The speculum is getting an overdue redesign, and we cannot wait

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Confession: I became a midwife because I hate pelvic exams.

I mean, yes—I am in awe of pregnancy. And I can vividly remember the New York City cab ride I took home after witnessing my first birth, where I sat teary-eyed and beaming and said, "This is it. This is my life now."

But really, it all began with pelvic exams. Because let's be honest: They are awful.

As a patient, it took me years before I was able to get through the entire exam; I had to schedule multiple appointments to make it happen the first time. At my first appointment, knowing how terrified I was, my extremely caring nurse practitioner just had me put the gown on and practice lying on the table. The next time, I put my feet in the foot-rests. I don't remember exactly what number visit I had my first actual speculum exam, but it was a lot.

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Through it all, I kept thinking about how I couldn't be the only one out there that hated this—even though no one talked about it. I decided that I wanted to be part of the movement that was going to make pelvic care respectful.

Despite my difficulties as a young adult, I am lucky. Because the upsetting truth is that our medical system is not set up to support the sensitive type of care that I received. Most people with vaginas are rushed through the process of a pelvic exam without consideration of the profound impact they can have.

The pelvis is complex, beautiful and powerful. It is also the home of some of our deepest vulnerabilities. And for people that have experienced sexual assault or traumatic birth, or for people who have vaginas but do not identify as female—well, the experience of a pelvic exam can be downright awful.

Plus, our society has ingrained a very negative emotional connection to the pelvis: It is dirty, gross, lewd…and wrong.

A huge part of the problem is the speculum—that metal or plastic device that brings a sense of dread to probably all of us.


Enter Yona.

Yona is made of a team of designers who have set out to redesign the speculum, and thus significantly improve the pelvic exam experience.



Freethink made an excellent video explaining this amazing new speculum concept. (Highly worth the less-than-six minute watch. But please note, they share some quotes of people who have had traumatic pelvic exams, which may be triggering for some.)

Freethink's video shares the very upsetting history of the speculum we all know and… hate:

They were designed by a man and tested on enslaved women. As Yona team member, Hailey Stewart, an Industrial Designer and Design Researcher, says, "putting the comfort of the patient first was certainly not on the top of his list."

Using a method called "radical empathy" (we love them already), the team at Yona has set out to change it all. They are also addressing the fact that "not all people with a vagina identify as female;" every person with a vagina deserves to have appropriate medical care to prevent life-threatening diseases, such as cervical cancer.

The new speculum design offers the following innovative features:

  • Improved view-field (so your provider does not have to expand the speculum as wide to see what they need to see)
  • Relaxed handle angle (so you don't have to move your bottom as close to the edge of the table as you currently do)
  • Single-handed operation (so your provider only needs to use hand to operate the speculum)
  • Concealed locking (so you don't have to hear of feel all that clicking)
  • Silicone coating (so you can say good-bye to the discomfort of metal or plastic)

So much YES, I can't even handle it.

Yona is not available in providers' offices yet. But you can check out their page for ideas on how to make this vision a reality (for example, share this information with your provider, and ask them to bring Yona in the office).

In the meantime, here's what you need to know about pelvic exams:

1. In the absence of symptoms or concerns, experts are not sure how often you need one.

According to the American College of Obstetricians and Gynecologists (ACOG):

"A limited number of studies have evaluated the benefits and harms of a screening pelvic examination for detection of ovarian cancer, bacterial vaginosis, trichomoniasis, and genital herpes. Data from these studies are inadequate to support a recommendation for or against performing a routine screening pelvic examination among asymptomatic, nonpregnant [person] who are not at increased risk of any specific gynecologic condition. Data on its effectiveness for screening for other gynecologic conditions are lacking."

In other words, we don't know enough yet. Ultimately their recommendation is this: "Pelvic examinations should be performed when indicated by medical history or symptoms… [or] if a [person] expresses a preference for the examination."

2. You should still see your pelvic health provider every year

Even if they don't do a pelvic exam, it's important to meet with your provider yearly to discuss your health and make sure you are up to date on screenings, vaccines, etc.

3. One of the most important aspects of a pelvic exam is the pap smear (a swab of the cervix that checks for cancerous or precancerous cells)

When a pap smear detects abnormal cells, there are several treatment modalities available to prevent it from progressing. And, if it is cancer, treatment is available and often effective.

Here are the current Pap smear guidelines for people without a history of abnormal results, according to the U.S. Preventative Services Task Force:

  • People age 21 to 65 years: Pap smear every three years
  • People age 30 to 65 who would like to lengthen the screening interval: Pap smear with human papillomavirus (HPV) testing every five years

If you have a history of abnormal results, your provider will guide you towards your specific recommendations.

4. Doctors (obstetricians and gynecologists) are awesome, but they are not your only option

Many people are surprised to learn that they have more options than they knew for pelvic health providers. Midwives and nurse practitioners provide comprehensive health care even when you are not pregnant and might be a great fit for your pelvic health needs.

5. Free and low-cost healthcare options are available

Clinics such as Planned Parenthood offer free and low-cost pelvic exams, as well as testing and treatment for sexually transmitted infections, and the prescription of birth control.

6. Until Yona arrives, here's how to make your next pelvic exam better:

  • Talk you your provider and tell them you're worried, uncomfortable or scared. If you don't feel like you are being respected, leave (but promise me you'll find someone else and try again).
  • Bring your bottom all the way to the end of the table. OR, make two fists with your hands, and stack them under your bottom to help lift your bottom off the table.
  • Use the footrests (aka stirrups) if you want to, or feel free to ask your provider if you can keep your feet on the table if it feels better.
  • Fan your knees out to the side like a frog. SO MUCH EASIER SAID THAN DONE, BUT, the more relaxed your muscles are, the less uncomfortable it will be, so take deep breaths and visualize a beach, a lake, or anything that makes you feel calm.
  • Wiggle your toes and relax your jaw.
  • Ask your provider to touch the outside of your leg with the back of their hand first. Then the inside of your thigh. When you say, "I'm ready," they can start the pelvic exam. Not before.
  • Ray Rachlin, midwife, and owner of Refuge Midwifery in Philadelphia, recommends telling your provider that you'd like to insert the speculum. They can guide it to the right place, but you are in charge of the speed at which it goes in.

Your body, your rules. It is not rude, wrong or unacceptable to tell your provider how you would like your pelvis to be examined.

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Jessica Simpson's life seems perfect. She has three beautiful kids, a wildly successful career, a seemingly solid marriage...she has it all, at least as far as we can see. But recent revelations prove that no one really knows what anyone else is secretly dealing with—and Jessica, by her own admission, has been struggling with alcohol issues.

The singer-turned-business-woman recently sat down with TODAY's Hoda Kotb, and it will air on NBC's TODAY Wednesday morning.

"I had started a spiral and I couldn't catch up with myself…and that was with alcohol," Jessica explained. "I would say it openly to everyone. 'I know. I know, I'll stop soon. I'll cut back'," Jessica continued when asked if she realized things were getting out of control. "For me to cut back, like I'm an all or nothing girl, and so I didn't know it was a problem until it was...I completely didn't recognize myself…I always had a glitter cup. It was always filled to the rim with alcohol."

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She's hardly alone. The rise of #winemom phenomenon is well documented and many parents struggle with substance abuse problems. But Simpson's story proves there is a way to get your life back.

Simpson quit drinking in 2017 after she found herself unable to get her kids ready for a Halloween party. She says she'd started drinking before 7:30 in the morning, before accompanying her husband, Eric Johnson, to a school assembly for their oldest daughter. Later that night she was unable to get her kids dressed in their Halloween costumes. The next morning she was so ashamed. Feeling like she had failed her kids she slept until they left the house, then got up and drank some more.

That episode was her tipping point. She quit drinking (as did her husband, Eric Johnson, who supports her in her sobriety.)



As parents, we know how overwhelming the demands can be...and how easy it is to sink into habits that don't ultimately serve us well. For Jessica, the way to heal was to sever her relationship with alcohol.

"I had to give [drinking] up," Jessica said. "I'm not going to miss another day. I'm not going to miss another Halloween. I'm not going to miss another Christmas. I'm going to be present."

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Mamas expecting babies this month are a special bunch—and not just because it's statistically unique to have a birthday during the shortest month of the year.

Science shows babies born in February already have advantages with everything from physical growth to creativity to even presidential elections. (It's no coincidence that President's Day is this month!)

Here are six reasons why February birthdays are so special:

1. They may be bound for the NBA

According to a 2006 study from Harvard researchers that examined data from 21,000 children around the world (including the southern hemisphere), those born in February were taller and weighed more at the age of 7 than their friends who were born during other times of the year. (Further proof: Michael Jordan celebrates his birthday on February 17.)

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2. Or on their way to a doctorate

The same study also showed winter-born babies performed best in a series of intelligence tests. As the researchers concluded, “The overall pattern of findings is that winter/spring babies are both 'bigger' on the anthropometric variables and 'smarter' on the selected neurocognitive variables."

3. They also have artsy sides

February babies are either born under the Aquarius or Pisces star signs—which are linked to the traits of originality and creativity. But even if you aren't one for astrology, a study complied from the United Kingdom's Office for National Statistics found that people born in February are more likely to be artists.

4. Which may set them up for stardom

Speaking of the zodiac, one study published in the Journal of Social Sciences found a disproportionate number of celebrities claim the Aquarius star sign. That includes everyone from Bob Marley to Jennifer Aniston to Shakira. It's also one of the most popular star signs for American presidents—including Abraham Lincoln (February 12) and Ronald Reagan (February 6).

5. Or, at least, satisfying careers

But don't feel bad for babies born in the latter half of the month: A survey from CareerBuilder.com found Pisces adults were among the “most satisfied" with their jobs. (They also have legs up on the competition if they ever find their way into a presidential election.)

6. They may have the rarest birthday of all

Babies on their way this year are out of luck. But, come 2020, a special group of newborns will have the distinction of being born on Leap Day, February 29. Sure, they won't get to mark their birthday for another four years, but they do get a prime pick of perks when that day does roll back around!

Snuggle up with that newborn while you can, mama. Once your February baby gets going, they'll be hard to stop.

[Originally published February 2, 2018]

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As the world continues to mourn father of four Kobe Bryant and his 13-year-old daughter Gianna, many are remembering Bryant for his role not only as a basketball great but also as a #girldad.

That is how SportsCenter anchor Elle Duncan remembers him. On ESPN this week she recalled meeting Bryant back in 2018 when she was 8 months pregnant.

She says Bryant asked her "How are you? How close are you? What are you having?" and when she told him she was expecting a girl he gave her a high five and said, "Girls are the best."

Instagram post by SportsCenter • Jan 28, 2020 at 4:59am UTC

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The two talked about raising girls, with Duncan asking Bryant for parenting advice. She also asked him if he and his wife Vanessa were going to have any more kids.

"He said that his wife Vanessa really wanted to try again for a boy, but was sort of jokingly concerned that it would be another girl. I was like, 'Four girls, are you joking? What would you think, how would you feel?'" Duncan recalls

She continues: "Without hesitation, he said, 'I would have five more girls if I could. I'm a girl dad."

As Duncan noted on Instagram, she couldn't have known that Bryant, then a father of three, would welcome another baby girl, little Capri Kobe, in 2019. All she knew was that she was impressed by this man who loved his girls so much.

"I'm glad to have had that brief time with him. I'm so sorry that 4th girl won't know her dad," Duncan writes.

During his 2018 conversation with Duncan, Bryant remarked on the athletic abilities of his middle daughter, Gianna, telling Duncan she was better than he'd been at her age.

Tragically, Bryant and Gianna died en route to a basketball game where she would have played and he would have coached.

"When I reflect on this tragedy," Duncan said on ESPN, "I suppose that the only small source of comfort for me is knowing that he died doing what he loved the most: being a dad. Being a girl dad."

Our hearts are with the Bryant family this week, and all the families of the victims of the helicopter crash.

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People often say that having a second child doesn't much add to the workload of parenting. There's no steep learning curve: You already know how to make a bottle, install a car seat and when to call the pediatrician. And you're already doing laundry, making lunches and supervising bath time—so throwing a second kid in the tub isn't a big deal.

Except that it is. Having a second child doesn't just mean attaching a second seat to your stroller. Adding a whole new person to your family is more complicated than that, and it's okay to say that it is hard.

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A study out of Australia disputes the popular idea that after making the transition from people to parents, making the jump from one child to two is easy. The researchers found that having a second child puts a lot of pressure on parents' time and their mental health, and mothers bear the brunt of the burden.

When looking at heterosexual couples, the researchers found that before a first child is born both partners feel equal amounts of "time pressure," but once the child is born, that pressure grows, more so for mothers than fathers.

Basically, parents feel psychological stress when they feel they don't have enough time to do all they need to. One baby makes both parents feel more stress, but mom's increase is more than dad's. When a second baby comes, that time pressure doubles for both parents, and since mom already had more than dad, there's now a gulf between them.

The researchers behind this study—Leah Ruppanner, Francisco Perales and Janeen Baxter—say that after a first child is born, a mother's mental health improves, but after a second child, it declines.

Writing for The Conversation, the trio explains:

"Second children intensify mothers' feelings of time pressure. We showed that if mothers did not have such intense time pressures following second children, their mental health would actually improve with motherhood. Fathers get a mental health boost with their first child, but also see their mental health decline with the second child. But, unlike mothers, fathers' mental health plateaus over time. Clearly, fathers aren't facing the same chronic time pressure as mothers over the long-term."

The researchers say that even when mothers reduce their work time, the time pressure is still there and that "mothers cannot shoulder the time demands of children alone."

Adding a second child to the family isn't just a matter of throwing a few more socks in the laundry: It means a schedule that is already stretched is now filling up with twice as many appointments, twice as many school functions. Mothers only have 24 hours in the day, and as much as we wish we could add a couple extra hours per child, we can't.

Time simply can't change to help us, but society can. As the researchers noted, when time pressure is removed, motherhood actually improves mental health.

We love our lives, we love our kids, we love parenting, but there is only so much of our day to go around.

Ruppanner, Perales and Baxter suggest that if society were to help mothers out more, our mental health (and therefore our children's wellbeing as well) would improve even after two or three kids. "Collectivising childcare – for example, through school buses, lunch programs and flexible work policies that allow fathers' involvement – may help improve maternal mental health," the researchers explain, adding that "it is in the national interest to reduce stressors so that mothers, children and families can thrive."

Whether you're talking about Australia or America, that last bit is so true, but this research proves that the myth about second-time parenthood isn't. Even if you already have the skills and the hand-me-downs, having a second child isn't as easy as it is sometimes made out to be.

We can love our children and our lives and still admit when things aren't easy.

[This post was first published December 18, 2018.]


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