Women's health

Women’s health is a huge topic, while it’s true that in the maritime sector women make up just 2% of seafarers at sea, up to 34% of the shore based staff are female. Looking at the bigger picture, women’s health directly affects just under half of our population globally, and indirectly (whether you like it or not!) the other half, we thought it was worth a blog about some of the issues, and the taboo’s, that could be affecting our maritime workforce and the women in our lives. 

It's common knowledge that women experience huge hormonal changes at puberty and menopause, both of which can have significant physical and mental health impacts. In the UK, there is a growing discussion and openness about peri-menopause (the years before periods stop altogether) and how for some women, this has devastating effects across all aspects of their lives, including work. Of course men experience changes at puberty, but their later life changes are less significant and generally don’t affect their ability to work.

In December 2023 the World Health Organisation (WHO) issued a statement to advise that every year, at least 40 million women are likely to experience a long term health problem caused by childbirth. So there’s a good chance that we all know one or more women affected, or if you are female… this could be you.

As part of a special series on maternal health, the study showed a high burden of postnatal conditions that persist in the months and years after giving birth. These issues include more than a third of women experiencing pain during intercourse, urinary incontinence (8-31%), anal incontinence (19%), anxiety (9-24%), depression (11-17%), perineal pain (11%), a fear of childbirth (6-15%) and secondary infertility (11%). 

All in all it doesn’t paint a great picture of life after childbirth for some women. If any of your workers experience these issues, either on or off shore, it could have a significant impact on areas of their working life and it’s something they may be reluctant to open up about.

Even before childbirth, we may take it for granted that contraception is available, certainly in the developed world. 

But in developing countries where sexual violence is not uncommon, contraception is considered lifesaving due to the high level of unsafe abortions carried out. Around 13 million women (and girls) under 20 give birth annually and complications in the pregnancy and birth is a leading cause of death. Consequently abortion is an option, but this carries its own huge risks.

Sexual and physical violence has affected one in three women under 50 globally (WHO), and this affects their physical and mental health both short and long term. It is not limited to developing countries. Women are also known to be more prone to anxiety, depression and somatic complaints (physical symptoms that can’t be explained medically) than men, so this risk only increases the incidence of anxiety and depression related conditions.

Unsafe sex, particularly in developing countries can lead to life threatening and other sexually transmitted diseases which can affect pregnancies, cause foetal and newborn deaths and leave women vulnerable to other diseases such as tuberculosis.

We work in an exciting multicultural maritime environment, but this can bring a degree of confusion and potential misunderstanding when it comes to the rules around males and females and direct contact. Of course where health is concerned, most rules allow for examination by a medical professional, but a chaperone of the patients choosing may be a good option. There is also the challenge of some beliefs limiting the extent of medical intervention allowed.

It's worth mentioning the communication challenges too. Language barriers, humour, interpretation, intent, and things that are generally just  ‘lost in translation’. Our Medical Operations Manager Rachel remembers many situations when she was working frontline and males would refuse to speak to her, due to their religion, simply because she was female. Frustrating for sure, but there is always another way to get the information you need! Google Translate is a fabulous tool and easy to access and use if you have internet access. 

Female Genital Mutilation (FGM) is becoming better understood now, but with that understanding comes the realisation of how widespread the practise is, despite world leaders pledging to end it by 2030. It’s as common now as it was 30 years ago in some countries, and you may be working with a woman from that region. But it’s still not talked about enough. 

Let’s not sugar coat it either, FGM is abuse. While often justified for cultural or religious reasons, it’s underpinned by the desire to control female sexuality. Prevalence varies and practise common in about 30 countries, mostly Africa where Gambia, Mauritania, Mali, Djibouti, Ethiopia, and others have over 50% incidence. In Somalia, 98% of the women have been subjected to FGM. Asia also sees high percentages with 90% of women from Malaysia affected. 

FGM is banned in most, but not all countries, though enforcement is weak. It’s easy to think that we will never cross paths with someone who is a victim, but migration and international workforces, especially in our maritime world, mean that you probably already have.

There are different severities of FGM from the least serious being removal of the clitoris, to the most serious where the vaginal opening is sealed. Apart from the obvious risk of pain, infection, urinary retention and haemorrhage in the short term, the long term outcomes include extensive damage to the external tissues, pain, infections, complications in pregnancy and childbirth, psychological damage, sexual dysfunction, and difficulties menstruating. 

The National FGM Centre website is a great resource if you would like more information about FGM: https://nationalfgmcentre.org.uk.

There’s even a free, short e-learning course that you can do to learn more about FGM and what to do if you discover an incidence: https://nationalfgmcentre.org.uk/fgm-e-learning-course/

It’s well worth being aware of these issues, which are often not talked about, but need to be exposed in order for the world to take action.

On a more day to day basis, we recommend the Wellbeing of Women website https://www.wellbeingofwomen.org.uk as a great resource for all things female related. 

A common issue affecting the worlds female workforce is period pain and severe bleeding. Far from being an annoying, often embarrassing, inconvenience once a month, periods can be incapacitating and 59% of women have had to take time off in relation to their period. But even if unfit for work due to pain or severe bleeding, many women don’t want to discuss it with a manager and worry that taking time off every month could affect their career. 

We’ve also probably all joked about feeling ‘hormonal’ from time to time, but the psychological changes experienced by some women are no joke. Mood swings, feeling worthless or hopeless, tearful, irritable, anxious or depressed are all signs of sensitivity to the hormonal changes and fluctuations and can affect work, day to day life and relationships at home and work.

As men and women have different reproductive organs, both groups are subject to specific conditions. For women that includes, but isn’t limited to, female cancers such as cervical, vaginal, ovarian and uterine; endometriosis, ectopic pregnancy, miscarriage, pre-eclampsia and eclampsia, gestational diabetes, fibroids, polycystic ovary syndrome (PCOS) and pelvic inflammatory disease (PID). Phew, that’s quite a list isn’t it. So, what is the point of us taking time to raise awareness of women’s health issues. Well, let’s go back to the beginning of this blog where we stated that women’s health is a huge topic, but it directly affects around half of our population, and the other half indirectly. That makes it important to us all.

There is still much embarrassment and reluctance to talk about women’s health issues, particularly in the workplace, and possibly more so in a male dominated workplace, no matter how well you all get on. Education is key and we hope this blog has gone some way to opening up discussions about things which may have been avoided previously. 

P.S. Don’t worry, we’ll talk about men’s health issues in a future blog!