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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