The idea that women need their own separate hospitals once felt noble. It came from a place of wanting to redress centuries of neglect. I understand the impulse. As an obstetrician and gynaecologist I work in these buildings and I have seen the pride that comes with creating spaces designed especially for women. But good intentions do not insulate a system from unintended consequences, and what began as advocacy has in many places hardened into something that feels much more like exclusion.
There is a strangeness to these institutions that one only truly appreciates from the inside. They often sit a short walk from major hospitals yet behave as though they are perched on distant islands. Calling for a specialist opinion that should take minutes somehow becomes a half day of negotiation, with precious hours slipping by. Scans are repeated because systems do not speak to one another. Records live in their own sealed worlds. Even the culture shifts. The place begins to see itself as a self-contained universe, which would be harmless if illness also observed those boundaries. It does not.
Do women’s hospital really offer the best treatment for women?Credit:
Consider a case I encountered last week involving a patient, heavily pregnant and with a history of asthma. She presented for care at a hospital for women but there are no respirologists available. Here we have specialist doctors for the pelvis area, but if you have an issue that involves your liver, your lungs, your heart, your kidneys, we are unable to help you as we have no specialists and none of the equipment to treat patients.
Even though my patient is in desperate need, and staff will do everything they can to try to coordinate care, no doctors from the general hospital will come to see this patient at the women’s hospital. In the end, she will be discharged from one hospital, so she can travel, maybe just 50 metres, to the general hospital for treatment. And once she is treated, she will need to be discharged again and return to the women’s hospital for an induced labor. This is lunacy.
As a clinician, a husband and a father of three daughters, I’m frustrated that women are receiving second-rate care. I’ve worked in a number of different countries in different environments. I’ve seen women who will do anything for the medical care that can save their lives and their unborn child – women who will wade across rivers while in labor – yet in the middle of our very populated cities we’re depriving women of good care for no good reason.
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The irony is glaring. We have abandoned gendered bathrooms in many public places. We pride ourselves on integration, inclusion and the removal of arbitrary barriers. Yet in healthcare we have built an entire parallel structure for women, as though they are somehow too delicate or too different to share the mainstream medical environment. It is a strange, quiet form of segregation, softened by pastel paint and warm slogans, but it is ultimately gender apartheid all the same.
The language around these places remains gentle and reassuring, and I get that many women will say they prefer a gender-specific hospital to respond to their personal needs. But gentleness is no substitute for competence. Women do not stop being whole human beings when they walk into labour wards or gynaecology clinics. They still have hearts that can go into arrhythmia, brains that can bleed, immune systems that can collapse and lungs that can fail. They deserve instant access to the full machinery of modern medicine. That is difficult to deliver when the machinery sits next door but the patient sits in a silo.
Obstetricians Kaushi Arulpragasam and Stephanie Sii with baby Richie Hicks at the Royal Hospital for Women in Randwick, Sydney, in 2021.Credit: Janie Barrett
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