New Delhi: A 26-year-old PR professional from Delhi was asked by her gynaecologist at a posh IVF clinic if she 'had a boyfriend or had ever used an i-pill' when she went in for a consultation last week, following months of extremely irregular and painful periods. Guessing that the doctor probably wanted to know if she was sexually active, she volunteered the information, at which point she was advised to get a Trans-Vaginal scan (ultrasound) done. However, several clinics and labs refused to do the scan on an unmarried woman, even with a doctor's prescription and after stating her express consent for the procedure several times.
Medical experts agree that Trans Vaginal Scans give a better resolution and more information about the uterus when trying to detect lesions, endometriosis, PCOS/ PCOD, or uterine irregularities which can be responsible for irregular or painful periods, intermenstrual spotting, weight gain or hirsutism, which are all common problems that young girls face.
"In an urban practice, if an unmarried woman comes in (for a consultation), one of the first questions the doctor should ask is 'if you don't mind can we ask you if you're sexually active or not?" If they are, then we can go ahead with a TVF scan (only with the patient's consent). If a parent or relative is accompanying the patient, then the doctor and patient should first interact privately. If someone says that yes I am sexually active but please don't mention it in front of relatives then they should obviously respect that", said Dr Archana Dhawan Bajaj, Consultant — Gynaecology/ IVF at Nurture IVF Clinic.
"We as healthcare providers need to get out of this backward mentality and learn to ask direct questions without passing judgements", she added.
A 22-year-old college student had very low haemoglobin levels because she is anaemic, but her gynaecologist's advice was: "Lose weight and eat better because otherwise how will you ever carry a child?".
"Is the goal for me to be healthy or am I a baby-making machine as per my doctor?" she asked. Another 25-year-old lawyer in the city said her OBGYN assumed
that she would not be sexually active because she was unmarried when she went in for a consultation regarding a vaginal infection. "I was given
an ointment and asked to come back in a few days. I went for a second medical opinion, and turns out that it was sex-related."
"If someone comes in asking about contraception, they should be asked to get an ultrasound, preferably TVS otherwise a full bladder abdominal scan. Then, their family history for diseases should be looked at and a basic blood investigation should be conducted. If she is medically fit, she should be explained about the contraceptive options at her disposal and their side effects", Dr Bajaj said. However, again, this seems to be far from the lived reality of several women in the capital.
Many teenage girls and working women in their early 20s reported that they were advised to lose weight and get married and have children as soon as possible when they went in for a consultation regarding PCOS PCOD (Polycystic Ovarian Syndrome/Disease). Losing weight is difficult for patients suffering from the disorder and the
better solution is to manage their lifestyle with exercise and diet. Patients also said that they felt that their health was being put in the background in favour of future, hypothetical children.