Freedom of...Sex?

I was recently asked to comment on the below statement for a course assignment. So I did. And here it is.

"ALL PEOPLE HAVE THE RIGHT TO FREEDOM OF ANY SEXUAL THOUGHT, FANTASY OR DESIRE"

Q: How do you feel about this statement?

I feel like modifying it - and dissecting it. 

People do (and should, I believe) have the right to freedom of any sexual thought. We all have strange, odd, embarrassing or gruesome thoughts sometimes. As long as we reflect on those thoughts and inquire into them, I believe it is normal, harmless and acceptable to have freedom of thought, including sexual ones.

Fantasies and desires are much the same, but (in my mind) may be more intensely correlated with action i.e. more likely to drive someone to carry out the fantasy or seek what they desire. Anyone does and should have the right to their fantasy and/or desire – but again, I believe it is important to examine these feelings by asking where they are derived from, where they might lead to and most importantly, what role would the sexual partner(s) have?

There are many kinky fantasies and unusual desires that make sex extra exciting, fun and pleasurable. For some people, these wishes might be secretive and only revealed in certain environments or relationships. This might be representative of an increased comfort level and a really positive dynamic or space. 

On the other hand, when it comes to fantasies and desires, there is a lot out there is harmful and walks a fine moral line. The word “any” in the above statement automatically makes me think of the most obscure, unusual and generally uncomfortable sexual situations. Take the movie “crash” for example, where the main character has sex with victims of car crashes. Or rapists who find forced sex arousing. Or men who like to watch child pornography. I know these are grim examples, but the point I am making is that although people have the freedom of thought, fantasy or desire, they do not have that same freedom to act on anything they feel. And when they do, they face charges/convictions for sexual assault or other sexual offences under the Criminal Code of Canada. My believe is that sexual abuse often stems from preexisting unhealthy thought patterns, fantasies or desires; however, the danger is not in those feelings themselves, but is in acting them out in a situation where the other person does not consent or does not realize the extent of what they are consenting too.

The question of consent poses further ambiguity. What if both people involved were highly intoxicated and in agreement, but one person ends up seriously hurt? Were they competent to make their own decisions, or recognize the potential consequences? What were the other person’s intentions? Did they even have any?

I believe sex is a very powerful thing. It can lead people to do things to people, with people or to themselves that can result in feelings of shame, guilt, regret, confusion, pain, jealousy, low confidence, humiliation – and a whole slew of other negative emotions. It can lead to legal action, divorce, unemployment, unwanted pregnancy, infectious disease and death. It can also be the most intimate, safe, sensual, enjoyable, comical and fun activity you can do with yourself or others and lead to personal growth, interpersonal bonding, experimentation, discovery, confidence and positive procreation! Anything that can elicit such a range of emotions and do as much harm as good is something that should be clearly understood and responsibly engaged in.

If the quote (from an unknown source) holds any truth and “thoughts become things!” then in an ideal world, all people would have the right to freedom of any sexual thought, fantasy and desire and a responsibility to manifest these thoughts selectively and responsibly.

DAY ONE

I'm not usually happy to get my period. Either because it's a pain in the ass to wake up just a bit too late and have another thing to deal with. Or because it's unappetizing to put my fingers up my vagina in the woods and walk around for the rest of the day with blood-stained briefs. Or maybe, it's because I wished I had gotten accidentally knocked up that month ;)

Tonight...as I was out for dinner....I noticed my consciousness sink into my stomach, and then my abdomen, my hips, my womb. Stiffness. Pain. Cramps. And...excitement. Tonight, with my hot water on my belly and hot moon tea in my cup, I am contemplating my journey that begins today. To explore, a little bit deeper, the meaning of each change that happens mentally, physically, emotionally - throughout my cycle.

I've been doing this for a while. Years actually. And what I've learned has offered tremendous insight...from rash (sometimes disastrous) decisions, bad dreams and insomnia to creative inspiration and my monthly desire to go for a run. But keeping track on paper is always a challenge and I know that when I do, that menstrual map is going to introduce me to the self that I have struggled to understand.

I'm loving the moon mysteries chart and have to say that I looked forward to today when I could officially put it to good use.

Day 1: (psyche) Spacey, tired, down. (physical) Bloated, zitty, dry skin, itchy. (other) Creative/crafty energy, super bad insomnia last night. (dreams) Big fat piece of chocolate cake....really. (word) Release.

Cultural Contraception

November has been a knowledge saturated month for me - i've indulged in learning across the spectrum of women's reproductive health: from embarking on a moon mysteries journey to better understanding my cycle to discussions on abortion rights and the high rates of eclampsia and obstetric fistulas leading to mortality and morbidity of women and infants in Africa. Alongside my new course in contraceptive management, my experiences this month have opened a new window into the complexities of the female experience - both that which is shared by all women across the globe and that which is so immensely different.

This continuum of reproductive health continues to challenge, intrigue and excite me. The mystery and significance of the menstrual cycle...the challenges and constraints of contraception...the significance of conception and the decisions, joys, burdens that come with that...and, the sheer magnitude of the act of birth and the vast array of ideals as to how to best execute that experience.

Lately, I have been particularly fired up about the potentially traumatic and devastating consequences of unplanned pregnancies. I have been on a mission to better understand why contraception works for some people and not others, what works for whom, and who gets access to what.

This multi-facted question deserves an equally tiered response - one that acknowledges the role of religion, politics, finances, illness, evidence and lifestyle. But I'm not about to launch into that right now. However, I would like to share some very brief and interesting insights into the foundational concepts that shape some religious contraceptive choices...straight from the BBC (see website for more religions). Whether you are religious or not, I think it is worthwhile to consider your own perceptions of conception and how that influences what options feel appropriate for you.

BUDDHISM

Buddhists believe that it is wrong to kill for any reason and fertilization is believed to be the moment when consciousness arises and life officially begins. Therefore, contraception that interferes with ovulation/fertilization is considered appropriate, whereas contraception that interferes with the development of a fertilized egg is not.
Contraceptive No-No's: IUD

JUDAISM

Jews believe that it is forbidden to "waste" seed. Therefore, contraception that does not interfere with the journey of semen to the uterus is appropriate. Barrier methods are not.
Contraceptive No-No's: condom, diaphragm, spermicide, etc.

ISLAM

The conversation around contraception in Islamic cultures is quite politically charged. The Qur'an does not explicitly condone or forbid any specific birth control. However, the Islamic culture has strong family values and believes children are gifts from god, so it is not acceptable to use contraceptive methods for early abortion or engage in contraception that permanently prevents the ability to conceive.
Contraceptive No-No's: tubal ligation, vasectomy

Moon Mysteries: Reclaiming Women's Menstrual Wisdom

Friday night book launch. What a nerd!

I'm super excited to check out "Moon Mysteries" tonight at Lunapads on Commercial Drive. When I heard about it I was full of jealousy. Not the raging type. More like the endearing envy you get for cool people who do cool things and you basically want to be them.

More words to come after actually reading the book, but you can check out this review on the Lunapads blog (more cool people doing cool things).

Abortion Democracy

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I could not find a better title for this post than the film itself...which I had the privilege of watching last week-end.

A compelling glimpse into the complexities of religion and politics and how they impact health care and human rights. There are many shocking elements to this documentary, not the least of which are the windows into the lives of various women who are so intensely dis-empowered by their sex.

The right to terminate an unwanted pregnancy is a deeply rooted and complicated question for many people - and many reasons. But at no point in all of history has conception been a female phenomenon (let's not discuss the tale of the Virgin Mary). And yet, it seems that for many of these women pregnancy and birth has become a gendered burden. One of fear, desperation, guilt, hopelessness, grief and often, mortality. 

And these are not issues exclusive to Poland, or South Africa, as illustrated in the film. They're everywhere. Despite our progress in reproductive and sexual health, women in Canada still struggle with this burden. Religion, politics and geography affect education and access to reproductive health services in Canada. The number of physician's trained to perform abortions have diminished significantly after a series of violent threats swept across the country in the 1990's. The few health care professionals who choose choice also choose chance.

This clinical skill is a choice based on personal values. Anyone who has studied in a health profession knows to leave their bias at the door. So, why does reproductive health remain an exception?

The Damsel's Dilmena

Until now I didn't realize the therapeutic nature of this blog. That my interest in writing about his topic is directly correlated with the stage I am at in my life as I battle with coming to terms with what it means to be female. In this day and age, so many of the expectations and stereotypes aren't really relevant for most women under the age of 25 . . . domesticity, marriage, gender roles, career planning vs family planning, childbirth, to breastfeed or not to breastfeed, to breastfeed or not to breastfeed - in public, saggy breasts, menopause . . .

Aside from loving chocolate, wearing skirts (occasionally) and the ability to talk for hours with a friend about each and every analytical detail of a situation, I don't see myself as being much different than any man. I completed a degree in mechanical engineering surrounded by 101 men and 9 other women. I wore hard hats and steal toe boots to work. I drove monstrous pick-up trucks, quads and school buses. I didn't shower for a week, and I didn't brush my hair for 3 months. I lived in a trailer on a construction site where I was the only female and ate bacon and eggs for breakfast every morning. I kayaked for three weeks on Canada's rugged seas and canoed for 17 days in the high north. I lived on a boat for 2 weeks every summer. I took helicopters through the mountains, float planes in a storm and wrapped chains around my tires to drive in the snow. I peed in the street, in the bush, in my kayak and in urinals when I had the chance. I took pride in the fact that I could drink a lot of beer and that I liked my scotch neat. I even bought men's boxers for the better part of a decade.

So . . . what is my point? My POINT is that I may have been less interested in engineering (due in part to playing with Barbies and not engines while growing up), judged my my female counterparts for what daily bacon would do to my butt (let alone my heart) and virtually incapable of remembering how to change the tire on the F350 truck after I did it, but I could and DID do it all.

As I sit here in a busy downtown coffee shop swarming with corporate men and women, and sitting opposite a chaotic table of disheveled mums with their two small children, I am appreciating the leap of faith these women must have made to have children. Yes, it is the most normal and natural role for women. But it looks so unnatural in this environment. Which makes me think why? Maybe it has to do with the equality women have succeeded in obtaining throughout recent history and the inequality inherent in childbirth. Men can't birth babies. They can't. They can watch the birth, they can feed the baby, they can raise the baby, but they can't be pregnant and they can't give birth.

More often than not, women are still the ones seen at 9 am on a Wednesday morning carrying a baby in one hand and a latte in the other while attempting to visit with their girlfriend. Although some men are also starting to assume this daytime care-giver role (thanks to paternal leave), the very nature of childbirth and breastfeeding (if one chooses) still requires the mum to be the first "stay-at-home parent".

And then starts the mental shift . . . am I the only woman approaching 30 out there who has started taking folic acid, become more risk adverse and decided to take my career in a more family friendly direction? Almost four years ago, I turned 26, met someone great, and promptly decided that having babies was what I was put on this earth to do. But... it's all fine and well to harp on about the curvaceous beauty of a pregnant body, the miraculous occasion of childbirth and the power to give life, when you haven't actually been there. The mum's sitting across from me communicate solely via their children, despite their best attempts to have a more intellectual conversation. I think they looked at each other twice to roll their eyes. Their frustration was entirely understandable. In the span of 8 minutes, one child was ferociously crying while the other sent a mug of hot coffee streaming across the table. I guess today as I watched these mums I couldn't help but wonder who else they were - before they joined the pee-wee club? A question that is likely in their own thoughts as their minutes, hours and days are filled with frequent feedings, messy diapers, crying children and spilt milk. Did they also think this was their ultimate purpose in life?

Spilt milk and unsuccessful coffee dates just comes with the territory - the territory of being a woman, with womanly parts and the responsibility/privilege to choose to travel a path that only women will travel. To accept the challenge and find solidarity in other women - even if you never have before. Women who are married, single, sexually straight, sexually curious, house-wives, corporate managers, public breast-feeders, formula feeders, fitness freaks, teenage mums or nearing 45 . . . you are no longer as clearly defined by these choices and values but by your shared position in society - and humanity. A position of duty and responsibility, purpose (no doubt), isolation (at times), sheer chaos (at others), exhaustion, reward and ultimate femininity - whether you like it or not.

To ignore this unique function of being a woman seems a shame. After all, the propagation of the human race (which is in itself a controversial discussion) relies on some of us stepping up to the plate. But I would argue that the compromises are greater and the decisions more complex - or at least very different - for women today. Today, pregnancy and early motherhood asks that you check your manual labor, corporate connections, intellectual conversation, independence, extreme sports, caffeine addiction, and scotch habits at the door of conception.

On the other hand, nobody will judge you for eating bacon for two . . . just as long as it's well cooked!

Sunday morning sharing...

Some people like to wake up and read the paper. I often choose to stare at a computer screen instead. Sunday morning for me is a great time to peruse the various blogs, links and sites that were forwarded to me in weeks past and didn't get the acknowledgment they deserve.

I've noted those worthy of further circulation below...

Artist Amanda Greavette from Gravenhurst Muskoka - a place responsible for many memories of my youth - offers an emotionally charged depiction of childbearing. Check out the painted curves in her recent Birth Project gallery. Beautiful work!

Read Taking Back Birth. Journalist for The Independent in Newfoundland, mother of two, and a dear friend of mine, Stephanie Trevorrow, reflects on her own contrasting birth experiences and the integration of the midwifery model of care into our society today. It's well researched, powerfully written and above all else, comes from a place of personal truth and experience.

And, last but not least, Women Painting Women is a really unique initiative to showcase, inspire and promote female artists. Some really interesting female portraits on this blog.

Enjoy :)

Operation Birth

I suppose it was inevitable that watching a c-section today would be shocking on many levels given that my previous exposure to childbirth was one in which natural processes, continuity of care and a family centered approach were emphasized. There is not a whole lot in the O.R. that is natural and voicing any preferences or opinions seems radical and futile. I suppose that when childbirth meets surgery there will be an inevitable conflict of interests. Surgery is man-made. Thus, we have full control and losing control has unpredictable, dire consequences. Certain things are done certain ways for a reason. In surgery, keeping track of instruments is more important than consoling the tears that lie behind the drape.

I stood, shifting my weight from one leg standing in a removed corner of the room to the other, which rested just feet away from her head. Wanting to go to her and DO something, I felt glued to my spot – bound by my submissive student role – guilty for judging those more experienced than me. As her body shook (a “normal” response to the spinal anesthesia disconnecting the central nervous system from the peripheries and stimulating the brain to respond as if the body is very cold), tears streamed down her cheeks as iodine streamed down her voluptuous belly into the creases of her thighs, and I watched as seven pairs of eyes blinked through their masks, focusing intently on a patch of flesh bordered by sheets and marked by the convergence of the bright lights. To my relief, the anesthetist gently touched her arm and asked her what was wrong..."I'm scared" she replied. He lifted his arm. "Are you cold? Or in pain?". She nodded her head no. And then the only face she could see disappeared behind her and out of view.  "Okay good" he responded. "Your husband will be in shortly". And he was. I was relieved to see him tenderly kiss her forehead and place his hand among the tangled tubes on hers. I absolved myself of my relational nursing practice responsibilities, walked straight to the foot of the bed and positioned myself in direct viewing of the big show. Bright lights, curtains and all.

As an isolated activity, the c-section surgery was fascinating to me. I love watching surgery. The learning channel taught me that. I’m always amazed at what a meticulous craft it is. They stretch the skin with a force comparable to stretching canvas, break and assemble bones with the calculated precision of a wood-worker and suture the layers of muscular, adipose and cutaneous tissue with the dexterity and efficiency of an experienced seamstress. A caesarean birth is no different (well, except for the breaking bones part). I witnessed a diligent, expert performance. It was easy for all of us to forget who lay behind the curtain. But just as the baby was drawn up from inside mum’s tum and into the pediatrician’s hands, and even dad left mum’s side to crowd around the newborn in awe, I remembered. I leaned down to her and asked how she was. She nodded, silently, and strained to tilt her eyes up at her baby. As I mustered congratulations I felt myself begin to cry. Luckily my mask concealed my recognizable expression. I quickly told her she would see her baby in a few minutes and I re-joined my colleagues where I felt protected from this human challenge. Safe from confronting this experience any further. One that she would likely remember for a very long time. Or, one that she would erase from her memory completely. Not sure which is better. 

All in all, the surgery went as expected with “no complications” and mum and baby both came out of it “alive and well”. The art piece of the surgeons’ performance was hidden beneath a single strip of clear tape and a blue hospital gown. Dad and baby moved one floor up and mum went to recover for hours - to choose her memory’s path: re-call and solidify or delete, delete, delete. Ultimately, what matters most is that she had a healthy baby. A comfort and joy that she would appreciate more fully once they were reunited upstairs.

I am incredibly grateful for this observation. And because of it, I am committed to being a different kind of nurse. To address women’s birth experience, should they be wanting to speak about it. To support women outside AND inside the O.R. To keep them with their baby and their loved ones for as long as possible. To respect and facilitate natural processes in this unnatural circumstance. To challenge the status quo and honor my instincts.

The G-Spot

I love nursing school. Mostly for the incredible resources I have access to on a daily basis.

Despite the title of this post, this is not a guide on achieving g-spot pleasure, but a layman's guide to getting pregnant. I always dreamed of teaching sex-ed classes...turns out dreams do come true!
http://websrvr40nj.audiovideoweb.com/avwebdsnjwebsrvr4501/portal/media/media-050516-pregnancy.html

more on Menstruation + Madness ...

For those of you who this post pertains to, please do not take offense to the title. I use the word madness simply to enhance the creative catchy-ness of the title and not to infer that anxiety makes you "mad" - necessarily - although in my case, I would say anxiety most definitely does make me crazy.

Anyway - to the point...

While studying psychopharmacology for my exam Tuesday, I discovered a few interesting tidbits unique to women. Firstly, women are more likely to men to experience side effects from drugs. I imagine that this is in part due to body weight, but is largely due to a number of more complex reasons for why medications affect each person individually. Secondly, menstruation can alter the efficacy of certain drugs. Take Benzodiazepines for example - a class of anti-anxiety and sedative-hypnotics. "Benzos" include the trade name drugs valium and ativan, which may be familiar to you. Among other indications, these drugs are used commonly to "take the edge off" prior to certain nerve-racking medical procedures or flights, to sedate people in psychiatric hospitals and (as the tabloids often point out) by celebrities to escape their lives. According to Austin and Boyd (authors of my trusty Psychiatric and Mental Health Nursing text), female hormones that fluctuate during the menstrual cycle can also affect response to drugs. Benzodiazepines, for example, bind to the same receptors that progesterone does (called GABA receptors) and therefore, the levels of progesterone can affect the efficacy and potency of benzodiazepines at certain stages of the menstrual cycle. 

So if you are taking these drugs, consider how your cycle might be affecting the effect of the medication. Put simply, progesterone begins increasing just before ovulation, which is approx. 14 days after the first day of your period, peaking a few days after ovulation and gradually decreasing and triggering menstruation. Refer to the diagram on my last post if you need a refresher on what hormones are doing when. So...in the case of benzos, efficacy of the drug may be altered with the changing levels of progesterone, and so may your mood. The few days of bleeding are the most hormonally stable. [sigh]. Yet again, menstruation rears it's ugly bloody hormonal head! haha.

In any case, the lesson here is to not be fooled by (nor ignorant to) the power of your hormones and how they affect your mood - natural or drug-induced. I think it's important to recognize these changes in your body, how they are impacting other aspects of your mental and physical health and to respond to them however possible. Insight into why you are feeling the way you are can be powerful in managing your emotions.

Menstruation Marks Monthly Madness

According to the diagnostic statistical manual of mental disorders (DSM), menstruating women everywhere are, indeed, going mad monthly. 

When my professor read the clinical definition of PMS aloud in my mental health class this week I couldn’t resist the urge to post it. The notion of problematic PMS psychosis provides the foundation for which the title and concept of this blog was developed, after all. After reading the below definition; however, I see very few differences between PMS and a multi-day hangover. So why do bitchy bleeding women get such a bad rap? In fact, the self-inflicted nature of repeated substance induced fun seems to me a more appropriate recipient of the clinical mental disorder terminology?

So girls. Let’s lose the stigma. When the last week of your luteal phase is approaching (approx. 21 days after the first day of your period for those with an average cycle – see diagram below), gather some girls and go have some fun. Several days of it.

I wonder what the diagnostic manual of mental disorders would think about that? 

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): Premenstrual Dysphoric Disorder (PMDD), otherwise known as severe Premenstrual Syndrome (PMS)

A.      In most menstrual cycles during the past, five (or more) of the following symptoms were present for most of the time during the last week of the luteal phase, began to remit within a few days after the onset of the follicular phase, and were absent in the week post-menses, with at least one of the symptoms being either (1), (2), (3) or (4):

(1) Markedly depressed mood, feelings of hopelessness or self-deprecating thoughts
(2) Marked anxiety, tension, feelings of being "keyed up" or "on edge"
(3) Marked affective lability (e.g., feeling suddenly sad or tearful or increased sensitivity to rejection)
(4) Persistent and marked anger or irritability or increased interpersonal conflicts
(5) Decreased interest in usual activities (e.g., work, school, friends, hobbies)
(6) Subjective sense of difficulty in concentrating
(7) Lethargy, easy fatigability or marked lack of energy
(8) Marked change in appetite, overeating or specific food cravings
(9) Hypersomnia or insomnia
(10) Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of "bloating", weight gain
B.     The disturbance markedly interferes with work or school or with usual social activities and relationships with others (e.g., avoidance of social activities, decreased productivity and efficiency at work or school)
C.    The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, dysthymic disorder or a personality disorder (although it may be superimposed on any other disorder) 
D.    Criteria A, B and C must be confirmed by prospective daily ratings during at least two consecutive symptomatic cycles (the diagnosis may be made provisionally prior to this confirmation)