Amy Coopes writes:
The pelvic mesh controversy, ethical dimensions of genetic screening and IVF, Closing the Gap on maternal and infant mortality and improving health care for sex and gender diverse minorities are some of the issues set to take centre-stage at Australia’s largest conference on women’s health next week in Adelaide.
A record 900 delegates will attend the Royal Australian and New Zealand College of Obstetricians and Gynaecologists’ Annual Scientific Meeting, bringing together eminent global and Trans-Tasman thinkers to discuss the latest advances and opportunities in women’s sexual and reproductive health.
Themed ‘Shifting Sands’, the 2018 edition aims to showcase the diversity and breadth of the specialty, which ranges from the care of pregnant women and management of issues like sexual dysfunction, pelvic pain and prolapse through to the “hardcore surgeons” of reproductive cancer, from puberty to post-menopause and beyond, according to RANZCOG conference organiser Professor Gus Dekker.
“It’s a very broad specialty, we have people that go from talking very much about psychological reasons for causes of organ dysfunction in women, all the way towards people who are hardcore surgeons and do primarily gynaecologic cancer surgeries,” he said.
While an exciting field to work in, Dekker – who specialises in high-risk pregnancies – said the scope of obstetrics and gynaecology also made it a complex landscape to navigate, involving midwives and diploma-qualified GPs through to highly skilled foetal and maternal medicine experts: the so-called “shifting sands” of specialisation.
“This conference is really about exploring those boundaries, where you sometimes have to work together, and sometimes refer, and how changes across the journey of your professional career,” he said.
Though maintaining a strong focus on subspecialty research, the 2018 conference aims to meet some of the big challenges for women’s health head-on, with sessions on global maternal health, perinatal mental health, adolescent gynaecology and transgender patient care, and the ethical frontiers of genetic and foetal screening and reproductive technologies.
A plenary on the pelvic mesh scandal recently making Australian and international headlines will also feature in the program, following a damning Senate inquiry into the controversial products and series of class actions against the manufacturers (as reported earlier this year by Croakey).
“The question now is, how are gynaecologists worldwide going to treat all these women who have the mesh?” said Dekker. “We will hear some interesting, controversial presentations on this issue.”
For the first time, RANZCOG will hold its annual Aboriginal and Torres Strait Islander Women’s Health Meeting (ATSIWHM) in conjunction with the ASM, with a mix of technical skills training targeting Aboriginal health workers and workshops for clinicians working in Indigenous communities. There will be sessions on: cultural safety; birthing on country; Ngangkari traditional healers; smoking, diabetes, domestic violence and mental health in pregnancy; premature births; and sexually transmitted infections and screening.
Meriam woman and director of Melbourne University’s Indigenous Health Equity Unit, Professor Kerry Arabena, will deliver the ATSIWHM keynote address on the First 1000 Days Australia project – a multigenerational, pre-birth, interventions-based cohort study of Aboriginal and Torres Strait Islander families, of which she is lead investigator.
Darwin-based obstetrician and gynaecologist and Yadhiagana woman Kiarna Brown will present during the ASM opening plenary on the government’s Closing the Gap strategy and the vital role individual clinicians and the College can play.
“We’ve really tried to have a broad focus on women’s health, looking at the psychosocial context in Australia and beyond,” said Dekker.
Some home truths
Looking inward, the program also hopes to confront some home truths for the specialty, with presentations on burnout and doctors’ mental health from #MH4Docs advocate Geoff Toogood, a session on mandatory reporting to AHPRA, and a talk from former AMA president Michael Gannon on the changing landscape of medical training and challenges of safe hours, work-life balance and technological disruption.
Gender equity is a pressing issue for the College, with 83 percent of trainees now female but men continuing to outrank women in Fellowship positions 52 percent to 48 percent.
Hobart-based obstetrician and gynaecologist Kirsten Connan recently completed a Masters research thesis into gender and leadership within the specialty, examining trends at 98 RANZCOG-affiliated hospitals in Australia and New Zealand and 20 O&G university departments across the two countries. She also surveyed the College membership on the issue, drawing an overwhelming response. Connan will present her findings at the ASM.
“It’s not unique to O&G, and it’s not unique to O&G in Australia and New Zealand, but there’s no doubt that, as we see in almost every other area across organisations and across workforces, women desire leadership,” said Connan. “It’s no less than men, in fact it’s often more than men, and yet women are the ones who can’t achieve or sustain high levels of leadership.”
A passionate advocate for the introduction of quotas, Connan said the medical profession had been slow to recognise the importance of this issue, and given RANZCOG’s unique place in the advocacy of women’s rights and wellbeing, it ought to be driving the debate.
“I think as a women’s health care College we should be leading the way, not following other specialty Colleges in relation to the discussion on gender and leadership,” she said. “And to do that we need to not just talk the talk, but to implement some really practical solutions as to how we can move our College forward to be not just a voice on leadership and gender, but also demonstrate the value of having women in leadership and what that means.”
It wasn’t just women who wanted change, she added, describing a “different kind of cultural era” for trainees where – regardless of gender – people were looking for greater balance between their professional and personal lives.
This was also reflected in a growing social consciousness and desire for the College to look beyond its own agenda, said Connan.
“One of the most exciting things about this conference is it’s looking with such a broad perspective at lots of things that I think many institutions are trying to capture, about the impact of social awareness,” she said.
The RANZCOG ATSIWHM and ASM will be held at the Adelaide Convention Centre from September 15-19, 2018. View the full programs here and here, follow @coopesdetat and @RANZCOG for updates, or join us on the hashtag #RANZCOG18.
• Amy Coopes will cover #ranzcog18 for the Croakey Conference News Service.
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