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  • Doctors’ shocking comments reveal institutional misogyny towards women harmed by pelvic mesh - a Patient Safety Learning blog


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    Summary

    Two years after Baroness Cumberlege shared her damning report, 'First Do No Harm', which highlighted serious failures in response to reports about harmful side effects from medicines and medical devices, too many mesh injured women still continue to be let down by the healthcare system. Women who have been harmed by pelvic mesh surgery have shared a series of appalling accounts of how they have been treated by their doctors while desperately seeking help for their injuries and complications. In this blog, we examine how these comments reveal an underlying misogyny held by many doctors, and a failure to take women’s concerns seriously.

    Content

    Asked to share the worst things doctors have said to them, members of the 9,600-strong Sling The Mesh support group responded by sharing a huge number of outrageous comments; comments that are belittling, misogynistic and demonstrate the scale of mass institutional denial. These accounts are not limited to one doctor, specialty or area, they concern surgeons, consultants and GPs from across the UK.

    There will be many doctors shocked and horrified by the comments shared by mesh-injured women, but there are clearly those whose attitudes and behaviours are completely unacceptable.

    Comments made by doctors included:

    • asking one woman who could no longer have vaginal sex because of extreme pain to consider anal sex
    • women being told they shouldn't be having sex over 50
    • women being accused of exaggerating their pain or being an “awkward patient”
    • being told to go home and have a glass of prosecco, and that “at least they don’t have cancer”
    • being told “your husband should be pleased” with the results of the surgery
    • suggesting women were neurotic and sending them for psychiatric assessments. One woman who reported this response was later found to have brittle plastic mesh slicing through her vaginal wall, causing agonising pain.

    Kath Sansom, founder of Sling the Mesh, shared these accounts with us, saying, “These comments are loaded with arrogance, lack of compassion and a failure of empathy, and they offer a shocking picture of the failure of individuals in the healthcare system to listen and respond to women. They have all been made by doctors, in the face of a clear evidence base for the avoidable harm caused by surgical mesh.”[1][2]

    Patient Safety Learning has included all of these comments in this community post, without attribution to ensure confidentiality. They are shocking and disquieting to read.

    Evidence of harm and the IMMDS Review

    It was patients themselves who first raised the alarm about mesh complications and lack of adequate support. Following years of patient-led campaigning, their battle to be heard and taken seriously finally saw a measure of success when pelvic mesh was included in the Independent Medicines and Medical Devices Safety (IMMDS) Review in February 2018, chaired by Baroness Julia Cumberlege.

    The IMMDS Review’s report, 'First Do No Harm', was published in July 2020 and highlighted the lack of research evidence about safety aspects of pelvic mesh, the failure of the health system to listen to women injured by mesh and a lack of awareness among doctors about mesh complications.

    Women still aren’t being listened to

    The First Do No Harm report recommended a system of redress for women injured by mesh, but this has not materialised. Instead, they face ongoing medical gaslighting for injuries that have resulted for many in pain, loss of sex-life, marriage breakdown, job loss and permanent disability.

    The comments shared in this blog relate to women’s experiences over time, and it’s clear that the NHS still has much work to do to address the inequality and misogynism they demonstrate.

    In April 2021 the Government held a call for evidence to inform the development of its proposed Women’s Health Strategy. In December they published a policy paper setting out the Government’s vision for the new strategy.[3] It highlighted the need to tackle the fact that the health system still too often does not listen to serious concerns raised by women.

    This will require further investigation of themes such as the quality of conversations and shared decision making, the role of information, education and training for healthcare professionals and how to embed changes within clinical practice. In their policy paper, the Department of Health and Social Care states that:

    “We will publish a strategy that will set out more detailed delivery plans against each theme and against specific health needs and conditions, aligned with this vision. In the strategy we will set out concrete proposals both on issues that only affect women and girls, and on issues that affect everyone but where there are sex-based differences in prevalence, experience, or outcomes. This strategy will be published in spring 2022.”[3]

    Helen Hughes, Chief Executive of Patient Safety Learning said, “Sex and gender bias in healthcare pose a serious risk to patient safety. We believe that women, and patient groups representing women, must be given ample opportunity to voice their concerns and to be listened to, believed and their concerns acted upon. . At the heart of this equality issue is the demand that women are treated fairly and with dignity. There must be zero tolerance of the dreadful misogynistic behaviour experienced by these mesh injured women, victims of avoidable harm.”

    Related reading

    “There’s no problem with the mesh”: A personal account of the struggle to get vaginal mesh removal surgery
    ‘Mesh removal surgery is a postcode lottery’ - patients harmed by surgical mesh need accessible, consistent treatment
    A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021)

    References

    1 E McFadden, S Lay-Flurrie, C Koshiaris et al. The long-term impact of vaginal surgical mesh devices in UK primary care: a cohort study in the CPRD. Clinical Epidemiology. 4 August 2021
    2 Tervaert, J. Autoinflammatory/autoimmunity syndrome induced by adjuvants in patients after a polypropylene mesh implantation. Best Practice & Research Clinical Rheumatology. 1 August 2018
    3 Our Vision for the Women's Health Strategy for England. Department of Health and Social Care. 23 December 2021

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