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]
you