Gynecology & Family Planning 101
Edit (13 July 2008): Since I wrote this post, I was able to get a picture with the nurse in family planning.
A lot has happened in the last few days. This week I got registered with the General Hospital in San CristÛbal to serve as a volunteer and shadow some doctors. I am going to be here for the remainder of the month until I head home. Expect to hear about some interesting experiences. My first two days were filled with plenty of them.
First off, I spent three hours in the ultrasound clinic on Wednesday. We mostly saw pregnant women. The doc showed me how to palpate their stomachs and assess the baby’s position. We proceeded to using the ultrasound to check on the baby. Each ultrasound was a different case. One woman’s baby was in a transverse position, another had an abnormally large amount of amniotic fluid, and a third bed-ridden young lady seemed to have lost her baby. I was able to identify the sex of a couple of them. I also learned a lot of new Spanish medical terms in the process.
Later when they said they were going to put me in consultation, I thought maybe I’d just be seeing the common aches and sicknesses. I didn’t know I was going to be set up with a gynecologist in family planning for the rest of the week. Needless to say, I saw some new and interesting things. In fact, I didn’t imagine even having the ability to experience what I have. The first day was basically observation. Some couples came in looking for contraceptive methods, several women came in for pap smears, and others came in for routine checkups on their IUDs or hormonal implants. I really enjoyed the experience and it didn’t make me sick! †I think it made me more confident of my choice to pursue medicine. What I appreciated most were the reasons for family planning down here. The main two reasons used have to deal with the health of the woman and practical reasons like costs and education. Doctors are especially concerned for the health of sexually active teenage girls and want to ensure parents can give their children the food and education they need. This means helping families control pregnancy, especially in a society where abortion is greatly frowned upon. The federal government subsidizes most costs in the process too. Today I got to help take new patient medical histories and even got to explain the basic contraceptive methods offered at the hospital to a new patient.
I’ve noticed a lot of differences in terms of the female agency here. One patient told us how it is usually hard for indigenous women who don’t give birth to boys. Sometimes they’re abused by their husbands as a result. The need for labor in the communities causes problems like this. Sometimes American men shudder when thinking of the feminist movement up there, but I find it appalling that women down here are still fighting for the most basic rights and respect from men. Imagine a situation where a husband speaks for his wife during a basic consultation, or where a woman has to have her husband’s complete consent before any type of contraception. It usually depends on what the husband wishes in traditional society down here. It’s especially interesting, because everything is still very much in progress, and you can notice it every day. I enjoy watching social development and have really learned a lot about how it intertwines with public health and medicine. Next I'm going to be in the emergency and trauma area. Expect to hear more soon! Thanks for reading.†
This is a picture of the hospital's main entrance. †It's a segundo nivel health center. †Patients needing more treatment have to travel about 50 minutes to the state's capital, Tuxtla-Gutierrez. (http://flickr.com/photos/elizacole/)