emergencies, including birth. Many of us are sent out to districts with no specialists or consultants, and these doctors are the first point of contact for certain communities.

Although it might not seem obvious in such large hospitals, please bear in mind that we doctors are sent out to all locations and we must have to undergo certain experiences, including labour, to prepare us for these future challenges.

5.      Your rights as a patient.
As a patient, you have the right to choose your doctors and those who examine you. However, this is dependent on the resources of the centre you are at. Your centre also has a right to choose how they conduct the training of their junior doctors.

In a private centre, you will have more flexibility, as is the case for most full paying places. There tends to be more resources available, and subsequently, your choice of doctor.

You can try to negotiate to limit the number of people allowed in the room. This is a reasonable request for the most part, and reduces the number of strangers that might go in and out.

You may also try to request having your husband in the room during the labour.

However, at the forefront, please remember that health staff often try to do the best we can within the confines of our limitations, and pray that during your labour, you will be attended by the doctor with the most experience to conduct a safe delivery, regardless of gender.

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