30th May 2023 (7 Topics)
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Women Health Concern: Curb unnecessary hysterectomies
Context
The Union Health Ministry recently urged State Governments to audit hysterectomy trends in public and private hospitals.
Key Highlights
- A Supreme Court petition claims that women from underserved areas are vulnerable to unwarranted hysterectomies performed for financial gain and exploitation.
- The top Court handed States and Union Territories a three-month deadline last month to execute these Health Ministry directives.
- Women who had needless hysterectomies have had their fundamental rights gravely violated.
What are the criteria for getting a hysterectomy?
- After caesarean births, hysterectomies are the second most common operation among women of reproductive age.
- Hysterectomies should be performed at the latter stages of a woman's reproductive life, or as an emergency intervention.
- Fibroids (growths surrounding the uterus), abnormal uterine bleeding and uterine prolapse, chronic pelvic pain, and premalignant and malignant tumors of the uterus and cervix are all medical reasons for removing a uterus.
- In some situations, oophorectomy, or the removal of the ovaries (the primary source of oestrogen), is also performed, which is a type of surgical menopause and has been related to a number of chronic illnesses.
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NFHS-5 Data: The highest percentage of hysterectomies (51.8%) were to treat excessive menstrual bleeding or pain; 24.94% for fibroids; 24.94% for cysts; 11.08% for uterine disorder or rupture. |
Health Concern:
- Removal of Ovaries: A 2022 review of 29 studies found a correlation between hysterectomy and chronic diseases including an increased risk of cardiovascular events, cancers, depression, metabolic disorders, and dementia.
- In India, hysterectomies in women above 45 years of age were associated with hypertension, high cholesterol, diabetes, and bone disease.
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What measures has the government taken so far?
- Under the Clinical Establishments (Registration and Regulation) Act, 2010, hospitals and healthcare facilities found to have coerced women into hysterectomies without informed consent can be blacklisted.
- Lack of awareness of gynaecological issues: The gap thrives in a culture where gynaecological care and disorders - outside of pregnancy - exist in oblivion.
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NFHS data on hysterectomies
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What about long-term treatment of women?
- Hysterectomies may cause long-term injuries and disabilities, requiring follow-up and post-operative care, both rarely available and affordable.
- In some cases, when hysterectomies are unindicted, women may continue to suffer post-surgery and need additional surgery.
- If they had pelvic pain due to endometriosis, it might not be solved by hysterectomy alone.
What is needed instead?
- Hysterectomies for those under 40 should be conducted on approval by two certified doctors.
- Women in need of treatment may be turned away due to gaps in government-run healthcare.
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