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What did you discuss with your healthcare provider at your last OB-Gyn appointment?

Hard truth – there’s a good chance your answer depends on your skin color.

The disturbing statistics about increased COVID risks for people of color shed much needed light on systemic injustice in our healthcare system; but you may not realize the problem extends to almost every facet of women’s health, from yearly check-ups to frightening mortality rates in pregnancy and childbirth. A recent survey of nearly 1,700 white and black, non-Hispanic women aged 18-49 pulls back the exam room curtain, indicating a double standard that often leaves women of color underserved and medically vulnerable to several risks.

Black survey participants were significantly more likely than their white counterparts to have had an office visit within the previous year, and more of them discussed their sexual health and behaviors during the appointment. But although all women have the same baseline female health concerns, survey responses show those conversations took markedly different turns.

Black women were more likely than white women to be asked about sexual behaviors (especially number of partners) vs. health concerns, more likely to be offered STD tests, and more likely to be recommended and offered condoms than a prescription for more reliable forms of birth control. A high number of black respondents reported specific instances of racial bias in their conversations with their provider, including brushing off pain and other medical concerns, shaming, and reinforcement of negative racial stereotypes.

It’s easy to understand how an interaction like that could negatively influence any woman’s decision to disclose important information during future visits, or even discourage her from returning at all. But the dangers aren’t just anecdotal. Consider these examples from other recent studies:

*Both missed diagnoses and missed wellness or prenatal visits regularly contribute to severe medical crises, from reproductive cancers to pregnancy related deaths; and several studies confirm black women are 2-6 times more likely than white women to die from complications of pregnancy.

*Lack of in-office education about and access to the most reliable birth control methods contributes to the higher number of unplanned pregnancies among black women.

*Doctors ignore or misdiagnose painful sex concerns for all women, making the topic difficult for the majority of them to discuss in the office; but 17% of women of color experience longer duration of pain during sex, which makes that conversation all the more crucial.

Although additional factors (many of which involve other systemic injustices) complicate these issues, researchers agree it is impossible to ignore the correlation between negative interactions with providers and serious health risks for women of color.

Those conversations need to change; and as the founding owner of Femina PT, it’s my pledge to help make that happen.

I chose to specialize in women’s health physical therapy because I wanted to help treat women’s bodies; but I learned quickly that education and advocacy were crucial to that mission. I’ve seen firsthand how shame and stigma from providers and the public contributes to real medical consequences for my patients. I’ve dedicated my career to speaking out against medical injustice; and I’ve spent more than a decade making sure my own practice measures up to those ideals.

At Femina PT, every woman will receive the highest standard of care – personalized to their history and concerns, guided by the most current and reputable scientific research in our field, and delivered with compassion and respect for their stories. That commitment goes beyond patient interactions to my hiring practices, my public education forums, and my discussions with fellow medical professionals.

If Black Lives Matter – and they do – there is no better arena than women’s healthcare to shatter the status quo. It is our privilege to serve women of color with women’s health physical therapy, or with referrals to other specialists in our network of trusted providers.

Citations

Townes A., Rosenberg M., Guerra-Reyes L., et al 2020. Inequitable Experiences Between Black and White Women Discussing Sexual Health With Healthcare Providers: Findings From A U.S. Probability Sample. The Journal Of Sexual Medicine online, April 30, 2020 1-9.

Townes A., Herbenick D., Carter A., 2019. Painful Sex Among White And Black Women In The United States: Results From A Nationally Representative Survey. The Journal Of Sexual Medicine 16:S1-S49 26

Flanders-Stephans M. Alarming Racial Differences in Maternal Mortality. 2000 The Journal Of Perinatal Education. 09:02 50-51.

“Racial And Ethnic Disparities Continue in Pregnancy-Related Deaths”. Centers for Disease Control and Prevention, 5 Sept 2019.

What Our Patients Have to Say

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Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

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