Sunday, September 14, 2008

At Your Cervix

I can't wait to see this documentary!

“Uncomfortable”; “Humiliating”; “Traumatic”; “Scarring”--words women too often use to describe pelvic exams. Most of the 90 million U.S. women who get pelvic exams think they are supposed to hurt. Women show disbelief when told that if done correctly on a healthy woman, pelvic exams should be pain-free.

The documentary, At Your Cervix, enters U.S. medical and nursing schools and breaks the silence around the unethical ways in which medical and nursing students learn to perform pelvic exams. These practices—which include nursing students being required to perform exams on each other in front of faculty and medical students “practicing” on unconscious, unconsenting patients—lead directly to the reality that most women find pelvic exams to be humiliating and painful. The existence of these egregious practices are challenged in the film by highlighting an ethical and more effective way of teaching the pelvic exam that has existed for nearly 30 years: the work of the Gynecological Teaching Associates (GTA) of New York City, in which the “patient” herself is the teacher.

Where the former methods literally use women as voiceless and passive objects in the context of student learning, the latter is based on the premise that the woman receiving a pelvic exam must be actively engaged in the process, and is in fact the only one who can provide adequate feedback on whether it is being performed not only correctly, but also comfortably. Following the experiences of students while highlighting the GTA program, this film is a call to end the unethical teaching of breast and pelvic exams, and a mandate to change the expectations that surround the pelvic exam so that it becomes an empowering experience for women.

Through three interwoven stories, At Your Cervix traces the history of gynecology, fraught with trials and errors. One of the stories follows Julie Carlson, a New York GTA who moves to San Francisco to attend a nurse-midwifery program at UCSF. She is shocked when told by faculty that she and her peers are expected to perform pelvic and breast exams on each other. She opposes this unethical practice, galvanizes other students and successfully demands policy change at one of the top nursing programs in the U.S.

The second thread exposes a common teaching model that exploits women's bodies in the name of medical education. Many students learn to do pelvic exams on unsuspecting, anesthetized women who have been admitted for surgical procedures in teaching hospitals. State laws to prohibit the use of anesthetized patients for teaching and learning are nearly non-existent. Many teaching hospitals cut corners and take advantage of their primarily poor patients, who often have less opportunity to negotiate aspects of their care. The film depicts students struggling with this ethically questionable practice and explores what informed consent really means.

Finally, the film highlights the work of the New York City Gynecological Teaching Associates (GTAs). The camera enters exam rooms as GTAs teach. Using their own bodies, these specially trained women teach future doctors and nurses the nuances of how to make a pelvic exam comfortable: where to place their fingers, how to insert a speculum, and how to talk with patients respectfully. At Your Cervix explores why GTAs do this work and what makes it so important.

At Your Cervix aims to improve how pelvic exams are taught and the care women receive. The film raises the expectations women should have of their healthcare providers and hopes to create a culture where pelvic exams are pain-free. The woman, the provider, the patient, and the cervix itself tell the story, a story that will dramatically affect the quality of these oft-dreaded exams, a story that will transform breast and pelvic exams into opportunities women actually welcome to discover more about their bodies, and about their sexual and reproductive selves.


Anonymous said...

I know that some women feel violated after pervic exams. I'v enever been one of those. I look at it more like the way the dentist fishes around the teeth in my mouth. Not a big deal. HOWEVER, the practice of anesthetising women and doing pelvic exams on her unknowing body makes me really rage with anger. How can this kind of thing happen!?! Unethical! Unthinkable. I'm looking forward to the documentary also.

Cam, April, Carson, & Hannah said...

Found your blog while blog hopping...and had to comment on this. I am a FNP student at the University of Utah and we just had the GTA's come to teach us. These women know what they are talking about and taught each of how we should do pelvic exams. It was a valuable learning experience that could not be replaced by any other.