Monday, April 12, 2010

Reserving all the judgment for ourselves

You know that saying: the best-laid plans of mice and men go oft awry? Well, because of our extensive experience with the going-awry, many of us abortioneers have pretty firm ideas of safer sexual practices, and some of us might have a certain trepidation about using anything other than "highly effective contraceptive methods" (see here for a ranked chart of options and explanation of its use in contraceptive counseling). 

At the same time, we all spend our days hearing every version of sexual history under the sun, and recognizing that women are not evil or dumb or fuckups when their practices or situations diverge from our own. We counsel clients about methods that are easier to remember or longer-lasting or invisible to an abusive partner; we brainstorm with them about ways to approach a partner about getting testing for STIs, condom negotiation, and respect for boundaries; we remind them about transmission methods of various infections and how to treat or manage existing diseases. We don't scold or scoff. The words "stupid" and "crazy" and "irresponsible" may exist in the world outside our walls, but not in here. 

But have you ever seen what happens when WE fuck up? 

This weekend I had a crazy, stupid, irresponsible experience: unprotected sex. The first of my life. I've been with my partner for ages, but we hadn't had sex in quite a while, and -- it seems crazy but -- somehow this time protection just slipped my mind. And afterward my partner asked if I had gone back on the pill, because he'd been expecting me to pause for condom-time but then I didn't. OMGWTFBBQ, said I. How can someone spend years and years trying so hard to avoid pregnancy, working in the world of unplanned pregnancy, and devoutly practicing protection habits -- then just FORGET? Needless to say, I was about as embarrassed and irritated at myself as your average patient who sheepishly tells you her story of one night of abandon, or one vomited pill. 

Well, I headed right to my medicine cabinet, looking for the pack of emergency contraception that I obtained nearly four years ago and set aside for just this purpose -- or more likely, I thought, for some friend who had a more unpredictable social life and might find herself unprepared. Ha. What was that I said about best-laid plans? I couldn't find the pack! I've moved three times since I first picked it up, and it must be in a box somewhere. So I texted a couple work friends, thinking they were likely to have a spare too -- but they didn't, and our clinic is closed on Sundays so it wouldn't be a snap to get it for cheap or free. No problem: I'll skip down to the pharmacy and buy it over-the-counter---Holy shit! I forgot the full price was fifty dollars. And my insurance doesn't have any coverage for non-prescription meds. 

It's so weird being one of the hoi polloi, the everywoman who faces everyday obstacles and needs to decide if she can afford to protect herself and has to deal with an awkward pharmacist. And really weird realizing I'm judging myself for being "such a dumbass" when I would never think that about someone else. 

Later that day, I heard from a friend: 
               um, how much do you know about herpes?
               i engaged in some high risk irresponsible behavior last night due to drunkeness
               i feel like i need to kick myself out of my [sexual-health-related occupation]

My god! We all make mistakes sometimes, and here we are feeling like something is deeply wrong with us -- like we don't belong in the profession! -- now that we have joined the ranks of those who "should have known better [but presumably didn't]."

Well, good thing it was my turn to blog, said my friend: 
              write about how we in sex/repro health expect ourselves to be models of responsibility and healthy sexuality
               but get down on ourselves when we slip up
               you can talk about your plan b
               and my herpes!

Well, there you go. Turns out this unpleasant incident was a good reality-check: it only takes a weird moment of forgetfulness and some bad luck to end up in the patient's seat or the pharmacy, and I must have had some unacknowledged belief that I was "too smart" to wind up there, or maybe "too smart" to get a pass on making a mistake. 

I know some of us have had the good fortune (so to speak) of being in a "dumb" situation early on, and having lots of compassion as a result. If you'd like to tell that story, please do so in the comments...and I promise I won't think you're stupid! 


  1. I think about this all the time. What makes Abortioneers so different, except we have the insider info on what to do in such an event? Good thing I was on crazy meds that made me take monthly pregnancy tests. It was good to know that even though I'm pretty good with my birth control method(s) I still had the reassurance. We're only human!

  2. What if someone had unprotected sex, then was cool about it because they could always just get an abortion knowing it's a pretty minor operation? Is high anxiety expected or required? Also, on the Herpes hysteria: I get canker sores now and then. Is that much worse than herpes?

  3. saltyC, you bring up some things that I probably should have made more explicit. I actually DON'T think herpes is the hugest deal. Like, its only effect on your health is to occasionally make your skin really irritated (right?). And I remember reading that a QUARTER of women have herpes, and something like 1/5 or 1/6 of people overall, so it kind of seems like someday we're all gonna have herpes and we'll just have to get over ourselves at some point. But because it's still quite stigmatized, that MAKES it a big deal because you might agonize about what your partners will say/do/think. And also getting access to Valtrex to suppress it may be a big deal depending on your insurance/finances. But yeah. Not so bad. We don't act like our patients are gross or stupid -- so it's startling to realize we've still got the internalized messages to a certain extent.

    "could always just get an abortion knowing it's a pretty minor operation". True -- sort of. In my experience not many women see it that way. Even though some women are 100% unconflicted about seeking an abortion if the need arises, it's typically not the route of choice because of the time, expense and discomfort involved.

    I'm a good example: no doubt in my mind that I'll seek an abortion if I get pregnant anytime soon, AND I probably could get the fees covered, but I'd still rather go through the half-hour hassle of spending too much for Plan B so that I don't have to wait, worry and wonder through several pregnancy tests, set aside a whole day for the clinic waiting room, feel crampy and lightheaded afterward, and have irregular bleeding for another several weeks. All stuff I could deal with, but would rather not!

    Certainly, life is a lot less stressful knowing that if I do end up with an unintended pregnancy, I won't be stuck with it. So the "high anxiety" isn't quite as bad, no.

  4. Thank you for a very thoughtful response. I'm glad there are level-headed ppl like you blogging.

  5. one time i forgot to put my nuvaring back in right way but then i checked the website and it was ok. the end.

    also herpes probably sucks a lot if you have it in your crotch.

  6. I've had two miscarriages (both early, both unplanned pregnancise). I've totally skipped taking birth control pills before and wound up pregnant. Then had an abortion. I've had sex without a condom. Quite a few times. I've taken Plan B - lots. I worked at an abortion clinic during all of those times. And I suspect that most of us never have safe oral sex (use of a condom or dental dam).

    None of us are perfect.


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