Overused and Underinformed: The Secrets of the Hysterectomy in the U.S.

Amie Newman

Are hundreds of thousands of women in the U.S. undergoing unnecessary hysterectomies without proper informed consent? Women's health advocate, Rep. Carolyn Maloney says possibly.

Updated 5/20/2010, 2:15pm EST: A point of clarification, for the record, from Mrs. Maloney’s legislative office: Congresswoman Maloney is not contemplating introducing a bill and, in fact, in response to a question from an audience member during the forum, made clear that she is considering looking into if GAO can do a study, not legislation. Indeed, she doesn’t like the idea of Congress mandating that a particular video should be shown prior to any medical procedure. Nonetheless, in 1978 and 1993, Congressional hearings highlighted the issue of unnecessary hysterectomies, and Congress does have a role to play in investigating the reasons why so many women are being encouraged to undergo hysterectomies when less invasive alternatives are often available, particularly since they can have a negative impact on women’s health.

Rep. Carolyn Maloney is wondering why people aren’t more outraged. Hundreds of thousands of women undergo hysterectomies in this country every year, but many don’t fully understand the extent to which this surgery will impact their health and lives. As a consequence, the Manhattan Democrat, according to an article in Womens eNews today, “Maloney Mulls GAO Study on Hysterectomy,” is on a mission to figure out whether or not mandating informed consent, by watching a video about the adverse effects prior to having a hysterectomy, is feasible.

It started when Maloney considered undergoing a hysterectomy herself but then was, according to the article, persuaded not to by friends who were women’s health advocates.

Why?

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According to the HERS Foundation, a nonprofit organization which provides information about the alternatives to – and consequences of – hysterectomies and which held the event where Maloney spoke about this issue recently, the effects of a hysterectomy’s damage are “lifelong” and 98 percent of women who have the surgery do not, in fact, need the surgery.

In addition, according to an ongoing study led by HERS,  

“99.7% percent of women…were given little or no prior information about the acknowledged adverse effects of hysterectomy — information that is a legal requisite of consent.”

Because of this, the HERS Foundation has created a video that they want women to view prior to the surgery taking place. Writes Cerra Whittelsey in Womens eNews:

About 600,000 American women undergo hysterectomies every year. Rarely do they hear anything from their doctors about adverse effects other than the inability to have more children, said Nora Coffey, founder of HERS, during an interview.

Many people are not aware that there are different types of hysterectomies which can involve the removal of not just the uterus, but may also involve the removal of the cervix, ovaries and/or upper part of the vagina. HERS says some types of hysterectomies are considered “castration” and clearly some women who have been through the various procedures agree.

This is drastic surgery and from all available evidence women do not seem to be fully informed of the drastic consequences. From urinary incontinence to loss of sexual desire to an increase in the risk of heart disease and osteoporosis, the list of after effects of a hysterectomy is a long one.

Indiana’s House of Representatives held a hearing on the issue after one of their representatives, Rep. Borders, spoke up about his own wife’s hysterectomy, the unexpectedly debilitating impacts and the subsequent decision that they were lied to about her need for the surgery. Borders has been a vocal advocate for informed consent prior to hysterectomies in his own state.

The full Womens eNews article is here and worth a read.

In case you’re not convinced that this should be a priority for women’s health advocates, the performance of a hysterectomy, according to the Department of Health and Human Services, is the second most common surgery for women in the U.S. And, by the way – the first? Cesarean sections. So, not only are hysterectomies and c-sections the most common surgeries for women in this country, but there is now growing evidence that they are two of the most overused.

I’d say it’s time for a reality check amongst womens’ health advocates. Understanding that the medical establishment is being allowed to persuade women that we “need” these invasive – incredibly invasive – surgeries related to our reproductive and sexual health should lead us to swift and concrete action.

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