A woman makes an appointment to see an OB/GYN (obstetrician/gynecologist) to manage her care during pregnancy and the birth of her child and also to manage the care of her reproductive health, including diagnosis and treatment. Pediatric gynecology specialists provide evaluation, treatment, and support tailored to babies, children, teens, and young people. A pediatric-adolescent gynecologist understands the unique issues that affect the development and anatomy of growing girls and young women. Young people can have specialized needs compared to adults. It is important for young people to have parental support and guidance before and during gynecology visits.
Why Parents Should Be Involved
Parents and guardians should be involved in all aspects of an adolescent, teen, or young person’s life, especially a visit to the OB/GYN. The prospect of going to any doctor can be daunting for the young person, but a visit to the OB/GYN can be unnerving. The parent or guardian can provide emotional support and answer questions before and during the visit.
The American College of Obstetricians and Gynecologists (ACOG) recommends teens start seeing an OB/GYN between the ages of 13 and 15. A younger child or adolescent may need to see an OB/GYN before her teen years. Young children are especially prone to certain injuries and infections. This is because their tissues lack estrogen.
The involved parent should endeavor to make the first visit a positive and learning experience. The first visit may be a conversation with the doctor about healthy living and what to expect at future appointments. The parent who is involved with their child can ensure that she receives proper education and information about her reproductive health. Dr. Holly W. Cummings says, “Your teen should think of the visit as a chance to get one-on-one health advice in a safe, comfortable setting.”
The North American Society for Pediatric and Adolescent Gynecology (NASPAG) asserts that comprehensive sexual education (CSE) is vital to improving the physical and reproductive health of adolescents worldwide while also promoting the development of self-esteem and healthy interpersonal relationships.
Appropriate Ways to Help Your Child
A parent of an adolescent or young woman should have an understanding of professional and appropriate behavior from medical professionals. A parent should talk about the demeanor of the doctor when their child is about to visit an OB/GYN for the first time. The doctor should be friendly, age-appropriate, non-judgmental, and respectful of the patient’s privacy, and keep the parent informed.
Educate Them on Professional Behaviors
A young child needs to be aware of what appropriate behavior is in order to spot inappropriate behavior from a medical doctor. Explain to your child that a doctor should be warm and friendly; respectful of her privacy and boundaries; use age-appropriate terms and communicate on her level; and ask questions about what concerns her and answer any questions she might have. Compassion is also an appropriate behavior for a doctor to have. Richard S. Hollis, M.D. said, “It is the patient who carries the burden of illness, but the compassionate physician shares that burden, lifting it when possible and lightening it when that is all that can be done. This sharing of the burden has always been the hallmark of the medical profession.”
Explain to your child that some doctors may behave in a way that is inappropriate.Explain that there are certain boundaries that a doctor must not cross: inappropriate touching such as without gloves; giving gifts to gain trust; keeping secrets; manipulating the child by praising her, and discussion of sexual topics.
Allow Privacy During Exams
According to the American Medical Association (AMA) Code of Medical Ethics, “Physicians who treat minors have an ethical duty to promote the developing autonomy of minor patients by involving children in making decisions about their health care to a degree commensurate with the child’s abilities. A minor’s decision-making capacity depends on many factors, including not only chronological age, but also emotional maturity and the individual’s medical experience. Physicians also have a responsibility to protect the confidentiality of minor patients, within certain limits.”
A parent should respect their child’s privacy during medical exams and allow her to speak to the doctor without being present, if necessary. However, it is acceptable for the parent or guardian to be present if the child feels more comfortable having them present.
Provide Emotional Support
The first OB/GYN appointment can be very stressful for a young child, teen, or young woman. However, the visit will probably just be a discussion, a conversation to get to know each other as doctor and patient (and family). The doctor should answer any questions the child might have and ask a few questions about concerns that are affecting the child right now – such as puberty, her period, and her emotional health.
The child will be looking to her parent(s) to provide emotional support and reassurance before, during, and after the appointment. Be there for your child, but respect her needs and wishes.
Inappropriate Ways to Help Your Child
A parent should want to always be present for a child. However, when a teen or young person has an appointment with an OB/GYN, they may want to speak directly with the doctor, without the parent present. To insist on being present, speaking loudly or authoritatively with the doctor or office staff, and making potentially embarrassing comments about the child
would be inappropriate ways for a parent to behave. These actions could make the child uncomfortable and could cause her experience at the OB/GYN’s to be negative.
Not Respecting Boundaries or Privacy
A young person should expect a doctor — or anyone, for that matter — to respect their boundaries and privacy. Many people who are in an authority position cross boundary lines in the workplace, sports, and medical environments. If a doctor, during an OB/GYN appointment, does not maintain a physical boundary with the patient — maintaining appropriate personal space and privacy — and an emotional boundary between the doctor and the patient, the doctor is not respecting the young person’s boundaries that can make her feel uncomfortable or unsafe.
Not Allowing Them To Speak for Themselves
If a young person’s parent is with them during the exam, the young person should be allowed to speak and ask questions of the doctor. This is the time for her to become informed, educated, and empowered about her reproductive health. Not allowing the young person to speak, and monopolizing the conversation with the doctor, can have a very negative impact on the young person and her medical future.
How to Handle Difficult Situations
You are finally home after an exhausting day that included taking your daughter to an OB/GYN appointment. You didn’t go into the exam room because your daughter didn’t want you to go with her. But now that you are home, she tells you that the doctor behaved in an inappropriate manner. It’s hard to take it all in because doctors are supposed to be trusted.
Kristen Houlton Sukura, executive director of the Sexual Violence Center in Minneapolis, said that doctors have implicit consent to touch patients’ bodies, so it’s tough for most people to get a sense of what might be inappropriate behavior or when they’ve experienced improper contact. “The sad reality is, whenever there’s a difference in power and authority, some people exploit that, and in our culture, we venerate doctors – we’re not trained to question them,” Sukura said.
RAINNN (Rape, Abuse & Incest National Network) — the nation’s largest anti-sexual violence organization —offers some tips for anyone when dealing with such a difficult situation:
- Believe the child;
- Offer supportive reassurance;
- Be present;
- Remind them it wasn’t their fault;
- Practice active listening;
- Accept their decisions for healing;
- Acknowledge their pain;
- Report the incident.
Stay Calm and Supportive
Staying calm and supportive during the interaction with your child after she has told you of inappropriate behavior by her OB/GYN is very important for the well-being of the child. Avoid over-reacting and yelling even if you are angry about the situation.
Seek Help if Necessary
If anyone, and especially a young person, has experienced predatory behavior in a medical setting, it is essential they seek help and report the incident.
Cases of Abuse in a Medical Setting
Recently cases of abuse or assault in a medical setting have been brought to light. Dr. David Broadbent was an OB/GYN in Utah who sexually assaulted many women during his 47 years of practice. Dr. Fabio Ortega was a Chicago OB/GYN who sexually assaulted and abused his patients for years. He was charged criminally and served prison time. Currently there are multiple civil lawsuits filed against Dr. Ortega.
Takeaway
A visit to the OB/GYN by a child, teen, or young person can be a daunting experience. But it is essential for her reproductive health that she be examined and treated, if necessary. It is unfortunate that a young person could face the potential of sexual predation by a trusted medical professional. The parent or guardian should prepare the child prior to the appointment by explaining what is appropriate and inappropriate behavior by a doctor while also respecting the child’s privacy and boundaries.