The No-Need Hysterectomy Dilemma

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As of recent, say within the last five to seven years, our dear doctors have gently started suggesting or offering hysterectomies, tubal ligations, and other such invasive and unnecessary surgeries as forms of treatment for nonthreatening (female) medical conditions. In particular, these specific “options” are being pushed and promoted for the “cure” of noncancerous uterine fibroids and benign cervical/cell dysplasia—all without the provision of information to the patient concerning suitable and less invasive, risky procedures. Wrongfully termed “options and/or alternatives,” hysterectomies and tubal ligations in nonmalignant cases such as those described above, should not have even been considered as choices of acceptable treatment. It's happening all over again, and it’s affecting the reproductive and general lives of women of color, as well as those from diverse (non-American) ethnic backgrounds. The crime is called, “coercive sterilization” and its “return,” to say the least, is terrifying.

Personally, within the last month of the New Year (2012), I have been told of three such cases, all involving women of color. Their ages range from mid-thirties to early forties. Last year, a dear friend shared such a story as well. She was experiencing a noncancerous, benign uterine fibroid condition for which a hysterectomy should have never even been considered. But nonetheless, it was and the horrifying measure? The unnecessary surgical method was suggested to her, as an ONLY option by her doctor, also a woman of color.

Back in the 1960s and 1970s, and much earlier where the reproductive lives of women and girl children of color were concerned, there were movements and discussions put in place to put the heinous crime to an end. Now it has resurfaced (or maybe had never really gone) and today’s women of color, including Native American women, as well as those women from places “outside” of the U.S.—in particular, Mexico, China, Romania—are in danger again of having their general and reproductive rights as women threatened. 

This “return” of an omnipresent vulnerability and endangerment should serve as a wake-up call to all women. The way to fight it is to become informed about your body and your rights. Become empowered; learn about your medical condition (become in-depth with YOU); be knowledgeable about ALL of the options available to you; seek second and third, maybe even fourth opinions, especially if you’re coming up against medical advice that goes against your prognosis—don’t be afraid to be your own medical advocate, and don’t ever be intimidated by your doctor. Ask questions; do your research—if you understand your medical condition, you should feel comfortable in providing this information to your doctor. Anything other than civilized behavior from your doctor (once you’ve approached him/her with your findings), should probably be seen as a definitive reason to seek out other medical professionals and/or additional opinions about your condition. 

In the spirit of life, wellness, awareness, knowledge and empowerment, please allow me to share the following articles, websites, medical data and history (in the U.S.) of sterilization abuse.

Shall we begin?

“Coerced,” “uninformed” sterilization abuse (unnecessary and invasive hysterectomies, tubal ligations, etc)…
It's like we've returned to slavery (or perhaps, never “escaped” from it—just more subtle now). You might not be fighting for your reproductive rights; you might have just received a pap result reflecting benign cervical dysplasia. Whatever the case, the same unnecessary procedure (hysterectomy or tubal ligation) has been suggested. Unfortunately, you are not the only woman of color that has been “offered” such an invasive and again, unnecessary procedure. Repetition is powerful, especially when you want something to stick, so again, I state: It's happening all over again and it’s affecting the reproductive and general lives of women of color, as well as those from diverse (non-American) ethnic backgrounds. The crime is called, “coercive sterilization” and its “return,” to say the least, is terrifying.

From Chicago Women's Liberation Union:
“Sterilization abuse, however, can occur on many different levels, and it will take much more than a federal order to prevent it from occurring again. When a woman does not know she had been sterilized or is knocked out and sterilized against her will, this is sterilization abuse in its most blatant form. However, more subtle forms of coercion or deception are often used. Misinformation is one tool of abuse—women are not told that the operation is permanent and irreversible, or are not counseled about other methods of birth control. Or women are wrongly told that if they don't consent, their welfare benefits will be cut off. And illegal as well as legal immigrants are sometimes threatened with deportation if they refuse the sterilization. The lack of interpreters in health care institutions makes it especially problematic for non-English speaking women to be fully informed of their rights and the nature of the procedure itself. The issue of informed consent is particularly important when hysterectomies are encouraged for reasons not medically justifiable. One particular Chicago hospital15 for example, routinely suggests hysterectomies for women with Class III Pap smear results, which only indicate non-malignant abnormal cell growth of the cervix, and would not usually require removal of the uterus.
Sterilization abuse also occurs when the operation is suggested to women in stressful situations when they are not usually capable of making an informed decision and when they are not given an adequate period of time in which to consider their decision. At L.A. County Hospital, for example, some women were routinely asked during labor whether they wanted their tubes tied.16 Sterilization is increasingly being described as appealing and hassle-free, and is even suggested as a way of improving your sex life in a new pamphlet issued by DHEW. “
…and the above was written in 1977! Why is this still going on??

From www.about.com – Surgery, article: Hysterectomy Interview with Supermodel Beverly Johnson/Uterine Fibroids and Hysterectomy/By Jennifer Heisler, RN, About.com Guide/Updated March 24, 2009/About.com Health's Disease and Condition content is reviewed by the Medical Review Board:
About? Supermodel, Beverly Johnson's “Ask 4 Tell 4” interview about her hysterectomy as a “cure” for noncancerous uterine fibroids – she was not able to have kids and was not informed about other less invasive surgeries…also about a specific hysterectomy that will keep a woman’s ovaries intact.
Was there any discussion of the different types of hysterectomy, such as procedures that leave the ovaries intact and allow menopause to occur naturally?

Beverly: Not that I recall. I do remember that when I was going into the myomectomy and hysterectomy I had to sign a release that if they needed to the doctors could remove my ovaries. One was removed with the myomectomy and the other with the hysterectomy. The hysterectomy turned out to be complicated, and the doctor actually had to go back in and repair because I was losing blood. It was complicated, a life-and-death situation. The three-day hospital stay for the hysterectomy turned into a month-long hospital stay.
Were your symptoms improved by the hysterectomy, or just exchanged for the symptoms of menopause?
Beverly: After all that time at the hospital, when I got home I was so weak. I could barely walk. I went to homeopathic doctors and had therapists and trainers to strengthen myself. It took five months. After the five months, I decided to travel to New York for the Costume Institute Gala. Almost immediately I was in terrible pain. Turns out I had a hernia as a result of the hysterectomy and had to undergo surgery again. I was dealing with so much that menopause hadn’t even entered my mind yet. Now that I look at it, I could have had symptoms of menopause.
Were you prepared by your surgeon or other medical professionals to be thrust into menopause while you recovered from surgery?
Beverly: To be honest, I don’t really recall. At some point after my hernia operation I went back to the doctor complaining about hot flashes, weight gain—the whole gamut. It didn’t occur to me that I was in full-blown menopause.
Were you offered any treatments or medication, such as hormone replacement therapy, to help manage your menopause symptoms?
Beverly: They did give me hormones and they didn’t do any good. I kept trying different cocktails. The emotions were so strong. Again, I tried everything including Chinese herbs. I finally understood my mother’s menopause. At some point I did find the right doctor and the right mix of hormones.

From “Mississippi appendectomy, a developing online archive of information about women of color and coercive sterilization”:
 Sterilization Abuse (tubal ligation, hysterectomies, etc) – Coercion and consent:

Sterilization (coercive, uninformed, unauthorized, unknown) of black women:

See excerpt from “Women of color and the reproductive rights movement” By Jennifer Nelson:

 ”Cervical cancer can be treated through surgery, chemotherapy and radiotherapy. During the initial stages of the cancer, a hysterectomy, the removal of the entire uterus may be performed. In a more advanced condition, the lymph nodes may be taken out too. For those who want to continue conceiving, other methods such as loop electrical excision procedure (LEEP) or cone biopsy may be conducted. In case these don’t eradicate cancerous cells, a trachelectomy may be recommended. This surgical process aims to remove cancer growths while saving a woman’s fertility. The downside of a trachelectomy is that very few doctors specialize in this surgical technique and there are no definite guarantees for a patient to retain their fertility.”
 
Further:
“Treatments for cervical dysplasia will vary depending on the severity of the disease. If a diagnosis of mild dysplasia is confirmed and all abnormalities have been evaluated, many healthcare providers will simply monitor the condition without the treatment, as spontaneous remission of mild dysplasia is quite common. However, treatment is almost always prescribed for women with moderate to high-grade dysplasia. Two general treatment categories exist for cervical dysplasia: ablation (destruction of the abnormal area) and surgical resection. Both methods are equally effective in treating the condition. Typically, ablation is the treatment of choice for mild cases of dysplasia and surgical resection is the preferred treatment for moderate to severe cases or cases where malignancies are present. Ablation procedures include carbon dioxide laser destruction of the abnormal cells or cryocautery – the freezing of the outer layer of the cervix. Resection procedures include partial or total hysterectomy; however, these procedures are typically only recommended in severe cases of dysplasia or in cases where malignant cells are present.”

Dedicated to all of the GREAT “amazons” of today—the world’s Dahomey, Shahnameh, Nusaybah bin Ka’ab’s, Fu Hao’s , Scythian-Sarmation’s—as these women did before you, OWN your emotional, mental/intellectual and physical strength!

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