Systemic bias against the childless

The following is my susbmission for the World Childless Week 2025 topic: Childless Healthcare.

Systemic bias against the childless

“You know how babies are,” the nurse said to me after I asked her to keep the door to my hospital room closed, because the baby down the hall kept crying. “No, I don’t,” I responded. “Mine keep dying.”

On the gynaecological ward where I was being treated for a complicated ectopic pregnancy, pregnant, but already grieving the loss of my second pregnancy and facing the prospect of a pregnancy related cancer, the sound of a baby crying was like a knife to my wounds. I would have hoped that a nurse might have thought about her response with a degree of sensitivity. Unfortunately, she barged into my room, even after I had pointedly shut the door, and interrogated me about how long I had been married, and then asked me accusingly, “why did you wait so long?”

On that same hospital stay, I was sent to radiology for extensive scans. I was asked if there was “any chance I was pregnant?” I had to explain that technically I was pregnant, but that it wasn’t viable. They hadn’t even read the referral that noted the scan was specifically to rule out gestational trophoblastic disease.

Fortunately, most of my health professionals have been a bit more tactful. For example, a wonderful midwife in the outpatient Women’s Health unit made sure I didn’t have to wait with other noticeably pregnant women. And on the aforementioned hospital admission, I had already been moved from another four-bed room, when one of the patients was visited by multiple children and babies. A kinder nurse had seen me leave the area, heading for the sitting area, a little upset, and had moved me into a single room. Drs rushed to explain in advance that “spontaneous abortion” was unfortunate medical terminology simply meaning miscarriage if they slipped up and used it. And I haven’t been (openly) judged about weight, age, etc when going through infertility. So I guess in this way I have been lucky.

 

But systemically, healthcare fails women, including or maybe especially women going through infertility or pregnancy loss, as we are the minority. And our emotional health, when we are often at our absolute lowest, can be cruelly ignored. Hospitals are not set up for us, and actively make our experience worse. For example, our hospital had an ultrasound scan waiting room with walls covered with posters illustrating the development of a pregnancy. Important information, but very painful to those losing their pregnancies. And of course, the waiting room was full of pregnant women. My eyes stayed low. Not the best choice of location to receive the diagnosis of a second, more dangerous, ectopic pregnancy, but that’s where the consultant chose to give me the news, even though there were more discreet side rooms that could have been used.

Over the months it took my ectopic to be treated, I also had to attend several outpatient clinics, once again surrounded by other pregnant women. I forced myself to have compassion because they may also have been experiencing difficult pregnancies. But the belly-rubbing (a stage I never reached) never stopped, and I once again feigned interest in the carpet. (These days I would at least have a phone to stare at. Not so easy to escape twenty years or so ago!) Would it be so difficult to have screens in waiting rooms, or in some way ensure that those losing or having lost pregnancies have reduced exposure to the heavily pregnant?

The Dr at the fertility clinic was kind when telling me that I had reached the end of the road. Still, in his haste to get me out of his office now that there would be no more lucrative payments from me, he offered to get the counsellor to call. Of course, that call never came. Cast adrift in my lowest hour, I received the message that I was no longer a priority to anyone.

Fortunately, in New Zealand, regular smear tests are given by our GPs or family doctors, and so I didn’t need to see another OB/GYN until I needed a hysterectomy more than a decade later. At my initial consultation, the wall behind the examination bed was festooned with baby photos, and was like a smack in the face to me, bleeding and uncomfortable, and acutely aware that my uterus had never been of any use to me. I could have accepted – begrudgingly – if the photos from his grateful patients (with successful outcomes) had been in his main office or in the reception area. But above the bed with the stirrups? That smarted. And after the hysterectomy, when I was recovering in hospital, the surgeon’s nurse dropped in to check on me, which I appreciated, but then she cheerfully told me all about the lovely family dinner she was having later to celebrate Mother’s Day.

Unfortunately, we are mostly exposed to these comments, images, and situations when we are feeling the most vulnerable. I’m a well-educated, confident woman, and could and would stand up for myself if these comments were made to me today. But every time I experienced bias, it felt impossible to speak up for myself, or to protest the assumptions and systems that discriminated against me, and that diminished me. I wish I had done more. It's why I speak up now – here, on my blog, and in the media from time to time. And I really hope that things are improving for the women who follow me.

World Childless Week 2025