Evelyn Resh

Sensual and sexual health and satisfaction for teens and adults

Archive for the category “Blog”

Gals, Think With Your Lady Parts!

When women talk about a man’s bad behavior they’ll often say he’s thinking with his Dick. This is precisely how I feel about our new president’s intention to “dismantle Planned Parenthood.” In response, I am suggesting to all my patients and friends that it is time for women to start thinking with their Lady Parts, or shall I say, to quote our president, our Pussies. Gals, it’s time for our Pussie’s to work on our behalf and what better issue could there be for them to champion than access to contraception and sexual health care?

The idea of eliminating Title 10 funding feels disturbingly sinister, at the very least.  Approximately 75% of patients who rely on Planned Parenthood for care are low-income people. And while a few of Planned Parenthood sites do provide abortion services, many do not. In fact, Planned Parenthood reports that 97% of the care they provide is not specific to abortion. Actually, they offer life-saving services like PAP smears, HIV prevention and screening, contraception, and basic GYN care. Our president and vice president’s Throwing-the-Baby-out-With-Bath-Water approach based on their “Pro-Life” stance has raised my index of suspicion of one or all of the following motives: a war on low-income Americans, a poorly informed effort to reduce the abortion rate below its current lowest rate ever, a desire for involvement in people’s sex lives (Yuck, what a thought!) or all of the above. Should Planned Parenthood funding end then millions of low income people will not have access to reproductive and sexual health care at all. The outcome will be catastrophic and the impact of that catastrophe will largely be shouldered by poor women and their kids.

At present it is estimated that over 45% of all pregnancies in the US are unintended. These are the result of either a method failure or because of not having contraception in the first place. In either case, pregnancy can be both expensive and risky to a woman. This is especially true for low-income women who are more likely to be in poor health when starting a pregnancy than wealthier ones. My experience has shown me that poor women often end up bearing the burden of pregnancy complications and then caring for their kids with little physical or financial support from anyone. With few social programs being funded and low-income men having little money themselves, poor women are often left on their own to make ends meet. In order to stop this from recurring, access to affordable and effective contraception is paramount. And men, RARELY IF EVER assume responsibility for this. This includes choosing to have a vasectomy when they themselves don’t even want more children.  Men across class lines are so squeamish and protective of their penises that they refuse sterilization repeatedly. Despite the fact that most father’s today have witnessed their partner’s vagina performing extraordinary feats of accommodation in childbirth and are at least momentarily awestruck by the capacity and the pain it must cause, they still find the idea of a small snip and ice pack on their Dick’s just too risky or potentially uncomfortable to take on; more Dick thinking getting in the way of common sense, if you ask me. This leads to further reproductive burden landing on women’s shoulders.

I cannot count the number of times that a weary, exhausted, doing-her-best woman presents for a post-partum exam at 6 weeks after delivery and is pregnant. Why? In the words of one such patient: I just couldn’t argue with him anymore. He just wouldn’t give up! I had sex with him to get him off my back.  Many of you reading this will immediately jump to the conclusion that this woman should show her he-man bully the door and never open it for him again. Trust me though, this happens to women who aren’t poor but they’re much more likely to have adequate contraception on board when it does. When my higher class patients present for a post-partum exam and sheepishly admit to having succumbed to their partners’ hassling them, despite my advice to the contrary, their far less likely to be pregnant.  The reality in medicine is that women with more money are on the receiving end of more and better care which translates into more effective contraception. Health care providers, by and large, prefer caring for wealthier white women and earn more money doing so. Compare the salaries of clinicians who work for Planned Parenthood to those who work in a private or hospital-based practice and you’ll see what I mean. Folks that are on the front lines in a Title 10 clinic are activists who understand and deeply sympathize with what can and does happen to the poor if they don’t have access to care.  Should the president succeed in “Dismantling Planned Parenthood” he will create greater disadvantages to the very constituents he appealed to during his campaign. This is just too weird!

I encourage you to let your Lady Parts help you think about what a poor woman faces when it comes to childbearing and parenting. Think about how burdensome it must be to face an unintended pregnancy simply because you couldn’t access effective contraception or your personal values don’t allow for a termination of pregnancy. Then, imagine what could happen to you should you be in the position of having lost your job and health insurance at the same time that your prescription for the pill is about to run out. My guess is if you do, you’ll better understand the importance of not dismantling Planned Parenthood, at least not before you get to the one closest to you.

Copyright E. Resh, 2017.

The teen is not the problem, it’s her mother..

Mesmother daughter2sages from mothers calling on behalf of their teen daughters are commonplace in my work day. Mother’s phone to report problems their daughters’ are having like irregular bleeding, nausea in pregnancy, and vaginal irritations. Many  are women I know as I was their midwife years ago when I delivered their daughters who are now my patients. This is sweet for me and brings my midwifery practice full-circle in a community I have been devoted to for over 20 years. But, regardless of history and the eternal bonds women forge through their childbearing experiences, having a conversation about someone’s symptoms and health via proxy is only reasonable if the patient is developmentally delayed or in a coma. When the patient is awake, sentient, and available after third period English I neither encourage nor recommend it. Further, pre-existing acquaintance with the midwife doesn’t give mothers a free pass on calling.

When I was a teenager, the last thing I would have wanted was my mother joining me in a discussion about birth control and sex – with anyone!  Nor would I have agreed to her calling my GYN practitioner with a related question.  Teens in my generation created as much distance between themselves and their parents where sex was concerned. And mothers helped by claiming their daughters were virginal until being proven otherwise when birth control packs accidentally fell out of their purses.  This approach had its drawbacks and share of bad outcomes.  But the pendulum has swung too far over to the other side now. Today’s  mothers believe it is necessary and normal to stay involved in every aspect of decision making when it comes to their daughter’s sexual health.  From my vantage point this is a serious mistake.

When a teen comes to see me for care – with or without her mother – I make it clear that she is my patient and my loyalty is to her first and foremost. I am her unyielding confidante and resource person, willing and capable of helping her safely explore her sexuality. I do not feel that the majority of sexually active teen girls I see are promiscuous or lack the capacity to make sound and informed choices. In fact, most girls understand and will follow my advice when given a chance to think it through. When mothers are in the exam room (instead of the waiting room), girls abdicate their power, won’t speak honestly with me, and become unmoored in their thinking. When mothers are so actively involved, I can’t help but wonder under what auspices – parent, friend, or envious (and sometimes) seething middle-age interloper?

When a teenager is sexually active her mother’s support and watchfulness is most helpful when maintained from a distance. Should a daughter tell her mother: I am having problems with my birth control then all that’s necessary is a suggestion: Sounds like you should give Evelyn a call. Expecting a daughter to call on her own behalf helps her practice self-advocacy skills, fosters a relationship with a health care provider, and conveys a mother’s confidence in her daughter’s abilities to make good decisions with advice from a reliable adviser. Last I knew this was what growing up was all about.

Sexuality has inherent risks for people of all ages – broken hearts, embarrassments, and method failures. This goes with the territory. At the risk of sounding glib, mothers should stay out of their daughter’s sex lives and foster their maturation by referring them back to their skilled health care provider. Keep the boundaries well-defined and suggest she put my office number on speed-dial.

Thoughts on Mother’s Day…

mother's dayHere it comes, the holiday that puts us all under pressure to do right – Mother’s Day. Even those who don’t really like their mothers end up doing something kind to mark the occasion. I have always felt that Hallmark should create a special line of cards for people whose mothers have been particularly difficult and careless. They could go something like this:
To My Mother on Mother’s Day -Your cooking was never glorious, your moods are notorious. But, as long as you’re on your medication things are great! Keep up the good work Mom, and Happy Mother’s Day!
To My Mother on Mother’s Day. Your passive/aggressive behaviors were text-book perfect. Good to know I learned from the best!
Happy Mother’s Day! To a mother who never gave up trying to hold her liquor.
Happy Mother’s Day! Thanks for the roaring holidays – you really know how to spike the punch – and land one too!
Perhaps those of us who have chosen to be mothers should use this holiday for a bit of contemplation while enjoying the flats of Pansies and boxes of candy we receive. As our sons and daughters age, we will invariably watch them doing things we consider seriously flawed or destined for failure. But maybe before we speak our minds we should pause and reflect on how we felt when our own mothers bossed us around as we were finding our way through life. I have a colleague who gets along well with her mother and I think I know why: Lydia told me that since having her children, her own mother, who is genuinely helpful and very involved in her life, has agreed with everything Lydia has decided to do with her kids. Now, just three years later, her mother remains universally agreeable even though Lydia herself reports having changed her mind on just about everything. I think Lydia’s mother is on to something big and sensible that we could all learn from.
This Mother’s Day, I am going to make a point of giving serious thought to Lydias’ mother’s approach. After all, I think I have been a good enough mother over the years so really, why doubt my daughter’s abilities? Perhaps we all should just sit back, be more agreeable, and listen closely for cues about what they need and want from us – and more importantly, what they don’t.

Be part of my Experiment

In my efforts to let more folks know about who I am and to grow my sexuality counseling and speaking life, I sought counsel from some wise and experienced hipsters who know more than a thing or two about how to navigate the ever-changing world of the Internet. The advice I received was unequivocal about the value of social media, an active on-line presence, Internet branding, and last but so not least, the extraordinary and seemingly unlimited power of the almighty Facebook page. My gang of talented “30 somethings” said to me: Ev, we need to get you “out there” and none of this can be under-estimated or under-utilized.” To that end, I am asking for a favor: please go to my professional Social Media Pages on Twitter, LinkedIn and Facebook, and “Like” or follow me. If you have friends you know might benefit from following me on social media And, after you read this month’s eblast, send it to a specific someone you know who would enjoy it.

Thanks so much for helping me with this experiment. I will report back with the results next month!

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