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ABC News
2 days ago
- Health
- ABC News
Delays in childbirth injury diagnosis are impacting women's mental health, survey finds
Warning: This story contains discussion of suicide. A long bike ride to the park is Kristy Keefe's idea of a perfect day with her sons. She relishes every precious moment, having missed out on too many years ago when a traumatic birth led to a mental health collapse. "I have pictures and I am like I don't remember that," she says. "Because I was there, but I wasn't there." Kristy says she has blocked out some memories after hitting "rock bottom" when her second child was unexpectedly born in the hallway of her home six years ago. The trauma of her son Riley's birth, coupled with a fourth-degree vaginal tear, triggered feelings of dread and isolation. "I was really anxious. I really didn't want to be in the house because that's where it happened," she says. "I didn't want to be left alone with my baby by myself," Kristy remembers, saying she was having intrusive thoughts about something awful happening to her child. "I just felt really vulnerable and unsafe. It went to rock bottom." For women's health leaders like obstetrician Nisha Khot, Kristy's story cuts deep. "It's just a sign that we have failed women," Dr Khot says. Perinatal Anxiety and Depression Australia says one in three women experience a traumatic birth, with injuries including pelvic floor damage, perineal tears, episiotomy, incontinence, pelvic organ prolapse, as well as psychological distress. Understanding the impact of those birth injuries was the focus of a new survey from advocacy group Birth Trauma Australia (BTA). Nearly 400 women from around the country were asked questions about their birth experience, injuries sustained, diagnosis of the injuries, pain issues, incontinence and mental health. BTA chief executive Amy Dawes says the longer birth injuries take to diagnose, the more catastrophic the consequences. "We found that women that had struggled to get a diagnosis, they were 2.4 times more likely to experience suicidal thoughts," Ms Dawes says. "It's a taboo within a taboo. I have … heard firsthand accounts of women sharing their experiences of being in a really dark place following their birth trauma and struggling to get care, being dismissed." The new research also found almost all (98 per cent) of those who experienced birth-related trauma reported ongoing physical injury or pain that was not managed. It found that distressing or emergency procedures (69.6 per cent) and poor management of pain or physical injuries (53.8 per cent) are the most significant contributors to birth trauma and can lead to significant mental health impacts. Improving the mental wellbeing of women after a traumatic birth is a top priority for Dr Khot, president-elect of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). "If you have physical trauma and you're struggling with your body functions, then that is going to affect you psychologically as well, so it's not as if they're two separate entities," she says. Dr Khot says, while shocking, the survey results do not surprise her. "You just had your first baby and suddenly you find that you are incontinent," she says. "That has such huge implications for you to be able to just lead a normal life … go out with family, look after your baby, hold your baby, just lift your baby. "You can't do any of these things because of your incontinence. That is bound to have a huge impact on your mental wellbeing. How could it not?" It has been more than a year since a landmark inquiry in New South Wales heard traumatic birth experiences can have tragic consequences, including suicide and suicidal ideation. The inquiry found a number of women suffered preventable birth trauma in NSW and urgent efforts must be made to address it. BTA says there is now more investment and education of healthcare workers in the space, but more is needed. Misdiagnosis and delays in diagnosing birth-related injuries were also examined during the inquiry. BTA survey participant and mother-of-two Kristy says she struggled to get professional support in the public system for her incontinence, which compounded her psychological distress. She says it was disappointing to be out of pocket, but feels the private gynaecology, psychology and physiotherapy expertise she received was crucial to her mental and physical recovery. "I feel that if I didn't go and get that help and paid all that money … that maybe I wouldn't be here today." Ms Dawes says Kristy's experience is common. "Everyday women and birthing people across Australia are falling through the gaps in care," she says "They're sustaining severe, sometimes preventable, injuries and they fall through the gaps in a fragmented healthcare system." RANZCOG, BTA and the Australian College of Midwives are developing a federal government-funded birth trauma education pilot project, which will guide clinicians in prevention and rehabilitation of birth-related trauma. BTA is also advocating for mandatory postnatal screening and more funding for psychological support and physiotherapy. In its most recent budget, the New South Wales government allocated an extra $83 million for maternity care, family care centres and maternal vaccination. Victoria is spending an extra $21 million on its perinatal mental healthcare program. The Queensland government launched an $11 million women's wellbeing line this year and is also funding 30 new mother and baby beds for in-patient treatment of severe perinatal mental health disorders. In Western Australia, the NSW inquiry has prompted the development of a birth trauma policy for its public hospitals. Incoming RANZCOG president Nisha Khot says she will be urging her obstetrician colleagues to prioritise the issue. "We should not forget that the reason we do what we do is because we want to support women. We want women to have good experiences and good outcomes," she says.
ABC News
18-06-2025
- Health
- ABC News
The controversial and very male history of naming body parts
Take a look at your body. All the parts you can see, as well as all those on the inside, have been given a name at some point in history. There are plenty of descriptive, fairly innocuous names. But many parts are named after people. The vast majority of these are men, whose identities are invisibly stamped on every human. This includes female body parts — even the G in G spot pays tribute to a man. "There are hundreds and hundreds of dead old white men living inside us," Adam Taor, author of Bodypedia: A Brief Compendium of Human Anatomical Curiosities, tells ABC Radio National's Late Night Live. But some doctors believe these names need to be retired, with more anatomically descriptive terms used instead. "The world has changed," says Nisha Khot, the president-elect of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. "So I think it's time to change the language that we use." Humans began carving up cadavers and taking a look at what's inside in ancient times. And the basic rule for generations of researchers was "name what you see". A leg bone looked like a flute, so it was given the Latin word for the musical instrument, the 'tibia'. Then there's the patella or the kneecap, which means 'little pan' in Latin. A less creative example is an unusually shaped bone in our pelvis called the innominate, which is Latin for 'unnamed'. That's because it doesn't look like anything else. Dr Taor describes the process as "like Pictionary but with a lot more blood on the floor". But as time went on, naming conventions became less descriptive and more personal. "Often body parts were named after people who discovered them … or doctors who were good at putting their name forward so that they got their name attached to bits of the body," Dr Taor says. As Dr Khot sums up: "It was a way of making sure that their memory stayed alive." Over more recent centuries, there were leaps and bounds in European anatomical study. And this was very much a boy's club. "It was men who did all of the study of the human body … Women rarely got a look in," Dr Khot says. "So that's the reason most body parts were named after men." One review looked at 700 body parts that were eponyms, or named after people. There were 432 people's names around the body (as some names are connected to multiple parts). Of these, 424 were men. The rest consisted of five gods, a king, a hero and just one woman. Raissa Nitabuch was a little-known 19th century Russian pathologist who studied the placenta. The Nitabuch layer — a layer between the uterus and the placenta — is named after her. But, as Dr Khot points out, it's not exactly a major body part: "You can only see it if you look under a microscope." The study also found the average year of eponymous term attribution was 1847, meaning much of our body reflects the medical world of the mid-19th century. Even when it comes to a woman's reproductive parts, "dead men dominate living women", according to Dr Taor. Take the fallopian tubes. They're named after 16th-century Italian priest-turned-anatomist Gabriele Falloppio (who is also the eponym for the fallopian canal and fallopian hiatus). Once you start looking, there are male names all around the female pelvis. From the pouch of Douglas (a Scottish surgeon) to Skene's glands (a Scottish gynaecologist) and Bartholin's glands (a Danish anatomist). The G in G spot is named after German-born gynaecologist Ernst Gräfenberg. "I really can't see why we should use those names for [parts] that are very specific to women … It makes me feel uncomfortable," Dr Khot says. The pudendal nerves, which take sensations from male and female genitalia to the brain, is a less gendered term but still reflects a cultural bias. It comes from the Latin word 'pudere', meaning to be ashamed. "I think that says something about the attitude of the male doctors who name these things. No wonder that people feel shame about their genitals … when it's hardwired into us," Dr Taor says. Pudendum has also been a term for genitalia — especially women's. But due to this connection with shame, its use has been curbed. The domination of dead men's names for body parts isn't the only issue; some of them have problematic backgrounds and connections. For example, within your heart is a collection of muscle cells called the bundle of His, named after the Swiss-born anatomist Wilhelm His Jr who discovered it in 1893. And according to Dr Taor: "Every beat of your heart is a memorial to a prominent pre-World War II Berlin doctor who helped legitimise Nazi atrocities." His became the rector of the University of Berlin in the 1920s and was a prominent advocate of eugenics, a pseudoscience involving "cleansing" the gene pool to create a genetically superior race. The Nazis later used eugenics — what they called 'rassenhygiene' or racial hygiene — to justify forced sterilisations, murder and genocide. Then there's John Hunter. He was a superstar Scottish surgeon-anatomist in the 18th century. Hunter's canal in our thigh carries his name. Dr Taor calls Hunter "the father of scientific surgery … one of the most influential surgeons who ever lived". But Hunter was also a keen collector of oddities and a bit "creepy", Dr Taor explains. He infamously stole the body of Charles Byrne, known as the "Irish Giant" for standing 2.31 metres tall, and put him on display. This was very much against Byrne's wishes before he died. Most eponymous anatomical terms also have more technical names. For example, Hunter's canal is also the adductor canal. There has been a shift towards using these terms, but in many cases, the Falloppio and Douglas varieties still dominate medical, and therefore cultural, vernacular. Dr Khot wants a more concerted effort of change, particularly for women's body parts and also if the man in question is a "troubling" figure. "The description of using somebody's name doesn't tell you what the body part is … My view is that we should call things what they are anatomically," she says. As one example, Dr Khot advocates the use of uterine tubes rather than fallopian tubes. And she says similar changes have been made elsewhere in this space, like for various medical conditions that affect women. She points to Stein-Leventhal syndrome, originally named after American gynaecologists Irving Stein and Michael Leventhal, which is now called polycystic ovarian syndrome, also known as PCOS. "I'm not saying we should erase history … The majority of these men did good things. They described anatomy, which has helped us grow science and grow healthcare," Dr Khot says. "But we have more women studying [medicine] and more women doctors … So I think it's time to change the language that we have used."
ABC News
29-05-2025
- Business
- ABC News
Federal Health Minister Mark Butler investigating 'souvenir' ultrasound clinics targeting pregnant women
With a sonographer shortage nationwide a growing number of women are going to have "souvenir scans" on their pregnancies at private enterprises. The scans are designed to offer peace of mind to nervous mothers. They can reveal a baby's gender or provide a memento of the unborn baby in 3D, and sometimes 4D. But many of these scans come with an added cost as unqualified examiners are verbally warning them that there could be a "problem" with their unborn child. Those warnings rarely come with a medical report, but can instil fear in young parents. It is information that has led Federal Health Minister Mark Butler to have his department investigate reassurance clinics and their practices. "I've asked the department to look at this closely," Mr Butler told 7.30. "It's something that's been brought to my attention through this media reporting. "I wasn't aware before that of the opening of these clinics, they're not registering on the the the health system particularly because they're not claiming Medicare benefits, they're not claiming private health insurance payments, they're private non-medical operations. Sonographers are not currently regulated under the Australian Health Practitioner Regulation Agency. This means there's no national competency standard, no recency of practice requirement, no national complaints process or even criminal background checks on sonographers. The practices at the clinics are also causing issues for doctors like Nisha Khot, the president of The Royal Australian and New Zealand College of Obstetricians. Dr Khot says a growing number of her pregnant patients are unknowingly booking in reassurance scans, rather than a medical ultrasound as pat of a recent boom. "There are more and more providers, who actually do these reassurance scans, they may not even do any medical scans at all," Dr Khot told 7.30 "What I have seen is that women will go along to have a reassurance [scan], they will not get a report, but they'll probably be told verbally by the person doing the ultrasound that there is a problem and that problem could be something minor. It could be something major," Dr Khot said. "But there's no report that goes with this ultrasound scan … so I don't know what has been seen. "I don't have the ability to act on what she's telling me." When mother of three Viv Mertikas was pregnant last year, she booked a 20-week medical ultrasound scan with a private ultrasound provider she'd never used before. "The whole process was very rushed, we were in there 5 minutes," she told 7.30. Dr Khot says a time duration that short for a 20-week scan is "suspicious". Not only did Ms Mertikas receive blurry ultrasound images of her son Phoenix, but her doctor was also never sent the medical report she paid for. "I contacted them, and there's no answer. I've left a voicemail and then I keep calling, and I keep calling, and then at my next appointment, I have with an obstetrician, and they've said as well that they have not received the report." She had to get her 20-week scan all over again, which cost her more than $300. Andrew Hewat was a sonographer for more than 30 years in the Geelong region, he says "anyone can pick up an ultrasound" and start operating. The industry wants sonographers regulated under the same umbrella as radiographers. "We think the public deserve to have the safeguards in place and to feel that they have trust in the profession, that they're working to those high standards that you'd expect of AHRPA registered professions," President of the Australasian Sonographers Association, Tony Coles told 7.30. "There's a Medical Radiation Practitioners Board of Australia, and we'd like to see sonographers registered through that board. "That would bring it into line with other medical imaging professions such as radiographers and nuclear medicine technicians who are already registered with AHPRA." Mr Butler said a decision on whether sonographers will be regulated will be made later this year. "We currently have a review underway to see where a range of allied health professions should be brought under the national regulatory scheme for health professionals," he said. "That's due to report to all health ministers over the next couple of months and sonography will be part of that report."
ABC News
12-05-2025
- Health
- ABC News
New Australian guidelines for miscarriage and early pregnancy loss released
Australia's first comprehensive national guidelines for the treatment of early pregnancy loss have been welcomed by women's health experts. The clinical guidelines, developed by the Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG), are designed to provide a benchmark for best practice medical care. "We don't actually have a standard of care for miscarriage in Australia because every health service does something slightly different and every clinician probably does something slightly different," Nisha Khot, obstetrician and president-elect of RANZCOG, said. Early pregnancy loss is common in Australia; it's estimated up to one in four pregnancies end in miscarriage, and more than 100,000 couples are affected by miscarriage every year. The clinical guidelines, published in late April, provide recommendations for the treatment of miscarriage, recurrent miscarriage and ectopic pregnancy up to 14 weeks gestation. Ectopic pregnancy occurs when a fertilised egg implants and grows outside the uterus. Dr Khot said in addition to providing health professionals with up-to-date evidence on the medical and surgical management of pregnancy loss, the guidelines were about ensuring empathy was "central to all the care we provide". Among the recommendations is a new definition of recurrent miscarriage, which was previously defined as a woman having three consecutive miscarriages. "[The new guidelines] have very specifically said that it is two miscarriages and they don't need to be consecutive for women to be able to access further testing to find out the cause," Dr Khot said. Isy Oderberg, co-founder of the Early Pregnancy Loss Coalition, said the guidelines would go a long way to supporting women and families who experience early pregnancy loss. "The time to just tell patients to go home and try again is over," Ms Oderberg said. "We need to offer patients proper care, proper oversight, let them know they're not alone, and not compound any grief they are already feeling with substandard care or a lack of empathy." Ms Oderberg, who had seven miscarriages on her way to having two living children, said miscarriage care varied significantly across the country and often came down to luck. "There are times when you go and seek care and you have an incredible, empathetic, knowledgeable clinician who can give you the right guidance and treat you well, both from a medical point of view but also in terms of empathy," she said. "But there are many, many horror stories. "It varies wildly and it gets worse when the person is from a marginalised or minority group, or if they're in a regional or rural area." Culturally, there has long been a discomfort around early pregnancy loss, she said, which has contributed to poor understanding of patients' needs and how to best support them. "We've seen a lot of doctors be dismissive … because it's just seen as a natural part of the reproductive cycle, which to some extent it is, but that doesn't lessen the grief." A global review of evidence in 2021 found the impact and consequences of miscarriage were "underestimated". It called for a comprehensive overhaul of the medical care and advice offered to women who have miscarriages. The new Australian guidelines recommend that communication with patients is "clear, empathetic and respectful" and that health professionals take care with terminology and use of certain phrases when discussing early pregnancy loss. "If the patient refers to their loss as a baby, [doctors] have to take that lead and refer to it in the same way," Ms Oderberg said. "It compounds a patient's grief if they don't take that lead, and use words like 'spontaneous abortion', which is still commonly used by a lot of doctors." In 2024, the federal government committed $9.5 million to miscarriage support and research, including funding a scoping study for a national miscarriage data collection. Ms Oderberg said it was important to understand where early pregnancy loss occurred, who was most affected, and whether rates were increasing. "The reason we need miscarriage data is because you can't create any sort of health policy without knowing who you're creating it for, where they are, how many people need the service … it's a fundamental plank of any decent policy." The Early Pregnancy Loss Coalition is now hoping to develop a national miscarriage road map, similar to the National Stillbirth Action and Implementation Plan, in order to look long-term at patient pathways, quality of care, and research funding. "A lot of what happens in this space of early pregnancy loss is not well understood because it is not well researched," Dr Khot said. "That is because there hasn't been funding for research in this area." In addition to further research, she said more psychological support was needed for women and families experiencing early pregnancy loss. "Whether that be counselling or mental health support, these are things women should have access to without additional costs." Listen to the full story on Radio National and subscribe to the Health Report podcast for more.
