In severe abdominal pain, Chelsi and Zoe went to an emergency department. They say they didn't get the care they needed

Several women have spoken to the ABC about negative interactions with the ACT's healthcare system where they felt their pain was dismissed and they received sub-optimal care.

One expert says such experiences are not uncommon and women's pain has historically been minimised, with sufferers seen as "hysterical" and told their pain is psychological.

What's next?

The territory's health minister acknowledges medical misogyny is a problem and says work is underway to address it.

At 19-years-old, bleeding heavily, unable to walk properly and experiencing severe abdominal pain, Chelsi Parker assumed the emergency department was the best place for her to go.

Instead, Ms Parker was told she had an infection and was sent home with medicine to control the bleeding — but not before being told the pain she was in was symptomatic of being a woman.

"They refused to give me an ultrasound and told me it was 'just women's things'", she said.

"I was told that, I'm a woman [and] this happens when it comes to menstruation and everything like that."

"It was just kind of, 'Go home, rest up and you'll be fine in a few days'."

Except Ms Parker wasn't fine after a few days.

So, still in pain, Ms Parker sought a second opinion from her GP, who she said was able to get her a referral for an ultrasound.

While waiting for an appointment, Ms Parker went back to the emergency department with more bleeding and more severe abdominal pain.

She said she was told her inf`ection levels had spiked, but again was sent home.

By the time she was able to get her ultrasound at the end of the week, it transpired she had pelvic inflammatory disease, a condition which meant she needed "round-the-clock antibiotic care" and a follow-up surgery.

As well as the lasting physical damage, Ms Parker said she was now much less trusting of the hospital, and of her own pain.

"Since then, I think I always push things a bit further than I need to because I'm gaslighting myself like, 'Oh, it's not that bad. I can push through'," she said.

Ms Parker has also been left with potentially permanent fertility problems, something she is still angry about around half a decade after her experience.

"I know that my fallopian tubes will forever be scarred," she said.

"They won't go back to normal. [The] risk of not being able to get pregnant is a big thing."

Pain not 'treated as an emergency'

Zoe, who the ABC has given a pseudonym on request, experienced a similar scenario when she attended the emergency department at North Canberra Hospital earlier this year.

A chronic pain sufferer, Zoe went to the hospital experiencing severe pain in her stomach as well as uncontrollable diarrhoea and vomiting.

She had already been diagnosed with gallstones and was on a waitlist to have them removed in the private health system.

The first time Zoe went to the hospital in this kind of distress she was cared for and given pain relief and monitored in a bed.

But when it flared up again, the experience was totally different.

"I was told I was constipated and wasn't going to get any painkillers and to go home," she said.

"And I said: 'Well, I'm not constipated and I actually have diarrhoea'.

"They said: 'Oh, no, you can be constipated and have diarrhoea at the same time."

Zoe also feels as though the level of pain she was experiencing was not taken seriously and she felt as though she was treated like a "drug addict".

"It [was] very upsetting because you don't go to hospital because you want to, you go because you need help," she explained.

"It's quite devastating, like you're there for help and they won't give it to you."

Zoe lives with a condition called complex regional pain syndrome.

Going to an emergency department when her pain is out of control is part of her pain management plan.

But she worries the emergency department is not always the best place for treating injuries that can't be seen.

"I don't believe they treat pain as an emergency," she explained.

"I think unless you have something that they can actually see that's wrong with you, you're not really treated by [them]."

Zoe said she had also been repeatedly questioned about whether her pain was real or was related to a mental health condition during some of her hospital visits.

Both women were keen to stress that not all of their experiences seeking healthcare have been negative.

Canberra Health Services declined the ABC's interview request.

A spokesperson said emergency departments "prioritise compassionate care for all individuals experiencing pain".

Our emergency departments teams have worked collaboratively on a cross-territory approach to pelvic pain to ensure we have a consistent approach to treating women presenting with conditions such as endometriosis.

We have an established pelvic pain pathway, and our approach has a strong focus on quality of life.

Our training covers many women's health topics including pregnancy complications, early pregnancy loss, dysfunctional uterine bleeding, pelvic pain, ovarian cysts and endometriosis. — Canberra Health Services

Research shows women receive 'sub-optimal' care

Dr Jane Chalmers, a pain science expert at the University of South Australia, said there had long been a culture or stereotype around women in pain being "hysterical".

She said there was specific stigma around women who were experiencing pain in the abdomen and pelvis.

"[That is], any pain that occurs in the abdomen or the pelvis . is considered normal pain for women," Dr Chalmers explained.

"You know, it's just a woman's lot in life, it's what women go through."

She said women were also more likely to have to wait longer than men for treatment for pain at emergency departments.

"We know that women are repeatedly asking for help from our healthcare system, from healthcare professionals and they're repeatedly being told that their pain is normal. It's just not true," Dr Chalmers said.

Women are also more likely to be prescribed antidepressants than men, which Dr Chalmers said had "underlying tones" that their pain was "in their head".

"We know that's not true, pain is pain, regardless of whether there's a physical cause that we can identify or not," she said.

Dr Chalmers said increasing awareness about the issue would help, as would education.

But above all, she urged "validation".

"We know that when women's stories are listened to, when they're validated, when their experience of pain is shared and listened to and believed, we know that their health outcomes are better," she said.

Growing moves to address medical misogyny

Multiple state and federal inquiries are currently looking at what exactly can be done.

A recent survey of 3,000 women around the country found two-thirds had experienced medical misogyny.

That was part of work launched by the assistant minister for health and aged care, Ged Kearney, who announced in 2022 that the federal government would be establishing a National Women's Health Advisory Council to address gender bias in health care across Australia.

ACT Health Minister Rachel Stephen-Smith acknowledged there was a growing awareness of medical misogyny across the healthcare system and said the territory would take heed of the findings from the federal inquiry in particular.

Ms Stephen-Smith apologised to anyone who'd had a negative experience seeking health care in the ACT.

"Right across our health system, there is a growing understanding of what is known as medical misogyny and the experiences of women who have had . their pain dismissed or their illness minimised or being misdiagnosed as having a mental health condition when there was a genuine physical condition going on," she said.

Ms Stephen-Smith pointed to work already underway to improve treatment and care at Canberra Health Services, including the establishment of a "pelvic pain pathway".

She said that meant a "clear understanding" of what should occur when someone presented to the hospital experiencing pelvic pain.

Ms Stephen-Smith said the Canberra Endometriosis Centre, as well as the pelvic pain and endometriosis clinic at the Sexual Health and Family Planning Centre, were additional resources that could help those in pain.

Within the clinical system, Ms Stephen-Smith said the governance committee was specifically looking into the issue of women's health and ensuring care was evidence based.

The ACT does not have a plan to hold its own inquiry, Ms Stephen-Smith said.

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