Chintada: Advancing the field of OB/GYN for all

Latavya Chintada, Staff Writer

There is no doubt that medicine has significantly advanced through the decades. These advancements have improved quality of life, reduced mortality rates and decreased disease rates. For example, the use of robotics in urological surgeries has aided in speeding up the duration and precision of surgeries. Likewise, other technological advancements in imaging, such as MRIs, CTs and ultrasounds, have improved the accuracy of diagnostic exams, allowing simultaneous detection of diseases in their beginning stages. Recently, a certain medical procedure conducted at the University of Maryland Medical Center made headlines when surgeons transplanted a pig heart into an 57-year-old man. This was the first pig-to-human transplant ever performed, and it speaks volumes about how far we have advanced medicine. While the ethics of putting a genetically modified pig heart into a human is a separate issue, these major advancements still raise the concern that some practices in medicine—which seem almost barbaric—still exist without major developments on them today.

A field that still holds some gruesome practices is the specialty of obstetrics and gynecology (OB/GYN). While there have definitely been significant developments in the discipline, it falls short in terms of making patients feel comfortable and at ease compared to other fields. An example is that of the insertion process of the intrauterine device (IUD). IUDs are used as a form of birth control to prevent pregnancy and are inserted through the cervix and attached to the top of the uterus. Those who undergo this procedure can experience a lot of cramping, spotting and irregular menstrual cycles as it involves a small piece of plastic being shoved inside the uterus, an internal organ. If other procedures involving internal organs such as colonoscopies can use sedation, then why can’t this one? IUD insertion has no sort of anesthetic or numbing for the patient; most patients are told to take over-the-counter pain medication before coming in for their appointment, which hardly seems appropriate for the amount of pain they will experience. As for why sedation is not deemed necessary for IUD insertions, some physicians have dismissed its need and instead raised concerns about the potential risk.  However, healthcare workers allow intravenous (IV) sedation for relatively minor procedures such as wisdom teeth removal, which is what I have experienced. 

While it is true that there are risks associated with IV sedation, as well as high costs, it is justifiable to demand proper anesthetic for such procedures. While patients can request IV sedation for their IUD insertions, it is less common and not commonly offered or discussed by the practitioner. Ultimately, it is the safety and comfort of the patient that needs to be in the physician’s top priority, and having a piece of plastic jammed up a sensitive organ to prevent pregnancy does not seem like the most comfortable procedure, or even something that should be a part of modern medicine. 

Likewise, the dreaded speculum is another element of modern OB/GYN that doesn’t seem quite updated for the times, and instead, a little barbaric. The speculum is a “hinged, two-bladed instrument” used to better inspect the cervix during procedures such as IUD insertions, pap smears and STD testing. This instrument originated from institutionalized patriarchy and racism, as its creator was a white man who tested it on enslaved Black women throughout the mid 1800s. It seems shocking that an instrument developed by a man for women’s health is still being used in practice today, as it does not aim for the comfort of patients. Many OB/GYN patients have described the speculum as uncomfortable and a source of anxiety and nervousness. This makes patients less likely to opt for these prophylactic gynecology exams, putting them at risk for undetected gynecological diseases. 

However, this is not to say that there will never be any developments regarding these matters. Thankfully, teams of women are working on redesigning the speculum to make it more comfortable and less frightening. Similarly, I hope there will be a consideration to making anesthetics more accessible during certain OB/GYN practices, such as IUD insertion. When there is a long history of women being mistreated in the male-dominated medical field, it is important that a specialty dedicated to women’s health has the proper tools and procedures to maximize the comfort and safety of its patients.