Medicalisation of Hysterectomy: A Qualitative Inquiry

Abstract

Hysterectomy is a surgical procedure that removes the uterus from the human body and is usually performed as a therapeutic response to gynaecological morbidities among women who have attained menopause. They are of different kinds depending on the intensity, such as partial, complete and radical. In several parts of the world, it is the second most common non-obstetric surgery after C-section. In India, too, hysterectomy has gained significant attention in health policy debates, as media reports highlight a surge in cases, particularly among young, premenopausal women from economically weaker sections, raising concerns over its increased prevalence and psychosocial and economic implications. This study investigates the contexts in which hysterectomies are prescribed by doctors and found that it is prescribed for less severe conditions like heavy menstrual bleeding that could otherwise be managed with oral medication or injections. Theoretically, overdoing of hysterectomy is practised and is conceptualised as an outcome of the societal discourse shaped by biomedical knowledge and practices. This is demonstrated based on the narratives from women who have undergone hysterectomies, supplemented by interviews with the doctors who performed these procedures. Interviews with two senior gynaecologists help triangulate key findings about medical practices followed for gynaecological morbidities and specifically for carrying out hysterectomies. The findings further highlight that the physical and emotional discomfort experienced by women during menstruation and its management and its consequences disrupt their daily activities and interfere with their livelihood opportunities, which in turn persuade several women to opt for hysterectomy as a definitive solution from monthly menstruation management challenges. The study reveals that the institutional, conceptual and interactional medicalisation creates an ecosystem that triggers hysterectomy as a primary medical intervention for a range of menstrual disorders and gynaecological morbidities and is closely linked to women’s everyday experiences and economic concerns.