By the power vested in me.

I recently had a client come in requesting pelvic work because of injuries from her first birth.

In her words, she had torn significantly, and had been stitched badly - she described something I've heard about from several other clients, the 'husband stitch', in which a doctor stitches the vaginal opening too tightly closed in order to supposedly make future sex with the birthing woman more pleasurable to an imaginary future male sex partner.

Which, alone, makes me want to punch these particular doctors in the nads. Hard.

Because - does this really need to be said? Sure seems like it does:

WOMEN'S BODIES DO NOT EXIST TO PLEASE MEN.

Ever. Under any circumstances.

This practice, like so many others, is a vestige of a dark age in which women were the property of men.

Please observe, dear reader: we do not fucking live in those dark ages anymore. Not here. Not now. And any doctor acting as though we do should lose his or her license to practice medicine IMMEDIATELY. 

Birthing women are generally not asked about this: 'Would you like this dodgy procedure?' It is just done to them - in a supremely vulnerable moment, I might add. Sometimes with a grody wink to the male partner in the room. Or so I am told.

But back to the story.

This client tore again with baby #2, and was attended to by a different doctor, who was shocked by the terrible work of the first doctor, and stitched her properly. 

She had been in pain for several years with the husband stitch, and then was no longer in pain. But she felt that the tone of her pelvic floor had suffered, and she wanted to work on her 'tightness'. 

Upon actually meeting this woman, she further revealed that her husband had been cheating on her, that she was fairly sure they would be separated within the year, and that her desire for a tighter vagina had to do with being able to keep a future male partner. She attributed the cheating to her vagina not being tight enough to please him.

This made me turn some colors. The room is thankfully dim enough that I had some cover. 

Once I had recovered my wits, I told her quite precisely the following three things. Mark them well, women of my heart. 

1) Your vagina is not a sheath for anybody's cock. 

It is the core of your body, the powerhouse of your pleasure, the holy portal through which you have, like a god, pushed two human beings into the world. It is not a fucking sheath for a DICK. So please, take the checkout magazine stands full of 1980s Cosmos that apparently line the aisles of your mind, and set them on fire, because that is a bunch of fucking nonsense.

2) If your husband is cheating on you, I GUARANTEE YOU that it has fuck all to do with the tone of your pussy. If he is cheating, it's because he is a cheater. Let's give credit where credit is due. If the sex you have been having with him has suffered since your first birth, perhaps that is because you were in excruciating pain whenever you did it, seeing as some idiot with diplomas on his wall gave you an unconscionable injury by stitching you badly and playing into this 1980s Cosmo complex you're harboring. But please understand: cheating is not about vaginal tone. Cheating - sleeping with someone else and lying about it - is about being an asshole.

3) You do not want a tight vagina.

That is a myth.

When we use tight as a descriptor, we are discussing the pussy as a sheath. We are centering our entire experience in the pleasure of a male partner. And while we, of course, care very much about the experiences of our lovers, their perspectives are not more important than our own, and we do not take responsibility for anybody else's good time. Please keep your eye on the proverbial ball here.

What you want is a strong vagina. 

A vagina that can grip, control, pulsate, and fully release a penetrating object at will - a cock, or otherwise - with a full range of sensation. A muscular vagina. A free vagina. 

If you do not have this experience, it is very likely because you - like many many many of the other women who come to me for pelvic bodywork - are, in fact, too tight. Your pelvic floor is hypertonic - it is in a perpetual state of spasm, and doesn't remember how to release. 

Much like a hand, a vagina has to be able to both grasp and let go in order to do much for you. 

If it is hypotonic, it is like a hand that is floppy and cannot grasp. If it is hypertonic, it is like a perpetually clenched fist. 

Far more of the women I meet under these circumstances come to me in the latter category than the former. 

A tight vagina is a PROBLEM. As a physical reality, and as a concept. 

Get with me on this. Strength is the key. Across the board. Change your language and change your life. Please. Inhabit your body like you are the boss of it, like your experience is important, like you are the one steering your world, like your pleasure matters. Because it FUCKING DOES. Female pleasure is raucously, explosively powerful. It is what brings women of all ages and races and sizes and abilities and orientations home into our own blessed bodies. It is the lever which moves the world. Its power is such a treasure that billion dollar industries have arisen to manipulate women, throwing a glamour around us that divorces us from our own sensations, focusing our sense of worth on our looks and throwing our lived physical reality under the bus. 

It is up to us to STOP FALLING FOR IT. 

We are not owned. We are not beholden. And our bodies are utterly magnificent, exactly as they are.

Please start fucking acting like it.

Love,

PCWS

Birth: Part Three.

Birthing.

My water broke nearly 2 weeks early, waking me up at 1:30 in the morning on a Monday. I woke Adam and called the midwives, who told me to go back to bed and sleep as much as possible. I didn't manage to sleep at all, but went into a very deep and restful trance, felt the location and intensity of the first contractions introducing themselves, which were like nothing I'd ever felt before, and had heroic preparatory dreams. 

The following morning we drove out to the midwives' office, where Catherine, Leslie’s partner, checked some of the fluid under a microscope to make sure that it was actually of amniotic origin. Upon confirming that it was, she told me that because my water had broken and because of the positive GBS results, they needed me to be in hard labor by nighttime - as I said earlier, a hospital would have given me 18 hours from my water breaking to deliver because of the GBS results, and the midwives didn't need to push that hard, but they did need me to get things moving. 

We came home, our beloved Willa came over and helped us to Mary Poppins our house into a place fit to birth in, and I started drinking castor oil cocktails by late afternoon. Castor oil is a trip: it's a bowel irritant (most hospitals will tell you not to drink it because it can cause diarrhea, which, apart from potentially causing dehydration, creates a mess for them to deal with - they would rather administer a pitocin drip they can control) and is a classic way to intensify contractions which doesn't in any way affect the flow and receptivity of the nervous system to oxytocin, as pitocin does. My former doc's PA had told us an incredible story about using it to bring on labor with her 2nd kid. In her own words: "My first kid was born at 42 weeks and was so big that he gave me a completely new ass, and I didn't want to deal with that again, so I made myself a castor oil and tequila sunrise at 41 weeks, and he was born 45 minutes later. No time for anyone else to even get there, so it was just me and the dog.”

Heartened by all of that, we made the cocktails with top shelf tequila and orange juice. That plus liberal nipple stimulation did the trick: contractions steadily intensified and grew closer together. At some point in the thick of it all, I attempted to use a vibrator to steer the sensations towards pleasure, but it just intensified what was already well on its way to overwhelming rather than making it more fun. It seems possible that if I had tried stimulation earlier it might have been possible to take the labor in a more orgasmic direction, but I honestly have no idea. Needless to say: if you try it, gentle reader, please do let me know how it goes :)

We were graced with the presence of three deeply trusted friends as our doulas through the night: Willa, Liz, and Cynthia, all of whom had attended births before, and the latter of whom is a L&D nurse who's seen a zillion births in hospital but for whom we were the first experience of homebirth. Because there were enough loving hands, whoever needed to could nap or eat or take time and there was always still someone with me, and frequently two or three people. I vividly remember the entire night, the faces and the words, dancing to Whitney Houston with Adam, the beautiful hands on my body, the unendingly generous support of my loved ones: Liz's care and levity, Cynthia's excitement and total confidence in directing me, Willa's unshakeable calm and loving encouragement, Adam's comfort and solid support. There was a lot of giggling and a lot of affection and absolutely no stress on anyone's part.

In the middle of the night, I got into the tub (they had set up a kiddie pool on a tarp in the middle of the living room) and realized that it was wonderful to be in the water because it was slowing contractions down and letting me rest. Cynthia was with me, and I told her that I was starting to consider a transfer because I had no idea whether or not the intensity I was experiencing was actually progressing my labor - this was the crux of the births I had seen rushed into C-sections - and I was fucking exhausted and didn't know how much more I could manage. Cynthia reminded me that I had said to her before going into labor that I didn't want an out, and that if I started talking about a transfer to please remind me that if I had an epidural I wouldn't be able to walk or feel my legs. (She also had been the person in touch with the midwives all night, and was aware that if I wasn't dilated enough to start pushing come morning when the midwives arrived that I would very possibly be transferred - it was Now or Never.) She told me that she would let me stay in the tub a little bit longer, but then we were going to get in bed and we were going to work the baby down, and that it was time to marshal all of my energies into making this shit happen.

And then she revealed herself as my Jedi master. It was fucking incredible. What followed was among the most painful experiences of my life, and it was without question the furthest my nervous system had ever been pushed, and I have no idea how it would ever have happened if I hadn't had this profoundly capable woman ordering me around like a cosmic drill sergeant. Everyone got into bed with me, and Cynthia had me turn one way on my side and focus on the eyes of the person in front of me, and I howled my way through several contractions, and then had me turn onto my other side and repeat the howling with someone else, and back and forth for what felt like thirty years until the midwives arrived at 6:30 in the morning. I looked up and saw Catherine smile at the ruckus I was making, was aware of her slipping on a glove to check my dilation, and felt an utter jubilation erupt in the room upon her finding that I was at about 9 cm. She pulled the lip of my cervix that remained out of the way and brought me to 10, and told me it was time to start pushing. 

I pushed in the tub for a while, but it was a huge and slippery contraption that made it difficult for anyone to support my body without actually getting in with me, so I moved to the floor, where I realized what exactly the quality of an effective push was, which was more or less that the hand of God was doing the work. Catherine suggested that we move to the bathroom, because the toilet is an ideal place to push, both because of its birthing stool shape and because it’s a place where the body is well accustomed to letting go. Pushing took on a lightninglike quality once I was on the pot, which scared the hell out of me, and I asked to move to the bed. 

Once on the bed, I had the central realization of the entire experience: namely that as mammals we are wired to flee from pain, but that the only way to move the baby out of me was by diving directly into the pain, into the lightning. Upon understanding that, I committed myself fully to riding through it without hesitation, and asked to move back to the toilet. I felt the baby move down and crown, and felt her head with my hand (there is no crazier sensation) and at the point that her head was emerging, Adam came and sat under me and held me while I pushed Kora out. At some point I felt my tailbone snap, and simply made a mental note that I would deal with it later. The hardest part of the entire labor was pushing out her body after her head had emerged - I scraped the bottom of the barrel of my energies, and tapped out the last of myself moving her all the way out. As soon as she was in my arms, she cleared her own nose and throat, let out a single yowl, and opened her eyes to see. 

After it stopped pulsing, Adam cut the umbilical cord. I watched that, saw all the blood on the floor, and because my nervous system had reached its limit (but probably also because I'm a fainter when it comes to blood) I passed out. Becky, Catherine's marvelous assistant, took the baby and passed her out to Cynthia and Willa (where Willa held her skin on skin), and lay me down on the floor, where I delivered the placenta. I’m told that everyone slapped me, Catherine gave me two shots of pitocin in the thigh to stop the bleeding, and finally after I passed out a couple more times she jerry-rigged an IV and gave me half a bag of fluid. It took about an hour and the threat of calling an ambulance for me to get it together enough to crawl out of the bathroom and into bed. Willa gave Kora to me to hold and I gave her the nipple for the first time. We missed the golden hour for breastfeeding because I was out cold, but we caught up without any issues.

Nursing.

I didn't know it, but milk doesn't come in for three to four days, and the baby is fine just having colostrum during that time - please call bullshit on anyone who tells you differently. Kora and I began to figure out nursing, and I realized that what is a strange and gorgeous and crazy process at the best of times has the potential to be downright nervewracking to a new mom who is utterly exhausted and has inaccurate judgement. So I made a lot of phone calls and asked everyone who had offered for help. I was advised by a family friend who is a lactation consultant to use Vitamin E on my nipples to prevent problems, which it absolutely did. When my milk started coming in 3 nights later, I became unbelievably engorged and used cold cabbage leaves in my bra to soothe the hot spots and hard places in my breasts while the tissues adjusted to the flow of milk. I asked for a lot of counsel until we got the hang of it. Once we did, and ever since, breastfeeding has been a deep pleasure.

Recovery.

The postpartum body takes time to heal. Time as in weeks and months. The landscape of the body is significantly changed by birth. There are huge amounts of ill-conceived pressure and shame, private and public, on postpartum women to pull themselves together and get back to whatever they was doing before all that, and it is frankly a fucking tragedy. There is nowhere near enough space created for the healing and rest and brand new life-giving intimacy that begins the moment a baby is born, and that, more clearly than nearly anything else I’ve ever come across, reflects the cultural demonization of the female body. There is little regard for the recovery of women after the fundamental act is complete, and little thought given to what we need to return to an active life with our health intact and our experiences integrated. 

I’m extremely lucky in that I have the kind of support that allowed me to carve out for myself what wasn’t given to me - but which is, for example, freely provided in a country such as France, which seems to have an entirely different model of medicine than we’ve created in the US - and I had enough of an education to know what to seek out. 

Briefly, these are the circumstances of my postpartum recovery, and the details of the care that were the most indispensable:

My entire pelvic floor was sore for about a month in ways that are difficult to describe to anyone who hasn’t experienced it: the entire structure of my pelvis had shifted in the most extreme fashion and I felt terribly bruised and torn. I didn’t want to be touched at all for about 6 weeks. The snapped tailbone took longer to heal, and I was in wincing discomfort, sitting and standing slowly and with extreme caution, for perhaps 3 months. At the point that I felt healed enough that I could tolerate deep touch, I began to work with my own hands into the scar tissue at my perineum where I had torn and been stitched, soaking with hot water to warm the tissue and then massaging myself intravaginally and externally around the scar as firmly as I could manage with castor oil using my fingers and thumbs, whenever I was in a bath or shower. This was something I had studied as a sexological bodyworker and thought about within the context of the protocols of Holistic Pelvic Care, and it helped a lot with the general discomfort and especially with the pinchy, sharp discomfort I would experience with any penetration. I also began to practice the Arvigo self-care protocols, which are delicious and simple and incredibly restorative, and the Holistic Pelvic Care exercises detailed by Tami Kent in her amazing book Wild Feminine.

It’s worth writing a little bit about castor oil packs here, because they are so wondrous. 

The topical action of the oil of the castor bean is a goddamn miracle. There has been precious little study in scientific quarters about why it does what it does, but its primary action seems to come from a component called ricinoleic acid, which has been shown in clinical studies to reduce pain and inflammation. It’s thought that castor oil helps to flush lymph, clearing toxins and excessive waste from the area where it is applied. What I do know firsthand is that castor packing has consistently reduced my recovery time from sprained ankles from a month to less than a week, that it does beautiful things to my digestion, that it visibly reduces inflammation in surface tissues, and that it makes deep tissue and myofascial bodywork much less painful when it is used. It’s a recommendation in the annals of Arvigo, and it has nearly unbelievable results with internal scarring in mucous membranes - Ellen Heed and Kimberly Ann Johnson, with whom I studied scar tissue remediation, reported having felt intravaginal scar tissue dissolve from a single application of castor oil. And it was hugely helpful to me in doing internal work on myself. 

After a while, I had two internal scar tissue sessions with Ellen, who brings a beautiful combination of laserlike, merciless focus and exquisite attention to her work, and found that receiving internal work was a major key to recovery. I believe this is true for all births - a significant amount of scar tissue is created by the act of birth, whether it’s a vaginal delivery or a caesarean, and scar tissue has to be addressed to maintain fluid and energy flow through the abdomen and pelvic floor. 

Another common postpartum situation is diastasis recti, in which the abdominal muscles separate. This can be a minor separation, a finger’s width across, or a major one, four or five fingers across. It’s not a thing to ignore, and it’s a strange and amazing road back to a normal abdomen - DRs don’t knit back together from crunches or any of the usual abdomen-building exercises, and in fact are made worse by most normal exercise. The best things I found to resolve mine were binding my belly with a splint from the Tummy Team and doing the one kind of abdominal exercise that works to resolve DRs in which one engages the deepest layer of abdominal muscle, the transversus abdominus. Katy Bowman talks about it quite a bit on her excellent blog.

The return of a body that feels like mine is ongoing - when I’m back in aerial training, I feel sore in all the right places, flexibility returns, and my core bounces back to what I know it to be. And: the time to train is dear right now, because making time for myself is a whole new equation with a baby. I end up doing yoga at home as often as I’m able. 

Also, kegels are real. They aren’t a thing to overdo in general - their effectiveness has everything to do with whether or not the pussy in question is lacking in strength from lack of engagement or over-engagement, too little tone or too much tone - but as a postpartum exploratory exercise, they’re pretty essential for beginning to feel like oneself again. I prefer the exercises associated with the use of jade eggs, as having something inside the vagina to provide some interoceptive feedback is wonderful, and the practices develop sensation and control involving both engaging and letting go, rather than just repetitions. 

The open portal.

I understand that this isn’t the case for everyone, but birth blew me open in a way I had never experienced and didn’t anticipate. My sensitivity to sounds and energies was on hyperalert for weeks, and as a result I became extremely private, still, quiet, and slow in the first weeks with the baby. The midwives had left a sign on our door when they left which asked that guests wash their hands upon entry, make themselves useful while visiting, and limit their visits to 15 minutes, and although that sounds unnecessarily draconian from a normal state of being, those rules actually saved my sanity. It was absolutely exhausting being with anyone but Adam and Kora. We rested, took a lot of space from the world, stayed in bed, watched Orange is the New Black, moved very slowly, read books, shnookled, and rested some more. Going outside for the first time 8 days after the birth was unbelievably overstimulating and brief - I could hear everything for several blocks around, and felt like a wild animal suddenly released into the middle of the city.

From that perspective, the care I’d recommend for new families is this:

Respect their space, and help them defend it if necessary from people like guilt trippy relatives, as best you can. Move slowly and with sensitivity. Speak quietly and gently. Ask them what kind of food they would like, rather than bringing food that you want to bring them, as digestive distress will affect both the nursing mom and the breastfeeding baby. Offer foods that support nursing: raw, clean fats like avocado and salmon, bone broth (if the mom is a carnivore) and coconut water are all incredible support to the recovering body. 

And, if you REALLY want to help, friends: offer to clean. Wash 4 dishes. Do a load of laundry. Get in there and clean. It is, in fact, the greatest and most intimate kindness. 

Resources.

These are some of the books I found to be especially wonderful.

Spiritual Midwifery and Ina May’s Guide to Childbirth by Ina May Gaskin

Heart and Hands by Elizabeth Davis

Birthing From Within by Pam England

The Birth Partner (Adam found this one absolutely invaluable - it’s also a required text in many doula trainings) by Penny Simkin

Orgasmic Birth by Debra Pascali-Bonaro and Elizabeth Davis

The Gentle Birth Method by Gowri Motha

The Thinking Woman’s Guide to a Better Birth by Henci Goer

The website that was far and away the most useful in preparing for the birth was www.evidencebasedbirth.com

In learning about breastfeeding, both www.kellymom.com and www.lalecheleague.org were awesome.

I STRONGLY recommend taking a birthing class, if you can, with a partner if you have one or with another loved one if you don’t. Ask around, go online, find out who’s really wonderful who is teaching in your area. The one we went to in LA was at a birthing center called Gracefull, taught by Elizabeth Bachner and J.J Brake, and it was tremendously helpful for both of us.

Your best resource, full stop, is your local community. Face to face as well as online. Ask around about midwives, hospitals, birthing centers, doulas, books. Talk to friends. Ask for support from people who have comparable priorities to yours and who you respect. I stopped speaking to people who I suspected would freak out about my plan to birth at home, because pregnancy really does render one more permeable than usual, and I was clear that internalizing other people’s terrors on any level held no benefit for me. Instead, I surrounded myself with people who could get with my program and support me in planning a fierce, unmedicated birth - and, better yet, with women who had already had such births. Talking to educated moms who are ahead on the curve is the single best medicine there is. 

Similarly, going into online forums can quickly become overwhelming - everybody on earth has a strong opinion and will want you to benefit from their wisdom, which cascades rapidly into oversharing and storytelling, not necessarily the most useful for a pregnant person just trying to do a little research. Set your filters properly when venturing into the jungle of the internet. 

And that, my loves, is all I have to say about that for now.

Thank you for reading. Please reach out with any questions or if I can support you in any way.

May you experience all phenomena as fodder for your growing awareness and deep, amazing joy.

GYNEPUNK IS THE FUTURE.

THESE WOMEN ARE MY HEROES. 

STRAIGHT UP.

"The Catalan collective GynePunk wants to decolonize the female body. To this end, it is developing first aid gynecological tools, for socially disadvantaged women, refugees, sex workers. But also for themselves."

READ ON & TAKE HEART:

http://www.makery.info/en/2015/06/30/gynepunk-les-sorcieres-cyborg-de-la-gynecologie-diy/

Birth: Part Two

On Hospitals, Hellraising & Homebirth

As a low-risk pregnant woman myself, I personally wanted nothing to do with hospitals, and plotted my birth to avoid them unless absolutely necessary. I wanted to optimize my chances of having a simple vaginal delivery, which meant starting in the place where that was the most likely. Beyond that, based on all that I'd seen in hospitals, it was clear to me that they are an inappropriate place for me to labor and birth unless I had an actual medical need for intervention, because hospitals are where I feel the LEAST safe - I wanted to know that any interventions that came down the pipe were truly an issue of safety, and had seen enough weirdness by then that I had very little faith in that being strictly true in a hospital setting. It's my nature to fight hard to be in charge of my experience and my body, and I’m capable of being a noisy and potentially violent asshole to defend my space if I feel like I'm being dominated or threatened - or, much worse, to submit in fear and then feel deeply injured. I wanted total autonomy, control over who was in the space and who my caregivers were, and was willing to endure a completely unmedicated process in order to ensure that.

So I decided to birth at home. Which, I found out, is rare - barely 1% of births in the United States happen outside of hospitals, including both birthing centers and homebirths. In choosing a homebirth, I let go of any possibility of pain medication during labor and delivery, and began to do a lot of research on other forms of pain management, planned transfers, the potential for needing an emergency transfer, and on what I could expect with regards to the safety of birthing in my apartment. 

I was lucky to know moms I greatly admire who had birthed at home in LA, and two of them recommended their midwives to me, as well as others they had liked but not chosen, and advised me to interview a bunch of different people, to check out birthing centers and to do some research on what I might want and who was a good fit for me. I went to three different birthing centers and interviewed 4 homebirth midwives: 7 midwives in all, all extraordinary people. While on the fence deciding between two of them, my partner and I were blessed to have a very frank conversation with the physician's assistant in my doctor's office, a knowledgeable, clever woman who has been a birthworker and educator for 25 years and knows everyone in town, and she essentially made the decision for us, saying that all of our choices were excellent but that one in particular was, in her opinion, the best she'd ever seen, by far the most experienced and the most deft in extreme circumstances. 

At our next meeting with that one, Leslie (the aforementioned gangstress who's been catching since the mid 70s), she described delivering a 12 lb baby in a bed with no tearing. And that was that, because for fuck's sake. Sold. 

Preparations.

Early in pregnancy, I started to receive acupuncture from a genius DoM who specializes in women's health and fertility, and got fantastic advice from her, which I now humbly & gratefully pass along to you:

The cure for nausea is PROTEIN. Which is a weird switch from normal nausea, and goes against most of what I'd ever been told I should eat and drink when nauseous (I heard a lot about saltines and ginger ale, and my usual go to when nauseous would be something like bread.) If nauseous while pregnant, have a couple of bites of something protein-dense: cheese, chicken, a boiled egg. Better yet, don't ever let my body be without enough protein already in my belly, and I won't get nauseous to begin with. I found this to be 100% true, and the only 2 or 3 times I felt sick enough to puke during the entire pregnancy were when I didn't eat protein in time. And I'm a delicate flower generally, prone to horrific motion sickness and emotional nausea. 

I do eat meat, and eating animal was a big deal while pregnant - I would recommend to anyone who is vegan and set on remaining so while pregnant to work with a nutritionist, even briefly, in the beginning of pregnancy (or better yet while planning their pregnancy) to figure out how to get the proteins and fats one needs to give a growing fetus everything good it needs for optimal health. 

I also saw my acupuncturist twice for something called Golden Needle sessions, also called Happy Baby or Beautiful Baby treatments in the traditional literature. In her words, these are energetic treatments to help differentiate the baby's stream of karma from the mother's. They're given at the transition from 1st into 2nd trimester and 2nd into 3rd. I hugely appreciated the concept, and in reality found both sessions deeply transformative. 

I learned a great deal from studying British OB and Ayurvedic doctor Gowri Motha's Gentle Birth Method - she has very specific things to say about how to eat to support pregnancy and prepare the body for birth which made a lot of sense to me. The main points that stuck with me are:

a) Contrary to the stereotypical pickles and chocolate cravings narrative, pregnancy is exactly NOT the time to eat whatever crap you might want whenever you want it.

b) Sugar and refined flour and other sticky foods create an inflamed body, pelvic congestion, and babies whose size is disproportionate to the pelvic size of their mothers. 

From her I absorbed the notion that a pregnant woman should gain between 25 and 35 lbs total over the 40 weeks of pregnancy, should stop eating refined sugars and flours and other mucus-producing, inflammatory foods altogether, for sure by the third trimester, and FOR SURE in the final month, and that pregnancy is, actually, the time to change one's diet for real, as everything that goes into a pregnant woman's mouth is an offering of raw materials for their baby for build a perfectly healthy body. 

The supplements I took throughout pregnancy, which additionally had the effect of clearing up minor chronic things like skin infections and making my digestion fabulous, were a food-based prenatal vitamin, a lot of probiotics, and fermented butter and cod liver oil pills. I ate a ton of butter and other oils, drank a lot of bone broth and whole milk, and in general stuck as much as possible to the Nourishing Traditions recommendations for pregnancy, which served me really well and supported a generally simple, super healthy pregnancy. 

Another piece of good advice I got from a wonderful midwife was to walk 3-5 miles a day: "Stop doing aerial, because you don't want to be building your core right now, but if you walk 3 to 5 miles a day, that baby will fall right out." Which I did, and while it would be downright absurd to tell you that my baby fell out or anything like it, my labor was of a totally reasonable length, tearing was very minimal & recovery was pretty damn fast, all told. I also read a lot of Katy Bowman's blog, which has a lot of great recommendations on what particular forms of exercise best prepare the body for birth - she's a big proponent of squats, which I did a lot of. I have never had such a commitment to regular yoga, but continued to do a brief practice as often as possible, and found that it strengthened and stretched my hips better than anything else. 

Perineal massage is a great idea and a lovely thing to do as birth prep. Ask your loved one or hire a sexological bodyworker or a women's health PT. There is also a device for perineal stretching that we can't yet get here in the US called an Epi-No - you can get it in Canada, but not here, stupidly - which is a hand-inflatable bulb doodad that I've heard is pretty wonderful. I have been advised by a more experienced kink player than I that it is essentially a glorified kink toy, so it's probably findable here in that form. Because the internet is simply amazing. 

What Went Awry

My particular issues during pregnancy were mostly incredibly annoying recurring vaginal infections, primarily yeast infections, which is very common: the body's pH goes bonkers during pregnancy, and all the normal flora goes wild right along with it. Then, late in the game, I tested positive for BV, yeast AND Group B Strep (more commonly referred to as GBS.) I took antibiotics for the BV, as it could have caused pre-term labor, and took Candex for the yeast, and took a shitload of supplements to help my body process all of that. But the one that was truly unfortunate was the GBS. 

GBS is a normal part of healthy vaginal flora for a third of women. If you ever wear a thong, chances are that you are among them. The bacteria comes and goes - a person will test positive and then negative 2 weeks later without having done anything differently. No one cares unless you are pregnant, at which point it becomes an issue for anyone who delivers a baby vaginally: the baby can be colonized in his or her passage through the vagina and vulva (it's a bacteria that resides primarily on external tissues), and a colonized baby can then develop an infection, which in a tiny percentage of babies can lead to serious problems requiring antibiotics and hospitalization. An extremely tiny percentage of infected babies die. 

The way United States medicine handles this is to give birthing women who have tested positive preemptive IV antibiotics. Had I gone to a hospital, that would have happened, and I would have let it - the alternative being that the baby is whisked away for observation after the birth. A hospital will insist upon prophylactic IV antibiotics if you have EVER had a positive GBS result on your record (even if a more recent test is negative), including one with a previous baby. No hospital will let a GBS-positive birthing woman sit in water, which is sad for anyone desiring a water birth. Also, if the event that begins labor is the water breaking (as opposed to contractions starting or the mucus plug coming out), hospitals will put a birthing woman on a clock for delivery - I believe they will give you 18 hours from water breaking to have the baby out - and this will frequently be the reason given for inducing with Pitocin. The wisdom of that timing is subject to quite a lot of debate, and 18 hours is on the short side in the spectrum of care worldwide. The threat of infection spreading up the birth canal and into the uterus is real, and can certainly happen if caregivers are penetrating the vagina with instruments or fingers to check for cervical dilation, or for any other reason - meaning that no one should check until they absolutely have to, as late in the labor as possible - but there are many things about an 18 hour deadline that make very little sense, particularly when there are already antibiotics involved which should, if they are working, make infection a non-issue. 

At a home birth, I had the option of refusing IV antibiotics and treating it instead in the way that is common in Europe, which is to do frequent peribottle rinses with a dilute solution of an antibacterial wash called Hibiclens, which you can get at any drugstore for a couple of dollars. (Note: NOT a douche, which rinses internal tissues. Peribottles are basically squirt bottles which are used to give a focused rinse to the external tissues of the vulva and perineum.)

I did a lot of research on this, and found a ton on the internet, most notably an AMAZING website called Evidence Based Birth. Out of everything I read, the statistic that jumped out was that 61% of infected babies are born to mothers who tested negative - as in, the birthing women who tested negative at 34 or 36 weeks developed the infection thereafter but weren't tested again, and then passed it on to their babies unknowingly. If no one was properly observing those babies, infections went untreated and became complicated and potentially fatal. That number clinched it for me, and luckily I had still had time to prove to myself the Hibiclens washes worked by retesting well before I was due.

So, at 8 months pregnant, I stopped having any sort of penetrative sex or touch (i.e. no perineal massage) to avoid spreading the bacteria into my vaginal canal, took antibiotics and a ton of probiotics for the BV, and crossed my fingers that they would also work on the GBS (there are various strains of GBS that respond to different antibiotics, but we were unclear which I had). I then started the peribottle washes, and when I was tested again I came up negative. I kept doing the washes on a daily basis until labor began with my water breaking, and then did them every 4-6 hours during labor. I refused IV antibiotics during labor because I wanted both my colostrum and the baby's gut flora to be intact, and I had concluded from all that I'd read that the local washes were every bit as effective statistically as systemic antibiotics. 

And we have been 100% fine. 

For which I am massively grateful.

Switching Horses Midstream, or: The Clusterfuck and How It Resolved.

A particularly steep learning curve began at 4 months, when a friend delivered her baby with the same OBGYN I had been seeing, and I was less than happy with the combination of neglect and swift, reactionary overmanagement with which she was handled in labor and birth. 

I remained with that doctor for a long while afterwards - I loved everyone else in her office, and I'd only even seen her once or twice, as her extremely wonderful physician's assistant saw most patients for office visits, and so I kept going with the idea that it would be fine for this woman to be my backup doctor, which all midwives require in the event that there's a transfer. The PA, who knew and greatly respected my midwives, said that she'd strongly recommend backing them up to the doc, and that it should be no problem. And I was optimistic. I knew myself to be more informed and less reticent about my desires than my friend had been, and told myself the story that the doc would be different with me. 

Then, between 7 and 8 months, I began having the tiniest bit of spotting. My midwives thought it was unlikely to be a big deal but wanted me to be tested for a UTI just in case, and I called my doc's office to arrange a test. I was told by the front desk that the doc wanted me to go immediately to the labor and delivery ward to be monitored for preterm labor. I assured them that I wasn't in preterm labor and that the spotting was negligible, and refused to go in - I had a bad feeling about going in for reasons ranging from unnecessary hospital bills (I had recently accompanied my loved one to the ER, where fuck all was done for her and she accrued a bill to the tune of several thousand dollars) to my distrust of the wobbliness of patient consent in hospital settings. I was again pressured to go, and, reasonably or unreasonably, got a very bad feeling. My midwives told me that they legally couldn't tell me not to go once I had been told to by my doc, but recommended that I go to be tested and monitored to another L&D ward at a different hospital known for being very laid back. I told them that I intended to switch doctors, and they agreed that this kind of reaction was a conveniently timed preview of what would happen in labor if I kept this doctor as my backup. 

I went for testing and monitoring at UCLA, where the young doctor let me insert my own speculum (she had apparently never been asked for that by a patient before) and gave me an ultrasound gently enough that the baby didn't squiggle and turn away from the wand, giving us a clear view of her magically familiar profile. I was prescribed 2 different antibiotics and an antifungal before even getting test results back. Upon calling in for results, I was told I had BV and that I should start a 10 day course of Flagyl (a broad-spectrum semiautomatic weapon of an antibiotic), and to call back for the results of urinalysis. 5 days of daily calls later, I was told by a random doctor reading me my chart verbatim that I had, in fact, tested negative for everything (and was therefore taking heavyweight antibiotics because the original doctor, for reasons unknown, had lied about my test results) and that no urinalysis had ever been ordered. 

Mystified, pissed off and disheartened, I got a referral from the midwives for their preferred backup doctor, a guy with privileges at Cedars named Dr. Chin, and went to see him for the one visit he required in order to get me in his system and agree to be my backup. He sat me down in his office and said some marvelously direct things: if all went well, we would meet this once and then not again until I wanted him to act as the backup for my next homebirthed kid; this visit was primarily for me to see that he's not super weird and for him to see that I'm not super weird (that is a direct quote); and, most importantly, he needed to say to me that my birth might not go the way I wanted. He wanted to drive home the point that I could end up in the hospital and under his care with a planned transfer for any number of reasons. That it would be the midwives' call if that was to happen, not his, and that he trusted them 100% to know if and when that should happen, as should I. And that if this should happen, he needed me to NOT FREAK OUT, to remain calm and to trust that he and everyone working with and under him would do everything in their considerable power to make sure that I had a safe and connected birth as close to my wishes as possible. OK? OK, i said. 

He then gave me an ultrasound, and within seconds caught what not a single other doctor or nurse or PA giving me an ultrasound anywhere had: "I bet you're spotting, huh?" he said. "It's because your placenta is low." Once I recovered my cool, I told him that the spotting had caused me to be misdiagnosed with infections and unnecessarily prescribed a lot of antibiotics, and that I fervently wished I had come to see him earlier, at which he clucked like a disapproving grandma. And upon making sure that I didn't have placenta previa (the placenta has to have a minimum of 2 cm clearance from the cervix in order to safely have a vaginal delivery - any closer than that can cause a lot of bleeding), he said "Yup, you'll bleed a little bit more than most women, and it's nothing to worry about." And he shook my hand, and vanished.

Hypnosis.

In the midst of all of this, I realized that I wasn't just dealing with a reasonable desire to not birth in a hospital, but had in actuality become terrified of the prospect, and upon reflection on Dr. Chin's fantastically rational perspective and the very real possibility that I would, for one reason or another, need to go to a hospital during labor, I decided to enlist the help of a hypnotherapist.

I saw Jim George for one session, and, despite my being a stubborn ass of a person who has never been susceptible to hypnosis or 'going under' or really any sort of suggestion, I cannot recommend him and the practice of hypnotherapy enough in this context. The man is an extraordinary wizard. I have never sat with a more completely present human being. 

Many things were said during that session, but most notable to me was his utterly convincing assurance that I was going to give birth at home, and that I knew exactly what to do. He said it, and it was so. I emerged from that session unafraid of birth, sure that I wasn't going into hospital, and knowing I would be calm regardless. 

Part Three forthcoming, famiglia! 

xoxo

Birth: Part One.

Dearest Loves.

I'm writing this note to offer whatever useful information I can to any of you who will ever give birth, or help facilitate someone else's birth, and to anyone who is interested in a very personal take on the ins and outs of homebirth in the modern world.

I had an amazing, well-supported pregnancy and the most ideal birth I could have imagined this past July, followed by easy breastfeeding and a relatively quick postpartum recovery. Some portion of that is certainly luck, but the rest is the result of several years of research, planning, and sticking to my guns. If there's any part of my experience that could help anyone else make the necessary choices to have their version of the same, I want to provide the straight story of the things that worked: good advice I received, my understanding of choices, preparations and outcomes, things to consider, and things to avoid. I discovered a lot during the months of pregnancy that I never found in any book. (There was also a ton of great information in particular books and websites, & I'll name those here as well, as there are countless forums with wildly conflicting opinions and books claiming to be The Book and it can be a loaded and confusing rabbit hole to navigate, so I can at least recommend the ones I found especially great.)

Again: I'm aware of what role good fortune played in my outcomes and certainly don't take any of this for granted, and also must champion the role of preparation to meet and elicit good fortune as much as possible.

Please take this for what it is, which is one person's highly subjective perceptions and opinions. It goes without saying that every birthing person is completely different, and what worked for me may have nothing to do with what will work for you. My intention is for anyone reading this to please take anything that feels right, and to let go of the rest. Nothing to fight about here.

Also, this contains a lot of information. Among other things, I'm going to be talking about my VAGINA. Because that is where babies - at the time of this writing, the majority of babies - come out, and it is where my baby made her grand exit from my body and into the open air. Dig? If that is TMI for you, don’t read this. You have been warned.

I went into my pregnancy having trained years before as a doula and then having assisted a handful of the births of close friends, all first births, all in hospitals in Los Angeles. Out of those handful, 3 went to an unplanned caesarian section (meaning that those women had not intended and scheduled it, as many do - they had wanted vaginal deliveries), and I think it's fair to say that those women were traumatized to one extent or another by the way they were handled. The 4th went beautifully until a resident (a doctor in training doing his clinical rounds) decided, without the attending midwives' knowledge, to try to dislodge the placenta: he pulled the umbilical cord and prolapsed my friend's uterus (which resulted in her needing to have her second baby as a scheduled caesarian some years later to avoid the risk of another prolapse.) The 5th was the best possible outcome, a beautiful experience with only relatively minor hassling and rushing on the part of the hospital staff: she was given a slowly elevating steady dose of pitocin to move things faster, asked for and got an epidural when the many hours of intensifying labor became overwhelming, and managed to get some sleep; we went through 3 or 4 shifts of nurses during the 24 hours we were there, and most were helpful and sensitive and kind; upon being checked in the morning after some hours of rest, her cervix had dilated beautifully; the doctor showed up in time to suit up and catch the baby. Everyone was healthy. 

I learned a great deal from doctor #5 about waiting during pushing, and saw that my friend barely tore at all as a result of not rushing, giving her tissues ample time in between contractions to stretch around her emerging baby. From nearly every other primary caregiver, I learned a great deal about what NOT to do: how not to scare a birthing woman or her family, how not to abruptly deliver bad news to the birthing person, how not to rush the placenta delivery, how not to lie, how not to refuse to pass a birth on to one's partner despite exhaustion after several deliveries in a row, how not to look at one's watch and push for things to hurry along based on one's own desire to make it to a date that night (yes, that really happened.)

I saw that the culture of each shift of nurses is distinct from the shifts that preceded and followed it, and that the nurses, unless challenged directly by another caregiver, will often make somewhat arbitrary decisions based on what they believe is the best care. Some will lie and be assholes to defend their decisions. My job as a doula with those nurses, who I've found to be a consistent minority, was to run interference and defend the space and agency of the birthing woman. With caregivers who were genuinely supportive of the birthing woman's own process, I helped, watched, and learned a lot as an ally and another set of capable hands. There are plenty of both kinds in the hospitals, as there are good and bad practitioners in any profession. The difference in a hospital setting is that it is completely unpredictable who will show up and when - and when someone unsympathetic to your needs shows up as your nurse in a hospital, it’s can be a hell of a lot of work to move the necessary pieces around to not have to deal with that person, or with those who are invested in them and their authority.

My conclusion is that, as a doula, I want to support everyone I love who chooses to birth in a hospital. For many of us, it really is the place where we feel safest, especially in as wild a state as one is in going through labor for the first time - it's great to be somewhere that feels so utterly capable of determining normalcy and handling problems. And for those of us with high risk pregnancies and predictably complicated births, those of us who encounter emergencies, and those of us who just want to schedule a caesarian, hospitals are a godsend. 

So. I would recommend to anyone reading this who DOES feel the safest in a hospital to BY ALL MEANS PLAN ON A HOSPITAL BIRTH. 100%.

Feeling safe is necessary for feeling relaxed, and relaxing as much as is humanly possible - not having to vigilantly ensure your own safety while trying to birth a baby - is the best way to have an uncomplicated and successful birth. Feeling in control and well taken care of, whatever that means to you, is the golden key to the best possible birth experience.

In no particular order of importance, I passionately recommend the following to anyone who wants a hospital birth:

1) Do proper research into the policies and outcomes at the different hospitals in your area - they vary enormously. 

Unless you're planning a caesarian, where do they really work their asses off to ensure vaginal delivery whenever possible? Where do they offer walking epidurals, in which the anaesthesiologists will scale down the intensity of the numbing to let the birthing woman feel her legs and control her own movement, which is essential for moving the baby's head into an engaged position in the pelvis and dilating the cervix? Where do they train their nurses to help position a laboring woman with an epidural to effectively move the baby down into that engaged position in the pelvis? What is their position on routine episiotomy, which should be that they do not perform them unless absolutely necessary? What are their recent statistics on C section outcomes? Will they allow you to eat and drink as much as you wish during labor to keep up your calories and energy, as they should?

Be very thorough with your questions, even if you feel like you're being a pain in the ass - please remember that you are considering who to employ to assist you with one of the biggest events of your life. You are beholden to no one. 

2) It must be said: births, especially first births, can be scary as fuck. Birth is beyond psychedelics. It is beyond extreme sports. It is the great leveler. So intense is it that, having now done it unmedicated, I have great respect for all of the reasons that that is a rare decision. It is a tectonic rupture in time and space, unprecedented in scope and depth, heralding an entirely new reality, comparable to a one way ride to another planet. 

That said, it is COMPLETELY UNDERSTANDABLE that most of us, raised as we are in a medicalized culture - raised to accept the authority and expertise of doctors, and to feel profoundly reassured by it - are much more comfortable having that experience managed for us. A doctor will tell you, from their experience, whether or not everything is normal and healthy, what to do and how to do it, and has in their back pocket a lot of tools for shaping the labor and delivery, including drugs and surgery. 

That said, PLEASE: CHOOSE YOUR DOCTOR WISELY. They're really not all the same. They have extremely different opinions on how things should go down. Please put your care into the hands of a person you agree with and trust, preferably someone who's recommended firsthand by someone who has comparable priorities to yours. Don't assume a doctor will rise to the occasion to do something different for you in the moment than they normally would, because they won't. They will do exactly what they have consistently done all along. So find out what that is. Ask around. If you want to work with midwives, ask them which doctors they love and recommend to have as their backup - they'll always know the best ones. You want to know in your gut that whatever interventions are being recommended are actually necessary, not merely convenient. 

3) At the risk of repeating myself: if you have never had a baby or seen a birth, you might not really know that it will be the most bonkers experience of your life. We've all seen the movies, but movies are always about something happening to someone else.

So: in all births, but especially in a hospital setting, you want to build in everything you possibly can to ensure that you will have all of the peace and support that you want. You will not be able to keep people out of the room in a hospital, but there are wonderful tricks to making sure it goes as well as possible. Mammals are not built to give birth under observation, so ensuring a maximum of privacy and quiet for your ease in a setting where there is generally very little of either is absolutely key. It is the trick of building a dark cave in the middle of a busy train station.

One such trick which I learned in a birthing class, the best I have ever heard and one I for sure would have used had I ended up in hospital, is to have whoever is filling out the intake paperwork state front and center that the birthing woman has PTSD. Whether she actually does or not (and it's really not for anyone else to say, frankly), saying that she does will ensure that the hospital staff act with much greater care and quiet and respect for space than they ordinarily might: i.e., they will knock before entering, keep voices down, and in general act in a manner that they should be acting anyways, in order to not trigger a freakout. This is a buffer that you want and need. Please don't underestimate the value of this.

4) Get an experienced doula. Seriously. Whether a partner is present or not. Having a seasoned advocate and badass support person whose entire job is to have your back under all circumstances is a tremendous, amazing boon in a situation where the birthing woman is very vulnerable and in a setting where things can happen very quickly. No to mention the arsenal of tricks that doulas have for relieving pain and moving the baby and every other thing one needs in labor. The doula is the person who will stay with you most or all of the time, whereas the doctor and sometimes even the midwife will arrive in time for the pushing and the catch. 

5) Birth is a hurricane of raw emotions and huge sensations and high stakes, and success relies upon being able to relax without self-consciousness into the wildness of all of that.

Therefore: Do Not Have ANYONE Present In Whose Company You Will Not Be Comfortable In An Altered State.  

What this means in reality is that if your mom, for example, wants to be there, but you know in your heart of hearts that you do not have a relaxed and easy time with your mom, NO MATTER WHAT, EVEN IF IT HURTS HER FEELINGS, DO NOT ALLOW HER TO BE PRESENT DURING YOUR LABOR. If she knows anything about anything, she will support you in whatever you need at this time, even if she doesn't necessarily like it. Because it's YOUR BIRTH, and is therefore about YOU. Please accept this Get Out Of Emotional Jail Free card from me. At no other time are you more wholly allowed to be entirely selfish in your choices, so - I implore you - don't let anybody get away with guilt tripping you about this. I have witnessed firsthand and heard endlessly about this exact dynamic: usually parents (but sometimes partners or siblings or others whose closeness "should" be OK but frankly isn't) in the room or at the hospital somewhere waiting and whose presence creates enough stress that the birthing body cannot relax enough to do its thing. The direct and quantifiable result of this is that the labor will stall. It won't happen to everybody this way, but it is frequent enough that it's a commonly told story. 

So: your mom, or whoever fits this description in your world, can come when the baby has been born and bring food and kvell with you. Find a way to say no. Create the buffer. Even if it's your partner. Even if it's your BFF. Examine your heart with great honesty about this, and only allow people to be with you in whose presence you can relax, for real.

6) If you would prefer to not have a C-section, I strongly strongly recommend prepping and birthing with a midwife, as they offer very different care than OBGYNs, and have a skill set that incredibly few doctors in this country are able to match. It was explained to me by an MD while I was pregnant that MDs are trained to intervene in a problematic birth, but not really ever trained in how to facilitate a normal healthy birth without intervening. Many midwives are able to administer drugs (although epidurals are only available in hospitals, as they are delivered by a line into the spinal cord rather than by injection or IV and are therefore more complex to deliver and monitor appropriately.) However: the midwife's expertise is how to employ every trick in the book to get things moving in the right direction without resorting to the surgery and drugs which are the doctor's provenance and are at best never needed, in my opinion. Midwives know how to do a ton of shit most doctors have no idea about and will tell you cannot be done. A perfect example is that it's a rare doctor who will deliver a breech baby - and yet midwives abound who, upon checking and finding out the position of the baby some weeks before the due date, can do a number of things to turn the baby into a more optimal position and/or deliver a breech baby without blinking an eye about it. 

And - you can absolutely have midwives as your primary caregivers in a hospital setting. There are a number of hospitals where that is on offer. So, again: research your options. 

7) Routine episiotomies are, in my opinion and in the opinion of the most experienced midwives I've ever met, a bunch of bullshit. They do not prevent tearing and in fact make tearing worse. There are women whose perineums are so godalmighty muscular and gangster that an episiotomy may be indicated during a delivery, but those occasions are rare. The comparison I was given by my midwife was the notion of trying to tear an intact piece of fabric versus trying to tear a piece of fabric that already has a cut in it - if you've ever tried to rip through something, you know how much easier it is when there is already a cut. Her opinion, as a midwife who's been catching babies since 1975, is that episiotomies performed routinely cause some of the worst damage and the most horrible recovery periods for birthing moms of anything that could happen, including caesarians, and are to be avoided. And, having pushed an average-sized baby out myself now, I concur: I had 2 stitches, was able to have sex after 6 weeks or so, have had minimal scar tissue formation, and my pelvic floor is more or less fully recovered at 4 months out. It is to some extent luck of the draw, but that doesn't make precautions and preparations irrelevant.

Part Two coming soon. Stay tuned, family.

xoxo

The Racist, Sexist History of Birth Control

VICE has just published a piece on the misogynist, deeply racist origins of hormonal birth control, and it is a fairly amazing read.

Cited at the top of the article and also worthy of some attention is the Danish study, published in psychiatric journal JAMA, showing concrete correlation between the use of hormonal birth control and diagnoses of clinical depression in users, particularly in adolescent girls. There has been an outpouring on the net of responses from women who feel that the study vindicates their personal experiences, which, consistent with medicine's historic dismissal of women's emotional and mental health, have generally and specifically been disregarded by doctors. Holly Grigg-Spall's response in the Guardian is particularly succinct on this. 

The VICE article is part of an ongoing series examining the history and future of reproductive rights to celebrate the 100 year anniversary of Planned Parenthood, bless them, and it is full of jewels.

Highly recommended, y'all.

Womanifesto. 2003.

In 2003, my doctor pressured me to start hormonal birth control in the form of a new plastic IUD that secreted tiny amounts of hormone into the uterus - such tiny amounts, he assured me, that they had no systemic impact at all. I had already had a horrible reaction to the single shot of Depo Provera he'd given me years before, and I refused. I then fought him tooth and nail to fit me for a cervical cap. By the time I left his office, I was in equal parts incensed and elated: cervical cap in hand, I was clueless as to how I was going to use it to not get knocked up. I felt bizarrely like I'd won and lost simultaneously.

Shortly thereafter, I found myself in a bookstore with a copy of Inga Muscio's book Cunt in my hands. I sat down on the floor, read the entire thing straight through, and then went home and wrote what follows. I had never written anything like this before, and after fact checking it obsessively, I sent it out as an email to my friends. I was 26 at the time of writing, and I still get occasional emails from complete strangers asking for the text, 13 years later.

Dearests.

The following, to whatever degree of organization it may reach before I deem it acceptable to send off to you, is for all the women I love, to read and, as you see fit, to add to, revise, & pass on to the women you love as a communal document. Men should read this too. Anyone & everyone who knows & loves women should be in on this conversation.

Certain things that are common to all of us have come to perplex me to no end, and I have finally just hit a fucking wall. 

The object of my present inquiry and fist-waving ire is the medical industry, & the way women are taught to perceive their bodies, and the incredibly duplicitous & bizarre approach taken by conventional medicine to things like birth control. It's at best annoyingly negligent & at worst fatal to be treated with substances that are developed with profit foremost in mind & which approach the patient as a consumer and a guinea pig. This plays with my life & health & the very fabric of my godly soul as if I am expendable, and this has come to be completely unacceptable to me.

I haven't had a major medical tragedy thus far in my life, but I know plenty who have, & I bet you do too. 

Medicine is by no means a perfect science & this is not my contention with it.

I demand an understanding of health & medicine that regards each & every single person manifest in a body as valuable. I want that & i don't think it's too much to ask.

& so: I hop off the soapbox & get into the belly of what this is for, this email.

This is for information.

What I want to share may or may not be old news for you - if somebody along the way enlightened you about the details of your cycle, alternative contraception, and resources for nonmedical interventions in unwanted pregnancy, bless them & spread the word. Keep spreading the word. This information, despite the fact that it comprises the most normal & basic facts about the bodies we inhabit 24 hours a day until the game is over, is for SOME REASON NOT TAUGHT ANYWHERE!

Why don't we get this in junior high? Why are there postmenopausal women who still have no idea how their bodies work? Why aren't moms passing this along with the first talk about menstrual blood?

My personal take is that it isn't taught in schools or popularly endorsed by medical professionals  because there is absolutely no profit to be had from educating people about the natural & healthy states of their bodies, & the ways one can be responsible for avoiding or pursuing a pregnancy in accordance with that. Mindboggling amounts of money are being made in the current configuration of power and knowledge, and you can't sell a damn thing to people who know what's up. We are held in thrall by by our own ignorance. 

Thus, it falls to us to learn, and to make it common knowledge. 

So: herein are the basics of what I know that it seems to me everyone should & certainly many of you do already know.

I believe strongly that all people with a cycle should have full access to this information. And, because the discussion is focused on fertility and pregnancy, this information is most relevant to people who have sex involving vaginas and penises. 

There are a few things in here. They are intended mainly for those among us who don't currently want to become pregnant, but it's all equally essential and helpful for those who do. The information is available. Use it how you will.

The first thing is how to know when you are and are not fertile.

The second has to do with what you can do if something goes awry and there's a possibility that you are already or will soon be pregnant.

PART ONE.

Firstly, it is essential to me to take responsibility for my own body as an adult woman. I don't trust strangers in labs and offices to care about me. This may be cynical, but it is nonetheless the result of hearing and reading many grotesque stories, and experiencing a thing or two with my own doctor which have resulted in him not being my doctor anymore.

Secondly, all forms of birth control, whether barrier or hormonal, kind of suck, in my opinion. Other than the possible variations on abstinence, they all have failure rates, varying levels of discomfort and interference during sex, and/or side effects - and they very nearly all fall to the female partner to handle. Condoms, the pill & all of its manifestations as patches, rings etc., diaphragms, cervical caps, spermicidal jelly, IUDs, nonoxynol 9, and the very sketchy Depo shots.

(Cervical caps, which were the method of choice during the glorious swell of feminist women's health movement during the 1970s, are the least horrible of the lot, in my opinion. But they too have statistical failure rates, and can be exceedingly difficult to find.)

If you disagree with the above statement, you can throw this email away & I love you very much & have no further reason to take up your time.

If you don't disagree with the above statements, & have yet to learn the circumstances in which birth control works, read on.

Every female past a certain age has a cycle, n'est ce pas?

You bleed, regularly or irregularly, approximately every 28 days. I myself bleed every 31 days. Different for everyone. About halfway through that cycle, you drop an egg. It sometimes gets screwy when you travel or are overwrought about something. Normal.

EVERYONE'S CYCLE IS DIFFERENT AND THE ONLY PERSON WHO CAN EVER KNOW ALL OF ITS NUANCES & QUIRKS IS YOU, but the basic arrangement is the same for everyone. 

(Of note: one of the side effects of taking hormonal birth control, or having taken it in any significant amount in the past, is that it will totally hijack the normal rhythm of your cycle. Synthetic hormones act to prevent pregnancy by essentially fooling the body into perceiving itself as pregnant all the time, and it takes time, months or years, for the natural timing of the neuroendocrine system to reassert itself without this constant chemical tampering. Trace amounts of synthetic hormone will remain in the body’s soft tissues until addressed. Therefore, supervised nutritional or herbal cleansing after quitting hormones is a REALLY, really marvelously  wonderful idea. Just saying.)

When your cycle is quite itself and you become even marginally aware of what it's up to, it becomes possible to know when you're fertile and when you're not.

You are fertile for about 24 hours out of every cycle, & that is ALL. One day out of the month.

It's tricky as hell trying to pinpoint exactly when that day is coming, but if your cycle is regular, it isn't particularly tricky to figure out more or less when it's come & gone, & to allow plenty of leeway for uncertainty.

Other than this, you are not fertile. There is still decidedly the possibility of various contractable sexual diseases, but you cannot get pregnant. 

This, when i found it out 10 years after it became relevant, was some powerful knowledge. I don't want progeny anytime in the immediate future, &, like most, i think condoms are a necessary evil & am fastidiously careful about things all things sexual. Sex Ed has effectively scared the shit out of all of us. 

However, in the context of a trusting sexual relationship in which everybody has been tested properly, it is possible to dispense with the horrible condom at the right moment.

I love this.

Additionally, it is ridiculous to have a body & not understand what the hell is going on within it, regardless of the presence or absence of lovers in one's life.

I love knowing everything. It is good for me. 

So.

An egg lives for about 24 hours.

Sperm can live in the body for up to 5 days. Conservative folks will say 7 days. 

Thus, if you have sex 5 days before you ovulate, you can conceivably get pregnant. 

If you want to get pregnant, figure out when this happens & do it like bunnies in the wild all week long. Lock yourselves in. Take the phone off the hook. 

If you do not, you need to know how to figure out when all this happens & be very careful all week long.

The way you can know when you have ovulated is multifold but simple. It is easy & good to make it a no-brainer part of your life. 

THIS IS NOT THE RHYTHM METHOD, which has about a 60% success rate. 

This way is known as the strict method, which combines a bunch of factors, and basically holds that the safest time to fuck unfettered is between the end of ovulation & the beginning of bleeding. If you want to go further & investigate when during the rest of your cycle is safe, please read & inform yourself further as that is determined by the length of your own personal cycle. The stuff I’ve put down here holds true for everyone.

1. Keep track of when you bleed. Write everything down: when it starts, when it ends, exactly. This is of utmost importance as it will tell you how long & how regular your cycle is & where it falls in accordance with the rise & fall of the moon, if such things interest you as they do me. The 1st day of blood is considered day 1 of your cycle in the parlance of birth control.

2. Go to the local pharmacy & buy a basal thermometer. Get them to order one for you if they don't have them. Many places don't seem to have them, or if they do it'll be part of a kit designed for couples trying to get pregnant. Don't be deterred by this - the tools are the same, regardless of intention. I had to look all over the place & finally somebody just ordered me three of them. They usually cost less than 4 bucks & they absolutely rock. It's just a thermometer which shows temperature to 1/10th of a degree. It will tell you when your egg has come & gone.

3. Get familiar with your genitalia. Aside from being endless wholesome good times, if you get to know your fantastical cunt as well as you do the rest of you, the workings of your cycle will become clear. The mucus that emerges from you constantly changes in color, texture, smell & taste throughout the cycle & if you get to checking it out regularly it will tell you everything you want to know.

& by the way, i'm a big fan of the shared responsibility idea. If you have a constant lover, he or she or they can & should be made aware of all of this too. It's an honor to know a body so intimately, & everyone involved should be aware of the comings & goings of said body, to my mind. 

If you are keeping track of when you bleed, taking your temperature, & checking out your mucus, you are golden.

PLEASE, please keep in mind that this stuff varies from woman to woman, according to natural tendency, what you've eaten, if you smoke or do drugs, if you've had a sip of wine or the whole bottle, if you’ve recently skipped time zones in a plane, if you're doing a lot of physical labor or none at all, if you're running around the city or lounging in the country. THE POINT IS FOR YOU GET TO KNOW YOUR OWN UNIQUE & GLORIOUS BODY. Only you can ever really know it. 

This is essentially how tracking your cycle works:

TEMPERATURE: 

Take your temperature every morning. Do it before you roll out of bed, before daily activities bring the numbers down. It takes a minute. Write it down. It's clearest to make a graph & keep track of it there. Write down any relevant-seeming details, like if you only slept for 2 hours, if you got up a while before to take a pee. Anything that might affect the accuracy of the reading. You will have lower temperatures until you ovulate, and then it will rise about 6/10ths of a degree. It might happen all at once or over a few days.

An egg lives 24 hours.

You want to record 3 consistently high temperatures before you throw caution to the winds. The book from which I first learned this provides this rule: Don't make love until you have recorded three consecutive temperatures that are .3 degrees higher than the constant was before it began to rise.

Yes?

OK.

MUCUS: 

Sperm need an alkaline, as opposed to an acidic, environment in order to survive for a while. This is where mucus comes in - your body produces a bunch of very alkaline mucus when you ovulate to kick up the chances of a pregnancy. This mucus is different in taste & texture & is just a whole other substance than it is at infertile times. If you're paying attention & checking yourself out throughout the month whenever you hop into the shower, this will become abundantly clear. IT IS IMPORTANT NOT TO CHECK OUT THE MUCUS WHEN YOU ARE HORNY, as lusty mucus is entirely different than cervical mucus.

It occurs to me what a horrible word mucus is.

Mucus. Mucus.

The mucus you want will be accessible with a shallow finger swipe - you don't have to do a serious prowl. Typically, fertile mucus will be more thin, white or faintly yellow, milky or clear, sort of liquidy and flowing, sweeter in taste, and there will be plenty of it. Infertile mucus is thicker, pastier, has more matter in it, stickier & gooier, and more strong and sour tasting. The closer you get to ovulation, the more clear & liquidy & profuse it will become. After you ovulate, it will return to the pasty gluey. When you are absolutely infertile, there will be little or no mucus at all. The specifics will vary quite a lot from girl to girl. Pay attention to your own monthly fluctuations & see what goes on for you personally. Keep track of the state of your deliciousness and record it all with the temperature observations. Write it all down on the graph. Makes everything super easy.

THE 4th DAY AFTER YOU OVULATE, the mucus will be back to the thicker type. This ideally will correspond to the 3rd day of higher temperature. THIS IS THE PARALLEL CHECKPOINT. If the temperature is still low or wavering, bust out the condoms or other barrier. If the mucus is still suspiciously flowing along, barrier.

Leave a day or 2 safety margin, definitely. 

And by all means, please please read. Read up on this. Don't take my word for anything.

PART TWO.

So, a condom has broken, or you've sucked it right off your lover with the might of your womanhood as I recently did, or there was no condom to begin with. This happens.

Here is what you can do.

AT THE TIME IT HAPPENS, as soon as possible - 

- Take 1 or 2 tablets of non chewable vitamin C, preferably a 500-mg pill, and insert it as far into your vagina as possible, up near your cervix. The C changes the pH of your vagina and makes you very acidic, making it very difficult for sperm to hang out for long. Insert a tablet or two every 12 hours for 3 days. If it irritates you, insert some plain yogurt with a teaspoon or a baby syringe or steal someone's turkey baster.

- Start pounding lots and lots of C orally. THIS IS NOT RECOMMENDED FOR WOMEN WITH KIDNEY PROBLEMS, & the oral doses will be less effective for you if you take lots of C already. In general, you can start taking major doses of C to bring on a late period whether or not there's been a mishap. Drink lots and lots of water with your vitamins, to help their passage through your system & keep it all moving along.

- Take 1 teaspoon of wild carrot seeds orally as soon as you can, and thereafter every day until you bleed. This is the old-time remedy & works by making the uterine wall slippery so that the egg can't implant. CHEW THE HELL OUT THEM TO RELEASE OILS, and make sure if possible that they haven't been chemically treated, as this makes them considerably less effective (as is true for all plant medicines.) Find organic or wildcrafted ones, if you have the choice.

- Start eating parsley like it's going out of style, and keep a sprig of it inside the vaginal canal as a pessary, much like a tampon, also up towards the cervix. It will get soft and fall apart and it's absolutely nothing to worry about. Can't hurt you. Change it twice or 3 times a day. This is also a time-tested remedy for any kind of late period, & one that has brought on blood for me consistently.

(ALSO: Since the writing of this, we had a second condom mishap, while traveling, at exactly the riskiest time of the month, & I was panicky enough that we trundled off to Planned Parenthood, goddess bless them, and they gave me the new & improved morning-after pill. It's called Plan B, rarely has side effects, & didn't disturb my cycle at all. Whereas the old pill brings on the blood early & rudely disrupts everything & makes you feel like hell for days, the new one is a motherlode of synthetic progesterone which delays ovulation for another 3-4 days to keep sperm & egg from bumping into one another and makes the uterine wall less friendly to implantation, effective only if the egg hasn't already made a nest for itself - i.e. pre-conception, as medically defined, NOT an abortifacient pill. It's not as sweepingly certain on its own, but can be safely combined in a pinch with any or all of the above home remedies for good measure. And while taking a single strong dose of hormone isn't an awesome thing to do, it's far easier to deal with the systemic toxicity of that than it is with the effect of years on the pill, and worth it to me for the peace of mind.)

AT THE END OF YOUR CYCLE, if bleeding has not yet commenced for whatever reason:

- You can investigate and work on them yourself, or find an experienced & trustworthy practitioner of acupressure or acupuncture and ask them to work on the 22 "forbidden" pregnancy points to bring on your period. These 22 points are traditionally avoided because they faithfully provoke uterine contractions and keep the period regular. This has worked quickly & well for me. Acupuncture and acupressure are High Arts.

- Visualization is some powerful shit when it comes to bringing on one's period. Concentrate your days & nights upon visualizing your womb gently shedding the egg and massage your lower belly to get things moving as much as you can stand it. Talk to your body in the shower. It will respond.

- There are a number of simple and effective recipes for herbal emmenagogues which will, if prepared carefully and taken at the right time (i.e. within 5 days of when the period is supposed to begin and no later), bring on a miscarriage. 2 of them are printed in Hot Pants by Blood Sisters, and others can be found at wwww.sisterzeus.com. They are potentially hard on the body, but if you are attentive & careful they are an option. *It is very important to note that herbs in this context work as a poison, and that in the event that they do NOT produce a miscarriage, the fetus will likely not be viable, and you will need to seek medical intervention to complete the process of aborting. So: this isn’t anything to fuck with if you are’t very, very sure about terminating your pregnancy. 

Here are the books i know (there are also a ton more out and available):

A Cooperative Method of Natural Birth Control. - Margaret Nofziger

Cunt - Inga Muscio (fucking GREAT, please read.)

Hot Pants (Do it Yourself Gynecology) - Blood Sisters (www.bloodsisters.org - they are awesome)

The New Our Bodies, Ourselves - the Boston Women's Health Book Collective.

A New View Of a Woman's Body - The Federation of Feminist Women's Health Centers

And a couple of recent teacher recommendations i'm about to crack into myself:

Woman, Heal Thyself - Jeanne Blum (contains precise information about the 22 forbidden pregnancy points)

What your Doctor May Not Tell You About Pre-Menopause - Dr. John Lee (This guy also wrote one about menopause and about breast cancer. There is apparently a lot of grody information in here, including a lot of AMA-suppressed research which conclusively links the use of the Pill to ovarian, breast & cervical cancers.)

Women's Bodies, Women's Wisdom - Christiane Northrup

*Hygeia - Jeanne Parvati

The Clitoral Truth - Rebecca Chalker

And an amazing website: www.sistezeus.com

Check the index in any of these for a trove of further references.

That's what i have to say about that for the moment.

The purpose to this is to get folks talking. We have to talk about this stuff, all of us. Write back if you feel like it. Edit this if you like, and send on what, if anything, you find useful. Inform your beloveds & friends. Correct me if I’ve screwed anything up or if you've learned differently.

Be in touch.

Love you.

Pamela