GUEST EDITORIAL
Bleeding Disorders in Women: Let’s Talk Diane Francoeur, MD, FRCSC President, Society of Obstetricians and Gynaecologists of Canada
I
t is a great honour to assume the role of SOGC president. I hope that I will be successful in representing our diverse membership and in advocating for women’s health in our country. Each year, the president of the SOGC selects a specific theme that he or she will advocate throughout the year. In choosing the focus of my presidential term, I decided to share with SOGC members my passion for the issue of hemostasis problems among women. Bleeding disorders, and the consequences, can affect all of our patients, whether our work is in obstetrics, gynaecology, nursing, or midwifery. I believe that in looking at this particular issue we will find many commonalities that will bring us together and exemplify the benefits of multidisciplinary collaboration, as well as the importance of providing quality care. For each patient with a bleeding disorder, we need a team, working together to ensure that all precautions are taken. We need nurses, confidantes extraordinaire, to guide young women who are wondering whether they are normal. We need family physicians who know the family history of those young women and who will refer them to us before their first menses. As family physicians frequently act as first line emergency responders, they can help us respond rapidly when a hemorrhage occurs, and thus avert transfusions. We need midwives who are knowledgeable about hemostasis, to ensure women at increased risk of hemorrhage do not give birth at home without preparation. We need gynaecologists who embrace other treatment options besides surgery and hormone therapy to manage menorrhagia and improve women’s quality of life. We also need obstetricians and maternal–fetal medicine specialists who can put together safe management protocols for women with rare and complex disorders, and anticipate the immediate management of the newborn when necessary. Also, multidisciplinary collaboration with anaesthesiologists, pediatricians, pharmacists, internists, and psychologists adds inestimable value to the management of these difficult cases.
Every one of us has an important role to play. The benefits of multidisciplinary collaboration are enormous. Such collaboration not only provides better care for our patients but also serves to improve our working environment and lessen our workload. With trusted colleagues working together, we can do much more for the patients we treat. Ensuring that every patient receives quality care is at the heart of our Society. It is what drives us to produce, update, and disseminate clinical guidelines that reflect the latest evidence-based knowledge available. It is the reason we advocate for women’s reproductive rights and government attention to shortages of health care workers. It is what motivates us to provide easy-to-read, comprehensive public education materials, allowing each patient to have the information necessary to make an informed decision. It is the basis for continued research, evaluation, and innovation. However, we can push quality care further. Every day, with every case, we must find ways to improve the services we provide and the work we do. In cases that centre on hemostasis, we are reminded how vital diagnostic assessments and early management are. The delay before the establishment of a precise diagnosis can reach 16 years when family history is unavailable. Improving the way we gather information during our first consultations with these young women will allow us to reduce the number of blood transfusions needed, to better prepare patients when it becomes necessary to perform a surgical procedure that may cause complications, and to improve quality of life for women as soon as their menses begin. This is only one of the ways in which we can approach the issue of hemostasis to ensure that affected women enjoy the same quality of life as everyone else, across the country. I hope that throughout my presidential term, we can share stories and ideas and look at other ways in which we can
J Obstet Gynaecol Can 2014;36(9):761–762
SEPTEMBER JOGC SEPTEMBRE 2014 l 761
GUEST Editorial
make improvements for the group of women affected by bleeding disorders. I have already had some ideas, although I am quickly realizing that it is easy to be too ambitious for a term that lasts only one year. I do hope, however, that we can review our clinical guidelines and provide informative sessions at our continuing medical education events to ensure that health professionals are prepared and knowledgeable about diagnosis, counselling, and treatment practices for women dealing with various types of bleeding disorders. We should also make sure that our public education materials include the necessary information for women to know that these disorders exist, and where and when to seek help. We should strive to further examine the social and cultural beliefs about menstruation so we can improve our delivery of services to the culturally diverse populations we work with here in Canada and around the world. We should advocate for equal access to diagnostic and treatment services for Canada’s First Nations, Inuit, and Métis women.
762 l SEPTEMBER JOGC SEPTEMBRE 2014
Much more can be done to support physicians, midwives, and other health workers in rural and remote communities, to connect them with specialists via telehealth. And we should work to build strong partnerships between disciplines within the institutions at the local level where we work, but also nationally, among our sister associations. Oh yes, and one more thing . . . we should all donate blood. Because even though we do our best, we will always be in need of blood reserves to save women’s lives. You know it. We will be very busy over the next few months, but thanks to your enthusiasm and your participation, it will be a great year for group learning, which will showcase multidisciplinary collaboration and the improvement of quality of care. I am very excited about the year ahead—I hope that, with your help, I can make a difference for our practices, for ourselves, and for our patients. I thank you for your support, and I look forward to working with you towards these goals.
Bleeding Disorders in Women: Let’s Talk Diane Francoeur, MD, FRCSC President, Society of Obstetricians and Gynaecologists of Canada
I
t is a great honour to assume the role of SOGC president. I hope that I will be successful in representing our diverse membership and in advocating for women’s health in our country. Each year, the president of the SOGC selects a specific theme that he or she will advocate throughout the year. In choosing the focus of my presidential term, I decided to share with SOGC members my passion for the issue of hemostasis problems among women. Bleeding disorders, and the consequences, can affect all of our patients, whether our work is in obstetrics, gynaecology, nursing, or midwifery. I believe that in looking at this particular issue we will find many commonalities that will bring us together and exemplify the benefits of multidisciplinary collaboration, as well as the importance of providing quality care. For each patient with a bleeding disorder, we need a team, working together to ensure that all precautions are taken. We need nurses, confidantes extraordinaire, to guide young women who are wondering whether they are normal. We need family physicians who know the family history of those young women and who will refer them to us before their first menses. As family physicians frequently act as first line emergency responders, they can help us respond rapidly when a hemorrhage occurs, and thus avert transfusions. We need midwives who are knowledgeable about hemostasis, to ensure women at increased risk of hemorrhage do not give birth at home without preparation. We need gynaecologists who embrace other treatment options besides surgery and hormone therapy to manage menorrhagia and improve women’s quality of life. We also need obstetricians and maternal–fetal medicine specialists who can put together safe management protocols for women with rare and complex disorders, and anticipate the immediate management of the newborn when necessary. Also, multidisciplinary collaboration with anaesthesiologists, pediatricians, pharmacists, internists, and psychologists adds inestimable value to the management of these difficult cases.
Every one of us has an important role to play. The benefits of multidisciplinary collaboration are enormous. Such collaboration not only provides better care for our patients but also serves to improve our working environment and lessen our workload. With trusted colleagues working together, we can do much more for the patients we treat. Ensuring that every patient receives quality care is at the heart of our Society. It is what drives us to produce, update, and disseminate clinical guidelines that reflect the latest evidence-based knowledge available. It is the reason we advocate for women’s reproductive rights and government attention to shortages of health care workers. It is what motivates us to provide easy-to-read, comprehensive public education materials, allowing each patient to have the information necessary to make an informed decision. It is the basis for continued research, evaluation, and innovation. However, we can push quality care further. Every day, with every case, we must find ways to improve the services we provide and the work we do. In cases that centre on hemostasis, we are reminded how vital diagnostic assessments and early management are. The delay before the establishment of a precise diagnosis can reach 16 years when family history is unavailable. Improving the way we gather information during our first consultations with these young women will allow us to reduce the number of blood transfusions needed, to better prepare patients when it becomes necessary to perform a surgical procedure that may cause complications, and to improve quality of life for women as soon as their menses begin. This is only one of the ways in which we can approach the issue of hemostasis to ensure that affected women enjoy the same quality of life as everyone else, across the country. I hope that throughout my presidential term, we can share stories and ideas and look at other ways in which we can
J Obstet Gynaecol Can 2014;36(9):761–762
SEPTEMBER JOGC SEPTEMBRE 2014 l 761
GUEST Editorial
make improvements for the group of women affected by bleeding disorders. I have already had some ideas, although I am quickly realizing that it is easy to be too ambitious for a term that lasts only one year. I do hope, however, that we can review our clinical guidelines and provide informative sessions at our continuing medical education events to ensure that health professionals are prepared and knowledgeable about diagnosis, counselling, and treatment practices for women dealing with various types of bleeding disorders. We should also make sure that our public education materials include the necessary information for women to know that these disorders exist, and where and when to seek help. We should strive to further examine the social and cultural beliefs about menstruation so we can improve our delivery of services to the culturally diverse populations we work with here in Canada and around the world. We should advocate for equal access to diagnostic and treatment services for Canada’s First Nations, Inuit, and Métis women.
762 l SEPTEMBER JOGC SEPTEMBRE 2014
Much more can be done to support physicians, midwives, and other health workers in rural and remote communities, to connect them with specialists via telehealth. And we should work to build strong partnerships between disciplines within the institutions at the local level where we work, but also nationally, among our sister associations. Oh yes, and one more thing . . . we should all donate blood. Because even though we do our best, we will always be in need of blood reserves to save women’s lives. You know it. We will be very busy over the next few months, but thanks to your enthusiasm and your participation, it will be a great year for group learning, which will showcase multidisciplinary collaboration and the improvement of quality of care. I am very excited about the year ahead—I hope that, with your help, I can make a difference for our practices, for ourselves, and for our patients. I thank you for your support, and I look forward to working with you towards these goals.
