SEMINAR TRAINING FOR CONTRACEPTIVE CARE – THE PHYSICAL EXAMINATION (CONCLUSION)
In the seminar doctors learn how important it is to identify and pay tribute to the specific body fantasy. One young woman, unable to make love since the birth of her last baby three years before, had already had two reconstructive operations to her perineum. She described her sense that each time she was stitched up the hole got smaller, ‘like cobbling up a hole in a stocking. If I had six children there would be no hole left’.
The moment of physical examination can be a time when deep feelings are shared. Such feelings include anger and grief, and it is surprising how much bereavement work goes on in the family planning consultation. The losses of miscarriage and termination might be expected, but it is not unusual for a patient to share such anguishes as the death of a parent. The moment of physical examination may trigger renewed grieving, as has been described previously (Montford, 1992).
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