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

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

yona_speculum

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.

14 outdoor toys your kids will want to play with beyond summer

They transition seamlessly for indoor play.

With Labor day weekend in the rearview and back-to-school in full swing, most parents are fresh out of boxes to check on their "Fun Concierge" hit list. It's also the point of diminishing returns on investing in summer-only toys. So with that in mind, we've rounded up some of our favorite toys that are not only built to last but will easily make the transition from outdoor to indoor play. Even better, they're Montessori-friendly and largely open-ended so your kids can get a ton of use out of them.

From sunny backyard afternoons to rainy mornings stuck inside, these toys are sure to keep little ones engaged and entertained.

Meadow ring toss game

Plan Toys meadow ring toss game

Besides offering a fantastic opportunity to hone focus, coordination, determination and taking turns, lawn games are just plain fun. Set them up close together for the littles and spread them out when Mom and Dad get in on the action. With their low profile and rope rings, they're great for indoors as well.

$30

Balance board

Plan Toys balance board

Balance boards are a fabulous way to get the wiggles out. This one comes with a rope attachment, making it suitable for even the youngest wigglers. From practicing their balance and building core strength to working on skills that translate to skateboarding and snowboarding, it's a year-round physical activity that's easy to bring inside and use between Zoom classes, too!

$75

Detective set

Plan Toys detective setDetective Set

This set has everything your little detective needs to solve whatever mystery they might encounter: an eye glasses, walkie-talkie, camera, a red lens, a periscope and a bag. Neighborhood watch? Watch out.

$40

Wooden doll stroller

Janod wooden doll strollerWooden Doll Stroller

Take their charges on a stroll around the block with this classic doll stroller. With the same versatility they're used to in their own ride, this heirloom quality carriage allows their doll or stuffy to face them or face the world.

$120

Sand play set

Plan Toys sand set

Whether you're hitting the beach or the backyard sandbox, this adorable wooden sand set is ready for action. Each scoop has an embossed pattern that's perfect for sand stamping. They're also totally suitable for water play in the wild or the bathtub.

$30

Water play set

Plan Toys water play set

Filled with sand or water, this tabletop sized activity set keeps little ones busy, quiet and happy. (A mama's ideal trifecta 😉). It's big enough to satisfy their play needs but not so big it's going to flood your floors if you bring the fun inside on a rainy day.

$100

Mini golf set

Plan Toys mini golf set

Fore! This mini golf set is lawn and living room ready. Set up a backyard competition or incorporate into homeschooling brain breaks that shift focus and build concentration.

$40

Vintage scooter balance bike

Janod retro scooter balance bike

Pedals are so 2010. Balance bikes are the way to go for learning to ride a bike while skipping the training wheels stage altogether. This impossibly cool retro scooter-style is built to cruise the neighborhood or open indoor space as they're learning.

$121

Wooden rocking pegasus

plan toys wooden rocking pegasus

Your little will be ready to take flight on this fun pegasus. It gently rocks back and forth, but doesn't skimp on safety—its winged saddle, footrests and backrest ensure kids won't fall off whether they're rocking inside or outside.

$100

Croquet set

Plan Toys croquet set

The cutest croquet set we've ever seen! With adorable animal face wooden balls and a canvas bag for easy clean up, it's also crafted to stick around awhile. Round after round, it's great for teaching kiddos math and problem-solving skills as well.

$45

Wooden digital camera

fathers factory wooden digital camera

Kids get the chance to assemble the camera on their own then can adventure anywhere to capture the best moments. With two detachable magnetic lenses, four built-in filters and video recorder, your little photographer can tap into their creativity from summertime to the holidays.

$179

Wooden bulldozer toy

plan toys wooden bulldozer toy

Whether they're digging up sand in the backyad or picking up toys inside, kids can get as creative as they want picking up and moving things around. Even better? Its wooden structure means it's not an eye sore to look at wherever your digger drops it.

$100

Pull-along hippo

janod toys pull along hippo toy

There's just something so fun about a classic pull-along toy and we love that they seamlessly transition between indoor and outdoor play. Crafted from solid cherry and beechwood, it's tough enough to endure outdoor spaces your toddler takes it on.

$33

Baby forest fox ride-on

janod toys baby fox ride on

Toddlers will love zooming around on this fox ride-on, and it's a great transition toy into traditional balance bikes. If you take it for a driveway adventure, simply use a damp cloth to wipe down the wheels before bringing back inside.

$88

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