The Stitch-Up by Emma Szewczak with Dr Andrzej Harris (Chatto & Windus £22, 288pp)

In 2019, Emma Szewczak was being sewn up following the birth of her second child when the midwife paused and said: ‘Your vagina’s fallen out.’ 

Those words, the author says, were the worst thing anyone had ever said to her. Not even a problematic first experience of childbirth could have prepared her for this.

Eventually informed she was suffering a prolapse, she spent three years seeing specialist after specialist, moving from the NHS to private care to the so-called ‘wellness’ sector, with no one able to offer a solution. 

Along the course of that journey Szewczak and her husband Dr Andrzej Harris (Associate Professor of Pharmacology at Cambridge) became angrily aware of how many aspects of medicine let women down.

Angry and frustrated, they wanted to find out why there’s a complete lack of treatment options for conditions (from endometriosis to menopause and everything in between) affecting vast numbers of women across the world.

The couple set out to examine ‘how medical misogyny harms us all’.

The shocking healthcare failures, in medical care and research, may or may not always be the result of institutional ‘misogyny’ – although most feminists (as I count myself) would level that charge. The problems are acute.

In recent years there have been many books on this subject, from Elinor Cleghorn’s Unwell Women to Breaking The Taboo by Theo Clarke.

The personal stories are bleak, the cold carelessness in female as well as male medical staff often appalling – as Szewczak and Harris make clear. 

The case for the prosecution mounts: the outrage of vaginal mesh implants, the lack of awareness of potential birth trauma and perinatal psychosis, unnecessary breast surgeries as well as vaginal nips and tucks post-birth, inappropriate intimate examinations, and (of course) the series of maternity hospital scandals, including Shrewsbury and Telford. 

Endometriosis makes thousands of women suffer but doctors often fail to consider the condition when women seek help for their specific range of symptoms. Why?

Underpinning this densely researched book is a simmering rage that women are so often addressed with patronage or indifference.

In case you thought the process of birth a doddle, Szewczak provides a frightening litany of possible complications: ‘Perinatal tearing… injuries to the pelvic floor… lacerations… episiotomies can become complicated with infection, pain and excessive bleeding… the bladder and urethra can be injured… severe bleeding and shock… damage to the symphysis pubis… postpartum haemorrhage…’. And much more. 

Who’d be a woman?

Which is my problem with the book. For none of the above horrors will be suffered by biological males calling themselves female – or ‘trans women’, as they would have themselves identified.

Yet routinely Szewczak uses the terms ‘cis woman’ or ‘cisgender’ for those of us born with the apparatus likely to cause us trouble throughout life, from the first period to the menopause and beyond.

How can a book that claims to attack the neglect of women’s health dare to belittle the experience of real women by calling it ‘cisnormative’?

And, astonishingly, just after the dire ‘obs-and-gynae’ catalogue above, Szewczak, with a degree in gender studies, attacks ‘misgendering’ (meaning consciously or accidentally calling someone the wrong gender) and ‘obscene waiting times for gender-affirming care’ for trans people.

Is ‘misgendering’ really as bad as a prolapse or stillbirth? For Szewczak, the answer seems to be yes.