'"Gyneco-Obstetrics": One more unanimously accepted great mistake,' by Dr. Nelson Soucasaux, at the Museum of Menstruation and Women's Health

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More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Endocrinology of menstruation - The curious relations between androgens and estrogens in women - Female sexual response - The Gräfenberg Spot (G-Spot) - Gynecological assistance: the three basic areas - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Symmetric Patterns in the Female Genitals - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience, and see his Art of Menstruation

"Gyneco-Obstetrics": One more unanimously accepted great mistake

Nelson Soucasaux , Brazilian gynecologist

After having exhaustively demonstrated that gynecology and obstetrics are very, very different medical specialities and that there are no scientific and logical reasons that could justify their usual integrated practice by the same physician (read the article), some complementary observations on how this serious mistake of the fusion of both specialities was perpetuated become pertinent.

As I've said, ". . .When everybody walks on the same direction, this may be a sign that they are following the wrong direction . . . ."

Unanimity is a situation that almost always should arouse some suspicion, mostly when it seems to be "absolute." I say that because, in several ways, unanimity may be very dangerous. Contrary to the suppositions of so-called "common sense," unanimity not always is a sign of being right, since it also may be a serious indication of error. And, in that case, the mistakes perpetrated become more and more dangerous because they seem to be the "right thing." The Brazilian expression "ondas de mal senso" defines quite well this kind of phenomenon, very common along all the history of humanity. (In English, that expression can be understood as a "dissemination of epidemic nonsense" in a community).

Carl Gustav Jung's studies on the intricate dynamics of the collective mind are highly advisable for the understanding of this subject. He studied the mechanisms responsible for a phenomenon that may be metaphorically described as "psychical contamination," and by means of which an enormous number of people in a community is influenced or even "taken" by some "ideas" that might be either right or wrong. It's needless to point out the tragic consequences of the acceptance, by the majority of people, of mistaken points of view. This is so because, in their position, the recognition of the mistake becomes very hard and meets a lot of resistance.

The dominant (dis)orientation that characterizes traditional women's medicine seems to be unanimously accepted by most of the professionals devoted to it. As a consequence and due to their ignorance of the problem, patients and people in general blindly tend to accept the "official" position. In this way, the almost absolute majority of gynecologists and obstetricians mistakenly suppose that: 1) the integrated practice of gynecology and obstetrics by the same doctor is fundamental for the practice of women's medicine; thus, every gynecologist must be an obstetrician and vice-versa; 2) gynecology is a fundamentally surgical speciality; therefore, every gynecologist must also be a surgeon specialized in female pelvic surgery (or gynecological surgery).

The mistaken supposition that every gynecologist should also be an obstetrician is almost unanimous. The fact that obstetrics actually is a speciality that requires surgical mastery ends up by "closing" the equally insane cycle that "demands" surgical practice on the part of every gynecologist. In this way, the eternal obstetric-surgical grip upon gynecology is maintained, with all of its regrettable consequences for medical assistance to women.

Here we have, therefore, an absolutely fantastic series of conceptual mistakes that continue being endlessly perpetuated in the history of women's medicine. In my book "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") I hope I have demonstrated that, according to the more elementary medical and scientific principles of reasoning, the official orientation that regrettably dominates all women's medicine is totally devoid of any logical basis, and constitutes a serious "disorientation." The suppositions that the usual "gyneco-obstetrics" are based upon are nothing but vicious standpoints perpetuated by socio-cultural and pseudo-scientific conditioning that, at the same time, are very useful for the maintenance of some "professional strategies" that have proved to be very advantageous for the physicians who work within this traditional context.

One of these suppositions is what I call the "obstetric view of women," an archaic standpoint still deeply-rooted in our culture which, in a tendencious way and in opposition to the reproductive, psychological and existential reality of modern women, still holds that women's fundamental role consists on conceiving, gestating and giving birth to children. In "Novas Perspectivas em Ginecologia" I demonstrated how this excessive emphasis on women's maternal side had a great influence on women's medicine, giving rise to the already mentioned "obstetric view of women" which, in turn, is partly responsible for the persistent and irrational obstetric dominance over gynecology.

The regrettable and sad reality is that, in a conservative society as this one we live in, to act in the area of women's medicine according to a wrong but traditionally instituted model becomes not only "more successful" (?!?) but also professionally more " advantageous." Worst of all is that, as I have already demonstrated, the persistence of that situation is incompatible with the evolution of medicine. The problem is aggravated by the fact that most women have absolutely no knowledge of that since, for many years, they have been systematically deceived and "confused" by the prevailing (dis)orientation that characterizes official women's medicine - that is, "gyneco-obstetrics."

For a strictly medical analysis of my criticisms to the combined practice of gynecology and obstetrics by the same doctor, see my articles "The Gyneco-Obstetric-Surgical Stubbornness and the perpetuation of one of the greatest mistakes of women's medicine" and "Gynecologist versus Obstetrician: What lies behind?" published here at the MUM, and "The Traditional Tie of Gynecology to Obstetrics and Surgery: Deep-rooted conditioning coming from the past and is devoid of scientific basis" and "The Obstetric Strategy in Women's Medicine," at my Web site www.nelsonginecologia.med.br. A deeper analysis of this subject can be found in my aforementioned book "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology"), published by Imago Editora, Rio de Janeiro, 1990.

Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993.

Web site: www.nelsonginecologia.med.br <http://www.nelsonginecologia.med.br>

Email: nelsons@nelsonginecologia.med.br