Adolescent Gynecology Service Begins at Children's Hospital

Children's Hospital in Boston, one of Harvard Medical School's teaching hospitals, has opened the country's first full services division of gynecology in a pediatrics hospital. The division offically opened on January 1, but so far only one patient has been admitted and the offical staff was not appointed until January 9.

Dr. Donald P. Goldstein, divisional chief, said in an interview last week that the program is an "outgrowth of a growing awareness on the part of several doctors at Children's and at the Harvard Medical School of a need for gynecological care specifically geared to the adolescent."

All Problems

The division is prepared to deal with all problems which fall under the heading of gynecology. This includes such things as congential disorders, tumors and inflammatory diseases, as well as counselling and information on birth control, veneral disease. pregnancy and abortion.

In the past Children's has handled three to four gynecological patients a week through its adolescent unit. The new division will have six attending gynecologists who will see patients on an inpatient basis and staff the three clinics to be held each week. There will be a clinic held for preadolescents, one for adolescents and one held "for all our pregnant patients," Goldstein said.

"No one denies that adolescents need gynecological care," Goldstein said, "as do preadolescents and children. The services currently offered in most hospitals would cover the needs of younger patients, but they are oriented emotionally and procedurally toward the older woman."

Many Differences

"The difference reveals itself in many ways," Goldstein said. "We will have smaller equipment on hand, for example--little things like that. Also, the manner of the nurses, the approaches taken on such issues as pregnancy--I would not talk in the same terms with a nineteen year old as I would with her twelve-year-old sister. It's a matter of education, information, experience."

A spokesman for the program, who did not wish to be named, cited as another major difference Children's attitude toward young people as being "members of families rather than autonomous individuals."

"In counselling, for example, we will try to involve not only the patient herself, but her parents as well. Families can be sources of support."

Children's Hospital already maintains a family counselling service. The counselling done through the division of gynecology will be an expansion of that program.

Goldstein also said that one of the functions of the new division would be educational. "We would like to have representatives of the division going out into the schools and other community groups, speaking directly to the girls on various subjects relating to gynecology," he said.

Teaching Hospital

"In addition, Children's is a Harvard teaching hospital." Goldstein said. "We would like some students to apply for residency here, whether or not they are planning to specialize in adolescent gynecology. They could carry their experience with these patients back to profit in whatever field they chose."

The doctors appointed to the division are Clement Yahia, Raymond Reilly, Theodore C. Baron, Robert Shirley, Kenneth Blotner and John M. Leventhal. All are on staff at the Boston Hospital for Women, Lying-In Division.