Nov 182011

“Have you ever been a victim of sexual assault? Because that’s the only way an exam would be that difficult for you.” – OB to mother who informed the OB that vaginal exams are uncomfortable for her.  This was asked in front of the mother’s partner.

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 November 18, 2011  Cervical exam, OB  Add comments

  39 Responses to “"Have You Ever Been A Victim Of Sexual Assault…"”

  1. “I’ll take ‘Blame The Patient For the Doctor’s Inadequacies’ for $400, Alex.”

  2. If he were asking for a patient history, this question would be COMPLETELY appropriate. But to say that an exam isn’t SUPPOSED to hurt and it MUST be because of abuse, that’s just too far. Unprofessional and like Jane said, a total blame game for not being sensitive enough during the check. If I were the patient’s partner or husband, I would have decked this doctor.

  3. Yeah because there is absolutely nothing awkward or uncomfortable about anyone besides my partner mucking around down there. Thanks doc for clearing that one up for me.

  4. I hate this!!!! I have a horrible time with exams. They have never hurt but I feel very very violated afterwards. I have horrible anxiety about it. I had never heard of an internal ultrasound and needed one to confirm PCOS. No one explained anything and just told me to take off my pants. I got upset and said why what are they going to do to me and the nurse was shocked that it would upset me and made me feel worse and then I heard them talking about hor ridiculous I was outside and maybe it was just because I was overweight that I had an issue with it. Maybe I just don’t want people sticking things in my vagina? Maybe I want a procedure explained to me BEFORE my feet are in stirrups?

    • Which reminds me. The second internal ultrasound I had to confirm pregnancy, they did not tell me about either. I guess that is common knowledge for most but I did not know. I said I need a minute and put my head in my hands and was shaking and crying a little and the woman is talking about how it isn’t going to hurt and getting all insulted that I am upset. Then she makes a comment about how I better get over it if I am pregnant. She knew I raise goats and I guess in an attempt to make me feel better, she talks about how awful it must be for the goats to not have epidural, which enrages me because I already knew I would not be having one (unless some horrible complication of course) and am a big natural birth person.

      If I have a problem with a stranger putting things in my vagina, I must have a problem. That’s how I am made to feel. I am sorry OP. I do not know why they don’t get it!!!

      • I wonder how much this attitude has to do with so many women having so much trouble reporting sexual assaults. We are expected to let doctors do what they will and be quiet about it, but then stand up for ourselves when it’s someone else.

    • (((HUGS)))

      I don’t know if you know this, but cervical exams and generally unnecessary and you can absolutely refuse them. Here are a couple of links for you on the subject-

  5. This doc MUST be a male. Hey, doc, let’s try giving you a prostate exam and see how uncomfortable you are. Vaginal exams are NEVER comfortable for me! Very often they are PAINFUL. I’ve NEVER been a victim of sexual assault. I can imagine that if I was, simply getting into stirrups would be uncomfortable, before the speculum is even inserted! OP, I’m sorry for your idiot OB!

  6. Have you ever been a victim of sexual assault? Because frequently victims of sexual assault have a problem relaxing enough… Not that that is the only reason…” There fixed that for you. Not completely, but it is better now.

    I’m rather torn on if it would be more appropriate to have the partner step outside. The partner may or may not know the truth. And the woman may feel more comfortable having her partner there to protect her when she is naked in front of some strange doctor. Or she may have never told him and doesn’t want to discuss it with him now. I’m just wondering about the incusion of the “asked in front of the mother’s partner.” I would think that anybody in the room while a doctor’s hand is inside your body is somebody you really don’t have anything to hide from, but I could be wrong. Of course I’m imaging an office visit and this might be a birth situation.
    The fact that the doctor insists that the woman being “damaged goods” is the only reason his VE’s would hurt is the more obnoixious part. But addressing the partner being there part. If the doctor in fact believes that the woman has been assaulted he must also be sensitive to the fact that maybe it isn’t something she likes to discuss in front of everybody. In other words, he is demonstrating that he doesn’t really care about her. If she has in fact been assaulted and that is in fact the reason VE’s hurt her then she just needs to blame it on the perp and deal with it, and not expect a higher level of care from him: It is her problem, not his. He has no intension of being careful or sensitive.

    • The comment made by the OB was phrased very poorly and was insensitive. But…. if a patient doesn’t want to discuss past history in front of her partner, she shouldn’t bring the parter into the exam room. The doctor is there to do a job, not to tip-toe around subjects, wondering “I wonder if they’ve discussed this or not…” If the doc/nurse/etc. has reason to believe that the partner present is part of the problem, that’s one thing (currently being abused, obviously causing more anxiety). But history of abuse? Maybe I need to read the pink link to change my mind, but I just don’t see a problem with this being discussed in front of the partner.

      • I interpreted it as the doctor subtly accusing OP’s partner of raping her. I can see that this would really upset someone. And if it were true, this would not be helpful at all. The woman would need help, and her partner would not be in the loop. I’m really interested to see the pink link.

      • I agree with Trisha on this one the doc’s insisitive and kind of a dousch but adding that the partner was in the room didn’t make the offence worse in anyway for me. If your partner isn’t trusted enough to know about your past sexual abuse or lack therof then why on earth are you having a baby whith them.

        • It is entirely possible that the partner is/has been abusive to mom. It is also entirely possible that mom has not disclosed past abuse to her partner for a variety of reasons that don’t necessarily revolve around the partner being untrustworthy. Bringing up a “taboo” subject between partners can open a whole can of worms, which may be quite detrimental during a pregnancy. Is it ideal for mom and partner to have full disclosure, trust and intimacy with one another? Absolutely. Is that the reality for every mom? Absolutely not. Doctors need to manage and treat reality, not ideals. That’s their job. And it’s not, frankly, that hard to do.

          • It also occurs to me that saying prior sexual assault is the *only* possible reason for discomfort that a seed of doubt may be planted in the partner’s mind. Because if a doctor says it, it must be true right? And if mom hasn’t discussed a prior sexual assault (even if untrue) what else could she be hiding? My first marriage was to someone JUST like this and I would have spent days trying (and failing) to convince him.

          • My husband used to be like that as well. It’s horrible. Thank God he changed.

        • No one has an obligation to share information about abuses they’ve suffered with ANYONE, even a partner. It isn’t a matter of trust; it’s a matter of learning to cope in your own way with your traumas. If talking about it helps, good. If it doesn’t, why should she? How does it affect her partner’s life in any way?

          • Not only do I agree that it isn’t an obligation but my husband does not know everything that happened to me from age 9 to age 25 when we met and there was a LOT of sexual abuse in there by SEVERAL different men. I SWEAR that I had a friggin stamp on my forehead that said “abuse me”. My step grandfather, moms boyfriend (who after breaking up with my mom became my dad’s roommate for several months), a friends dad, a guy I was “dating”‘s step dad and that is just naming a FEW. My husband and I have discussed a few things. He knows there was a lot. He doesn’t know many details. He knows it is very difficult to discuss and if it comes up we talk about it as much as I can and then we move on. He doesn’t feel as if he is having information withheld from him. He doesn’t feel that I am hiding anything. He is comfortable with what has been shared. He knows that things that happened (particularly the friends dad) affect our sex life and he deals as he can, just as I do. It doesn’t mean our relationship is less or isn’t everything we want it to be. We have been married for five years and have two children. Stating that we don’t have a good relationship and shouldn’t be having children if I haven’t relayed to him the entire 16 years of sexual abuse from multiple abusers is wrong and just incorrect!

            Things come up all the time. We were 25 and 35 when we got married. There is all kinds of stuff that we still don’t know about each other, that’s a LOT of history to detail IN detail all at once. I hope we have the rest of our lives to learn those things! :) However, I also believe that there are things that I will never know about him. He had 35 years to do all kinds of things that I wasn’t a part of. I just found out yesterday that he was made fun of as a child for being brown skinned! In five years, with two biracial children.. HOW did I not know that before? It just never came up. It took the movie “The Help” to bring up the conversation.

  7. WRONG! I have never been a victim of any kind of sexual assault, and before I had kids VEs hurt me pretty badly. So badly that I would still be aching later in the day from them. Sometimes, they just hurt, and often, that is because OBs or whoever is doing them is not gentle enough. I have only had one since my VBAC, and I don’t know if I was okay because he was so gentle or because I have now had something a LOT bigger come through there.

  8. “Not yet, but I think it’s going to happen to me in a few minutes if you have anything to do with it.”

    No means NO. ALWAYS. The end.

  9. It has been in my chart with my midwives from day one that I have sexual abuse and PTSD in my history. It was part of their standard intake information, when I was fully clothed and sitting alone with the intake nurse, prior to any kind of exam. Had my husband been with me, he never would have known about the question, because it was on a form that was “just my information”. (Not that it matters, since he is well aware and totally supportive.) I really think this is the way to do it. You just never know the dynamic between two partners, and just because a partner is present at appointments doesn’t mean mom is comfortable with full disclosure on this subject. And, given that approx. 1 in 4 American women will experience sexual assault in her lifetime, and that experience can have a profound impact on not only how mom experiences examinations, but also pregnancy and birth, this should be a standard question. Additionally, since many women would simply not disclose this to anyone, including a doctor or midwife, shouldn’t birth professionals simply treat ALL women gently and sensitively as if this were a possibility, particularly a woman who is showing signs of discomfort or distress? As I said, my midwives are well aware, and they have been careful with me to the point that it is almost funny. I find myself saying to them during exams, “No, really, it’s fine. You’re doing a great job!” Lol. One last point, as many others have mentioned here, sexual assault is obviously not the only reason an exam may be unpleasant or painful. This OB’s statement suggests that either mom has not been previously forthcoming about her history and is “damaged”, or that she must not really be experiencing what she says she is experiencing. And that, friends, is what makes him/her an asshat.

  10. The more I think about this, the more it bugs me. The doctor is trying to shame the mother into not voicing her discomfort at the exam.

    “Because that’s the only way an exam would be that difficult for you.”

    In other words, the doctor is exonerating himself or herself of any possibility that s/he is performing the exam badly. That’s the first thing. The second thing is that the doctor is then implying that NO OTHER WOMAN in the history of this doctor’s practice has ever complained about a vaginal exam. (My midwives? They say every woman hates them, btw.)

    The doctor has to know that one in three or one in four women *has* been a victim of sexual assault, and therefore **one time out of three, this doctor’s tactics work.** The doctor uses a woman’s previous victimization in order to enforce compliance now.

    Let me repeat that: The doctor is using a woman’s previous victimization to victimize her again.

    That is why this doctor is a total jerk. Because he or she is using past pain to enforce silence about present pain.

    • He might as well have put a knife to her throat and told her that if she complains he will tell her partner that she is a liar as she has clearly been raped and is now a candidate for an honor killing. Creepy isn’t it! Okay, maybe the honor killing part is a bit over the top, but I bet it shuts-up a lot of women. It lets the doctor live in his lttile world where he never hurts anyone. Then he can sleep at night.

      • Well, I don’t know about all that. But it does put mom in a position where her only choices seem to be to say, no, I’ve never been sexually assaulted (which may or may not be the truth), so I guess it must not hurt that much, I must be overreacting and I’ll just be quiet and let you keep hurting me. Or she reveals that she has sexually assaulted in a manner and/or timeframe for which she was not prepared, which is in and of itself assaultive.

        • But if she says “Yes, I was assaulted” the doctor says, “Yeah, that’s why you’re so oversensitive.” The question isn’t asked for purposes of treating her gently but for getting her to shut up. Why do I assume that? Because if the doctor cared about how she felt, the doctor would have said, “I’m sorry. I’m being as gentle as I can, and it should be over in about a minute.”

          I’m also assuming the mother wasn’t screaming and sobbing and thrashing around in a full-blown panic attack. The OP says “uncomfortable.”

          So the mother’s options are to say, “Yeah, I’ve never been assaulted so I’m way blowing this out of proportion because other women have it worse.” Or else, for 25 to 33% of women, it’s “Yes, I was assaulted, that must be why this is so bad, otherwise I’d be totally fine with it.”

          Very few women would shoot back with, “Actually, the reason it’s uncomfortable is because a near-stranger is sticking fingers into a private place that’s very difficult to reach, that’s why. Now be gentler and remember it’s your exam, but it’s my body.”

  11. Yes I have….BY YOU! What’s YOU’RE DOING RIGHT NOW!
    Now kindly take your fingers and tools OUT.

  12. I used to have horrible, intense pain during internal exams because of stage 4 endometriosis. My IVF doctor was as gentle as possible but sometimes he would have to do things that would be uncomfortable or even painful. If he didn’t need both hands, he would even offer to hold my hand or have a nurse hold my hand. He is a wonderful human being.
    I just had my first pap smear after giving birth and WOW. It was the least painful exam EVER, due to the endometriosis being somewhat healed by pregnancy and because the nurse practitioner is very good at her job and very gentle!

  13. I’ve never (thankfully) been sexually assaulted. I’ve been heterosexually active for my entire adult life. I’ve had two easy vaginal births.

    And… vaginal exams are uncomfortable. Period.

    I’ve never had one that was actually painful (bar the odd short hair caught in a speculum), and it seems I’m lucky that way, sadly. I find them humiliating (as I do not find my lover’s hands), varying degrees of uncomfortable (worst in labor!), and something to be endured when required and avoided if not.

    Sounds to me like this sOB “perfected” his techniques on women under general anesthesia!

    • Agreed. I’ve never been assaulted, but for some reason pelvic exams freak me right out. I shake, I sweat, my heart rate is sky-high, and it doesn’t matter if the doctor is nice or not. Then I go home and spend the rest of the day trying to tell myself it wasn’t that bad (ha).

  14. Not only is it victimizing the woman but also her partner. He’s defenseless to any past trauma she’s endured and right now, he’s helpless again. People generally won’t talk back to authority, and we’ve been raised to hold doctors on an authoritative level. I feel terribly for both OP and her partner.

    I was abused as a child. No one in healthcare even seems to take assault or abuse into consideration during exams, birth, or when it’s necessary to be naked. With so many girls and women faced with abuse I’m saddened it is still so taboo.

  15. ::sigh:: This one hit home a bit for me. I have been sexually assaulted and one of those assaults was by a GYN and her nurse. (Yes, I said her. Both females.) And when I say assault, I mean full blown assault. So needless to say, vaginal exams are beyond uncomfortable for me. So are breast exams.

    BUT… I feel quite certain that they would be even if I had never been raped. I’m a very modest person and any situation that requires me to remove clothing makes me tense up. So I don’t agree with this doctor when he says that only sexual assault victims would find exams to be uncomfortable.

  16. I’ve never been assaulted.
    I cry every time.

  17. Vaginal exams are uncomfortable for ALL women, you jerkwad. Shall I stick something up you and see how much fun you have?

  18. Well I *am* a survivor of sexual abuse and, guess what doc dork, my midwife and ONE GYN doc could/did preform VEs without any pain or discomfort. But several other OBs, yourself included, just don’t pay enough attention and hurt me. And, guess what, this abuse victim isn’t remotely modest around other women, so, no, I’m not just ‘tense’.
    …stupid ob, sorry OP.
    Btw I am horrified by the thought of a male OBGYN, and they were strictly banned from my prenatals and births, and I’m equally sure even a well trained/careful male GYN would hurt just cuz I would be far too uncomfortable with them down there.

    • Would you allow a man into your birthspace if it was necessary?

      I am a doula and recently had a client who also didn’t want any males in her room but had to change her mind because we needed a paediatrician.

  19. I wonder if the medical board would like to hear about this doctor traumatizing victims of assault.

  20. This is a reply to Jade above, unfortunately can’t reply directly from my cell. Yes, absolutely. I do understand the concept of medical emergency, and I’ll pick that over my comfort level (now, likely to be uncomfortable in my skin for the next week or two). My 2nd was born in a hospital and there was Mec in the waters, so they had a neonate response team (peds department) waiting in the room. There was a man in that, but they were a couple of feet away and not part of the birth. And there was 1 obgyn in that group that was male, if i’d come in and he’d been the only one availible he would have overseen (hands off) the resident (teaching hospital), and I told them I could deal with that. Of course in an emergency who knows who I would be dealing with (which happened with the birth of my 1st), but at that point everything gets locked away to be dealt with later except the emergency at hand.

    • Fair enough. yeah with my client, we were expecting needin g a large team of people to assist as soon as the baby was born. The midwives, the neonatal team and I worked well together to have the team wating outside the door, to come in if they needed to (that did have to)

  21. The only VE that I’ve ever had that hurt was by a rude OB who was angry with me. She didn’t put any type of lube on the speculum, and made inappropriate negative comments about my thighs.

  22. A doc actually said this exact thing to me. My now ex-husband was out of the room . . . he had raped me at knifepoint twice and the second time he got me pregnant. Had my ex been in there, I would have probably acted super offended and went to post the quote on this website.

    Too bad he can’t be charged . . . in my state (and most other states) a husband can legally rape his wife if they live together (or apart and no divorce/separation has been filed). They don’t do anything about spousal rape unless divorce/legal separation is pending.

    So maybe before you judge the doctor, maybe see that the woman may very well have been sexually assaulted and just can’t say it in front of her partner.

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