#Obstetrics and Gynecology

[emgoesmed]

3/21/2023

7 day stretch complete! Wrenching my circadian rhythm back to normal after night shift. Listening to The National and sipping coffee in a cafe. Drinking in the sunshine; it's finally starting to feel like spring. Feeling better after a pretty terrible start to the week. Going to relax tonight and finally read The Seven Husbands of Evelyn Hugo. I have a handful of shifts left on L&D and in the OR and this rotation will be over in 2 weeks - time is flying, in a good way.

[trauma-and-preg]

Who got space for one or two parient during the holiday we need full intake exam check evrything off before being treated for supposed trauma for the vacation neck brace frequent code and diagnostic exam and procedure to do on us most probably high level of care if not full life support in icu and how know maybe we will find out that we are pregnant whit the blood test or more pregnant then we though like almost to term maybe only sky is me and sab limit for the 27 to the 2. We are curently 23 and 22 both female. If any medical team have question orwish us to fill paper work a head contact us in dm

[wikipediapictures]

Copper IUD

[gaynpc03]

I'm not a "endometriosis warrior"

I'm not fighting endometriosis, she's not fighting me

We're locked in an eternal standoff. She's got her hands around my ovaries and all my vital organs and I've got my middle fingers up telling her to fuck off (and threatening to cut her off myself)

[feminist-furby-freak]

about this post of yours:

https://www.tumblr.com/feminist-furby-freak/741545317484347392/even-from-the-same-sources-nhs-and-cdc-mens?source=share

why are TIMs not advocating for "people w prostates" and "ppl w testicles" language too? cuz isn't that also "misgendering"? (maybe im misunderstanding the point of ur post though. like I get that they call "ppl w cervixes" inclusivity, and by them not doing it w men too, it's a double standard. is it abt controlling women, and how we identify ourselves as a group? I don't fully understand what their goal is for this "inclusivity" to be one way?

again, maybe im j misunderstanding the point of your post but I don't get -- if its abt being inclusive of misgendering -- it doesn't apply to both?

or is it not directly TIMs and instead like cis-identified males only caring abt using "inclusive" language when it doesn't interfere w what they want to do (call themselves men too and not "ppl w prostates")?

it j feels weird being yelled at all day (I'm exaggerating ofc) abt girldick, so why would TIM be okay w other stuff being j called men? (I'm assuming they are not okay w it, but I see it doesn't matter practically as people are still saying men and then "ppl w cervixes")

sorry for the long ask!! thanks for your help!

Ding ding ding. Yes this is a lesser discussed point. The double standard is proof that it is not about being invalidated or inclusivity. TIMs know that they are men and know that “men should be screened for prostrate cancer” applies to them. They whine about everything from not being included in period campaigns to individual lesbians not letting them rape her. They don’t complain about being included in men’s health because they don’t actually care abt inclusivity they just want to insert themelsves into women’s spaces. Not to mention, they have never had barriers to healthcare because of their sex so they don’t care. Removing the word women from medical language is about further breaking down the category and meaning of “women” and making it harder for us to organize and talk about our issues. That’s it.

TIMs hate the idea that there are some (now, very few) spaces and resources that are not and will never be accessible to them. The last remaining one is gynecology and obstetrics. That is why they have this campaign against “Women’s Health” as a field. As someone pursuing graduate education in the field yeah my degree is still called Women’s Health and Midwifery but in most academic spaces we do this stupid dance around language. My undergraduate women’s health journal changed to “gender minority to health” and said I couldn’t use a picture of a uterus with my article about childbirth because it’s exclusive. This is actually why I left. In a country where more women die every year from complications of birth, “activists” are campaigning to make it harder to discuss and research women’s healthcare. Soon it will be practically impossible to talk about women’s health at all. A few years ago when the gender movement had a shred of common sense the rhetoric was include trans women in everything except for women’s health because obviously that doesn’t apply to them. Unless people start speaking up in a few years they will probably rename the discipline entirely. TIMs are now showing up to OBGYN offices/clinics expecting to have their “neos” treated because “it’s practically the same.” I can assure you they are not and regular women’s health providers do not have training to provide care for those surgical creations. Anyway that’s my rant.

[annoyedmultitrylionnaire]

[benjaminallhope-fulltimemind]

This isn't surprising not one bit, Texas has archaic abortion laws and will real what they've showed much to suffering and death of many women. This will obviously affect the health sector in Texas and strain health services for women who may need to leave the state to receive medical treatment or even a simple gynecology exam. Republicans never cared about women nor the fetus as it was always about control, this patriarchy 101 and anyone with a working brain and empathy can understand that. Men never have to fear having our bodily autonomy from being taken away, well until Republicans start mandating men and women breed resulting in the LGBTQIA+ community being seen as 'unproductive' but hey that's later on the Republican agenda. For now we can still fix this mess, we will not and must not settle for anything less than abortion being enshrined in our constitution.

[acrossthewavesoftime]

Do you have any theories as to the cause(s) of Mary and Anne's obstetrical problems?

In fact I do, but II would like to preface my reply with several huge caveats:

This is all mere speculation based on historical information.

I'm not a doctor, so I have no authority to speak on medical issues of any kind.

Even a doctor could not form a concrete diagnosis based on what little historical circumstantial evidence there is; they would have to examine the person in question for that, which is naturally not really possible if we're talking about someone who died in 1694.

With that out of the way, here's what I think: It may not have been the same medical issue for both sisters. While Mary struggled to conceive, Anne's children often were stillbirths or died very shortly after birth. I know a lot more about Mary, though, than Anne.

Mary was married extremely young; she was 15, and just a few months shy of her 16th birthday when she was sure that she was pregnant. Now, the body of a person this young is absolutely not meant to be pregnant, and I wonder if that may have been a factor triggering the first miscarriage, with the rough carriage ride to Breda, where she wanted to meet her husband while the latter was on campaign, also factoring in.

As far as was reported, the miscarriage proved pretty hazardous for Mary's health, keeping her abed for weeks. To me, it seems likely that she may have sustained internal injuries that may have prevented her from ever successfully carrying a child to term.

There is an interesting detail that causes me to suspect that Mary and her physicians had a similar suspicion: In the late 1680s, Justine Siegmund was a guest at the court of the Hague.

Justine Siegmund, ca. 1690.

Justine Siegmund was the officially appointed midwife to the electoral court of Brandenburg, and had delivered a great many children of the German royalty and nobility, while still attending other births in the Berlin area.

Siegmund had initially started to become interested in gynecology and obstetrics after she had suffered a uterine prolapse at the age of 20. The midwives her husband had consulted had been unhelpful and diagnosed a false pregnancy (a diagnosis that was uttered in connection to Mary's last pregnancy, too), causing Siegmund to feel not taken seriously, and suffering a lot of pain as a result of not receiving adequate medical care.

Following her own traumatic experience, Siegmund trained to become a midwife herself in order to improve conditions for other women.

She rose to become the city midwife of Legnica in 1670, and in time was appointed to the court of Brandenburg by Friedrich Wilhelm "The Great Elector" in 1683.

Said elector had been married to Louise Henriette of Orange for his first marriage, who had been William's aunt. The elector had also played a role in William's guardianship during his minority, and of the Brandenburg children, William had reportedly been pparticularly close with the oldest, Karl Emil, who died in his late teens. Friedrich, the next eldest brother, would become the first King in Prussia and became elector in 1688, the same year his father died and Justine Siegmund may have arrived at the Dutch court.

Given her prominent position as court midwife, it looks as if Friedrich sent Wiliam and Mary Justine Siegmund for a consultation. Their struggle to conceive was discussed openly enough among their family; Sophie von Hannover, for instance, also weighed in on it in letters.

For Justine Siegmund, the trip to The Hague must have been a professional success; not only did it prove that the electoral court held her in high esteem, the Netherlands, and especially the medical faculty at Leiden, were the ideal place for a medical professional to meet new people and exchange ideas. Among her contacts, and contributing anatomical engravings for the handbook for midwives Siegmund was writing, was Govard Bidloo, who in 1695 would be appointed to the unenviable post of personal physician to William III.

What made her so special among other midwives of her age was not just her position at court: while it was customary for midwives to be women who had born a child of their own, Siegmund never had any children.

She also, and this is where things get quite interesting, performed medical interventions that went beyond monitoring pregnancies and assisting during birth. Indeed, what first caught the eye of male medical doctors of the time was not a particularly difficult birth she helped to bring to a successful conclusion, it was the removal of the Duchess of Legnica's cervical tumor.

So while her official title was that of a midwife, Siegmund's expertise was also in the field of gynecological surgery.

To me, it would make perfect sense that Siegmund was sent from Brandenburg to the Netherlands in order to examine Mary, and, if possible, perform an operation on her to 'fix' whatever prevented her from having children.

In time, Siegmund returned to Brandenburg. What she may have discussed with Mary and William remains mere conjecture, but I would consider it likely that she informed them of the impossibility of another pregnancy due to the injuries Mary had sustained a decade earlier.

So, all things considered, I think that Mary was a victim of marriage politics; although it is mere conjecture, it seems likely that, had she been married later, and thus had started to try for a baby at a somewhat more advanced age (say, in her early 20s), the chances for a successful pregnancy, birth and subsequently healthy mother and infant would have been drastically increased.

As for Anne, I reach the limitations of my deducting based on historical circumstantial evidence. I simply have not come across enough sources pertaining to Anne's reproductive health yet, and don't have the medical background knowledge to speculate with reasonable certanty on possible conditions.

Perhaps her lifestyle (which was an inescapable cycle of never ending pregnancies, being therefore prescribed to rest and good food being one of the few things she could indulge in at the time) may have contributed to her struggling with giving birth to a healthy child; to this day, doctors will (and are in some places even mandated to) warn expectant mothers who fall into a medical definition of being overweight that their weight might impact the development of their child adversely.

This is very likely not the sole reason and more of an additional, contributing factor, but it is the only speculation on the subject of Anne that I can comfortably express without veering into the realm of half-baked, and uninformed conjecturing.

Perhaps someone with a much more sound combination of medical and historical knowledge would like to add some commentary or criticism on this?

[wineonmytshirt]

*this is personal so please don’t feel obligated*

if there are any lovely humans here who also struggle with gynecological issues of any sort could you send me a DM if you’re comfortable doing so? i’m having soooo many problems i have for years and years and i’m so confused and anxious and frustrated and angry and it would just be nice to connect with someone who understands yaknow? ☹️ thank you !! 💟

xo love, Jen xo

[pitch-and-moan]

I Wash My Hands of This!

The story of Ignaz Semmeweis, as told through his fictitious diary after he'd already been committed to a mental institution. What should be a gripping medical thriller is actually just two hours of arguing about washing one's hands before surgery.

[drchernysheva]

Like every medical college graduate I’m still struggling with choosing the field I want to pursue

I’m still thinking about OB&GYN and oncology/mammology (which is brest radiology/surgery in the US)

I’ve been a head of OB&GYN college student community for 3 years. Very anxious to move forward and don’t know if I’m ready or good enough

[emgoesmed]

3/30/2023

Studying for my shelf exam tomorrow, running errands, and packing to move this weekend.

🎧 Is It Really You - Loathe / Sleep Token (non-acoustic)

[gynecologyconference2023]

[wikipediapictures]

Hormonal intrauterine device

“This is a Mirena IUD, a form of long-lasting reversible birth control. A Planned Parenthood doctor inserted it me in 2012 and it was removed in 2016.” - via Wikimedia Commons

[dilaxshini]

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[kael-writ]

CW: sexual violence and medical trauma

yknow, I wanted so badly to be able to entirely blame myself for bolting from the gyny yesterday. If it was just a problem with me, I can have total control of it.

but I dont think the way they handled it was ok. I had a crying panic attack about a vaginal exam and said "well it seems like I dont have a choice". They also knew I hadnt been to a gyny in 20 years. I barely looked at them. I hugged my body. It was really obvious I was very uncomfortable and scared and upset.

I think it would have helped a lot if they had done things to help me trust them - like say it was my choice, I could take breaks if I needed, and talked more about the procedure. Talked to me more about making me comfortable.

Also, I dont know that this procedure even WAS necessary when they were just "seeing for themselves" what the ER had already found.

Instead they just kinda said, we need to do this, and not much else- and then with two complete strangers staring at me, ordered me to undress from the waist down. Just like that, right there in front of them. They couldnt offer me a gown, to undress in private, or something? My last gyny was that long ago but I swear that's what she did then.

I panicked and bolted. And yes, I could have acted differently. Im not saying I dont have ANY responsibility or way to make the situation better. Im just saying, I think gynys ought to change how they deal with people who may be severely uncomfortable.

After talking to two female friends, BOTH of them mentioned feeling panic of the gyny. I bet this is really common, especially with young people.

When I was in the ER, and at Planned Parenthood, they did a lot more to make me comfortable and feel safe. I refused a pelvic at PP, and the lady did just kinda assume I was having a pelvic instead of asking, but they didnt push me to do it.

In the ER they presented it as my choice, they talked about taking breaks, they talked me through it, they offered breaks, they offered aftercare when I was crying and working on my breathing to prevent a panic attack. I felt safe, understood, and respected.

I was supposed to get my surgery from that hospital, where I had built trust, that week, and then insurance got declined. And that made me have to start all over. And this is hard.

It hurt to have to feel like I am not allowed access to a great care team because Im too poor, and being poor in part because of medical disabilities that include mental and physical chronic illness. What a sick joke. American healthcare.

I didnt even really go through any major sexual trauma, nothing that happened to me in terms of actual sex was even entirely non-consensual, just kinda not having my full consent fully respected the whole time and stuff like that. And stuff like getting groped at parties or whatever, frankly really normal stuff. I also do have some history of being mistreated by medical people in the past, mostly due to being queer and mentally ill. but nothing really major. I cant imagine what this would be like for someone who had survived something much more extreme. 

The last person I trusted with my body I knew for a year, and he scared me very badly (trigger warning for this, but - he expressed a fantasy of killing me, during sex, out of nowhere. /TW). So why should I trust a woman I JUST met?

I want to survive, I dont want to suffer, I dont wanna get more disabled, I dont wanna lose my job. I am worried and scared, sad, exhausted, ashamed, lots of big feelings, I need help and support, and it falls on me to do this. I have therapy in a few hours, and I will come up with a plan. but I would like to not be the only one who learns from my experience. I would like some doctor somewhere to hear my story some day and learn.