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Flower Power

I have recently returned from a trip to Japan. We went to see the cherry blossom in season, which was beautiful. Also in abundance were many other types of bloom. Wild and cultivated, manicured or weeds. It was stunning.

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Contraception Top Trumps!

Here’s a round-up of contraception methods, envisaged as the childhood game ‘top trumps’. If you feel I’ve left important pros/ cons or pieces of information out, please tweet me @SquiSquaSque !

I’ll try to update daily with a new card everyday for the next fortnight or so.

Hoping and praying: *for various reasons (lack of knowledge or planning, inability to negotiate) sometimes people do! ** This is an estimate based on the statistic that 80%trying to get pregnant do so within a year.

Fallopian Tube Sterilisation: either clips can be put on to block the Fallopian tubes, or they can be surgically dissectedclosed off. I’ve seen this performed a few times at elective Caesarian section, on request. It isn’t very common in the UK where contraception is widely available. I’ve been told by an Obstetrician that in his home country (a developing nation) it is much more popular for financial and cultural reasons.

Progesterone Pill: a.k.a the mini pill. Take it continuously, so no need to remember when to stop and rest as with the combined pill. As with all progesterone based hormonal methods, this stops your ovaries from ovulating (releasing eggs) and also helps to create a mucus plug in the cervix.

Contraceptive Patch: Works in a similar way to nicotine patches- sticks on to the skin and delivers a substance to your blood stream. I’m not convinced that they are very readily available as I’ve only ever seen them on Sex Ed leaflets.

Mirena: Progesterone based, fitted in to the womb.

Progesterone Depo: A twist on a classic- this injection delivers the hormone progesterone subcutaneously, where it slowly releases in to your body. This suppresses ovulation and thickens cervical mucus. Usually given every 8 weeks. A new preparation is available that is given every 13 weeks and can be self-administered at home. A terrible idea for anyone afraid of needles.

The Combined Pill: Tablet containing the hormones oestrogen and progesterone. This helps to stop ovulation (release of an egg for fertilisation). It is taken for 21 days, with a gap of a week, during which a ‘withdrawal bleed’ takes place. In the UK GP services seem fairly well placed to deliver fairly easy access to the pill, at least compared to other forms of contraception (I’m a bit bitter- I’m currently in the midst of a six week wait to get my contraceptive implant sorted). The main difficulty seems to be remembering to take it. Some people have lifestyles and personalities that are more amenable to this than others.

The Diaphragm:  Fits over the cervix, acting as a barrier to sperm.  Unlike true ‘barrier’ methods like the condom and femidom however, sperm is allowed to enter the vagina, so this method does not offer protection against STIs.   There seems to be some belief that only people who have already given birth can have them.  This isn’t true, but anecdotally I’ve heard from friends that some health care professionals can be reluctant to giving nulliparous people some methods (such as this and the copper coil).  So there may be some truth in this!

Natural Fertility Awareness: I’ve never seriously considered this as an option. It relies on a lot of organisation and not having sex some of the time. However, the real reason is that I didn’t think it was actually any good. My gut reaction is not to believe this ludicrously high effectiveness rate* but that may just be a hangover from sex Ed indoctrination. This figure is quoted from NHS choices who probably have less of an axe to grind than my old PRSE teacher.

Femidoms: work in a similar way to condoms, in that they are made of latex and work as a barrier. They sit in the vagina however, rather than over a penis. For some reason, they never seem to have become as commonplace as condoms, therefore seem much less widely available.

The implant: roughly the size of a match. This sits in your upper arm for up to three years, slowly releasing progesterone to suppress ovulation and thicken mucus at the cervix (entrance to the womb in The vagina). Needs to be fitted by someone with training, e.g. nurse or doctor at a GP or sexual health clinic. Waiting for this can make it a bit trickier to get one inserted, but once it’s in place you’re good to go for three years. Has a very low failure rate and fertility returns very quickly once removed.

The Copper Coil: inserted in to the uterus through the vagina, using a special device. The copper helps thicken the mucus at the cervix (entrance to the womb) to stop sperm from entering. It can also help stop a fertilised egg from implanting into the womb. Because of this theoretically it can be fitted a number of days after sex and act as emergency contraception. However, it needs to be fitted by a professional and this often takes time to arrange. For this reason it doesn’t often seem to be used in this manner, at least not in the UK.

Condoms: Widely available in good (and bad) shops everywhere, as well as some loo vending machines. Generally very cheap (I’ve seen packets for sale in Pound shops). Therefore financial limit to access is fairly small, if still present. However there are some schemes in the UK to get free condoms to particular groups. Red-faced teens in chemists up and down the country show that there’s also a social barrier to obtaining them too. Non-contraceptive uses: good for preventing diseases in penile penetrative sex (e.g. penis to anus).

*Lower efficacy rates been reported (e.g 82%). Lower effectiveness is generally linked to inexperience in using them.

References:

BPAS, accessed Friday 23rd February 2018 at {https://www.bpas.org/more-services-information/contraception/for-men/}

NHS choices, accessed Friday 23rd February 2018 at {https://www.nhs.uk/conditions/contraception/}

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A Century On…

Today is the 100th anniversary of the UK’s ‘Representation of the People Act’, which gave (some) women (over 30 and living in their own home) the right to vote.  It also extended the franchise to a wider group of men.

Now in the UK, any woman over the age of 18  has the right to vote.  We have a female  head of state and Prime Minister.  However, we also live in a country where women are under-represented in most other positions of power.  This ranges from parliament to the boardroom.   There is also growing recognition that gender equality is a wider issue and that the efforts of  privileged white women is only part of the story, even if it is acknowledged as important.  Let’s remember and celebrate that things got better 100 years ago, but not forget that we still have a way to go.

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Choices

In the UK, the Abortion Act 1967 made termination of pregnancy up to 28 weeks’ gestation legal. There has been tinkering around the edges with this, and of course Northern Ireland is currently exempt, which sees many women still obtain abortions, but privately in the mainland.

Choices

To the Teenager who thinks

She’s just not ready to be a parent.

To the thirty-something year old who knows

They never will be.

To the Mum of three who feels

That she is already so stretched,

That she just doesn’t have it in her

To keep another whole.

To the nulliparous (childless) woman,

With a freshly painted nursery on standby,

As she lies back and begins to comprehend

The ultrasound image and the heartbreak it conveys.

To those who can’t.

Don’t want to.

Not right now or maybe ever.

To each and every one of you.

You have

Choices

And

They are yours alone to make.

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The First Rule of Feminist Book Club…

… is to tell everyone about it!

I read this excellent piece by Classicist Mary Beard on women and traditional power structures. This evening I gave it to a friend, asking her to pass it on to someone else that she thinks will like it afterwards. Hopefully this will be the start of an informal circular book club.

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Revision special

In just over a week, I’m sitting a professional exam. I’ve been spending most of my doodling time on that, so here’s a scribble from the margins:

Uterine fibroids are growths in the tissue of the uterus (womb). They can be quite common, particularly with increasing age, and can cause pain and per vagina bleeding. Fibroids: probably not your friend.

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Hardline feminist?

 

‘Hardline feminist?

Resister of of society’s preconceptions of femininity?

Or just a human without a razor?’

Recently a group of the Midwives were scandalised by a woman who arrived on to labour ward with proudly hair legs.  I laughed and smiled when they told me how ‘unkempt’ she was – unknown to them, I too had a pretty good going leg thatch, hidden beneath my theatre scrubs.  This tends to change as the weather heats up and I start to don Summer dresses and skirts.  It’s not necessarily that I like smoother legs, I just have a feeling it would be unseemly to show off the lovely down that keeps me warm over winter.

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Telling your elbow (and other things) from your ars*.

I’ve stumbled across a few examples of misunderstandings about (cis/typical) female genital anatomy that have really surprised me recently. A common one seems to be that the vagina (entrance to the uterus) is the same ‘hole’ as the urethra (where wee comes from). In humans at least, it isn’t. This comes up on the labour ward a fair bit- perplexed partners asking how baby can ‘get out’ if a catheter is put in. An episode of The Guilty Feminist included a confession by one of the presenters that she didn’t know where her urethra was, “even though I’ve pushed a baby out of it.” I am very sure she hasn’t.

Above is a diagram. Imagine you are standing next to someone laid on their back, legs akimbo. There are three ‘holes’, all shown in red. The top one is the urethra- connected to the bladder. Wee comes out here. The middle one is the vagina. The lowest is the anus. It is my dream that one day everyone will be able to sketch it as easily as the hairy penis with balls. You know the one I mean. You’ve probably seen it scrawled on a bus seat, toilet door or similar.

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We’ve Come a Long Way.

Condoms – simple barriers used as contraception.  Originally made out of the insides of animals (mmmm, sexy).  They’ve come a long way though, and a recent article in the Guardian describes some of the changes that are currently going on – from rebranding to innovations in the actual way that they are constructed.   As a barrier form of contraception, they are also one of the few methods that protect against STIs.