Those Walls of Babies

Back when I was doing my Masters in Political Science in the early 1980s, a fellow student and friend was writing her thesis on the Patriarchy and Women’s Reproductive Health.  She researched the way women were treated in the reproductive health field, ranging from contraceptive prescription practices, to the voice (or lack) that women had in their treatment.  I remember her commenting on the lack of privacy given to the woman in the layout of operating theatres and delivery rooms, where the hospital bed ensure that the patient faced the doors.  Fortunately, these days, this no longer occurs (I can personally vouch for that given my recent experience).  But there are other areas where women’s needs are ignored, even in the practice of medicine that is devoted to women’s health.

What I am about to discuss may seem trivial to some.  I don’t put it in the same category as the lack of physical privacy and dignity that I referenced above.  But it is real, and for many women, very distressing. 

I’m talking about the dreaded Wall of Babies.  Those of us who have been to fertility clinics are probably familiar with these.  The photos sent in by happy customers, spreading their love and thanks to the doctors and staff of the clinics who helped them have their children.  (Given my situation, I’ve never been to an obstetrician’s office, but I would expect the same there.) For those of us who visit these clinics, the photos are both a source of hope, and a source of pain.  Personally though, by the time I got to the fertility clinic they were mostly a source of pain, reminding me of what I had already lost, and what I might not be able to have.

So back in March, when I first visited my gynaecologist (here in NZ we go to GPs for regular smears, and other routine gynaecological issues, so I’d never actually seen a gynaecologist - outside of hospital - before), I was surprised to find that behind the examination bed there was a board covered in photos of babies.  I will say that it gave me an unexpected ouch moment. To be fair, it may have been a particularly traumatising examination that made me react to all those photos.  But it felt like a bit of a slap in the face, nonetheless.  I want to say that it didn't really bother me, but obviously, months later, I'm still thinking about it, and remember how I felt.  But I have been thinking primarily of women who might have been through the same things I've been through (pregnancy losses and infertility and unsuccessful fertility treatments), or worse, but more recently than me, women who aren’t 12 years on, women who still feel the pain of their experiences or situations acutely.

It surprised me to see a Wall of Babies at this doctor’s office, and I didn't expect it.  His special interests are listed as laparoscopic surgery for a range of gynaecological conditions, and it seems to me that this is the larger proportion of his business, rather than obstetrics (though he does do some obstetrics work).  He doesn’t (as far as I can see) work in the infertility field at all.  (And I have to say I really like him as a doctor, and wouldn’t hesitate to recommend him.)  But he is aware of the impact of losses.  He was my doctor 12 years ago, when my second ectopic pregnancy was diagnosed in the public hospital, and I remember him being kind then, despite having to deliver the news in the waiting room under a huge diagram of pregnant bellies.

It does though seem to be an “industry standard” where doctors like to show off their happy thank you photos.  From my years in this field, it seems to me that there are dreaded Walls of Babies in OB/GYNs' offices all over the world.    

And it made me wonder: 

• Do the baby photos give their pregnant patients comfort and confidence in the doctors’ abilities?
• Do the baby photos ever upset any of their patients?

 The answer to both these questions is obviously yes.  

I wonder what the overall impact of such photos is on patients?  Are they beneficial?  Do more patients walk out happy as a result of feeling hopeful or inspired? I hope that the answer to this is YES, that this is what doctors believe and is the reason they display these photographs (rather than from pure ego - "look how my patients love me!").  

Or do they do more harm than good?  Do more patients walk out of their offices upset by these photos, feeling "less than," and/or reminded of loss?  

Does the good outweigh the damage done to gynaecological patients, or obstetric patients who have lost their babies? 

I suspect not.  I suspect that the trauma of seeing such photographs when someone is being diagnosed with cancer or other fertility-threatening conditions, or when they are losing or have just lost their babies, far outweighs the comfort a worried obstetric patient might feel during her consultations.  None of us visit an OB/GYN for fun, not even pregnant patients in New Zealand.  (Seeing an obstetrician during pregnancy here suggests a high-risk pregnancy, as midwives handle the majority of deliveries.)  Making it more emotionally upsetting seems thoughtless and even cruel. 

I wish that doctors would think about the principle “first, do no harm” in every part of their practice, and pay attention to the emotional as well as the physical well-being of the women who are their patients. At the very least, I wish that they would think about these photos and wonder how they affect their patients.  Maybe someone could even get a Master’s student to do a study?