Despite the United States being one of the most developed countries in the world, we are living in a political climate where a woman’s bodily autonomy and access to healthcare are not guaranteed in the same way that a man’s is. With over 35% of counties in our country living in maternity care deserts as of 2024, and the overturning of Roe v. Wade in 2022, a huge portion of our population is put in a vulnerable and unjust situation. This is only perpetuated by a lack of education on the female body and a resistance to allowing grown women to make decisions about their own bodies.
Women’s healthcare is severely lacking in comparison to the care that is offered to men. Throughout history, women have been excluded from medical research and clinical trials, which has only deepened the roots of this misogyny. This exclusion partially stems from the idea that women’s complex hormonal systems and menstrual cycles allow for too many variables that could compromise study results. Consequently, modern-day medical professionals now lack much knowledge about the female body and, in turn, how certain medications and treatments may affect it. “It’s decades and decades of lost information that we now have to backtrack and try to gather,” says Dr. Mary Afsari-Howard, board-certified obstetrician-gynecologist (OB-GYN) and the founder of FemForward, a mobile health clinic that offers medical services out of an RV.
Because of these shortcomings in the medical field, doctors often misdiagnose the issues that women experience. “For example, … women’s hearts are smaller [than men’s], and the signs of heart attack are different [from] the ‘classic’ ones we learn about,” says Marieke Bigg, the author of “This Won’t Hurt: How Medicine Fails Women.” “Studies have been done where women have reported the same symptoms as men but have been diagnosed with anxiety rather than a heart attack, or [their symptoms] have been misinterpreted as symptoms of menopause rather than a heart attack,” adds Bigg.
Aside from misdiagnoses, doctors often blatantly dismiss female patients’ concerns. Endometriosis is a prime example of how women’s pain is rarely taken seriously in medical environments. “Endometriosis [is] an actual physical disease … [of] tissue growth … all around your uterus [and] around your ovaries … [which] causes severe pain,” explains Afsari-Howard. “Most people [with endometriosis] tell me they go to multiple doctors, they go to the emergency room, and they’re pretty much dismissed. They’re given ibuprofen [and] told period pain is normal.” About 15% of women have endometriosis, but getting diagnosed with it is extremely hard due to the dismissal and invalidation that most people experience when relaying their symptoms to a doctor.
Bigg recalls the story of a young woman she once met who had recently had a child: “[She] struggled with endometriosis since her periods started. Every month she would just be in excruciating pain and she couldn’t get a diagnosis — no one would believe her that her pain was excruciating, to the extent that she [started] to doubt herself. Only when she gave birth, [did she realize] how bad her endometriosis had been, [describing it as] ten times more painful than childbirth.” It takes, on average, eight years to be diagnosed with endometriosis — eight entire years from the initial time a patient tells their doctor that they are in pain to the time they are diagnosed with the condition.
Access to care is also a huge issue for women nationwide. There are many places in the country where there are no doctors who specialize in caring for women. “Almost half of the counties in the U.S. actually don’t have an OB-GYN,” says Afsari-Howard. “There are places in this country where women [cannot] access care … without driving for five [or] sometimes ten hours.” This issue is only becoming more prevalent as the restrictions on women’s care tighten and doctors become fearful of facing legal liability, such as license revocation or even criminal charges, for simply treating a patient. “Almost 30% of [Idaho’s] OB-GYNs left the state after the abortion bans were implemented, so that is a third of doctors that were serving women in [the] state [that] are now gone.”
These issues however, don’t affect everyone equally across the board. Inherent racism in medicine practiced in this country has led to one of the highest maternal morbidity/mortality rates for black and brown women within all first world countries. “Black women have three to four times higher risk of dying from pregnancy related causes than white women … and Native American and Alaskan Native women [have] two to three [times higher risk], and these disparities persist regardless of income or education,” Afsari-Howard says. “[Aside from pregnancy] we also see [these disparities] when it comes to heart disease in women, gynecologic cancers in women, and access to things like abortion and contraception [for] Black, Latina and Native women.”
Additionally, socioeconomic status plays a huge role in access to care for all Americans— insurance issues can limit the care that a patient is able to receive if providers don’t take their insurance and they cannot pay out of pocket. According to KFF Health News, “Health coverage plays a major role in enabling people to access health care and protecting families from high medical costs. There have been longstanding racial and ethnic disparities in health coverage that contribute to disparities in health.”
While medical care for women has improved in the past couple of decades, especially in areas like consent and trauma informed care, we still have a long way to go. The hope as of now, is that we are in the midst of a step back, right before the two steps forward. To ensure progress, medical clinics and doctors should be working towards ensuring that interpreting services are available in order to effectively communicate with patients, as well as making sure patients know about doctor-patient confidentiality. Allowing patients to explain their symptoms and medical history by asking open-ended questions so that the provider gets the whole picture and the patient feels listened to is also essential. In terms of advocating for yourself, it is important that you ask questions and play an active role within your own health care. Knowing your own body and staying firm in your experiences is vital — no one, especially medical professionals, should be invalidating what you know to be true of your own experience or trying to dictate what you should do with your body. “[Don’t] be afraid to speak up for your own sense of bodily autonomy. You have a right to freedom in your body,” says Afsari-Howard.
