“Women are right, we can practice with more delicacy,” assures a gynecologist

“Giving in is not consent,” insists Amina Yamgnane. It is necessary to have the consent of patients before carrying out a treatment or procedure. “Now that women are speaking to us, I think we have a duty to hear them.”

“We can practice with more delicacy”, the women “are right”, says Tuesday March 26 on franceinfo Amina Yamgnane, gynecologist, who publishes Taking care of women – to put an end to gynecological violence at Flammarion. This book is a real plea to change the way we look at the violence suffered by women during a medical procedure: “Abuse in care concerns around 20% of women who have the opportunity to consult”she explains.

According to her, “the majority of abuses are negligence and failure to collect consent”. The lack of time of practitioners is to blame. “Doctors scotomize [rejetent inconsciemment hors du champ de la conscience] these consultations. In general, we don’t ask for consent, we don’t listen to the patient much, we don’t give her many explanations.”she lamented.

franceinfo: Gynecological violence are not isolated cases?

Amina Yamgnane: Scientific studies demonstrate it. Abuse in care concerns approximately 20% of women who have the opportunity to consult. Gynecological and obstetrical violence is not limited to the sexual predation of a few rare delinquent professionals in the profession. This involves neglect of care, blackmail, insults, threats and, where appropriate, physical and why not sexual attacks. Attacks, the most serious abuse of care, are the least frequent, between 0.5 and 1.5%. The majority of abuses are negligence and failure to obtain consent.

Is the weather the real culprit?

Exactly. I challenge anyone to conduct a consultation in ten minutes which would involve listening to the woman, taking into account all her background, responding to her complaints, examining her delicately, giving her a prescription, explain it to him and transcribe everything in a file. Doctors scotomize these consultations. In general, we don’t ask for consent, we don’t listen to the patient much, we don’t give her many explanations and that’s how we produce chain consultations. It all starts from there.

Doesn’t this just concern women?

It concerns everyone. For the simple reason that men are subject to care.

“My first experience as a student consisted of ten trainees, of which I was one, performing a rectal examination, each in turn, on a patient who was butt naked in front of us, who had not been asked to ‘notice.”

Amina Yamgnane, gynecologist

at franceinfo

Consent, which is a right, is often evaded?

Of course, medical school taught us how to offer tests to patients, but never taught us: what do we do when a patient does not consent? So we of course use guilt, unfair information, paternalism, infantilization to make patients give in. Giving in is not consent.

Did it take you a long time to realize this?

It was during professional training which consisted of listening to the testimonies of women who really considered that our technical skills were there. But they questioned us about our know-how and our know-how. This made me very angry because I was in technical excellence and I didn’t really see what these women were asking of me.

You can be criticized for confusing authentically perverse practitioners with those who have made an unfortunate statement or indelicate gestures. It’s not the same thing…

There is no question of putting everything on the same level. Indeed, we do not treat the detection and exclusion of a sexual predator or a lack of consent using the same logic. We are not at all in the same logic. This is why the concept of gynecological and obstetrical violence which encompasses all these issues is undoubtedly one of the obstacles to finding an exit strategy.

We are confronted on the one hand with associations which basically say “all gynecologists are bastards” and doctors who say “it is not up to women to teach us our work”. How do we get out of this?

It is a gift that was given to health professionals by user associations. I know I’m pleading in a vacuum with this question. It’s about finding exits. It’s not a question of femininity. What draws the line between a well-treating gynecologist and a mistreating gynecologist is not the fact that he is a woman or a man, it is the fact that he is trained or not trained. It is not through confrontation that we will find solutions. There is no point in suggesting that women give birth at home with untrained professionals versus going to the hospital. This is not where we will find the solution.

How do you react to those who say that we have gone too far in the medicalization of pregnancies?

40% of women giving birth for the first time will not succeed without medical help. 20% cesarean sections, 20% forceps or suction cup. Even if we let women do it, only six out of ten will succeed on their own. What do we call going too far? We still save lives. Without medicalization, we find ourselves with dramatic maternal and infant mortality rates. On the other hand, this medicalization which saved lives, we did it at a price which was important for women to pay and now that they are speaking to us, I think we have a duty to hear them. We can practice more delicately. They are right.