Originally from Formby (near Liverpool, UK), Dr Deborah Bateson has taken an unusual route into medicine and specifically, the field of family planning.
She’s the Clinical Associate Professor of Gynaecology & Neonatology at the University of Sydney and is the Medical Director of Family Planning, New South Wales. Her curiosity took her from Formby to Oxford, Africa to Hong Kong and eventually Australia, where she now lives.
Curiosity and variety are the spice of medical life
“I went to school in Formby and then went to Oxford University to study biochemistry. I was quite adventurous and I wanted to get out of Formby so I went to Africa and did this and that. I was very keen after that to go back and study, so I did tropical nutrition and tropical medicine at the London School of Hygiene,” says Dr Deborah.
This led to a stint working in Tanzania as a nutritionist and it’s this experience which ignited her passion for helping people through medicine.
“It was actually the first cases of HIV that were coming into our hospitals (that’s a long time ago now, the early 80s), that spurred me on to study medicine. It was working there, and seeing those great health inequalities that really spurred me on to become a doctor.”
Dr Deborah married an Australian and followed him to the other side of the world where she applied to study medicine. But he got a job in Hong Kong, which prompted another move…
“So, I studied medicine at the University of Hong Kong. I was the only non-Chinese student; it was quite interesting! It was a great place to study medicine.”
Dr Deborah was 29 years old when she started studying medicine. She had her first child during the first year of her studies, her second daughter was born during her third year and her third daughter was born when the family returned to Australia and Dr Deborah was doing her Australian Medical Council exams. To balance her family and work life, she had to be bold.
“I was an intern at St Vincent’s and I had to persuade them… actually, I was the first person to suggest job sharing. So, I was the first job sharer in the hospital and that went really well.
“They said, ‘Look, we don’t mind you job sharing so long as you find someone.’ You’ve got to work as though you’re the same person so you’ve got to find someone who’ll provide the same level of care. I managed to find excellent people to job share with, including a male registrar.”
On a family planning course, Dr Deborah realised she’d found her “spiritual home” and the ultimate direction of her career.
“I had a fabulous mentor, Dr Edith Weisberg. She was a very courageous advocate for family planning and she was interested in research.
“You also have this huge privilege of sharing intimate parts of people’s lives, and supporting people. […] It’s empowering people – giving them knowledge and control of their body and fertility. And you combine the clinical and the medical and the social – and the political! There’s never a dull moment. It’s a very interesting job.”
Dr Deborah says that variety and curiosity have been important to her in her career. As well as clinical work and research, she enjoys mentoring other doctors.
“I think working with younger doctors is incredibly rewarding and it keeps you young, you learn a lot form the younger doctors! It’s about keeping an open mind. That’s a really important role I think.
“I didn’t start studying medicine until I was 29… it doesn’t matter how late you start you can fit a lot in. People start a lot later than that too. I think that’s a great thing. The big difference now is that recognition of self-care. I was the first person to even ask about job sharing and now it’s more embedded across practice, though it still doesn’t happen often enough. Preventing burnout is so important.”
She adds that it’s variety and curiosity which have helped her outside of work too. Aside from her love of travelling, she enjoys walking and spending time with friends (including non-medical friends) – and she prioritises this.
“What’s really been supportive for my balancing my career and health and mental health is having a very varied life and taking time to do things I love. I love travel. I’m actually just about to go on a walking trip with my girlfriends in New South Wales. So, it’s making sure I’ve got time to spend with my friends. I do have a varied life and varied friends! I’ve got many friends who are doctors but I also have a whole lot of friends who aren’t (I’ve got a whole lot of friends who are journalists, actually!).
“It’s about making sure I do have time to take time off and go walking or go to the cinema or the theatre when we can. It’s about putting aside work and making sure you’re paying attention to your partner (if you have one) and your children and family and your friendships – I think friendships are incredibly important.
“And however fascinating medicine is, make sure you’ve got interests outside of that. That’s where my walking trips are great – I’m not on the internet, I’m not on my mobile phone. I’m outside. You need to make sure you have that time and that curiosity about life in general. Constant curiosity is very important.”
Dr Deborah’s final tip for those wanting to strike a better balance is to be bold; “speak up if things don’t seem as safe as they could be, to prevent burnout. We’ve had a lot of excellent examples of people doing that recently and I think it’s important people seek support if they need it.”
Family planning with Dr Deborah Bateson
A UN statement read; “everyone must have access to scientifically based comprehensive sexuality education included in school curricula, as well as timely access to safe, effective, affordable and acceptable methods of family planning of their choice.”
Access, education and choice have been pillars in the work of Family Planning organisations for some time. It’s a constantly developing field as the medical advances, technology, politics and social attitudes change and evolve.
Dr Deborah Bateson is the Clinical Associate Professor of Gynaecology & Neonatology at the University of Sydney and is the Medical Director of Family Planning, New South Wales. During her 20 years in the field she says she’s seen a lot of changes.
“It’s certainly not dull and there’s always interesting challenges. I think in family planning organisations, there’s always been that focus on excellent communication and I think that is really important. Patient or client central care is what has remained central too.”
Making sure patients are aware of choice
The amount of choice available in contraceptive methods – and how we can communicate this to patients – has changed a lot over the last decade.
“In the medical world now we’re much more aware of communication and shared decision making – I think there’s a heightened awareness around that,” says Dr Deborah.
“Just ensuring that people have all the information for themselves and we’re supporting that informed choice. When it comes to contraception, people are not unwell, they’re there to choose the contraception that best suits their needs. One size doesn’t fit all!”
LARCs (Long Acting Reversible Contraceptives) are one such change and Dr Deborah says there’s new options on the horizon.
The scope of what Family Planning does has changed
Dr Deborah adds that the scope of what family planning organisations do has changed too. Abortion care, gynaecological problems, cervical screening and domestic violence have been added to the scope of what Family Planning does.
“We’ve got consumer groups – we’ve got young people’s and Indigenous women’s consumer groups, for example, who feed into how we design and how we run our practice. That’s also a real change.
“Those expanded services too – about 12 years ago we introduced domestic violence screening. Now we’re asking around reproductive coercion. There’s been a big change in how we address gender-based violence.
“It’s a really important opportunity to ask these questions – you can’t miss those opportunities so we’ve embedded it into our practice.
“There’s also education around LARC methods, IUDs different options around contraceptives and we’ve also got trained people who can put them in. I think that’s a really important thing – we do a lot of training for GPs and nurses too. We want to make sure that if there’s a woman in a rural town, there’s pathways for her to access her chosen contraceptive safely.”
The future of contraception and family planning
Telehealth has changed the way in which organisations and clinics can deliver care. While it won’t replace face-to-face consultations, Dr Deborah says it’s an important change that’s opening up access for people in rural areas.
But that’s not the only change in the future of family planning.
“I think there’s going to be huge changes and I have to say I’m delighted,” says Dr Deborah, There’s something of a renewed interest in contraception which is great. There’s a lot around autonomy and what we call self-care. That’s a really important thing and that comes back to that shared decision making.
“One of the big changes will be in technology. Now we’ve got these huge technological advances with e-health and mobile health which can provide women and men with contraceptive options. We’ve got telehealth… I was just reading about artificial intelligence ‘boxes’ in Kenya which can provide information and answers to young people’s questions. Again, we must remember, it won’t replace face-to-face consultations, but things will change.”
‘Green’ contraception and multi-purpose contraception
Another interesting ‘trend’ in the world of family planning is ‘green’ contraception. As the world becomes more conscious of protecting the planet, women (and men) want more environmentally friendly contraception options.
“We recognise that women want to manage contraception themselves, so there’s things like the Sayana Press which allows women to give themselves the contraceptive injections.
“The other key area is multi-purpose technologies, such as vaginal rings which can prevent HIV or other STIs at the same time as providing contraception. There’s lots of exciting innovations and it has been recognised that the users – whether that’s women or men – they need to be involved from the beginning in the design of these new products.
“The other key development is what we’re calling ‘green contraception’. That’s around recognising climate change – it’s important to consider when we’re thinking about contraceptive methods and we know that women are looking for contraceptives that have a lesser footprint on the environment. For example, methods with lower doses of hormones (like LARCs). […] There’s a real impetus now to look at effective non-hormonal methods of contraception. There’s a renewed interest in contraceptive methods for men too; they’re wanting to take more responsibility and women are accepting of that and want that too.”
