Women’s hospitals are meant to redress neglect. In reality, they’re punishing women

The idea that women need their own separate hospitals once felt noble. It came from a place of wanting to redress centuries of neglect. I understand the impulse. As an obstetrician and gynaecologist, I work in these buildings and I have seen the pride that comes with creating spaces designed especially for women. But good intentions do not insulate a system from unintended consequences, and what began as advocacy has in many places hardened into something that feels much more like exclusion.

There is a strangeness to these institutions that one only truly appreciates from the inside. They often sit a short walk from major hospitals yet behave as though they are perched on distant islands. Calling for a specialist opinion that should take minutes somehow becomes a half day of negotiation, with precious hours slipping by. Scans are repeated because systems do not speak to one another. Records live in their own sealed worlds. Even the culture shifts. The place begins to see itself as a self-contained universe, which would be harmless if illness also observed those boundaries. It does not.

Consider a case I encountered last week involving a patient, heavily pregnant and with a history of asthma. She presented for care at a hospital for women but there are no respirologists available. Here we have specialist doctors for the pelvis area, but if you have an issue that involves your liver, your lungs, your heart or your kidneys, we are unable to help you as we have no specialists and none of the equipment to treat patients.

Even though my patient is in desperate need, and staff will do everything they can to try to co-ordinate care, no doctors from the general hospital will come to see this patient at the women’s hospital. In the end, she will be discharged from one hospital, so she can travel, maybe just 50 metres, to the general hospital for treatment. And once she is treated, she will need to be discharged again and return to the women’s hospital for an induced labor. This is lunacy.

As a clinician, a husband and a father of three daughters, I’m frustrated that women are receiving second-rate care. I’ve worked in a number of different countries in different environments. I’ve seen women who will do anything for the medical care that can save their lives and their unborn child – women who will wade across rivers while in labor – yet in the middle of our very populated cities we’re depriving women of good care for no good reason.

The irony is glaring. We have abandoned gendered bathrooms in many public places. We pride ourselves on integration, inclusion and the removal of arbitrary barriers. Yet in healthcare we have built an entire parallel structure for women, as though they are somehow too delicate or too different to share the mainstream medical environment. It is a strange, quiet form of segregation, softened by pastel paint and warm slogans, but it is ultimately gender apartheid all the same.

The language around these places remains gentle and reassuring, and I get that many women will say they prefer a gender-specific hospital to respond to their personal needs. But gentleness is no substitute for competence. Women do not stop being whole human beings when they walk into labour wards or gynaecology clinics. They still have hearts that can go into arrhythmia, brains that can bleed, immune systems that can collapse and lungs that can fail. They deserve instant access to the full machinery of modern medicine. That is difficult to deliver when the machinery sits next door but the patient sits in a silo.

The defenders of separation often speak of focus and specialised care. What I have seen is something very different. I have seen the kind of duplication that would make any health economist wince. At a time when money is tight and the workforce is stretched, it makes no sense to maintain duplicate services that still cannot match the breadth of a general hospital.

There is something even more uncomfortable beneath all of this. If men were told that their cardiac care, neurosurgery and trauma services would now be consolidated in men-only hospitals, nobody would tolerate it. The absurdity would be obvious and the backlash immediate. Yet when the same logic is applied to women, it is presented as empowerment. It is not empowerment. It is a polite withholding of care. It is a system that ensures women receive only part of what they need while applauding itself for compassion.

I do not doubt the sincerity of those who built these institutions. Many were responding to a history of underinvestment in women’s health. But rectifying an injustice by creating a new form of separation is a poor bargain. It keeps women physically distant from the expertise they require at exactly the moment they need it most. The days when women might have to share a ward with five men are long behind us. We are left with a structure that flatters itself with the language of advocacy while quietly constraining the very group it claims to uplift.

Women’s health will not advance through isolation. It will advance through integration, meaning that women are not separated from the rest of adult medicine and surgery. It will advance when women are treated not as a special category requiring a separate building but as full participants in the medical system. They deserve access to every specialty, every resource and every layer of the healthcare network without delay or detour.

We can keep the warmth and dignity that women’s hospitals aspire to offer. What we cannot keep is the separation that sits beneath it. No amount of soft lighting or curated aesthetics can compensate for the loss of immediacy and depth that comes from being physically cut off from the rest of medicine. If we value women’s health, we should bring women back into the centre of healthcare rather than push them to its edges.

Associate Professor Vinay Rane is an obstetrician, gynaecologist and lawyer. He is a founding director of Melbourne Mothers and Thrive Fertility, and holds leadership roles on the Councils of the Australian Medical Association (Vic), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the National Association of Specialist Obstetricians and Gynaecologists.

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