From Unplanned Pregnancy to Womens Health Advocate

[Music]

[Applause]

growing up

i was never taught about my body for a

large part of my childhood i was raised

by a single dad

and as i’m sure you can guess the last

thing a dad wants to talk to his

daughters about

is anatomy sex and orgasms

i also grew up in a very religious

household i went to church

every week and went to a christian

private school there was no sex

ed no health education and although i

had access to google

what even was i going to search imagine

if i asked you to pull out your phone

and google

sex education or female anatomy i think

you know what type of videos are going

to pop

up some of you may be wondering why

didn’t i ask my doctor

so i want to take you back to my first

pap smear

i needed birth control as many sexually

active teenagers do

and i went to the gynecologist’s office

at 17.

they take you back to a patient room and

they tell you to undress

it’s cold and they give you a thin sheet

to give you a sense of

protecting your modesty when in reality

your doctor is about to get a front row

seat to all

your business whether you have a sheet

or not the doctor introduces herself

and says it’s time for your pap smear

you smile

and nod so inconspicuously so she’ll

never know it sounds like she’s speaking

another language

then out of nowhere she pulls out a

metal penguin-looking beak

calls it a speculum tells you to lie

back push your butt to the edge with

your legs

wide open as she uses the metal beak to

open your vagina so she can swab your

cervix

at the time i had no idea what my cervix

was

so how on earth was i supposed to ask

clarifying questions

when i hadn’t even been taught the words

to ask the questions

even if i did ask questions my doctor

might not have been able to answer them

because things like the anatomy of the

clitoris is left out of medical

textbooks

years go by and my doctor’s visits stay

consistent

i had no idea what was going on but i

got the hang of things

so there i was a sexually active 20 year

old

and i got pregnant paralyzed on the edge

of my bathtub staring at a positive

pregnancy test

i felt a flood of uncertainty fear

and doubt fear of the future

and doubt of myself i felt the weight of

potential for both of our lives was

resting heavily on my shoulders

now i won’t get into the specifics of my

decision

but i will say that no one is more

qualified to make that decision

than a woman who is taking stock of her

life on the edge of a bathtub

so there i was a pregnant 20-year-old

with no sex education

no clear idea of what pregnancy even was

and a lot of decisions to make with very

little information

luckily i had no idea i was about to get

the education of a lifetime

for those of you who know me you know

what i’m about to talk about

the grandma to my baby girl is none

other than the

vagina ecologist the vagina ecologist is

the online persona for dr teresa irwin

a female pelvic medicine and

reconstructive surgeon in san marcos

texas

this is a woman who has dedicated her

life to surgically repairing pelvic

dysfunctions that often result from

pregnancy and childbirth

i mean can we talk about luck within the

first couple times that i met dr irwin

we had already talked about sex

incontinence kegels hype oppressives and

female anatomy

i went from having absolutely no sex

education to talking about pee

poop and vaginas at the dinner table

at the beginning of last year we started

talking about her goals

she talked about how much she loves her

job but that so much of what she does

could be prevented or helped with

education

now you may be thinking isn’t this how

you get paid

if there was readily available women’s

health education

wouldn’t she be out of a job and the

truth is

she wouldn’t mind being out of a job not

that she doesn’t like her job

but because if she did not need to

perform her surgeries that would mean

that less women are suffering and more

women are

educated on how to take care of their

bodies

most women are taught that incontinence

leaking and prolapse is just a normal

part of getting older and having babies

the fact that no one wants to talk about

is that 50 percent of women will

struggle with incontinence at some point

in their lives

50 percent 50 percent of women will

uncontrollably leak urine or poop

50 percent of women will miss out on

time with their families

they may feel embarrassed and not want

to leave the house

they may need to go to a nursing home

because their incontinence issues are

too much for their family to handle

fifty percent of women will struggle

because of a lack of education

this is when we got a kooky idea why

can’t we provide that education

and the short answer is we are in six

months we created her online persona the

vagina ecologist

and we grew her social media following

from zero to over 75

000 followers across platforms the goal

was simple

to empower women with the education they

need to reduce their risk for pelvic

dysfunctions

what we found out is there is a huge

demand for women’s health education

we were flooded with questions from

women all around the world

who had been suffering in silence and

just needed a place to learn about their

bodies

this lack of education is the product of

many years that the scientific community

believed that

men and women were essentially the same

and the only ways that they were

different were predominantly in

their nether regions so a lot of the

research that developed our

pharmaceutical drugs and the information

that goes into medical textbooks

was done primarily on men this poses a

unique health care disadvantage to women

because

men and women are not the same they can

process drugs differently

they have different hormone levels and

they may not even have the same symptoms

for common diseases

one study found that women are more

likely to die of a heart attack

because they often don’t present the

same symptoms that men do during the

onset of a heart attack

since the research was based on male

symptoms it takes doctors longer to

realize that a woman is having a heart

attack

and it takes longer for her to get the

life-saving treatment that she needs

we desperately need reform in health

education that acknowledges the unique

differences between men and women

but until there is systematic reform we

can empower ourselves with the education

to be our own health advocate

education gives us the tools and the

vocabulary to vocalize our questions

in a way that will make us understood

imagine if i went to the doctor and i

said

i was uncomfortable down there

do you think she would be able to know

what i was talking about

maybe after 10 follow-up questions but

how about if i went to the doctor and i

said

i am having bladder discomfort when i

pee can you please run

a urine analysis and a culture to see if

there’s bacteria present

not only will she understand what i am

saying but i will also have demonstrated

that i have the knowledge to do a

preliminary diagnostic on myself

so i evaluated where the pain is coming

from

when i feel the pain and what my

combined symptoms could mean

now i don’t want everyone to go out and

start using webmd against their doctor

i don’t think that’s going to help

anybody but i’m talking about health

education that allows you to take an

active and

informed role in your health and to

understand what is going on with your

body

being able to articulate the health

problems you are experiencing

increases the likelihood that you will

get the care you need and get it sooner

when you are educated when you know what

is going on with your body

you can take an active and informed role

in your health and work

with your doctor towards treatment and

let’s say the doctor refuses to run a

test for whatever reason

or if they offer to run a different test

when you are educated

when you know what is going on with your

body and when you feel empowered to use

that knowledge to your benefit

that refusal can trigger alarm bells so

you can say

can i get a second opinion or can i get

that refusal in writing

this empowerment completely shifts the

doctor-patient relationship

many of you may remember when serena

williams gave birth to her daughter in

she almost died due to a pulmonary

embolism which is a condition

in which one or more arteries in the

lungs becomes blocked by a blood clot

she had a medical history of this

condition and so she recognized the

onset of the symptoms

she went to tell the first nurse that

she could find what was going on

and requested a ct scan with an iv of

heparin

serena knew exactly what was going on

with her body and the types of tests and

treatments she needed to save her life

but instead of immediately getting her

those tests

the nurse thought that the pain

medication might be making her

her confused and so instead they ran an

ultrasound on her legs

serena continued to be her own advocate

and insisted on what was going on

and eventually they got her a ct scan

and she was right

several small blood clots had settled in

her lungs and minutes later she was on

the iv drip

serena saved her own life by being

educated on her health

and by being empowered to be her own

health advocate

and this story is even more powerful

when you put it in the context

that right now the us has the highest

maternal mortality rate of

all developed countries and even though

many of these deaths are preventable

the rates are actually increasing in the

united states

this also disproportionately affects

minorities because

black women are three to four times more

likely to die due to pregnancy related

complications

we can no longer deny that there is bias

in our medical system that costs women

their lives

especially women of color this is why

education is essential for actively

combating the inequality that is

passively flourished in our medical

system

and why education is essential for

empowering women to be their own health

advocates

we have the knowledge we have the

technology

and now we just need to put forth the

effort to make sure that the systems

that we have put in place

the systems that govern us the systems

that heal

us and the systems that educate us are

adapting and evolving with us as we

become more fair

more aware and more equal

doctors have spent years in education

and training to get their expertise

and doctors are still human they are

limited by time resources and the

patient’s understanding of their

language

and i’m not talking about english or

spanish i’m talking about the medical

jargon like the penguin-looking beak

that doctors call a speculum doctors

spend almost a decade

learning a whole language of technical

names and hyper-specific terms

that allows them to communicate more

effectively with other doctors

and it can unintentionally make it more

difficult for them to communicate to

us they’re patient when you learn the

language of medicine you will be

empowered

to communicate your needs in a way that

will make you understood

it is also essential that we have

experts who are willing to try to

explain what they know to us

and as patients and as the public we

need to creatively bridge the gap

between their expertise and our

understanding

by translating their knowledge into

terms we can learn and understand

so if you have expertise to share start

brainstorming

creative ways to explain commonly asked

questions misconceptions

or even what you wish you knew when you

were first getting started

show your support for equality in

women’s health care by signing online

petitions to get clitoral anatomy in

every medical textbook

now i know not everyone can have the

vagina ecologist on speed dial

but there are so many experts who are

already sharing their expertise online

and want to answer your questions the

critical step is learning how to ask the

questions

so if you’re ready to learn start

evaluating where your lack of knowledge

comes from

it could be school religion or even a

generational lack of knowledge because

your parents can’t teach you

what they never learned but once you

learn it

then you are able to pass that knowledge

onto your children in your community

to initiate a generational change once

you know where the gaps in your

knowledge lie

start looking for digestible ways for

you to learn

follow a doctor on social media or

introduce an educational podcast into

your daily routine

this will allow you to take an active

role in your health by passively

learning on platforms you already use

every day

when i first went to the doctor i was so

shy

i wasn’t able to ask questions and it

wasn’t the doctor’s fault

because i was embarrassed about my own

lack of knowledge and understanding

i felt like maybe i wasn’t supposed to

know what was going on with my body

my body was just supposed to magically

take care of everything and i was just a

passenger along for the ride

and the longer i went without the

knowledge the more i felt like i didn’t

need it

if i’d survived almost two decades

without knowing the difference between

my vagina and my labia

how much of a difference could it

actually make

and the truth is it might not make a

difference right away

but as time goes on you might start

having discomfort

you might have children you might have

an irregular growth

and you might not catch it before you

end up in dr irwin’s hospital room

the burden of health care reform is

shared by doctors and patients

health education and reform may be a

couple of years away

but educating yourself is something you

can do today

to drastically transform your health

care experience

as someone who has been uneducated about

women’s health and now knowing what i

know in just a short time

i cannot believe how much different it

feels

it’s one of those things i can’t explain

to you

you just have to experience it

and i hope that one day all women will

experience it just as i have

and hopefully it won’t take two decades

and an unplanned pregnancy to get there

thank you

[Applause]

[Music]

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