Women of colour endure discrimination in Austria's gynecological care

Photo by CCNull, remixed by Global Voices (CC BY 2.0 DE)

Abortion is legal in Austria within the first three months of pregnancy after consultation with a doctor. And every year, around 30,000 abortions are performed in Austria. Women of colour make up for more than a third of those who undergo an abortion, and nearly half of them were not born in Austria. Why is this?

According to a report by Austrian gynecologist Dr. Christian Fiala, 40 per cent of immigrants use effective prevention methods in comparison to 58 per cent of people born in Austria. It is considered the first, and to date, the only, representative study on the topic of sexuality and prevention in Austria for people aged between 16 and 49 years old.

Dr. Fiala states in the report:

Abortion rates would therefore be more common among women with a migration background. In general, because of hormone scepticism and a misconception of fertility, unwanted pregnancies are more common.

From 2012 to 2019, the use of the birth control pill dropped from 60 per cent to 44 per cent among women. According to Dr. Christian Fiala's 2019 Contraception Report, repeated misinformation regarding the pill increases skepticism towards it, which may lead to more unwanted pregnancies as the pill is one of the most effective contraceptives. Only a small percentage of people have replaced the pill with another effective contraception method.

However, another gynecologist, Dr. D. Jalali, believes that the misinformation may come directly from doctors. She told me via Zoom:

The survey of Dr. Fiala does not define whether this has to do with their own misconceptions (about fertility) or whether it has to do with being misinformed by their doctor. I can’t even start describing the number of women, mainly women with a migration background, who have received the wrong information regarding their fertility and anticonception. Often, these young women already have a long history of being mistreated in gynecological issues, which results in an unwanted pregnancy with harmful health complications, leaving no other option than going through an abortion, whether wished for or not.

On top of that, many claim that sexual education classes—which lack adequate teachers—are under threat by conservative groups in the country, and the pill is not covered by state insurance. If the costs were covered, more than half of the women surveyed in a thorough study from GynMed, a clinic for pregnancy and family planning, say they would switch to some method of prevention.

The “morning-after pill,” which is an emergency contraceptive, is, on the other hand, easy to buy if women overcome its stigma. The pill has been sold at Austrian pharmacies without a prescription and without age restriction since January 2014. In practice, however, women say they are asked to present a prescription at pharmacies.

The ‘white gaze’ of Austria’s public healthcare

Since 2020, the emergence of the Black Lives Matter movement has sparked more awareness of racial discrimination in Austria. For example, the historian, anti-racism expert, and journalist Vanessa Spanbauer explained to local media that “medicine is often aimed at white people.” Doctors appear to be influenced by—often unconscious—prejudices about ethnicity, resulting in certain population groups receiving less care than others.

Studies have also shown that women from different ethnic backgrounds react differently to diseases, for example, Polycysteus Ovarium Syndrome (PCOS). PCOS, whose symptoms include the forming of cysts, hormone imbalances, weight gain, and infertility affects one out of 10 women. Yet, it appears that the disease impacts women of Arab and Asian cultures differently from Western women, which in turn might influence its diagnosis. Obesity, for example, may be perceived as a “sign of prosperity rather than a negative impact in some cultures,” according to the study on “Ethnic-Specific PCOS.” Therefore, in some cultures, people with PCOS may not think anything is wrong if they put on weight. 

But it's not only about culture. The study asserts that ethnic differences lead to more or less prevalent symptoms and different responses to treatments. For example, South Asian women with PCOS will have a greater risk of developing diabetes and have more severe symptoms by the age of 25 than white Europeans. “Differing genetic predisposition, as well as environmental differences, commencing in utero,” the research says, might explain this.

In a Facebook group of more than 16,000 (international) women in Vienna, members regularly post complaints regarding discriminatory gynecological care based on ethnicity. Some say they have been to doctors for two years for an issue which was solved by the right gynecologist in 20 minutes with complete healing after two weeks, or they have been diagnosed with a mental disorder several times instead of having their physical ailments acknowledged. Patients of colour who believe they are affected by this “white gaze” in the Austrian healthcare system suffer, in addition, from mental health issues because of discrimination.

Vice covered the topic for neighboring Germany. In it, Jasmine, a 33-year old patient, said, “These racist experiences in hospitals and doctors’ offices made me feel like I was worthless. As if I were disturbing and exaggerating and keeping the doctors away from their ‘real’ patients.”

Parissima Taher, a psychologist, commented on this regarding the practice of psychology: “In psychotherapy, I was told that I have to accept difficulties in my relationship. Because the men here [in Austria] want white women and it will be difficult to find a man other than my partner who finds me beautiful,” she told me, before adding, “and this is unfortunately still true, currently. I experience it on a regular basis in my work with my clients [who have faced discrimination by other psychologists].”

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