Faced with criticism and accusations of violence against several practitioners, the profession of gynecologists and obstetricians wants to react and restore a bond of trust. A few days before their annual congress, the National College of French Gynecologists and Obstetricians (CNGOF) held a press conference on Wednesday to take a first step towards patients.
For the three days of the Pari(s) Santé Femmes congress organized in Lille, “a special place has been reserved this year for patient-caregiver relations and benevolence”, indicates the CNGOF. The college must present doctors with new recommendations for the clinical practice of pelvic examination as well as a charter of care in the delivery room, aimed at providing a framework and specifying when the medical examination is really desirable and when it is possible. to do without.
An examination not always recommended and never imposed
Thus, pelvic examinations (under speculum or by vaginal examination), as well as endovaginal ultrasounds, currently recommended in a certain number of cases for detection and prevention purposes, are often useless and should not be systematic, recommends the CNGOF. For example, in a pregnant woman without symptoms and without a history of preterm delivery, the systematic measurement of cervical length by endovaginal ultrasound is not recommended because this examination is not associated with a reduction in prematurity, specifies the college.
In a pregnant woman with no symptoms and no risk factor for preterm delivery, the systematic use of vaginal examination during follow-up consultations is also not recommended because it does not reduce pregnancy complications. .
In addition, the college recommends asking patients about the existence of current or past violence, including in the context of gynecological or obstetrical consultation or follow-up, the pelvic examination being “less well experienced (anxiety, discomfort, pain , embarrassment, shame) in women with a history of violence than in women without. “Even if a pelvic examination is recommended, it is only offered to the woman, who accepts it or not”, insisted in a press conference Xavier Deffieux, gynecologist who participated in the development of the recommendations.
The recommendations come as voices grow across Europe to denounce obstetric violence, with some rights groups claiming that women are routinely denied informed consent and are subjected to rude and degrading behavior by medical staff and, in some cases, unsafe practices. The fact remains that “a gynecological examination may be badly felt, may lack benevolence, but it cannot be equated with rape, otherwise the gynecologists, already too few in birth rooms, will become even more rare, so badly does the profession feel this assimilation”, warns the CNGOF.