Breathe Easy, You've Found Me ((HUGS))

People will wonder why this blog is needed, why minority midwifery student? It's very simple actually; I was looking for this blog...but I couldn't find I created it. We all have unique experiences, and every experience, every story, can help someone else. I am a black girl from the hood at an ivy league professional school. That, alone, is reason enough to write. Somebody was looking for this blog. Someone wanted proof that what I'm doing can be done - even when you come from where we come from.

To that person especially, WELCOME.

Friday, October 17, 2008

That Old Problem

I reposted three posts from last year that deal with being a fatty girl in nursing school and practicing skills, including pelvics, on your classmates. They're listed in the archives under 2007. I put these back up because a friend, a dear blog follower, is now going through the same things that I was going through when I wrote those posts last year, and I wanted her to be able to re-read what I wrote, and what you guys had to say, again. I have also been discussing this with those who I've been interviewing, and it's been interesting and sad at the same time. I want everyone to know that in some places there is no choice but to participate... that professors actually require, demand, coerce students to participate in these clinical didactics. I want it to be known that I find this appalling. Seriously. Not that we would practice on each other (that can be beautiful) but that we would not have a choice... in this profession, especially... to dictate what happens to/who touches our own damn bodies.

There is a new article in the latest Journal of Midwifery and Women's Health (Sept/Oct 2008, page 403) that discusses this phenomenon. The author calls for us to re-examine the practice of students practicing on each other. She brings up some very valid points surrounding informed consent... basically students have the same rights to informed consent for procedures performed on them... and that informed consent is not valid if it's under coercion or fear of the person consenting.

I totally agree with the author.

It's time to re-examine it, and NOW, before somebody sues, or worse, women are traumatized.

((HUGS)) to my friend who's dealing with this. You're beautiful. And Kind. And good people, period. Your body belongs to you and only you. You have a responsibility to yourself to protect your body (and mind and heart and soul) from gross violation. What happened to you in lab is not acceptable and you have every right to be angry and hurt.


Ciarin said...

Awful, just awful. I totally agree with you - no one should be forced to do this. That's completely unethical. At Frontier (where I graduated) it is optional. Most of us were ok with it. A couple were not. Others graciously volunteered for a second exam so that these people could still have an opportunity to practice.

Gratitude said...

Dude, Thanks.

Re-reading the posts everything resonated. Your words and my worries about lab definitely overlapped.

Now I know that I am not alone and my eyes are opened to what my classmates (thin and thick) must also be going through.

Next steps: Unknown, but I'm working on it.

Navelgazing Midwife said...

Hmmm. I never considered that a midwifery student wouldn't want to be examined. How else are we to learn if it isn't on each other? Even women who have a history of abuse can teach how they should be properly treated. I believe the class demonstrates its trustworthyness by how many students willingly remove their clothes. I suppose if one doesn't feel "safe" with all the members, one might not want to disrobe/be touched. Perhaps *that* is the issue that needs to be addressed, not the rule of conformity.

As a fat woman, I offer my body all the time to students to learn how to touch me, feel nothing when trying to find my uterus and ovaries, how to use the BP cuff on me, how my vaginal walls fall in on themselves... I would much rather deal with the momentary discomfort of being naked and having inept hands on my body as I know I can teach prospective midwives much about tending to fat and formerly abused women.

I find it odd - and sad - that other midwifery students might feel otherwise.

Anonymous said...

Navelgazing--Different strokes for different folks I guess.

Some of us don't feel comfortable being naked or vulnerable outside our bedrooms or with people other than our partners.

Nothing pathological in that.

The problem is not being naked in a room full of fellow students. Its being exposed in front of people with power, i.e. Faculty.

mm said...

We were required to do breast exams on each other at my nursing school. Lab partners were to do them on each other... my lab partner was a non-outed gay woman... I didn't really care... I was already a lactation consultant and wasn't really modest about boobs even before being an L&D nurse... but our group fibbed and said we'd done it behind the curtain, when the instructor was with the other groups ... some of them were very upset about it.

doctorjen said...

Hmm. I guess I don't quite understand why some folks seem to think that all students ought to be willing to allow other students to learn on their bodies. We don't expect all patients to be comfortable with students (or I hope we don't anyway) and allow them to opt out, and in fact I've heard much talk about how to make patients understand that there is no coercion - no downside or retribution if you refuse a student. But somehow we expect students to be different?
I personally was comfortable being practiced on, and in fact served as a model patient for physical diagnosis for the first year med students for 2 years. I'm also generally not real modest and am comfortable changing in locker rooms, and showering at the YMCA in public. It truly doesn't bother me, and I felt pretty much no discomfort at being practiced on. Of course, these were students who were below me in school, not my own peers and not folks in any position of power over me, and perhaps that made it easier.
I've met folks, however, who were very uncomfortable in the same situation. I think it should be perfectly okay to not want to bare your body to your classmates, or your instructor. I think students deserve a right to privacy, and the coerciveniss of everyone else is doing it, and if you don't do it someone will miss their chance to learn can, I think, make someone extremely uncomfortable. As the previous commenter said, there is nothing pathologic about not necessarily being comfortable baring your body in a fairly coercive situation to folks you would not normally choose to see you in a vulnerable situation. I can imagine being made even more uncomfortable about being the only student to protest being practiced on, and to be met with sort of bemused and patronizing response that you can opt out if you want, but of course usually everyone feels just peachy about letting the other students examine them, and if you opt out someone else will miss their chance. I just don't understand Barb's comment, either, that even if you are an abuse survivor you can teach others how to treat you - but doesn't the abuse survivor have the right to determine their own personal boundaries in the first place? All trainees have the need to learn, I realize, and I'm extremely grateful to every person who ever let me practice on them - but I think it's quite possible to train without ever needing to coerce an unwilling participant into practicing that makes them personally uncomfortable. In my experience as both a former learner, and now as a teacher, there are enough folks like myself who are comfortable serving as practice that we don't need to insist that those who are uncomfortable with it go through with it in the name of education.
I don't understand why trained patients/models aren't an option - hopefully paid as well. That eliminates the need to practice on either patients or fellow students. I never want a client in my care to feel uncomfortable about any exam I perform, or to feel they aren't given the option to refuse anything I want to do - I don't understand why students aren't given the same respect.

Morag said...

My school is very small and the expense of hiring trained teaching patients/clients would completely preclude it as an option. We either learn on classmates or faculty, or we can't learn on real people until we're in clinical sites.

We learned these skills on each other and our instructors who were always willing to offer up their bodies for our learning. I'm not sure that another option was ever offered (it should have been) but again, it's perhaps a little harder when there is no money for paid volunteers. I expect though that other midwife volunteers in the community would have been willing to volunteer as well, but given that these women wind up as adjunct clinical faculty when students get to preceptorships that would also involve a power differential which some would have difficulties with.

I understand and respect that learning these skills on/with classmates is patently not ok for some women, and honestly, I've been happy to have more than my share of exams (and pokes when it came to IV and venipuncture skills) in order to accommodate both their discomfort and my small schools limited resources.

Personally I'm so exquisitely grateful for the opportunity to learn with my classmates, and all of their varied and wonderful bodies. I feel like their input in my education is all the more impactful because they *are* my classmates.

I'm sorry that your and your friend's experiences were so upsetting. It shouldn't be that way.