labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Friday, March 27, 2009

Men In a Women's Field

You know, I've heard so many women say they wouldn't go to a male ob/gyn or midwife because they "don't get it" or for the sheer fact of being male. I don't necessarily agree with this, but I certainly don't think people should go with someone they aren't comfortable with regardless of the reason.

The reason I don't necessarily agree is because just being female does not make the provider a better ob/gyn physician or a midwife. Some of the most horrible things I've heard come out of providers mouths were from women. Some of the worst manipulation of a perineum has been done by women providers in my presence. So as you can see, I just can't agree that men providers in the obstetrics and gynecology fields is backwards.

I do, however, often wonder what drives men into women's health. I wish I had asked some of the great men providers I've worked with why they chose the field. Many of these male providers are the same age as my parents, so they entered at a time more men were entering the field in general. None of the residents I work with now are men, so I don't have the opportunity to ask any entering the field now.

But, I do want to share something I witnessed that expressed such caring and compassion that I was struck speechless (not something that happens often) that may have answered my questions about men entering women's health. After an arduous labor and second stage pushing that seemed to last my entire 12 hour shift that ultimately led to a cesarean for failure to progress, the doc followed us into the recovery room. This particular doc is a man of few words, and awkwardly tried to express his well wishes despite the situation. As he did so, he gently took a warm blanket and spread it over the bed. Before he left the women's bedside, he pulled the blankets up as if tucking her in. I am sure some will read this as a patronly act, but I know this was not the intention. This very simple act of trying to provide comfort and warmth for this mom and baby was very touching.

19 comments:

Someone Being Me said...

My last two OB/GYNs have been male and I love both of them. One delivered my son and the other is about to deliver my second son in 2 weeks. I only left the first because my insurance changed. Prior to them I had 3 female OB/GYNs and didn't care for any of them. I feel the men are more willing to let me tell them what I am comfortable with and more responsive to my needs. They also just seem gentler. It makes me sad that a woman could miss out on having a fantastic OB/GYN just because he is male. But I do understand having to go with someone you are comfortable with.

Curdie said...

I was thinking about this today because it just hit me that all of the doctors I chose are at least 60 years old.

After trying to figure out why this is I realized that cheating was rampant in my high school and college because my (cheating) classmates wanted to be doctors.

I would hope that a person couldn't cheat their way through medical school, but every single person I met in college who wanted to be a doctor (and there were many because I was a TA in organic chemistry for awhile) was lacking in the integrity department.

Sooo, my primary care doctor, my kids' pediatrician, and former and current OB are all males with white hair.

I'm wondering if I need to branch out. Actually, my last OB I chose solely because he had the best VBAC rate in the city and he would not try to push pit on me....and he just happened to be in his 60s.

Are my fears of people cheating their way through medical school unfounded? Should I really be so down on my generation?

P said...

Based on my years of working in women's clinics (and a few that were at teaching hospitals, and therefore saw a large rotation of various practitioners - med students, residents and attendings - both male and female), I totally agree with your assessment of male v. female practitioners. While not consistent across the board, I also saw some of the most catty, vile comments/treatment of clients from female OB's, and some very wonderful and caring male OB's. Although I will say that (as a patient) I rapidly left the practice of an OB who had a poster saying "I really HATE this" on the ceiling above the exam table. Nice, eh? But even better than the OB's as far as compassion/caring - in my experience anyway - have been either the Family Practice Docs, DO's, PA's or the RNP's in women's health - male, or female. In the case of the PA's and the RNP's, I'm guessing it might have something to do with the motivations to get into the field, but not needing the high profile/high power position etc. That being said, if I had to *blindly* choose a practitioner to do a pelvic exam, I'd go for a PA or RNP over an OB any day.

Carbon said...

I have found myself preferring male providers. They seemed more attentive and responsive somehow. Also, I have some perception (faulty, probably) that my female providers might possibly substitute their own experiences for mine.

I once heard the reasons why men (anyone really) go into OB/GYN. 1. Being able to provide care for many young healthy people (not just very sick ones). 3. The rare combination of surgical opportunities with continuity of care over the long term. The latter also stands on its own as a bonus of course.

Reality Rounds said...

It is such a personal choice, but I feel more comfortable with women as my OB/Gyne health providers. I had a horrible experience with a male OB/Gyne for my first pelvic exam as a teenager, so that did it for me. My first child was delivered by a fantastic male OB doctor, but he was not my primary. He just happened to be on call. My second was delivered by midwives, and it was a fantastic experience! Most people have no clue what CNM's do. My husband was very nervous about Midwives, and we had to sit down and have an "intervention" with him before he "got" it.

womantowomancbe said...

Curdie,

I've read that cheating is rampant in schools today -- all levels from elementary through college, regardless of profession. The old "honor code" just doesn't apply any more; and children/students are pushed to believe that the only thing that matters is the grade, rather than the knowledge they are supposed to possess. I've heard some older kids (high school & undergrads) in an interview about cheating and honesty basically say that their parents only cared that they were making high grades, and if they had to cheat to do it, so be it. :-( It's sad that our culture has degraded to such a state in which making an honest grade is not held up as the highest standard.

-Kathy

threekidchaos said...

My ob/gyn is a man & I love him. He repaired my episiotomy (done by a GP) after baby #1 & he could tell I was starting to freak as soon as I got in the OR so he came over & held my hand until I was out. I had some complications while pregnant with baby #2 & he just oozed compassion. I'm now moving 3 hours away & I'll make the trek back every year for my annual because no one else will measure up. I don't think gender really matters so much as personality. At least that's what I've found.

Reality Rounds said...

I responded to a post on the Happy Hospitalist blog about how I would recommend a CNM to any low risk pregnant patient. Here is one "doctors" response:
Bad Medicine, Good Solutions said...

" This is one of the silliest things I've ever read. It's like saying if you are a safe driver you won't need car insurance. Or even if (s)he is really nice, I don't need to use a condom. Any one can catch a baby, including the inanimate vehicle the woman is driving in enroute to the hospital. OB complications are not restricted to easily identifiable factors. There are also emergent complications which the Midwife is not trained to deal with. Only OB/GYN's are trained to deal with all complications. To be willing to invest 9+ months of your body, time and energy into a fetus and then at the end take the risk with some one who is not capable of handling all the complications is pure stupidity.

Midwives are on par with poor choices like not vaccinating your child or smoking."

I am still so infuriated with this ignorant attitude. How do you feel about his response?
Here is the link if you want to rip this dude a new one"
http://thehappyhospitalist.blogspot.com/2009/03/nurse-practitioners-as-hospitalists.html

Knitted_in_the_Womb said...

While I've seen some good female OB's and some bad male OB's, I have to agree that as a doula, I've seen more rude/condescending/catty behavior from female OB's toward my clients than from male OB's.

I did chemical research out of college--a male dominated field. I found that the few female PhD's in my department really had a chip on their shoulder. Almost as if they'd had to work so hard to get there that they'd lost their compassion. I had a female supervisor after having 3 male supervisors, and disliked her so much that I was looking for a new job within a month.

I think that for men in OB, they can retain their maleness--which includes a desire to protect women, but for women in OB...well they've fought so hard to get there through the competetiveness of medical school...and then often had their own babies while in residency...that they just really do loose compassion.

And saddly, aren't women just sometimes more catty than men in ANY setting? I remember trying to explain this it a male classmate in college, and he just couldn't "get" it and didn't really believe me when I was trying to explain some of the in-fighting that was going on with women in our social circle.

Labor Nurse said...

realityrounds, thanks for sharing, but I won't be going to that blog/post/comment. I have totally given up on trying to make it known about the benefits of nurse midwives, direct such professionals with that attitude to the research, and generally conversing in such interactions because I have found that those who hold those opinions don't want to change their mind. So be it. I speak to those willing to listen and be open minded.

Knitted in the womb, I think you hit the nail on the head- women can be catty!

Sarah said...

I am seeing a male OB for the very first time now, during my third pregnancy. I saw a wonderful CNM for my first two, but that was when we lived in another state. When we moved to MO, I was frustrated to eventually learn that CNM's do not have priveleges to attend hospital births, nor do family practice docs. With this in mind, and also greatly taking into consideration some medical problems i have, I did my research on finding a low-intervention, respectful OB. Most of the recommendations I got (like from local doulas, etc) were men. I kinda cringed at that and wondered if I could ever get past a male OB, even if he was really compassionate, looking at my hoo-ha. :)

I switched OB's once, after the first guy, who ironically had come very highly recommended, just was not my cup of tea. Did more research and interviewed the current OB. I think someone else used the phrase, "oozed compassion," and that is just what this doc does!! He has gone far and above my expectations, is so respectful and encouraging of my knowledge as a CCE-in-training, and in a lot of ways, feels like a friend. (He's also very young, 33.) As for gentleness in his vag exams, he is just as gentle as my wonderful, former CNM.

What "knitted in the womb" said about male OB's retaining their maleness, including protecting women, really resonated with me. The ones who can strike the delicate balance between respecting a woman's ability to give birth, and intervening only when necessary vs. using every intervention in the book in the name of protection--now those are the really special OB's!

Even before I read this post, I had been thinking about asking my OB why he wanted to go into this field. On his website, he says that his lifelong dream of wanting to be an OB/GYN is finally fulfilled. I'm really wondering if young teenage boys really dream of being an OB/GYN?? :)

womantowomancbe said...

A friend of mine switched from her male OB to a midwife after one of her favorite OBs (an older man) retired, and her other preferred OB started practicing with a couple of younger good-looking guys (one who reminder her a great deal of her own husband), and a couple of other OBs she just didn't like. Since it was just the luck of the draw whether she would get the one she was comfortable with or the other four she was not comfortable with, she completely jumped ship. Yes, the male factor had something to do with it; but had the men all been ugly and/or old, she probably would have stayed with the OBs.

-Kathy

evil cake lady said...

I don't know; I've been appalled at the "care" male OBs have given to my clients in labor just as often as female OBs. I think it just comes down to the individual.

Personally I am more preferential to women, probably because there's a much larger pool of women caregivers (nurses + CNMs + OBs) and so I see a much larger percentage of caring and comforting women.

SacredAngel said...

In my experience, men are gentler and more willing to listen. I think a lot of it has to do with the fact they don't have these parts so they don't factor in their own experience when you're discussing your stuff.

Matt said...

Thank you for this.

- Matt (birth and postpartum doula)
http://maledoula.blogspot.com

Erica Douglas said...

I've always visited female gyns but I recently had a lap procedure for endo. I was pretty freaked out right before the surgery and my male gyn came over and kissed the top of my head as the nurse put the oxygen mask on me. I went to sleep very comforted. He is such a great human being, as well as a good doc.

Labor Nurse said...

Erica, I am a bit disturbed that your doctor gave you a kiss. Ya, I know it was not meant as a romantic kiss, but this just crosses all sorts of boundries, professional and otherwise. However, I am glad that you felt your experience was comfortable and safe. But I can't imagine that gesture going over well with other women who may see him for gynecological care.

Joy said...

Your last paragraph brought tears to my eyes!!!

As far as Man vs. Woman... I have to say that every experience I'd had with a woman doctor has been negative. Their exams hurt more, for one, and they seem less sympathetic.

Whereas all the male doctors I've met seem more patient and methodical and I never even felt their exams (seriously, pain FREE)!

Harishjay said...

I've seen more rude/condescending/catty behavior from female OB's toward my clients than from male OB's. ..Neonatologist In Pune