Body Image Issues in Obstetrics
LESLIE J. HEINBERG
ANGELA S. GUARDA
Obstetrics and gynecology (OB/GYN) are medical specialties that address women's reproductive and sexual functioning. Because yearly pelvic and breast examinations are recommended for all women of reproductive age, gynecologists are the most regular providers of women's health care. For sexually active women, contraception, sexually transmitted diseases, and obstetric care also result in frequent OB/GYN visits. These necessary visits are often experienced as anxiety-provoking events, associated with feelings of embarrassment, humiliation, vulnerability, discomfort, or shame. Body image discomfort is especially relevant during the gynecological exam, given its focus on breasts and genitalia, body areas that women are socialized from childhood to consider private and intimate. Associated thoughts, feelings, and behaviors may activate negative body image schemas, and apprehension about gynecological examinations may result from the vulnerability and loss of dignity inherent in the lithotomy (feet in stirrups) position. Gynecological and obstetrical exams also involve assessing weight, which makes the majority of women anxious. Indeed, Ogden and Evans found that mislabeling normal-weight women as overweight resulted in a drop in mood and self-esteem.
Women may avoid important preventive care and treatment because of these body image concerns as well as fears of cancer, sexually transmitted diseases, infertility, and moral judgments. Conversely, because of the intimacy and regular frequency of exams, women may have a closer rapport with their OB/GYN than with other health-care providers and be more