CT women are ‘ingrained in womanhood to suffer.’ Female lawmakers are pushing to change it

A group of female Connecticut lawmakers, sharing stories of medical treatment, noticed a common thread — pain that was either untreated, normalized or entirely ignored by the health care community.

Experts say it’s a pervasive problem, rooted in generations of gender and racial bias that leads to mistrust, unnecessary suffering, and in the worst cases, death among female patients.

Lawmakers said they are hopeful a conversation with health care practitioners Monday in Hartford will serve as a starting point for future policy to enhance health care education, training and research opportunities to improve patient outcomes.

“There’s a gap in care when it comes to managing women’s pain,” Rep. Rachel Khanna said. “By participating in this forum, we’re shining a light on this problem and changing the conversation. So when women complain of pain, they’re taken seriously and treated properly.”

“I remember being discharged from the hospital because I was having preterm labor and I ended up going back to the hospital that same day in excruciating pain. My pain wasn’t even believed in that moment, and I ended up having my son in my T-shirt,” Rep. Kai Belton said. “As a Black woman who comes from a community that does not trust the health care system for the most part, an early experience like that kind of sets the tone right for the rest of my life.”

Rep. Aimee Berger-Girvalo said she started to go into shock after an “extraordinarily painful attempt at an IUD insertion.” Afterwards, Berger Girvalo said she got into her car, calmed down, and moved on with her day.

“I actually didn’t discuss it with anyone because it has always been my impression that that is just normal. And it wasn’t until my daughter told me that she’d had a very painful procedure that I suddenly went, ‘Oh, well, that’s not okay. That’s not acceptable.’”

“It’s ingrained in womanhood to suffer,” Berger-Girvalo added. “I think we suddenly are coming out of the fog, the nightmare of the expectation that suffering is just our lot in life and ‘Aren’t we so much stronger for it?’”

Rep. Mary Welander said she suffered constant discomfort and pain for 15 years as a result of “very serious health effects” brought about by her three pregnancies.

“It wasn’t until recently that I had two female physicians, a surgeon and my new primary care (doctor), who actually took time to listen to me and said, ‘This is not how your life is supposed to be,’” Welander said. “If I had not had those conversations, then I think I probably would still be suffering.”

Welander underscored the importance of raising expectations in health care and taking personal agency.

“The more that we can have these conversations, especially with our daughters and say, ‘You should expect to be listened to. It shouldn’t be the novelty that someone listens to you,’” Welander said.

Welander said that “clinicians need to know that that expectation is changing too.”

“They are going to be encountering patients who are going to say, ‘I want my time. I want the attention, and I want to be treated like a human being.’ And it shouldn’t sound like a novel action, but I think this (conversation) is the beginning of it,” Welander said.

Sarah Gantley, an APRN in obstetrics and gynecology said that at the same time, providers need to recognize that many patients will not feel comfortable self-advocating.

“While I love encouraging my patients to speak up for themselves, I think that that’s not something that we can expect of everybody,” Gantley said. “(For) a whole, huge, decent population of people, that’s not something that they are able to do or feel safe doing.”

Gantley said this can include people who speak English as a second language and groups that have been marginalized by the medical community, like people of color, LGBTQ+ patients, and women in general.

Gantley said that other patients lack access to pain control because they lack transportation, time off from work or child care, which can preclude practitioners from prescribing pain medicine.

Gantley stressed the need for more patient advocates, care coordinators and insurance coverage for transportation to break down some of these barriers.

“I think our entire health care system needs an entire overhaul, but I know that that’s not going to be accomplished in the very near future,” Gantley said. “But I think on a very basic level, we need to make sure that we are giving people the tools.”

Lawmakers and health care professionals discussed the possibility of incentivizing training and research through legislative funding and assessing current re-education mandates for practitioners to identify areas where the state could require training that would address the pervasive inequities in pain management.

Other health care experts emphasized the importance of dismantling traditionally white heteronormative patriarchal systems and building practices that center on patient experiences and uplift marginalized communities.

“There’s this idea that if you center the marginalized, then everybody gets great care,” Dr. Nancy Stanwood, a board-certified obstetrician-gynecologist who serves as the chief medical officer Planned Parenthood of Southern New England. “If I can create a system where somebody with the fewest resources and who feels most disenfranchised from medicine feels able and safe to come and get care with us, then I’ve made it better for everybody.”