"Gynaecology is not trauma informed"

About: Ninewells Hospital / Gynaecology

(as a service user),

I am a young woman who has long-term problems with stress incontinence. 

As a person, but also as a survivor of childhood sexual abuse, it took a lot for me to disclose this, and to seek help with it. 

I initially got help from physiotherapy (pelvic floor exercises etc.) The physiotherapist was excellent and I cannot praise her enough. 

The problem improved to a degree, but further help was needed and in time, I was referred to gynaecology. 

Long waiting list, but that's fine, and to be expected. 

I then got an appointment with a male gyanecologist, which I rung up to change, and was given an appointment with a female some months later. The physiotherapist confirmed that the first thing she said at the top of her letter was that I should be seen by a female. 

When that appointment came around, the female gyanecologist was very good and supportive, and provided trauma informed support. I have no issues there at all. 

It is the system rather than the individual gyaecologist which is not trauma informed. 

I had an incontinence dish fitted, and was told that I would be given an appointment in six months time so the gynecologist could then remove it, clean it and re-insert it. (Appointment I actually received was in 7.5 months time, not 6, and I don't know if this means that the incontinence dish would be in longer than it should, but they're stretched so it's fine). 

I was told though that if there are any problems to get in touch. 

At the time of this incontinence dish I had a chest infection and was coughing really badly constantly. It was immediately clear to me on leaving the clinic that the issue was still there. That night, I soaked through two pads and my trousers, twice, soaking the sofa also. 

I could feel with my finger that the incontinence dish was very low down, and I tried to put it back up, but couldn't. It seemed to be out of place, and the incontinence problem seemed worse than ever, but with the incontinence dish stuck inside I no longer even had the option of inserting a different more short-term device that I had used previously, that had helped. 

As I had been advised to get in touch if there were any issues, I rung the number I'd been given, the day after it was fitted, but was told that there were no gynecologists available, to ring up the next day instead. They did not take any details from me, or offer to arrange for someone to call me back. 

I did go into avoidance mode for a few weeks, as I found it all really difficult to deal with. 

In the meantime, I got a letter summarising the details of my appointment where the dish was fitted, and it had my gynecologist's office details to get in touch if needed. 

A couple of weeks afterwards I worked myself up to ringing her office, and I left a voicemail on the PA's phone, but no one got back in touch. 

10 days later, I rung again, and reached a really lovely lady who was picking up calls. She was very understanding, and advised me that she would send an urgent email to the gynecologist and ask for someone to get in touch. I said that I would take an appointment with any gynecologist, not just my own (although obviously ideally female, and would be flexible to attend any cancellations etc if they came up, The staff member advised me that she would pass this on, and to get in touch directly with her a week later, and she gave me her direct number for this. 

A week passed and I heard nothing, so I called back. She advised that she had not heard anything, but that her colleague may have done, for me to call back in a few days when her colleague was back in the office. 

At this point, I was becoming so frustrated and distressed by the difficulties getting someone to even call me back, never mind actually help me deal with the issue. In the meantime, I would try to remove the incontinence dish, but would get really distressed, and I was living with the issue of my stress incontinence being as bad as it ever was, and all the stress, discomfort and anxiety that that involves.   

I rang the main appointments line, to see if there was any way they could help. I was given an appointment for weeks later, although when I did say about how much I would be struggling in the meantime, the receptionist said that she would put me through to the gynae assessment unit, who may be able to provide advice. I thought I was being put through in case they could provide advice, but when put through they asked me what was the problem, asked if I was in any physical pain, and said they were an emergency service, and could only help if I was in physical pain. 

I explained that I understood that they prioritise those in physical pain, and that that is how they define an emergency, but that I at least wanted them to try to understand, that although I am not in physical pain, this is causing me a lot of distress, and greatly impacting on my life. I cannot remember if I specifically stated that particularly as a sexual abuse survivor, the mental distress caused is surely as relevant, but I do know that it absolutely should not be this hard. She said that she was going to put me through to a third person who would get me a sooner appointment. When she tried to transfer me, the line went dead. 

I hoped they would call me back, as they had my number, and it surely made more sense for them to call me back, rather than me calling them, as I had been transferred a couple of times, and wasn't sure who I was speaking to. I have not heard anything from them since. 

I have now managed to get an appointment with a nurse at my GP practice, who said she will try to remove the incontinence dish for me. 

I have cancelled all subsequent appointments with gynaecology, as I honestly cannot deal with the stress of trying to navigate their systems, and although the one time I actually saw a gynecologist she was nice, and was trauma informed, it feels to me like the whole system beyond that is such a nightmare, that any sense of trust or safety in them is gone. 

So I am now back to square one, with the problem as bad as it ever was, but with no way to get help with this, and it feels like it's just a problem I'll be stuck with for life, and it feels so unfair, and I find it really hard to deal with emotionally. 

My biggest piece of feedback is to please not tell people to get back in touch if there is a problem, if your systems then make it next to impossible to get in touch with you. 

And when someone is sobbing down the phone to you about the amount of distress the problem is causing them, please do not trivialise that just because it's not physically painful. 

And no where was anyone apologising for the fact that despite being told to get in touch if there was a problem, that I have spent weeks trying to get in touch with them, and all I have had is unanswered voicemails, messages not returned etc. 

Services should not be this difficult to navigate, and people should be treated better, particularly with such a sensitive and emotionally triggering issue as this.