2023-06-28 20:43:09
Perrine Millet, gynecologist, trains caregivers to better identify and manage the medical consequences of violence once morest women. She explains the need to rethink patient follow-up.
Perrine Millet (second from left) during the debate moderated by Flavie Flament following the broadcast of the investigative documentary on gynecological violence. Antoine Flament/M6
Published on June 28, 2023 at 8:05 p.m.
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In the documentary Spread your legs: investigation into gynecological violence, broadcast on Téva on Wednesday June 28, women testify to the trauma of their childbirth. Episiotomies sewn up raw, denial of their dignity… They denounce what others have endured for a long time in silence, and this free speech connects them to a kind of #MeToo of gynecology. Some take part in the debate following this broadcast, moderated by Flavie Flament. Two gynecologists answer them. Joëlle Belaisch-Allart, president of the National College of French Gynecologists and Obstetricians (CNGOF), sticks to a position of “knowledgeable” unfavorable to listening, while Perrine Millet, although of the same generation, develops a point of view much more empathetic.
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A few years from retirement, in 2015, this “somatician” created an interuniversity diploma (DIU) to train caregivers on the medical consequences of violence once morest women. This unique training in France is only delivered in two universities: Paris-Cité (ex-Descartes) and Grenoble. Since 2017, two hundred and fifty caregivers (half of them doctors) have been trained. They are… mostly women. Interview with Perrine Millet, that the injunction “Relax, lady! » always bristled.
When did you become aware that the medical gestures of gynecology and obstetrics might be badly experienced by women?
From my initial training. But it took me a long time to put the word “violence” on it. I remember very well my amazement, when I was an intern, in front of a woman in full labor. She was literally tied up: an infusion on one arm, the blood pressure monitor on the other and the monitoring on her stomach… An aberration! Then there was my experience of medical terminations of pregnancy [IMG, accouchements par voie basse et avant terme d’un enfant non viable, ndlr]. Labor was induced when the uterus was not yet at term. As there were few epidurals at the time, the women suffered terribly… And they were not offered to see their babies. Witnessing this suffering was unbearable. Then, when I moved into the office, I realized how much the gynecological examination posed a serious fundamental problem. My gesture is necessarily intrusive, I tried to make it acceptable, to ensure that my patients were partners in the consultation. I was trying to put them at ease. I invited them to undress only halfway. I was talking to them during pap smears. We are caregivers. Our will is care. But it happens that it hurts, and sometimes it is even experienced as rape.
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Is this feeling very shared?
A very large number of women close completely during the examination: they make a reflex contraction of their perineum. It should alert us and lead us to ask them questions. And then we discover the immensity of the violence committed once morest women. There are so many of them affected! But abuse, incest, modify the reactions of the body. We, gynecologists, are at the forefront. If we are not trained in it, we miss it. We must get out of societal denial. We must recognize the gendered, sexist and systemic nature of violence once morest women.
How is the interuniversity diploma that you created structured?
We start by contextualizing a lot: we give the figures, it helps to raise awareness. We work on the posture: that of the caregiver, that of the patient. We lead to a reflection on unintentional violence, we invite to another care, validated by women. By reflecting on the violence of care, which is an anomaly in relational functioning due to the dominant position of the medical profession, we restore trust. Above all, the idea is not to keep them away from gynecologists: we are at the forefront of screenings. It is therefore up to us to know how to deal with them, being aware that they may have experienced trauma that will make the consultation and our actions extremely problematic. All body care workers must be trained in this.
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