Why so many Chinese women feel invisible to their gynaecologist

A viral video on Weibo has sparked discussion on painful medical tools and the lack of care women suffer during gynaecology appointments
While pain relief treatments such as epidurals during labour remain uncommon in China, hospitals can still do more to provide comfort and communicate with patients

Phoebe Zhangin Shenzhen

Published: 9:30am, 16 May 2024

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When I was pregnant last year, the required monthly visits to the gynaecologist’s were my worst fear. It was the one place where I didn’t feel human but rather like a vessel, or a piece of meat.

The first thing the doctor would say to me was, “Take off your underwear and lie on the table”. Then, she would squeeze some gel on my belly and start rolling an ultrasound probe up and down my skin with her right hand. She would type on a keyboard with her left hand when she spotted something on the screen.

The process usually lasted 15 minutes. The whole time, the doctor never spoke to me directly. She occasionally shouted incomprehensible measurements at her assistant, who recorded them on a diagram of the human uterus.

It was a strange and uncomfortable experience. They were examining me, but I felt entirely irrelevant.

I am not the only one who has felt this way. Earlier this month, a post went viral on Weibo, with a blogger calling the speculum – a tool used in pelvic exams – “a modern-day torture instrument for women”. The tool has two long blades that look like a duck’s bill. A doctor parts the woman’s labia and inserts the speculum and then slowly opens the blades to look inside and inspect the cervix.

The blogger shared her experience of being at the doctor’s and the discomfort she felt during her appointment, wondering why there haven’t been any improvements.

Patients sit in the waiting room at West China Hospital Sichuan University in Chengdu, Sichuan province, on April 8, 2019. Photo: Shutterstock

Many others commented on her post, leaving messages about the pain they had suffered. One said she asked the doctor to be careful when inserting the speculum, to which the doctor apparently replied, “ You’ve had sex before. Just relax”.

Another said that even though modern medicine is so advanced, it is still so painful for women to give birth, because women are rarely the focus of those advancements.

It’s quite difficult for the situation to improve when discussions about women’s health in this context are still scarce in China, if not a taboo subject. Furthermore, at the gynaecologist’s, a woman’s body is often seen as a vessel for carrying children.

During my pregnancy, I was often told by doctors that I should be careful with the kind of medicine I took for fear of affecting the fetus. Epidurals during birth are also not common in China, even though the government has been pushing for this.

Some hospitals under pressure to make money might choose tools and procedures based on cost in addition to effectiveness, regardless of the discomfort they cause women. Photo: Shutterstock

The National Health Commission said that in 2020, even though 82 per cent of the public said they were willing to use epidurals, only 30 per cent had access, and 70 per cent of the women were still giving birth in pain.

In 2017, a pregnant woman fell from a hospital building in Shaanxi province, after she was unable to have a Cesarean delivery. Police said they believed it was suicide. The hospital and her husband reportedly placed the blame on each other, each saying that the other hadn’t agreed to the C-section. No matter who was telling the truth, the poor woman’s opinion doesn’t seem to have been considered.

According to a survey released in 2022, the low rate of epidural use stems from the public knowing little about the procedure and fearing it might affect the baby or the mother. Furthermore, many hospitals have a shortage of anaesthetists, making it difficult to carry out the procedure.

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Moreover, from the hospitals’ perspective, pain relief may not be a high priority. Hospitals in China face intense pressure to make money. If tools such as the speculum prove to be effective and cheap, it’s difficult to push for new products entering the market.

Even though there are pain management guidelines for anaesthetists, such as which drugs to use, they are usually for surgery and severe illnesses like cancer, not so much for body exams and other types of discomfort the medical world might consider mild.

But even so, I believe there are small things hospitals and individual physicians can do to relieve patients of pain. Communication always helps. Chinese hospitals tend to focus just on curing the disease, and with little attention paid to comforting patients who are confused, scared or lack any medical knowledge.

If doctors tell patients beforehand what kind of procedure will be done, what kind of discomfort to expect and how long it will last, or even do small things such as applying lubricant on the speculum, or warming it up first, it would make a big difference.

Phoebe Zhang is a society reporter with the Post