The truth about having sex while you’re pregnant

Nine months would, for many people, be a long time to go without sex. Understandably, the prospect of such an extended dry spell may make the newly pregnant feel some anxiety.

So can you have sex while pregnant? Of course, according to the Mayo Clinic, so long as your doctor hasn’t advised against it due to a complication. Know that the fetus is cushioned by amniotic fluid in the amniotic sac, as well as your uterine muscles. It won’t get poked or crushed or jostled by a penis or toy or anything of that ilk—don’t worry. 

And with that, here are some answers to other commonly asked sex-during-pregnancy questions.

What you should know about sex while pregnant

When should I abstain from sex while pregnant?

Before you undertake sex during pregnancy, definitely consult a doctor rather than the internet alone. For most people, provided they aren’t experiencing complications, pregnancy sex isn’t likely to end in miscarriage or (despite what you may have learned on Friends) speed along labor.

Some things that might indicate it’s time to abstain are, according to BabyCenter.com: vaginal bleeding or unusual discharge, a dilated or shortened cervix, premature labor, a low-lying placenta encroaching on your cervix (a condition called placenta previa), the presence of untreated sexually transmitted infections, and a genital herpes outbreak, either yours or your partner’s. In any of those scenarios, speak with a healthcare provider before getting down to business.

Photo via Pixabay

What about oral or anal sex while pregnant?

Of course, vaginal sex isn’t the only option: According to the Mayo Clinic, oral sex is a safe bet during pregnancy so long as your partner is very careful not to blow air into the vagina, which sounds like a good thing to avoid regardless. Apparently, it can trigger pregnancy complications serious enough to threaten the fetus’ and your existence.

Anal sex, on the other hand, is perfectly fine so long as it’s comfortable. Be cautious and don’t switch from anus to vagina without washing the penis or toy first. That can introduce infection-causing bacteria into the vagina, which is not fun when a person isn’t pregnant and becomes potentially dangerous when they are.

Hormonal and bodily changes might also mean you simply aren’t interested in sex during portions of pregnancy, which is totally fine. Breast tenderness, back pain, a general feeling of unwieldiness—these are all things that could understandably make a person feel less sexy than usual. You should have sex, while pregnant or otherwise, only when you want to.

Photo via Pexels (CC-BY)

Can you have unprotected sex while pregnant?

Unprotected sex during pregnancy isn’t necessarily a bad idea, but the only time we can responsibly recommend abandoning a condom is when you and your partner have both been recently tested for and cleared of sexually transmitted infections, and when you’re in a mutually monogamous relationship. If there is any chance at all that your partner might have an STI, and/or if you are having sex with a new partner while pregnant, use protection. Contracting an infection while pregnant can have a number of health-threatening effects on both the mother and the fetus, and can mean that the baby is born with that infection.

Photo via Pixabay (CC-BY)

How long can you have sex while pregnant?

Personally, I am not sure if this means “for how long can a pregnant person have sex during a single sex session” (to which I would say, to completion if it feels good) or “for how long into a pregnancy is it safe to have sex.” Assuming it’s the latter, you can have sex until you go into labor, again, provided your pregnancy is free of complications. And as BabyCenter.com warns, if you do not have herpes (oral or genital) but your partner is positive, it’s advisable to abstain from sex (oral, vaginal, and anal) for the duration of the third trimester. For reference, that starts at week 28.  

What happens if you have bleeding or cramping during sex while you’re pregnant?

The American Pregnancy Association is adamant that nothing—neither tampon nor penis nor sex toy—be inserted into a bleeding vagina if its owner is pregnant. While bleeding is far from atypical during the first trimester, during the second or third, it’s cause for concern: bleeding and cramping can be signs of miscarriage or an infection.

The APA advises that, if you bleed after intercourse during the first half of pregnancy, it’s probably because of cervical tenderness, but sex should still be avoided until you’re cleared by a doctor. If you’re bleeding in the second half, consult your physician right away.

Photo via Pixabay (CC-BY)

What are the best sex positions while pregnant?

The best sex position is the most comfortable sex position, and what’s comfortable will change as the pregnancy progresses. Early on, when you haven’t yet begun or are just beginning to show, a pregnant uterus won’t be much of a barrier to any position. Parents.com advocates the intense-sounding “sit and stare”—straddle your seated partner and stare at one another’s eyeballs—for heterosexual couples, along with doggy style and side sex. Missionary and other such supine positions apparently put pressure on the aorta as the uterus expands, which could potentially restrict blood flow to the placenta and thus, oxygen to the baby. The farther along you get, the more advisable it is to have vaginal sex from the side (spooning) or behind, with the pregnant party on top or perched on the edge of a bed or a counter or a sturdy table.

Again, when it comes to matters of medical concern, doctors are always a better source of information than the internet.

Editor’s note: This article is regularly updated for relevance. 

Read more: https://www.dailydot.com/irl/sex-while-pregnant/

These Are The Sexual Activities Most Likely To Cause Injury, According To Science

People do die having sex; if they don’t, they can get severely injured. This is something that’s notoriously difficult to categorize or rank, though.

The US Centers for Disease Control and Prevention (CDC) lets you see how many people in the US have died from “exposure to sunlight”, so it caters to vampires, but the closest we can find to sex-based injury appears to be the very ambiguous “overexertion from repetitive movements” and “exposure to vibration.”

Even the estimates for death via sex-induced heart attacks vary wildly. One places the number at around 11,000 victims in the US alone – mostly elderly men, it seems. Another suggests that the number is far lower, in the tens or hundreds of people per annum.

Ladies and gentlemen, this is nothing short of a logistical nightmare. The best we can do is rank sexual acts in terms of number of accidental injuries they are related to.

So, in ascending order – and leaving out some of the more (ahem) imaginative forms of reaching that naughty nirvana – here are the most inadvertently dangerous sex acts, according to science.

6 – Oral Sex

Again, this is difficult to verify, but there are very few studies or reported cases on accidental injuries as a result of oral sex.

You can imagine that there’s a fair few, of course – words like “blowjob” could be wildly misinterpreted – but whether it’s fellatio or cunnilingus, the risk of inadvertent injury is insignificant. You’re more likely to injure yourself if you engage in autofellatio, which has been known to cause a handful of spinal injuries.

Ick. Tetiana Volkonska/Shutterstock

5 – Use of Sex Toys or Objects

The problem with trying to rank this is that sex toys come in very different shapes, sizes, and types. There’s no single category for “injury via sex toy” in any scientific study we can find.

One analysis, in the journal Sexual Medicine Reviews, notes that “urethrovesical foreign bodies result mainly from sexual or autoeroticism practices and need individualized management.” This means that objects inserted into the urethra, which often cause considerable harm, are so diverse that each treatment is unique to the situation.

As there’s simply not enough data available, we’re going to make a reasonable assumption that this is more dangerous than oral sex, but not as risky as adventures involving an actual penis.

4 – Cowgirl

Yes, vaginal tearing is awful and does happen, but accidental injuries of this kind are rare. The vulva and vagina are relatively hardy – after all, babies are a lot more traumatic than penises are, in general, and they survive that.

The penis itself, however, is extremely prone to fracturing, and while uncommon, the incidence of this coitus-based catastrophe taking place is probably being underestimated. As noted by a study in the International Journal of Impotence Research, “some patients may be too embarrassed to seek medical attention from emergency rooms.”

Several studies have attempted to rank various sexual positions over the years, generally focusing on the risk of penile fracture, or PF. The aforementioned study, which came out just this year, found that in terms of surgically identified PF injuries, cowgirl was the least risky sexual position, accounting for 10 percent of cases.

3 – Masturbation (and general hand-to-genital contact)

Snap. jannoon028/Shutterstock

Masturbation is certainly one way to cause injury to the penis, particularly if it’s overzealous. Yes, if you get creative you may get something wedged into your vagina that can cause lacerations, but again, you can only bend a penis so far before you hear a terrible, gut-wrenching pop, followed often by a crimson fountain.

In this sense, “penile manipulation” – which, granted, also involves tucking in your tiny soldier into your trousers and other such tasks – accounts for 18 percent of all cases of PF, according to the same study.

Incidentally, according to the authors, in “Eastern countries, there is a higher incidence of cases associated with penile manipulation,” specifically the kind designed to force your willy to wilt.

“As many patients believe that the penis has a bone structure or cartilage, and that these are responsible for erections, they may try to manipulate their penises and make them snap – like fingers,” they note. Blimey.

2 – Missionary

The same study places missionary next, which leads to PF in 26 percent of cases. They suspect that, unlike any woman-on-top positions, the more frequently vigorous nature of the male-dominated sexual activity leads to a “great impact at the time of trauma” when the penis slips out for a brief moment.

1 – Doggy Style (in general)

Regardless of gender, and regardless of the, er, entry point, doggy style seems to result in the majority of PF, for the same reasons as described above. This study suggests it is responsible for 41 percent of all PFs.

At this point, a caveat is required. Another study from 2014, one that examined causes of PF using similar methods, came to very different conclusions.

Writing in the journal Advances in Urology, the team found that woman-on-top was the most dangerous (50 percent of PFs), followed by doggy style (29 percent). Penile manipulation was attributed to 14 percent of all PFs.

Unlike the more recent research, these academics argue that when the woman is on top, with her full weight on the penis, it’s harder to stop sex if an injury is about to occur.

In any case, it’s difficult to know which study is more accurate, but both rank doggy style quite highly. So, on average, it’s probably the most risky activity overall.

Risky business. Haoka/Shutterstock

Incidentally, in both studies, heterosexual intercourse appears to be far riskier in terms of PF than homosexual intercourse.

Heterosexual doggy style, for example, was 10 times more likely to result in PF than the homosexual equivalent, according to the 2017 study. The 2014 study reports that 10 percent of PF patients were homosexual, and 67 percent were heterosexual. Both studies involve small data sets, so it’s difficult to know how applicable to the wider world these figures are.

Bonus Round – Fisting

This is described by a review study in the Journal of Forensic and Legal Medicine as “an uncommon and potentially dangerous sexual practice,” one that is “usually a homosexual activity, but can also be a heterosexual or an autoerotic practice.”

Based on the findings of 14 separate peer-reviewed studies, external anal and/or genital trauma is observed in 22.2 percent of cases – a greater than one-in-five chance. Internal injuries, on the other hand, were found in the “totality” of patients. We’d argue, then, that this is the most dangerous and near-conventional sexual activity, because some form of injury will always occur.

This, of course, depends on whether you think damage to the vagina or rectum is worse than a penile fracture. Argue among yourselves.

Read more: http://www.iflscience.com/health-and-medicine/these-are-the-sexual-activities-most-likely-to-cause-injury-according-to-science/

The Speculum Finally Gets a Modern Redesign

It was afternoon in the San Francisco headquarters of Frog, the design firm best known for its hand in creating the iconic look of products like Apple's original Macintosh computers. Hailey Stewart, one of Frog's industrial designers, had scattered an array of prototypes on a table. On one end, you could see cylinders of foam that looked almost like skinny vibrators, with handles that stuck out at different angles and sketches of levers and screw mechanisms. And on the other, the common speculum—the device used in routine gynecological exams to inspect the cervix. Stewart picked one up and cranked it open. "You're literally in the stirrups with that sound"—the device made a loud, painful sounding click—"and it's like, excuse my language, but what the fuck?"

Most of the designers in the room had never seen a speculum before. Some (the men) had never considered the contents of a pelvic examination—stripping off your clothes, laying on an examination table, and strapping your feet into stirrups, while a doctor pries you open with a cold, metal gadget. But Stewart hadn't gathered her colleagues just to explain what happens to women at their annual exams. She had a greater goal in mind.

For the past several months, mostly during down time and on weekends, Stewart and interaction designer Sahana Kumar had been studying this device. They'd wrenched it open and closed, studied the curve of the bills, read endlessly about its history. And now, she told the rest of the designers at Frog, they had taken on what was turning into a particularly ambitious project: redesigning the speculum for the 21st century.

The current design of the speculum, fashioned by American physician James Marion Sims, dates back to the 1840s. The device had two pewter blades to separate the vaginal walls, and hinged open and closed with a screw mechanism. Sims, sometimes called the "father of modern gynecology," used the speculum to pioneer treatments for fistula and other complications from childbirth. But his experiments were often conducted on slave women, without the use of anesthesia. So to say that the speculum was not designed with patient comfort in mind would be an egregious understatement.

And yet, the speculum today looks almost identical to the one Sims used more than 150 years ago. The most noticeable difference between the original Sims device and the one you can find in gynecological offices today is that instead of pewter, modern specula are made of stainless steel or plastic.

That the speculum is old is not, on its face, a problem. It's that the design is neither optimal for patients nor physicians. Doctors have to stretch the speculum's bills wide in order to see as far back as the cervix, and even then, it's not always possible to get a good look inside. (Some specula come with built-in lights, but the problem has more to do with tissue falling in than the darkness of the vaginal canal.) All of that pressure causes discomfort; one review of the medical literature found that some women even avoid the gynecologist because of the dreaded device.

Mercy Asiedu

In 2014, the American College of Physicians went so far as to recommend against pelvic exams, citing the "harms, fear, anxiety, embarrassment, pain, and discomfort" associated with speculum examinations. Those side effects impact gynecologists, too. "The more comfortable a patient is, the faster they can do their job, the more patients they can see," says Stewart. "There's actual monetary value to [patient] comfort."

It’s not that nobody’s tried to change things. In 2005, a San Francisco-based company patented the design for an inflatable speculum called FemSpec. The device was made out of polyurethane, the same material used to make condoms; a physician could insert it like a tampon and inflate it like a tiny balloon. It debuted to some fanfare, but ultimately flopped. As an article in The Chicago Times pointed out, most women never even got to experience the new speculum "because it is so new on the market that most doctors aren't using it."

"With a speculum, you just shove it in and expand it as wide as you want to get the visualization you want. With this, you have to put it in and gently move it around, kind of like a joystick." — Biomedical engineer Mercy Asiedu

Other do-overs have focused on more modest improvements. A prototype called the Lotus, created by a student at the Pratt Institute, kept the bill shape but curved it slightly for a more ergonomic insertion. The design also included a rotating handle to open the speculum bills vertically, and a hidden lever mechanism to prevent pinching. It seemed promising, but after appearing in a student showcase last year, it never turned into anything real.

In Oregon, a group called Ceek Women's Health has begun clinical trials for a series of new devices—including a sleeve, a speculum with narrower bills, and a speculum that patients can self-insert. Their goal is to create a variety of specula to serve a variety of patients, rather than recreating another one-size-fits-all tool. "For women who have a lot of tissue, women who have had more than two vaginal births or a high BMI, for women with a history of trauma or rape, for post-menopausal women who have vaginal atrophy—there isn't any product to address their needs," says Fahti Khosrow, Ceek's co-founder and CEO. Give physicians a whole new toolkit, she says, and they can better serve their patients.

Perhaps the most promising new design comes from Duke University, where researchers are testing a device that could circumvent the speculum altogether. Mercy Asiedu, a doctoral candidate in biomedical engineering at Duke, designed a tampon-sized device with a 2 megapixel camera attached to the end. "The speculum was originally designed for a physician to view the cervix from outside the body," Asiedu says, "but with current technology, you can easily view the cervix from inside the body."

Asiedu tested her prototype in a pilot study with 15 volunteers this year, the results of which were published in the journal PLOS One in May. Every single patient said the smaller device provided a better experience than the speculum.

The Duke study looked at patient satisfaction, and Asiedu acknowledges that physicians may offer more criticism of the device. The design emphasized comfort, modesty, and patient empowerment, not necessarily ease of use for physicians. "With a speculum, you just shove it in and expand it as wide as you want to get the visualization you want," Asiedu says. "With this, you have to put it in and gently move it around, kind of like a joystick."

When Stewart and her team set off to redesign the speculum, they knew what they were up against. Plus, Stewart says, "I hadn't even seen a speculum."

So before they started researching or sketching ideas out, Stewart and Kumar listed the things that had bothered them in gynecological exams. There was the noise (like a can opener), the temperature (freezing cold), the feeling inside (as if someone was stretching your insides like a rubber band). When they acquired a set of specula, one plastic and one metal, they realized they needed to change the aesthetics too. These things looked like medieval torture devices.

First, Stewart explored how to silence that ratcheting sound. She and Fran Wang, a mechanical engineer at Frog, investigated new types of opening mechanisms. No concept was too bizarre. What if, like a pufferfish, they used saline to inflate the device from the inside? Or what if they used air, blowing it up like an air mattress? They looked for inspiration in nature (cobra hoods), in machining (milling chucks), and in everyday objects (bicycle pumps); they studied how a tripod clamps open and shut, how ski bindings clip in and out, searching for ideas that might replace the old-fashioned screw mechanism.

Frog

Next, they considered new materials. Instead of constructing the device out of plastic or metal, they decided to cover the whole thing in autoclavable silicone—a material that wouldn't feel cold, could be easily sterilized, and would make insertion more comfortable. "On the metal speculum, there are pokey bits," says Wang. "Those shouldn't go near your delicate body parts! Having all of that covered in silicon, it prevents tissue from getting damaged. And also when you look at it, it's nicer."

They experimented with using three prongs instead of two, opening the device into a triangle shape. They tried shrinking the device to the size of a tampon, or borrowing design language from the vibrator industry. They put the device's handle at different angles, ranging from 90 degrees to 120 degrees, to find most ergonomic position for physicians. And then they 3-D printed a few different prototypes and put them in the hands of OB/GYNs and medical providers.

"The one they were really excited about was the one that opened up using three bills, rather than just two," says Stewart. The triangle-shaped opening gave physicians the same field of view without having to open the bills as wide, making the process less "stretchy" for patients. OB/GYNs also liked the device's handle at 110 degrees, which enough extra space between the physician's hand and the patient's body to eliminate the "last scooch" down the examination table. The silicon covering was a big hit, too. A button unlocks or locks the speculum with one hand, freeing up the other hand; a push handle eliminates the need for screws. Even more comforting, the speculum was totally silent.

Conferring with OB/GYNs made one thing very clear, though: The project wouldn't succeed with redesigned hardware alone. Stewart wondered why she felt more comfortable getting a bikini wax than she did seeing the gynecologist once a year, and the answer boiled down to the environment. One felt cold, clinical, and scary; the other, relaxing and personal, even if it was more physically painful. If they wanted to redesign the speculum, they had to redesign the entire experience.

Half a year later, the project has turned into something of a coup d'état on the modern pelvic exam. There's the speculum itself, still in development with the insight from several OB/GYNs who have signed on to help. There's a list of guidelines for physicians, which include simple but meaningful tips like giving patients somewhere to hang their clothes and explaining the components of the exam. "It's never going to be perfect," says Kumar. "So how do we at least prepare people emotionally for how it's going to be, and make them feel like they got some value out of it at the end?"

There's also a mock-up of an app, which would let patients fill out forms, ask questions, or follow a guided meditation before the exam. Kumar invented a gear kit—a stress ball, socks to cover your feet in the stirrups—to improve patient comfort, alongside the new speculum. The team also added Rachel Hobart, a visual designer at Frog, to help brand the experience. The result is called Yona.

For now, the Yona project is still an early-stage design concept. Stewart and Wang are still hashing out new speculum prototypes, while Kumar and Hobart refine the app and experience. They're working with their board of physicians to fine-tune the idea, to negotiate what's feasible and what isn't. And collectively, they're searching for partners who may have similar goals, like the tech-savvy healthcare service One Medical, who can bring Yona from concept into reality.

The trickiest part, it seems, is developing something that physicians will actually adopt. It's not lost on the Frog designers that other prototypes have failed after physicians bristled at the idea of investing in something new, either financially (the cost of purchasing a new device) or mentally (the time it takes to learn how to use a new device). Gynecologists have been using the speculum for over a century, and so far, it's worked. Why change now? "You could create the most beautiful, most unique, most user-friendly device, but if a doctor doesn't want to learn how to use it, your patient's never going to see it," Stewart says.

But Wang says that's mostly a matter of getting the product out there, showing physicians how great it can be for them and for their patients. She knows the traditional speculum works fine for most gynecologists. "It passes, but it's not great," says Wang. "But we're working on making it better. When you give [physicians] the option to choose a better one or a worse one, then they're going to choose the better one. But they might not know that until they get that option."

Read more: https://www.wired.com/story/the-speculum-finally-gets-a-modern-redesign/

A guide to fun, safe, shame-free anal sex

Out of all the items on the sexual menu, anal gets arguably the worst rap, an undeserved stigma that likely comes from a widespread lack of knowledge about butt stuff.

According to Alicia Sinclair—a certified sex educator and founder of b-Vibe, a sex toy company dedicated to anal play—one common explanation for squeamishness is a lack of preparedness. When people start experimenting with sex, they typically confine touching to their genitalia. This leaves out an orifice that, for many, turns out to be pretty pleasurable.

“The anal sphincter is really strong and it’s also really delicate and it has a lot of nerve endings, so it’s important to just remember, just like every other part of your body, you probably want to have a learning curve,” Sinclair told the Daily Dot. Vaginal sex tends to feel better when people play around with their own bodies before enlisting a partner, building up to penetration. Most of us don’t spend equal time figuring out what works for our anuses, though.

“When we talk about butt stuff,” she continued, “it’s kind of like, ‘Oh yeah, we just tried it one day.’ It’s from 0 to penis, there’s no investigation, no touching, no feelings, no kind of getting used to the sensation.”

One of the stories she hears most often, Sinclair said, is agreeing to anal to please a partner and ending up with a painful experience because both parties wandered into the act blind. If pain, fear, and guilt “are what you associate really early on with anal sex,” Sinclair added, “it is going to be a scary thing that maybe you’re a little bit reluctant to try.”

Screengrab via b/60/YouTube

But anal sex, despite the taboos and stigma, is something that a solid number of people have tried: According to a 2017 survey by Skyn condoms, 36 percent of millennials surveyed sometimes have “female anal sex” and 15 percent have “male anal sex.” As Cosmopolitan reported, rising numbers of young people seem to be engaging in anal sex, with 40 percent of 20-to-24-year-old participants in one study having tried anal, and 20 percent of women ages 20 to 39 having had anal in the past year. While numbers on a page can’t tell us anything about how much those people enjoyed their experience, they can at least help us gauge popular interest.

Anal sex needn’t be intimidating, nor any less safe than any other kind of sex, so long as you’re using protection. In other words, without bulletproof certainty that you and your partner are both mutually monogamous and unless you’ve both recently cleared in a screening for sexually transmitted diseases, use some kind of condom regardless of the orifice involved. Stern warning aside, here are Sinclair’s top DOs and DONTs for fun anal sex.

How to have anal sex: Dos and don’ts

DO:

Take the time to learn about anal

Do your research before you get started, reading up on any elements that might make you nervous or about which you might have questions. Don’t be afraid to use yourself as a test subject.

Sinclair suggests testing the waters while you shower. “Just taking a minute or so and putting a finger in and sort of just feeling around to say like, ‘Oh, yeah, how does this sensation feel and what would it feel like if someone was doing this to me?’” she said.

Solo play affords you the chance to be “both the giver and the receiver,” Sinclair said, a point that may be of particular importance when it comes to integrating sex toys. Naturally, Sinclair likes butt plugs for escalating anal pleasure but recommends taking yours for a spin by yourself first. Familiarize yourself with what might be a very new sensation before involving a partner.

Screengrab via Nicki Minaj/YouTube

Talk with your partner before you try anything

“I totally understand, sometimes it’s hard to be like, ‘Hey, I’m interested in playing with my butt, are you interested?’” Sinclair said. “Having that initial conversation will set the tone for the entire experience, especially if you do it outside the bedroom, not in the dynamic where it’s five minutes away from having sex.”

Maybe you’re thinking, OK, but it’s not like I can just broach this topic over Wednesday night chicken in the same breath as I ask to be passed the salt. But the thing is, you can. I’d say, you should. Ask whenever you feel comfortable—this ultimately isn’t a big deal question.

READ MORE:

Take a moment to pre-clean

As a teen and into my twenties, I occasionally heard a secondhand story about an acutely embarrassing anal-sex-induced bowel movement on some anonymous parents’ white sofa. I remember the details vividly enough that I could likely convince a stranger I was there. You may have heard some version of this same story, and you may worry that anal sex will trigger the kind of shitty interruption that becomes fodder for adolescent sleepovers from now until forever.

If you’re concerned about what your partner might find up your rectum, or if it’s been a minute since you’ve voided your bowels (Stress! Dietary irregularities! Constipation never strikes at sex-conducive moments!), or if the possibility of poop worries you, consider a pre-clean. Sinclair suggests alcohol-free baby wipes, and if you can/it makes you feel more comfortable, going to the bathroom 30-60 minutes before sex. Enemas might also appeal, but NB: Use too much water, and you might invite more mess. Sinclair recommends just a couple cups of warm water (test it on your wrist) one to two hours before anal play. Follow the instructions on an enema bulb for more specific guidance.

And, if you are using toys, please do wash them in hot soapy water between uses.

Photo via Pixabay

Take small steps

Many readers will be unused to an object of any size penetrating their anus. It’s an excellent idea to start small and scale up, taking the time your body needs to adjust to new sensations. Sinclair recommends starting with fingering if you’ve just begun solo play, graduating to larger-sized toys or a penis. That’s advisable whether you’re working with a partner or not. Go slowly, whether you’re giving or receiving.

READ MORE:

Use lube!

The anus does not self-lubricate, and unlubricated penetration can translate to tears in anal tissue that make it much easier to spread STIs. Add lube, liberally, keeping in mind that water-based lubes—while great for silicone sex toys—evaporate quickly and require frequent reapplication. Coconut oil makes a good natural lubricant, but no lube can guarantee your anal skin won’t tear, so again: Go slowly.

DON’T:

Double dip

“The anus and the vagina are two very distinct ecosystems, and you don’t want to spread bacteria from the anus to the vagina,” Sinclair advised. The anus houses different bacteria than the vagina does and introducing microbes from the former into the latter can result in uncomfortable infections like bacterial vaginosis. When engaging in butt stuff, wash hands and genitals before switching from orifice to orifice, and use a fresh condom or gloves when changing holes.

Photo via Pixabay (CC-BY)

Surprise your partner

Consent is key to a mutually satisfying sexual encounter. With that in mind, let’s maybe abandon the shocker: As Sinclair put it, “surprising your partner with a new sexual experience is never a good idea.” Unless you and your partner have established that a finger in the butt would be welcome at some point during the sexual encounter, maybe don’t jam a digit up there, and certainly, don’t stick your dick or your dildo in anyone’s butt before they tell you it’s okay to do so.

Editor’s note: This article is regularly updated for relevance.

Read more: https://www.dailydot.com/irl/how-to-have-anal-sex/

Experts In Australia Are Blaming Dating Apps For The Rise In Gonorrhea

Experts in Australia are blaming dating apps for the country’s recent rise in gonorrhea. A report published by New South Wales University’s Kirby Institute found that between 2012 and 2016, there was a 63 percent increase, with over 23,000 people being diagnosed with the STD.

Experts believe the increase is related to the heavy usage of dating apps such as Tinder, eHarmony, and Grindr.

Dr Wendell Rosevear, a campaigner for sexual health, told news.com.au that people often use dating apps to have “frequent, sometimes anonymous encounters”. 

He explained how people used to meet in person in social places like nightclubs. “Clubs are dying because people are becoming more reliant on social media and app connection,” he said.

Associate professor David Whiley, from the UQ Centre for Clinical Research at the University of Queensland, told 9News earlier this year that sexual irresponsibility might be a result of people wanting to increase fun by taking sexual risks.

Rebecca Guy, study author from New South Wales University, told the BBC that gonorrhea wasn’t always so common in young heterosexual people, especially those living in large cities. “Rising rates in this group highlight the need for initiatives to raise awareness among clinicians and young people about the importance of testing,” she said.

The new study showed that HIV has seen a less significant increase than gonorrhea in recent years, with 1,000 new cases in 2016. Meanwhile, chlamydia is still the most diagnosed STI in Australia. 

Gonorrhea, often referred to as “the clap”, causes unusual discharge from the penis and vagina. It can lead to pain when passing urine, and in women can sometimes be symptomless. The STD can pass between sexual partners easily during unprotected vaginal, oral, or anal sex. If left untreated, the bacteria can have serious effects on a woman’s cervix, causing issues like pelvic inflammatory disease, which causes severe abdominal and pelvic pain and can increase risk of infertility.

Read more: http://www.iflscience.com/health-and-medicine/experts-in-australia-are-blaming-dating-apps-for-the-rise-in-gonorrhea/

LGBTQ teens face sexual assault at higher rates than most

Late Sunday, BuzzFeed News published an interview with actor Anthony Rapp accusing House of Cards lead Kevin Spacey of sexually assaulting him when he was 14. The actor later came out as gay amid the allegations, sparking backlash for his timing, deflection, and general conflation of predatory behavior and sexuality.

But Rapp’s allegations against Spacey aren’t an outlier. In fact, sexual harassment and assault are ongoing problems in the queer community. And for the most marginalized members within the LGBTQ letters, assault rates remain startlingly high.

A hidden problem

In 2016, BuzzFeed LGBT’s U.K. editor Patrick Strudwick wrote a piece on domestic violence and emotional abuse in the queer community. He described a pregnant queer woman named Sam, who was repeatedly sexually assaulted by her girlfriend Lynn. According to Sam, it was extremely difficult for her to come out and seek help within her community, in part because sexual assault is so gendered. Her queer friends think of rape in purely heteronormative terms, equating assault with vaginal sex between a cis man and a cis woman.

“How do you say to your friends, ‘My girlfriend rapes me’ when their only mental definition of rape is a man forcing his penis inside a woman’s vagina?” she told BuzzFeed. “How do you say you were assaulted when it comes back to the idea of ‘that doesn’t count?’ Well, it does count.”

And it’s pervasive. According to the National Center for Lesbian Rights, one in eight lesbian women are raped in their lives, and four in 10 gay men are exposed to sexual violence. Nearly 50 percent of all bisexual women experience sexual assault in some form, as do bisexual men. And when it comes to transgender people, 64 percent are assault survivors.

Breathe in breathe out #lgbt #depression #rape #sexualassault #suicide #trevorproject #election2016

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The Human Rights Campaign expands on those statistics with even wider margins. According to HRC, nearly half of all lesbians have been raped, experienced domestic violence, or stalked by their partner. That number jumps to 61 percent for bisexual women. And over a quarter gay men have been raped, stalked, or experienced domestic violence from their date. Again, that number increases for bisexual men, clocking in at 37 percent.

It’s not just adults that are victimized. Teens and children are, too. The CDC reports that 18 percent of gay, lesbian, and bisexual students have been “forced to have sexual intercourse at some point in their lives,” compared to 5 percent of heterosexual high school students. Meanwhile, 23 percent of LGB teens actively dating someone reported some form of sexual violence within the past 12 months, compared to 9 percent of heterosexual teens.

Trapping assault victims

Why are LGBTQ assault statistics so high? When it comes to intimate partner violence, the staggering rate for LGBTQ couples could indicate a combination of living in a culture that hypersexualizes gay, lesbian, and bisexual people while also making them feel ashamed for being queer. LGBTQ folk are also more likely to be poor and stigmatized. In other words, when it comes to sexual violence, it’s easier for aggressors to ensnare victims who have less power.

For the most marginalized groups in the LGBTQ letters—particularly transgender women and queer women of color—there aren’t many resources available for support. A transgender woman seeking safe refuge from partner violence may be turned away from women’s shelters, even in progressive cities like New York that specifically outlaw this behavior.

“Societal discomfort with transgender persons has rendered transgender victims of sexual assault, gay-bashing, and domestic violence without necessary services,” Blue Grass Rape Crisis Center notes. “Medical personnel can respond with judgment and have been known to withhold care to people they perceive to be cross-dressing. The criminal justice and the legal systems often re-traumatize victims.”

And for a queer teenager who may be exploring their gender identity and sexuality for the first time, an abuser in a position of power and control may be able to manipulate them for their own advantage. Think about Rapp’s allegations against Kevin Spacey. In the mid-1980s, there was much less open conversation about sexual assault in American culture, let alone about a teen boy victimized by an older man. Where could a 14-year-old go if he was assaulted by an older, successful Broadway star?

Even today, queer teens assaulted by predatory men and women may have a fledgling support system that’s unable to help them, if not actively working against them. Some families blame the child for their own assault or burden them with shame for being queer. And police departments around the country still struggle with handling sexual assault cases, let alone respectfully dealing with LGBTQ victims. Combined with internalized homophobia, transphobia, or biphobia, the trauma LGBTQ sexual assault survivors face is further magnified.

“My self-esteem has been shot to pieces,” Sam told BuzzFeed. “It’s taken years to rebuild, to get me back to a place where I realize I’m worthy of love that isn’t transactional or conditional.”

As the LGBTQ community continues to talk about the sexual allegations levied against Spacey, remember that there’s a larger issue going on. Queer and trans Americans—much like women of color—are regularly targeted for harassment and assault by abusers who know they have nowhere to turn, who know they might not be believed. And living in a society that still stigmatizes gay, bisexual, and transgender people for being who they are makes it all the worse for victims to come out and call out their abusers.

If you are a victim of sexual assault or want more information on sexual assault, contact the Rape, Abuse & Incest National Network at 1-800-656-HOPE (4673).

Read more: https://www.dailydot.com/irl/sexual-assault-harassment-lgbtq/

Regular marijuana users have more sex, study says

(CNN)Dr. Michael Eisenberg, an assistant professor of urology, sees a lot of patients at the Stanford University Medical Center who have problems performing in the bedroom.

To determine what the problem is, they’ll go through a laundry list of regular activities. Often, patients will ask whether they need to smoke less marijuana.
There isn’t a lot of research on the topic. However, with marijuana becoming legal in a growing number of states, Eisenberg thought it’d be worth exploring.
    What he found surprised him.
    “Usually, people assume the more frequently you smoke, the worse it could be when it came to sex, but in fact, we learned the opposite was true,” Eisenberg said. His study was published in this week’s Journal of Sexual Medicine.
    The study looked at data from the US government’s National Survey of Family Growth. It asked more than 28,000 women and nearly 23,000 men how often they had sexin the four weeks prior to the survey and how frequently they used marijuana in the past year.
    Women who didn’t use marijuana reported having sex six times on average during the past four weeks. Women who used marijuana daily had sex 7.1 times on average.
    The trend was similar for men. Men who abstained from marijuana said they had sex an average of 5.6 times in the four weeks before the survey, compared with the daily marijuana users who reported having sex 6.9 times, on average.
    “We were surprised to see the positive association between users,” Eisenberg said. “This was across the board: marital status, race, none of that mattered.” The study focused on heterosexual sex, and it didn’t explain why there might be a connection between sex and marijuana.
    Eisenberg said past research on human and rodent models has shown that marijuana use may generally increase arousal. However, studies have also shown that too much marijuana use can decrease sperm count, and while men may want to have sex more, orgasm may be a challenge.
    “It can have a different impact on different people,” said Joseph Palamar, an associate professor in the Department of Population Health at New York University, who is not connected with the current study.
    He thought it was a “cool epidemiological paper” that “did the best it could with the data,” but it did have limitations. “It’s unclear from the data if people had marijuana in their system before or during sex,” Palamar said. Someone could smoke in the morning but not have sex until the evening, when it wouldn’t be in their system any more, for example. He added he’d like to see a study that could show more of a direct effect on frequency.
    Palamar authored a small study comparing the sexual experience of people who are under the influence of alcohol versus marijuana.
    Studying 24 adults, his research found that people under either influence had increased feelings of self-attractiveness, but alcohol seemed to make people more social and bold and helped them make more connections with potential partners, compared with those people using marijuana. It showed that drinkers typically have more regrets about who they slept with and are less choosey, whereas marijuana users tended to be more selective.
    Because marijuana is still illegal in the majority of places, Palamar found that most people have to smoke in private, and that could lead to more opportunities to initiate intimacy, compared with people who drink, since alcohol is everywhere.
    Marijuana may also have increased some people’s sensitivity during the act itself, although some reported getting so “lost in their own heads,” they weren’t paying as much attention to their partners, and they did not enjoy sex as much.
    “And if marijuana makes you paranoid, as it does with some people, it could really, pardon the pun, screw your ability to have an orgasm,” Palamar said. Some women also reported vaginal dryness when they smoked pot, and that too can limit sexual pleasure.

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    Both scholars hoped these studies will encourage other researchers to dive deeper into the topic. In the meantime, Eisenberg said that if a patient asks whether his frequent marijuana use is getting in the way of his sex life, he will tell them that “it may not be the culprit.”
    Regular marijuana use can have other impacts on your health. Research in adults is still limited, but what we know is that smoking can irritate your lungs, and studies have shown it can raise your heart rate, making you more vulnerable to a heart attack.
    “For most people, we tell them instead to go to the gym and lose 20 pounds,” Eisenberg said. Being overweight can give men arousal problems.
    “We always talk about anything that can be good for your heart can be good for your penis,” he said. “For a lot of guys, hearing that is an amazing motivator.”

    Read more: http://www.cnn.com/2017/10/27/health/marijuana-increased-sex/index.html

    Apples Billion-Dollar Bet on Hollywood Is the Opposite of Edgy

    Days before Apple Inc. planned to celebrate the release of its first TV show last spring at a Hollywood hotel, Chief Executive Officer Tim Cook told his deputies the fun had to wait. Foul language and references to vaginal hygiene had to be cut from some episodes of , a show featuring celebrities such as Gwyneth Paltrow, Jessica Alba, Blake Shelton, and Chelsea Handler cracking jokes while driving around Los Angeles.

    While the delay of was widely reported last April, the reasons never were. Edits were made, additional episodes were shot, and Apple shifted resources to another show. When was released in August, it didn’t make much of a splash. The early stumbles highlight the challenges ahead as Apple mounts an ambitious foray into showbiz. The company plans to spend $1 billion on TV shows over the next year and has hired a team that’s already bidding for projects against the biggest media companies in the world.

    With $262 billion in cash and securities in its coffers, Apple has the money to make as much TV as anyone, but some in Hollywood are beginning to wonder whether it has a clear strategy. The most valuable company in the world, Apple is under the constant glare of regulators, reporters, and competitors. Furthermore, the people who use the hundreds of millions of Apple devices have pretty mainstream views about the brand’s appeal. Macs, iPhones, and iPads are also often in the hands of children—a group unsuited for much of the edgy programming that’s fueled the new golden age of television.

    The secretive company says little about its plans. No one in Hollywood knows where the shows will be available to watch, how much they’ll cost, or even how Apple will publicize them. But in recent weeks, a visit to Apple offices in the Culver City suburb of Los Angeles has become as much a rite of passage for Hollywood producers, agents, and filmmakers as dining at Spago. So clues are beginning to emerge, based on interviews with more than a dozen people who’ve met with Apple executives or work there.

    The company has had many fits and starts in Hollywood over the past two years, with as many as four different executives claiming to be responsible for its big move into Tinseltown. To lead the latest charge, Apple hired Jamie Erlicht and Zack Van Amburg, former heads of Sony Corp.’s TV studio. The two men have sterling reputations as key members of the studio that produced . They’ve hired other industry veterans to oversee the development of new shows. They also plan to hire at least 70 staffers—including development executives, publicists, and marketers—to fill out their division. “They are professionals with deep relationships with many of the people who make some of the best shows on TV today,” says Jon Avnet, who directed 10 episodes of Sony’s TV show .

    Erlicht and Van Amburg have agreed to remake Steven Spielberg’s anthology series  with NBCUniversal and are in the bidding for another show, about morning TV show hosts played by Reese Witherspoon and Jennifer Aniston. Apple wants to have a small slate of shows ready for release in 2019. “I think for both NBC and Apple, it’s about finding that sweet spot with content that is creative and challenging but also allows as many people in the tent as possible,” says Jennifer Salke, president of NBC Entertainment.

    However, Apple isn’t interested in the types of shows that become hits on HBO or Netflix, like —at least not yet. The company plans to release the first few projects to everyone with an Apple device, potentially via its TV app, and top executives don’t want kids catching a stray nipple. Every show must be suitable for an Apple Store. Instead of the nudity, raw language, and violence that have become staples of many TV shows on cable or streaming services, Apple wants comedies and emotional dramas with broad appeal, such as the NBC hit , and family shows like . People pitching edgier fare, such as an eight-part program produced by filmmaker Alfonso Cuarón and starring Casey Affleck, have been told as much.

    Yet like Netflix Inc., Apple is thinking globally. The company hired Amazon.com Inc. executive Morgan Wandell to oversee its international division and is about to hire Jay Hunt to oversee development in Europe.

    All this has led many producers to label Apple as conservative and picky. Some potential partners say they walk into Apple’s offices expecting to be blown away by the most successful consumer technology company in the world only to run up against the reality of dealing with a giant, cautious corporation taking its first steps into a new industry.

    Apple isn’t the first tech company to underwhelm Hollywood. Yahoo! Inc. and Microsoft Corp. spent millions of dollars on TV shows before pulling back within a couple of years, frustrated by the slow pace of development and their inability to attract audiences. Even Amazon, at first considered a success story, is now drawing complaints from writers and producers over casting decisions and instances of buying scripts but not producing them. The online retailer also fired its studio chief in October over allegations of sexual harassment.

    Streaming video is just one of many fronts in the global battle between technology titans. After years of flirting with Hollywood, Silicon Valley companies are finally writing big checks, spurring a doubling of video production over the past decade. Amazon spent an estimated $4.5 billion this year on movies and TV shows, while Facebook and YouTube will spend more than $1 billion each. Netflix, which plans to spend $8 billion in 2018, dwarfs them all.

    Yet no one arouses more interest in Hollywood than Apple. One reason it quickly climbed the list of places to pitch new shows: the almost cult-like attachment many have for its phones. “Their brand is the most important thing,” says Avnet, who’s made shows for Snapchat and YouTube and is in the process of making one for Facebook.

    By funding original shows, the company also can remind customers to think of the Apple TV streaming device before the Roku or Amazon Fire TV Stick and to use Apple’s year-old TV app instead of Amazon Prime Video or YouTube. With iPhone growth slowing, the company is looking to other divisions to deliver sales. ITunes, Apple Music, and the TV app are part of its services business, where CEO Cook wants to double revenue by 2020, to about $50 billion.

    Yet Apple isn’t trying to compete with Walt Disney Co. or Netflix to become the biggest backer of TV shows and movies on the planet. Instead, the company wants its shows to complement those of other networks and streaming services that consumers already watch on Apple devices. Its new shows, however, will no longer be placed on Apple Music, which will limit its focus to music-related video.

    Whether Apple can channel consumer demand in TV as well as it does in smartphones remains to be seen. Around the time Apple delayed the release of , its top brass also decided the TV unit should move up the release of , a reality competition series in which entrepreneurs pitched celebrity investors on their idea for an app, so it would make its debut on Apple Music in time for the company’s Worldwide Developers Conference in June. Apple execs loved the show and thought it would endear the tech giant to software writers. The show wasn’t supposed to be released for a couple of months, and there was no marketing plan in place—a vital step in the age of too much TV. Apple pressed ahead, and the show came and went with little fanfare beyond a couple of savage reviews. The show is “a bland, tepid, barely competent knock-off of ,” according to ’s Maureen Ryan. “There’s no reason” for Hollywood to lose sleep over it, she wrote. Apple is betting the same won’t be said about its broader TV strategy.

      BOTTOM LINE – Apple will spend $1 billion next year on programming for television. By sticking with mainstream shows, it could miss out on viewers who increasingly favor edgier fare.

      Read more: http://www.bloomberg.com/news/articles/2017-10-25/apple-s-billion-dollar-bet-on-hollywood-is-the-opposite-of-edgy

      Reality shrivels. This is your life now: 88 days trapped in bed to save a pregnancy

      The long read: Months before she was due to give birth, disaster struck for Katherine Heiny. Doctors ordered her to lie on her side in bed and not move and gave her a 1% chance of carrying her baby to term

      When I was five years old, my parents decided they could no longer watch the nightly news. Or rather, they could no longer watch it if I was in earshot. The coverage of the attack at the Munich Olympics had caused me to have such an intense fear of being killed by gorillas that I couldnt sleep. No matter how many times my parents explained the difference between terrorist guerrillas and primate gorillas and that there were no gorillas in Michigan anyway I remained sleepless with worry late into the night for weeks. My parents eventually gave up and subscribed to the afternoon paper as well as the morning one.

      The problem is not just that I am a champion worrier. Its that I court worry I seek it out, I invite it into my home, never remembering how hard it is too dislodge it from its comfortable chair by the fire. I watch true-crime documentaries when Im alone. I Google photos of black widow spider bites. I know the statistics about paracetamol overdoses. I have memorised the beaches with dangerous riptides. I have installed a carbon monoxide detector in every house I have ever lived in. And when I got pregnant with my first child, I bought What to Expect When Youre Expecting and the chapter titled What Can Go Wrong was the one I read first.

      Retained placenta; umbilical cord prolapse; foetal arrhythmia; toxoplasmosis; preeclampsia; placental abruption; gestational diabetes; cytomegalovirus: I read about all of them, and learned the warning signs. Perhaps to other women, these complications remain obscure, shadowy threats during pregnancy, but to me they were hard, clear, immediate dangers. When my obstetrician told me that mine was a perfectly normal pregnancy, the very first thing I said was: Are you sure?

      And yet I was surprised when disaster struck. The things you worry about arent supposed to happen thats what worry does. Its a preventative. And my disaster happened quickly, without fanfare or drama. One second, I was a nice, normal, happy pregnant married woman of 32, walking across my bedroom to my desk while my husband made lunch downstairs. And then the warm fluid gushed out of me, soaking my clothing and leaving a little wet spot on the pale green carpet.

      I yanked down my jeans and pants, expecting blood, but there was only wetness. I knew it was very likely that my waters had broken, but I was barely 26 weeks pregnant. It didnt seem possible. I stepped out of my clothes and went to the top of the stairs to call my husband. He stood on the landing with his hands all sticky from making hamburgers, and I told him what had happened. We discussed it for a surprisingly long time. Was it really so bad? How much fluid? Maybe a cup? Was there blood? Was the baby still kicking? Should I call my doctor? Yes, we decided.

      I wrapped a towel around my waist and called my obstetrician. He was a man in his late 50s with a perpetual hangdog expression, and for this reason, my husband and I called him Doggie B. I loved Doggie B. Nothing ever surprised him, nothing ever alarmed him. I could not picture him giving me bad news, and because I could not imagine it, I felt it wouldnt happen.

      I want you to meet me at the hospital, Doggie B said. Go to the maternity ward. And I want you at Georgetown Hospital where they have the neonatal unit.

      I put on fresh pants and jeans and my husband and I drove to the hospital. It was 29 January 2000, and an ice storm was just beginning. Something happened to me on the way to the hospital: my mind split in two. One half was convinced that that this trip was unnecessary, that, of course, my water hadnt broken, that I was just fine. The other half was just as sure my waters had broken and that I would almost certainly go into labour and give birth to a baby too young to live. The two halves of my mind rotated inside my head like the lights of a lighthouse, the worried part flashing and then disappearing, replaced by the calm one.


      At the hospital, a doctor who looked just like Andie MacDowell performed a pelvic exam and took vaginal swabs. A nitrate test was done on one of the swabs for the presence of amniotic fluid. (Its presence would have meant membranes containing the baby had ruptured three months prematurely and would most likely cause me to go, disastrously, into labour.) The other swab was for sent off to the lab to check for the presence of arborisation, otherwise known as ferning, because amniotic fluid produces a delicate, leafy pattern under the microscope. Both tests were negative, although they were running a repeat just in case. I began to feel a little ridiculous.

      The Andie MacDowell doctor told us that there was no evidence that I was leaking amniotic fluid, but that they were going to admit me, she said, on the strength of my story.

      The strength of my story! I was appalled. Im a writer of course I told a strong story. Maybe I didnt need to be here, I told my husband, as nurses wheeled my gurney into a private room. Maybe I should just tell an equally strong story about how nothing was wrong and go home.

      The doctor came back. I just saw the ferns, she said. You have definitely ruptured. Well try to delay labour as long as possible.

      Three months? I asked.

      Yes, thats the hope, she said.

      I wouldnt have been so scared if it werent for the look on her face.

      Dom
      Illustration: Dom Mckenzie

      Nurses came into my room and began to bustle around me while the doctor explained that my condition was called preterm premature rupture of membranes, or pPROM. The two most dangerous (and most common) complications of pPROM are extreme pre-term birth and chorioamnionitis, a bacterial infection of the foetal membranes. Both are devastating for the foetus. I reached for my husbands hand.

      The nurses put me in Trendelenburg, meaning my hospital bed was tilted so that my head was 20 degrees lower than my feet. (I thought it was some long German word that meant head below feet on the side of a mountain.) A nurse wrapped a foetal monitor to my belly with a thick strap, explaining that it could be read from the nurses station, and they would know immediately if I began having contractions. Another nurse slid a pair of puffy compression leggings on to my legs. They inflated and deflated every other minute with a whooshing sound. It was like having Darth Vader breathing at my bedside. I was told to lie on my side in order not to put pressure on my vena cava, which would lower the babys oxygen supply. Yet another nurse poked a needle into my arm to start a line for intravenous antibiotics.

      The doctor gave me a shot of steroids to help develop the babys lungs, in case the baby would shortly be needing those lungs to breathe. Arent steroids counter-indicated in pregnancy? I asked.

      Yes, but its more dangerous to go without, she said.

      Doggie B called the hospital to stay that he couldnt make it in because of the ice storm. In his absence, the doctor ordered the nurses to give me a shot of terbutaline, a medication that can delay preterm labour for up to 48 hours.

      Please, I begged. I dont want any more shots. Im not in labour. This could be so bad for the baby.

      From the moment I learned I was pregnant, I had divided the world into things that were OK for the baby, and things that were bad for the baby. The first group included rice, poached chicken and yoga, The second group included alcohol, secondhand smoke, deli meat, smoked seafood, raw eggs, soft cheese, pt, caffeine, unwashed vegetables, diet soda, eggnog, x-rays, aspirin, ibuprofen, antihistamines, nasal decongestants, cough syrup, librium, valium, sleeping pills, castor oil, vitamin A supplements, paint fumes, insect repellent, acupuncture, cats, hair dye, altitude, saunas, reptiles, tick bites, microwaves, electric blankets, rollercoasters, bikini waxes, stiletto heels, hot dogs and tap water. I trusted no one but myself and Doggie B to categorise items, and certainly not a doctor I had met 10 minutes before.

      They gave me the terbutaline anyway. It made me dizzy and cold, though it makes most people hot. They piled more blankets on top of me. My hands shook uncontrollably.

      The neonatologist came to talk to us. He had thick glasses and he talked in percentages. It was clear that he was not interested in offering comfort; he was there to convey information. He told us that for babies born at 26 weeks, the survival rate is 50%. Of the surviving half, one-third had major disabilities, and are likely to be dependent on caregivers for ever. It was common for them to have breathing problems, cardiac disorders, brain bleeds, cerebral palsy. Brain damage, deafness, blindness. Another third had more moderate disabilities: spastic muscles, significant hearing loss, impaired vision without blindness. The final third (the best we could hope for, apparently) had milder learning disabilities, anemia and digestive complications.

      I watched him dispassionately, not really listening. He was so stereotypically nerdy that I couldnt get over it. Why was he telling us all this scary shit anyway? I wasnt going to go into labour. The baby wasnt going to be born yet. Why couldnt anyone understand that?


      The first night was longer than I would have believed possible. Visiting hours ended and the nurses chased my husband out. He drove home on streets that crackled and shifted with ice. I was not allowed to stand, or even sit. I was served a dinner that I was too nervous to eat. And I learned about bedpans. Peeing into something the size and shape of a casserole dish while lying in bed with your head angled toward the floor is messy and awkward.

      But that is not the worst thing about bedpans. The worst thing is the other people involved. Having to ask someone to bring you a bedpan, having to make conversation with that person while you use it, having to apologise because your aim is a little off and now theres a wet spot on the sheets, having to ask that person to wipe you, having to ask her to wipe you again because you still feel damp and sticky, having to thank the person, and you do really thank her, you are so grateful, its just that two hours ago you were an upright person with a little dignity, and now youre not.

      The hospital lowered the lights in the hall, just like on a transatlantic flight. Nurses went by on squeaky shoes. I lay on my side and gripped the metal railing of my bed. The lighthouse in my mind revolved, and for one instant the room was flooded with cold, bright, white fear for the baby. Then it was gone. Certainty that the baby would not be born early stole over me, and I gathered that certainty close. I lay awake and watched the sleet falling outside my window. It occurred to me that I could not see the ground.

      Doggie B came to see me the next day.

      Can you believe this? I said to him. Me, your most paranoid patient!

      He didnt bother to deny that I was his most paranoid patient. When he spoke, his voice was mild and unconcerned. He said that I would remain on bed rest, and unless infection forced us to act sooner, he would deliver the baby at 33 weeks, when the greatest risk was over.

      I didnt want to have the baby at 33 weeks. I wanted to have the baby at 40 weeks, like everyone else. I knew the risks. But I had also been told the risks of preterm infection: a baby born with brain damage, cardiac defects, limb abnormalities, microcephaly, hydrocephalus, paralysis, bone lesions, eye lesions or possibly no live baby at all. I refused to weigh the risks; I would simply not go into labour, nor would I develop an infection. That was all there was to it.

      I frowned at Doggie B. Why 33 weeks? Why not go to May 10? That was my due date.

      He shrugged. OK, May 10.

      He was a much better liar than the Andie MacDowell doctor.

      After Doggie B left, the nerdy neonatology doctor came to my room again. He wanted me to go down to the neonatal intensive care unit (NICU). You need to see what a preemie looks like, he said, pushing his glasses up his nose. You need to prepare yourself.

      The Andie MacDowell doctor was there, too. A three-pound baby takes some getting used to, she said. You dont want to see one for the first time in the delivery room.

      To both of them, I turned a deaf ear and a sullen face. I was not going into labour. I was not going to go to the NICU and no one could make me. Conversation was cut short when another nurse came in and told me that my monitor had showed slight disturbances, and gave me another shot of terbutaline.

      I cant believe terbutaline makes you cold, this nurse said as she took blankets from the blanket-warmer and I shivered beneath them. Out in the hall I heard her say to someone: That one is so contrary.

      I could see remotely that all these doctors and nurses knew something I didnt. I found out much later that what they knew were the odds. Fifty per cent of women with pPROM go into labour within 48 hours, and 95% deliver within one week of rupture. Four of the remaining 5% deliver within two weeks. One percent of women with pPROM experience spontaneous resealment of the membranes and go on to carry the baby to term.

      One per cent.


      Do you knit or crochet? one of the nurses asked me early on. Lots of bed rest patients find that helps them pass the time. No, I read and I write, I answered, pretentiously. And untruthfully, because I have always watched a great deal of TV.

      I couldnt write because I couldnt sit up. I also couldnt write because if I focused too much on my situation, the lighthouse in my mind would revolve and the worried, scared part of me would rush out, gibbering with alarm, baying, screaming, howling that the baby was going to be born too soon, the baby was coming now, the baby was going to die. How could I write with that going on?

      I had a headache from being in Trendelenburg. I couldnt remember what it was like to look someone in the eye, so long had I now spent gazing up at everyone from thigh-level. When I ate, it was one wobbly, precarious forkful at time. After a while, I just gave up and if I couldnt eat it with my fingers, I didnt eat at all. I drank through a straw, until everything tasted the same: like the plastic of the straws.

      I couldnt write, so instead I read. Constantly. Ceaselessly. I had to hold the book open in front of me sideways, like someone gripping a large steering wheel. My husband brought me books and I stacked them on my overbed table, and as I read each book, I held the next book in my free hand, with my finger marking the start of the first chapter so that as soon I finished one book, I could immediately start another. I must have read dozens of books while I was in hospital, and I can only remember one of them.

      Only one book held my interest. I told my husband exactly where to find it on the bookshelf near my desk and he brought it to me: Steven Callahans Adrift, a memoir of the 76 days in 1982 during which Callahan had survived in an inflatable life raft after his sailboat sank. I had fallen in love with the book when it was first published, in 1986. It seems like a strange choice of reading for a teenage girl, especially one as studious and non-athletic and seasickness-prone as I was. But I have always been drawn to survival stories: they dovetail nicely with my chronic fear of disasters.

      Callahan spent more than two months in a rubber raft in the middle of the Atlantic, spearing fish to eat raw, using solar stills to distil water, and making endless, desperate makeshift repairs to his patched and leaking vessel. I had read Adrift many times over the years, but now I read it again, and was inspired by his suffering and ingenuity in a new way. I was in a hospital bed where nurses brought me meals three times a day, and I slept in a bed on clean sheets and was in no danger of drowning. I could do this. I could.


      You dont sleep in hospital. You cant sleep. Too many people coming and going. A nurse comes every four hours to check your vitals: temperature, pulse rate, blood pressure, babys heartbeat. Another nurse comes in every two hours to make sure you are doing your kick-counts. Meals come three times a day, plus a night-time snack for pregnant women, which means four times someone comes into your room to deliver a meal, and four more times someone comes back to collect the tray. A nurse comes every time you need to use the bedpan. An orderly comes every morning to take you for an ultrasound. Your obstetrician comes by every day to check on you, and you dont want to miss his visit, because he is the only one who tells you what you want to hear no, theres no sign of infection; yes, Im sure youll carry to term. The hospital chaplain stops by once a day. She was a mousy woman with a perpetually scared expression. Its not a good look on a hospital chaplain.

      So thats more than 30 people coming to your room and interrupting your sleep. And then theres the physical part of it. If you are confined to bed, after you lie on your side for a few days, it begins to feel as if your hip sockets are lined with metal shavings, as if the sheets are covered with shattered glass. Before long, red, rough, scaly patches the size of saucers appear on your hips and your shoulders the beginnings of bedsores. The compression leggings chafe your thighs.

      You forget how to sleep. The line between waking and sleeping used to be as clear and sharp as the line down the middle of a road, but after two weeks, that line has blurred and is almost invisible. You stagger back and forth across it like a shambling drunk, until there is no more sleeping and waking; there is just this dim, dull, soupy consciousness. Your reality shrivels down into one long, hazy, beige-tiled tunnel. You used to worry, but it has gone beyond that now. Worry used to be inside you, but now you are inside it. Worry is a dome that has descended over you and trapped you. This is your life now. This is your world.

      Every day about 10am, an orderly arrived with a gurney and I carefully scooted on to it and then the orderly pushed the gurney through the hospital halls to the prenatal department.

      Two weeks had gone by, and I hadnt gone into labour. This seemed to surprise everyone but me and Doggie B, who began, cautiously, to speak of resealment. The nerdy doctor came by and gave me a whole bunch of new statistics about what the babys chances were at 28 weeks, at 30 weeks. He didnt go beyond 30 weeks, though. They removed my IV. Everyone talked about something called BP as though they were speaking of the Rapture. (Bathroom Privileges.) The atmosphere in my room became positively springlike, despite the snow outside.

      Doggie B said the first step would be for me to get up and take a shower. A shower! Nothing could have been more tempting. He gave me a date. Now it was something to look forward to. I had my husband bring in a bottle of my favourite shampoo and a bar of coconut soap. The day finally came. A nurse removed my circulation leggings. I sat up slowly and swung my feet to the floor. The nurse took my arm and helped me to stand. I stood there, swaying. Amniotic fluid poured out of me and splashed to the floor. The nurse let go of my arm in surprise. I lay back down and turned my face to the wall.

      It took me a while to regain my strange equilibrium, especially considering that the doctors now suspected I had been leaking continuously since the first rupture. Rupture of the membranes is considered prolonged (and therefore dangerous) when more than 24 hours passes between the rupture and the onset of labour. My waters had broken more than 300 hours ago. The risk of sepsis was very high.

      Katherine
      Katherine Heiny. Photograph: Leila Barbaro

      But still, two days maybe three and the stubbornly optimistic side of my personality fought its way to the forefront and re-planted its battle flag. The Andie McDowell doctor wrote in my chart: Patient needs to understand that resealment is highly unlikely at this time and that preterm birth is almost a certainty. Yeah, well, thats what she thought. This baby was not coming early. I simply wouldnt allow it.

      Another week in bed went by. Every once in a while, they had me stand up, and every time I leaked amniotic fluid. But still I didnt go into labour. Nor did I have a fever or abdominal pain, the two greatest indicators of infection. Life as I now knew it went on.

      After I had been on bed rest in the hospital for 25 days, there came a time when I stood up and no fluid gushed out of me to splatter on the floor. The nurse and I looked at each other in amazement. Go take a shower, quick! she said. Ill change the sheets on your bed.

      It was not the slow, luxurious shower I had dreamed of, but I can tell you this: it was pretty fucking nice. They didnt allow me out of bed again that day, but I was finally taken out of Trendelenburg. I stood up the next day and again there was no leak. I took another shower.

      When Doggie B came to see me next, I was sitting in a chair to greet him, radiant, both my pride and my belly enormous.

      I had done it. I had resealed. I was in the 1%.


      Doggie B wanted to send me home. I fought him. I had been in the hospital for almost a month at this point, and I was pretty much institutionalised. Go home? Without the foetal monitor? With no nurses to listen for the babys heartbeat every four hours? No daily ultrasound? Uh-uh. He was crazy if he thought I could handle that much responsibility. I told him that I needed to be in the hospital near the NICU. I pointed to my chart where it said Severe Risk Pregnancy in big scary letters. Doggie B stood firm. He discharged me and my husband drove me home.

      Steven Callahan writes of seeing the first food after his rescue a cake of chipped coconut topped with a dot of red sugar and how he looked at it in wonder and thought: Red! That was exactly how I felt when I saw my house again. Green! Blue! Lilac! My hospital room had been unrelentingly beige.

      I was still on almost total bed rest, allowed up for 15 minutes twice a day. A shower in the morning and dinner at night. Out of the hospital, the lighthouse in my mind revolved faster and faster, unchecked by the nurses reassurance. I counted constantly how often the baby kicked, and took my temperature five times a day. The amniotic sac had resealed, but the rupture had been extremely prolonged, greatly increasing the chances of an infection reaching the baby. Even feeling the babys movements could not quell my worry. Doggie Bs receptionist learned to put me straight through to him when I called.

      Time ground slowly by. My husband brought me breakfast in the morning before he left for work. Our housekeeper brought me lunch. My husband brought me dinner and we ate at the card table he had set up in the corner of our bedroom. Then I crawled back into bed and worried until I fell asleep, woke up, and started another day. That was my routine, and I never varied from it. I dont mean I never varied from it significantly; I mean I never varied from it at all.

      Thirty-one weeks. Thirty-two weeks. Thirty-three. Still I didnt go into labour. I lay in bed and stroked my abdomen with my fingertips. Thirty-four weeks. Thirty-five. March ended and April began. A blizzard of cherry blossoms replaced the snow outside my bedroom window. Thirty-six weeks. Thirty-seven weeks. I no longer watched TV or pretended to read books. I knew nothing but my belly and the endless waiting. Time had softened and stretched like taffy, pulling itself into long, gooey ribbons. Thirty-eight weeks. Thirty-nine. I was certain that the baby would be born on 21 April, the same day Steven Callahan was rescued. But 21 April came and went. And then one day I got up to take my morning shower and felt the slightest trickle of fluid run down my leg. My waters had broken for the last time.


      Our son was born 12 hours later at Sibley Hospital in Washington DC. We named him Angus. And so my life changed again in another minute, another second. The two halves of my mind fused back together. I went from severe-risk pregnancy to healthy new mother. I was totally unprepared. For so long the goal had been to stay pregnant I had almost forgotten that a baby was the end result. I knew nothing about newborns, nothing about breastfeeding or burping or vaccinations. The nurses had to show me everything. One them said, in a careful voice: Ive heard about you, I think. I could tell that whatever she had heard was, at best, a mixed review. Didnt you rupture very early and do a lot of bed rest over at Georgetown?

      I felt a stubborn thump of pride. Thirty days at Georgetown. Eighty-eight days altogether.

      Wow, she said. I bet you never want to see a hospital again.

      I didnt know how to tell her that almost the opposite was true. It wasnt just that I knew about hospitals now, and knew I could survive a long stay in one. I was a different person from the one who had been admitted all those weeks and months ago: a tried person, a changed person. Very few experiences transform your view of the world and yourself, but bed rest did that for me. I had beaten nearly unthinkable odds. All the things I have always meant to fix about myself but had never got around to my stubbornness, my hypochondria, my inflexible nature had turned out not to need fixing. Had, in fact, turned out to be survival skills.

      Twenty-four hours went by, and I cried because I never wanted Angus to get any older. The impossible had happened: time had speeded up.

      Six months later, I arranged to speak to Steven Callahan by phone. I told him how much his book had meant to me, how much he had inspired me. We discovered that we had both been obsessed with numbers, with calculating and re-calculating the days of our progress. I told him that my ordeal had altered me in some fundamental way, that sometimes I even missed the mind-bending, terrifying force of it. He agreed.

      Sometimes I feel a loss, he said, in terms of the fact that few if any experiences I will ever have again can equal the intensity and importance of that one. You try to mine the precious elements of the experience, but they slip away from you, and thats another loss. You try to appreciate this enormous gift youve been given, but eventually you just get on with it.

      The precious elements of my experience were fading, too. I took my bathroom privileges for granted now. I slept on my back again. I went for walks. I worried about traffic jams and deadlines and love handles, just like a normal person. I got on with it.

      Angus is 17 now, taller than me, taller than my husband. He has the beginnings of a moustache and a voice as deep as James Earl Joness. He knows how to do laundry, and make spaghetti. He can take the Metro by himself, and he learned to drive this summer. Its possible he watches porn on the internet. (Its extremely possible.) I have new fears and worries, about teenagers. The bright, icy terror of the hospital is behind me, but it has taken a long time.

      One day, when Angus was about three years old, I cleaned out a closet and unexpectedly found the plastic water pitcher that had been by my hospital bed. In an instant, the lighthouse in my head revolved, and everything went white and cold. I was certain that the baby was in danger so certain that I had to run to the bathroom and vomit. I dont know why this surprised me, or why I thought I would be different, immune to the after-effects of my ordeal. All survivors have scars.

      Main illustration by Dom McKenzie

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      Read more: https://www.theguardian.com/lifeandstyle/2017/oct/24/88-days-trapped-in-bed-to-save-a-pregnancy-bed-rest

      Women ‘deserve apology’ over mesh implants

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      Media captionStephanie and Peter Williams say it’s made it “impossible” for them to be intimate

      Women left in permanent pain and unable to walk, work or have sex because of vaginal mesh implants deserve an apology, a senior MP has said.

      Dr Sarah Wollaston, chairman of the health committee, said some claim they did not consent to having the device fitted and were unaware of the risks.

      MPs also called for an inquiry into the implants which are used to treat pelvic organ prolapse and incontinence.

      The medicines regulator says most women have a positive experience with them.

      Earlier this year, the BBC’s Victoria Derbyshire programme revealed that more than 800 women were taking legal action against the NHS and the makers of vaginal mesh implants.

      The implants, usually made from synthetic polypropylene, are intended to repair damaged or weakened tissue.

      ‘Clear failings’

      While they have been used successfully in many other parts of the body, they appear to react differently when inserted in the abdomen, leading to some women being “cut” – and once problematic, they can be very difficult, sometimes impossible, to remove.

      In a Westminster Hall debate on Wednesday, Conservative MP and GP Dr Wollaston said there were “very clear failings” that had been “allowed to continue for so long and at the heart of that it has been the inadequacy of clinical trials, recording and consent”.

      She said mesh should be retained as an option where alternative procedures may result in worse outcomes or complications.

      But she said there had to be a guarantee that “proper” clinical trials would be carried out as the products had been introduced and marketed “aggressively” without “adequate” trials.

      “Fundamentally, at the heart of this is, there’s an absence of data, and I’m afraid there’s been cavalier practice.

      “We cannot allow this to continue in the future and I think the women who have been affected deserve an apology, they deserve recognition of the extent of this and the delays in which this has been recognised and has been taken forward.”

      ‘Thousands affected’

      Calling for a full public inquiry, Labour’s Emma Hardy urged the government to suspend operations using the implants while a “full retrospective and mandatory audit of all interventions using mesh” was carried out.

      Ms Hardy said “thousands” of women had been adversely affected by mesh implants.

      “We know these devices are regulated by the European Union – I hope the minister will make a comment on how the government proposes to take this forward after we leave the European Union, and at the heart of it to ensure the safety of women is prioritised,” she added.

      Image caption Mesh implants are used to treat organ prolapse and urinary incontinence

      Paul Masterton, Conservative MP for East Renfrewshire, said his party in Scotland – with Labour – had “stood firmly behind ” those affected.

      “Please suspend this procedure – if you’re not convinced enough evidence is there, suspend it while you gather it together,” he said.

      “Mesh is rapidly becoming one of the great global health scandals and I’d implore all of us in this place to do what we can to protect women from this potentially devastating procedure, and to ensure our nation becomes an example to others in how to achieve justice for all those who have been broken by mesh.”

      The Labour MP for Alyn and Deeside, Mark Tami, spoke about a constituent’s suffering and called it a “national scandal”.

      The Medicines and Healthcare products Regulatory Agency has previously said it was “committed to help address the serious concerns raised by some patients”.

      Related Topics

      Read more: http://www.bbc.co.uk/news/uk-41671020