This week Bianca and Amy interview Jennifer Block, author of the books Pushed and Everything Below the Waist, to discuss her work researching women's health care and the insidious ways in which many harmful interventions are branded as feminism and sold to us without any discussion of the cost they can have to our bodies and health.
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This week Bianca and Amy interview Jennifer Block, author of the books Pushed and Everything Below the Waist, to discuss her work researching women's health care and the insidious ways in which many harmful interventions are branded as feminism and sold to us without any discussion of the cost they can have to our bodies and health.
www.bebomia.com
Follow us on Instagram, Facebook, TikTok, YouTube, Pinterest, LinkedIn or Twitter.
At the end of the day, it's like, do we value, do we value the uterus as much as we value like the testicles or ? You know? Yeah. Like, would we do this to men? I, that's always the, the feminist, like, you could just always fall back on like, what if this were happening to men?
Intro:You were listening to the Hot and Brave podcast with Bianca Sprague from Bebo Mia, where you'll hear brave stories, hot topics, and truth bombs that will either light fire to your rage or be the bomb you need for your soul.
Bianca Sprague:Hello everyone and welcome back to the Hot and Brave Podcast. I am your host Bianca Sprague, and we are talking all about the body this season, and we're gonna look at how bodies are treated in healthcare because this feels like a really great entry point to be exploring, you know, the care of our bodies. Last season we talked all about rage and there was so many places for the book, "Everything Below The Waist, Why Healthcare Needs a Feminist Revolution" written by Jennifer Block, this book came up over and over and over again. Our entire team loved this book, as did our community. We had a bumping in book club about it. Um, and we are so thrilled to welcome the author Jennifer Block the podcast today to talk about why our healthcare system, as we know it, is deeply flawed. I hope this isn't a spoiler alert for anyone, . Um, and the consequences that our systems had for women across a variety of buckets, including reproductive health and sexual health, overdiagnosis, overtreatment, and the lack of adequate evidence-based information on women and women's bodies guiding the way. In addition to Jennifer, I'm joined by fellow Bebo babe and my bestie Amy C. Willis.
Amy C. Willis:Oh, hello. I am very excited to be here. I loved this book so much. As you mentioned, book club was bumping and everyone really enjoyed it within the community, and I also saw a lot of parallels within this book to my own work in terms of information and misinformation, uh, issues around consent, the normalizing of certain things and practices and how that leads us to no longer question them. And just cuz they're normal, does that mean that they're the best thing for us or the healthiest thing for us? So I'm very excited to get into this conversation with you and Jennifer.
Bianca Sprague:Thank you for being here. And I also wanna flag, because we have Amy here and it's January and a lot of folks start doing a lot of like big plans for 2023 because it's early in the year. So we set a lot of goals and there can be a lot of, um, stuff around changes to our body. Um, so hopefully everyone has just adored the episode with Virgi Tovar that we did last week. Um, so go check that out if you haven't. Um, so rather than dieting boo or thinking there's anything wrong with your beautiful body, maybe you might consider your relationship with alcohol. And if you are curious about any part of that, I strongly suggest you reach out to Amy and her incredible movement called Hol+ Well h o l with a plus sign, w e l l. Seriously go, go check that out. Um, to see if you would like to explore your relationship to alcohol, cuz that actually will have the biggest bang for your buck. If you were to make any change to shine this year, 2023, I would be curious about that as an entry point. Um, so anybody here with a little bit of sober curiosity? Go check out Amy. Alright. We also have Jennifer Block joining us and Jennifer is a journalist focused on health, gender, and contested areas of medicine. Uh, so her articles and commentary have appeared all over the place. Some of them are the BMJ Long reads, the Washington Post Magazine, Newsweek, the Cut, the New York Times, and so many more. Her first book "Pushed", led a wave of attention to the national crisis in maternity care and it was named the best book by the Kirkus Reviews and Library Journal. This actually is the entry point she had to moving over into exploring not only childbirth. But you know, healthcare for women at large, uh, she was a reporter with type investigations Block won, several awards for her investigative reporting on the permanent contraceptive implant Essure, which has since been discontinued. And we'll be talking about that in our interview today for early chapters of"Everything Below the Waist" she won a whitening Creative non-fiction grant and she lives in Brooklyn, New York with her son and she's joining us today. Welcome, Jennifer. We're so excited to have you.
Jennifer Block:Well, I'm excited to be here. Thanks for
Bianca Sprague:Yay.
Jennifer Block:Thanks for, um, thanks for having me. Uh, you know, like in the, in the book publishing world, my book is ancient already, so I'm mine.
Bianca Sprague:I know.
Jennifer Block:You know, you're not getting me fresh with like my practice talking points and you know, this is gonna be a little more real. Bianca Sprague: Well that's perfect have around it is probably a less about the polished talking points. Good.
Bianca Sprague:I know that you have a typed timeline, so we really wanna make sure we get through the stuff that we're dying to talk about cuz we are super fans. And our last season of the podcast we referenced your book at least three times an episode cuz it was all about women's rage. And so I was like, all paths led to "Everything Below the Waist".
Jennifer Block:Wow.
Bianca Sprague:They're like talking about abortion, "Everything Below the Waist", talking about birth control, "Everything Below the Waist", talking about what happens to folks give, well they're in labor."Everything Below the Waist". Yeah. There it was. Good. Um, so it feels, um, perfect that we will be, you know, season this season's all about the body. it's, it feels very applicable to talk about all paths leading to the same place.
Jennifer Block:Yeah. Well rage. You know, there's plenty of rage to go around.
Bianca Sprague:So we know a little something about that. What made you start this project? Like why did you have this desire to go dig in research, which is a really shitty task?
Jennifer Block:Um, well, I kind of fell into writing my first book "Pushed". Um, I, I, I wanted to work in magazines. I landed at Ms. Magazine, um, when it was still independently owned and, uh, based in New York, and I ended up getting hired there. I was an intern there, and then I got hired and I just sort of fell into the role of health editor, like just by happenstance. Um, and basically like the nut of the"Pushed" story , uh, came to me when I was way too young to write a book. And, um, so I, I I, but I got this like early sort of education in, you know, that there can be something happening, um, in practice, in medicine that is accepted. Everyone says it's the way to do things. You know, there's medical consensus, but it's not necessarily based on evidence. And that's kind of a, you know, we, we live in a very, you know, north America, I don't think US and Canada so different. We live in a pretty like, medically authoritative culture. So I, I got this kind of early exposure to, oh, there can be like this routine practice happening that really is so misguided and, um, and really, uh, like coming out of "Pushed", uh, where I had really focused on the event of childbirth being practiced in a way that was not evidence-based. Um, and really like hijacking the physiology, right? I kind of just like stepped back and looked more broadly at. Healthcare, um, across the lifespan specifically for women, and said, oh, wait a minute, , there's more happening here. This isn't like limited. And I don't know why. I would've thought that it would be that, you know, it would only be in the area of, um, Childbirth care that there would be this, this mismatch between practice and evidence. And sure enough, when I pulled back, I saw a lot more going on and there also had been movement in the medical community. Uh, there were conferences happening about overdiagnosis and overtreatment words that really didn't exist when I was writing "Pushed". And I was like, oh, these, this is exactly what I saw. And this is, yeah, of course this is happening. There's overuse of, of prescription drugs, there's overuse of surgeries. It's not just C-section, it's hysterectomy, it's, you know. And so I just started seeing more and more issues, um, and I saw that that thread, you know, across lifespan. And I also coming outta "Pushed", I had still had this lingering confusion to be honest about why. Um, birth wasn't more of a feminist issue, and so I kind of had that analysis too. Like I still was working through that and, and then try, you know, wanted to apply it to conversations about the pill and hysterectomy and, um, abortion, even abortion care. So that's sort of the long story. I decided to undertake this like, you know, massive project.
Bianca Sprague:This beast. It's funny you'd say that about the feminist issues because, um, we talk a lot about neoliberalism on the podcast. It's one of my favorite topics of, and then how so many folks feel, um, like we're just essentially guided with a new message and how all of these medical decisions, uh, have actually been framed in the feminist aspect is that we have choice now, which was essentially that same, like the pink pill used that same method, um, that we just had to like essentially frame it as feminism. So you know this like you don't have to breastfeed because it's actually like part of the patriarchy is forcing us to be tied down by like feeding our babies. And so we just had this like lactivism, it's actually like the feminist thing is rejecting breastfeeding. Like all these places that the, it was just like you just had to make a new script and then people felt empowered with whatever the choice is. Now, all of our beautiful listeners, whatever you choose, , as long as it's an informed choice, it is the most empowered choice. Um, but the difference is when the messages are, um, intentionally planted so that we think we're making our own choices. But really there's, there's an intention to, you know, sell more formula or to, you know, prescribe more things for our body or to move us quickly through the hospital labor and delivery floor. All of the like themes throughout"Everything Below the Waist" had so much like trickery, so that it did feel feminist. Fuck the treat us like shit.
Jennifer Block:I mean, I think you could probably look at, uh, various, uh, interventions, you know, the epidural and certainly formula and um, you know, fertility medicine people started comparing. um, you know, oh, if the, you know, the ability to freeze your eggs, it's like the new pill. It's, it's all sort of presented and it's a very convenient way for industry to present it, um, as this empowering thing. This is gonna, you know, allow you to live in the world and, you know, this pesky female biology, you don't need to deal with it. It's just holding you back, you know? Um,
Bianca Sprague:yeah.
Jennifer Block:And it's, it's so rarely that, is it ever that simple? I don't know that we could look at any one of those things and say like, yeah, that worked, that got us. Bianca Sprague: No. You know, I mean, I think, you know, and has in. In the time that the pill came out, yes. I think the pill was probably like the most revolutionary, um, liberating medical technology. And then of course, like ti- the times the circumstances changed, and I don't, I don't think we can say that anymore.
Bianca Sprague:Because so much of our sexual health and our sexual behaviors were done in secret. And there was like a, you know, a very clear, um, time that you should have been, I'm putting should in air quotes everybody, um, but like should, as you know, once you were married and once all of these things. And so it did create more options that we could essentially be violating the social terms. Um, but now I'm like, we had all this shit's above board. So like it's everybody's problem. like birth control is now all, all party's problem . Um, Yeah, so it's interesting just like some of these things are really antiquated. So now really the pill that used to be revolutionary for women, which I agree, it was probably one of those profound things in our, in our sexual liberation. Um, now we've just like dealt with a mountain of consequences and there's other options. And now it's, we still are holding the whole thing, which is no surprise. That's what happened with most of the conveniences that have rolled in at one time. They were liberating for us and now, um, you know, they're just more work. We had a chance to talk to Darcy Lockman last season about "All the Rage", essentially what you did for healthcare. She did around division of labor and the equity for males and females and like, you know how what started as liberation and now it's really like women, you're still doing the mothering, the invisible labor going to work. And men are like, of course I support you going to the wor- into the workforce. I support anything. And she was like, but it doesn't mean that they're gonna take anything off your plate., it's the same thing like, we support your liberation. Go get your pink pill. Jennifer Block: Right. You know, focused on benefits without costs. Like, and, and that's the way it's been presented to us too. The epidural. And, you know, in me, in the medical world, it's just like, it's always the benefit without the cost. There's cost. Yeah., um, Amy, I know, you know, we talk a lot about this with alcohol as well, that there's, um, like so much more happening than what the conversation, like, it's the, like the ducks that they're like bopping along, but under the, under the surface, they're this churning, whirling. Um, did you like, wanna sh- like highlight some of the other places that, that you've seen around the parallels? With the messaging for women in our healthcare.
Amy C. Willis:Mm. Yeah. One of the things that, when thinking about my own work and then thinking about this book is the normalization of all of it. The normalization of the options that are presented to us, the benefits of it, without any kind of cost, um, analysis. And I think when we normalize things, we stop questioning them. And so I think both in terms of alcohol and in terms of reproductive health, sexual health, um, we've stopped questioning all of it.
Bianca Sprague:It kind of stops the conversation.
Jennifer Block:Do you mean like with, with alcohol is, um, just the normalization of like, mommy needs a glass of wine like forever. Do you remember the, did you guys have the store Forever 21?
Bianca Sprague:Yeah.
Amy C. Willis:Yeah, we do.
Jennifer Block:Yeah. Yeah. Do you remember like the meme going around? It was like forever 39 and it was like, just sells yoga pants and wine. Bianca Sprague: Yeah.
Amy C. Willis:Yeah. Yes. So all of . Yeah. So all of that, so like mommy wine culture is part of it. Um, how integrated alcohol is becoming pretty much everything that we do, we just, we don't question its presence when we see it in, um, movies or on TV as a way of coping, as a way of de-stressing, as a way of celebrating. It's, it's just there in the background. Um, and I think in a lot of similar ways, it's sold to us as a feminist solution, even though it's actually quite harmful for women in particular. So I think that there are a lot of parallels happening there.
Bianca Sprague:The book we just listened to. Hmm. Oh, "Ordinary Insanity". Um, now I really liked the book. I didn't love how she essentially denied fetal alcohol spectrum disorder as a thing. Um, so we're gonna just put that to the side. But, um, she does talk about, um, like when we look at the risks about, um, . We talk a lot about how women's, for example, with their health should manage alcohol in pregnancy. And then, but like we don't ever actually talk about the other side of the equation, that men should also abstain from alcohol while their partners are pregnant because the rate of domestic violence goes up. They need, they're available to like step in in a crisis. Um, you know, the, some of the depressive impacts are also impacting the parental brain changes. Like there's, there's all of this part, but it's all put on like if you wanna take care of your baby, which has now become a very public affair. Something that used to the risks and everything was done very privately. Um, and now it's one of the other shift. With the, you know, evolution of both society and medicine that you're publicly pregnant and then people have a public stake over the fetus and the choices of the pregnant person. Um, and so it's, it's kind of just interesting that we are holding onto part of these things that feel revolutionary or feminist or progressive. Um, but they've actually just. Like everything with the patriarchy churned through and, um, the script just keeps changing. So they're actually really oppressive and stifling and harmful.
Jennifer Block:Well, it seems to me like it, like there's so often an overcorrection and I, I don't know, as an American I'm always like, oh, we just kind of bastardize every, you know, good thing that comes out of Europe., . Um, like active, like the active management. I mean, I remember that history. I don't know if you know that story, but like, you know, they kind of did it a totally different way in Ireland, and then we took it and we're like, oh, we'll call this active management of labor.
Bianca Sprague:Yeah.
Jennifer Block:But there was, I think again, there's like, there was an overcorrection, there was like a public health directive to never drink during pregnancy that anyone, even a drop of alcohol could harm your baby. And it, you know, or, or like, uh, you know, you could look at also like the, the cheese and the sushi and um, and then people said, wait a minute, like, you know, in France and Italy, pregnant women are having wine with dinner. It's like, their babies are fine. Like, let's be honest about this. It's not, there's not, it's not zero. It's, it's...
Bianca Sprague:yeah
Jennifer Block:...like, let's, let's just give people the real information here that there is a, you know, I don't know, you probably know better than me, what the real is, what is, what is actually the risk, um, you know, of one glass of wine a week or one glass of wine a day. I don't know. Um, but so to me, uh, it's, it's. Like a problem of ever correction. But I was also thinking as you were talking, like, oh God, this is gonna be about as popular as advocating natural birth. You know, this is like , um, you know, take yourself away from the possibility of, um, narcotics and epidurals.
Bianca Sprague:Yeah.
Jennifer Block:Yeah. I like, love to hear, hear that. That's what they should do.
Bianca Sprague:Um, yeah.
Jennifer Block:You know, that's not a winning it, it's not a winning pair campaign. And also, you know, nobody in your family can have any alcohol or.
Bianca Sprague:Yeah, I know, I know. Well, it's, it's so interesting. Like, I just wish they, we would just get more creative with the conversations and then we always just look at like one piece, like, let's just look at the epidural. And I was like, but there's so much more happening. Like psychosocial, emotional, financial, like there's no one of these changes that make anything a should. Like if the epidural is a thing that makes someone feel really empowered and awesome, and now the focus can be on like safe housing or the focus can be on, you know, coping with their O C D then like, wonderful. But there's no should for individuals and our medical system, which it has to, it kind of goes with like the masses and doesn't really have a lot of nuance for the, you know, depth and humanity of all of it. Mm-hmm.. Did, did you have a section that as you started digging and digging, I can't, I still can't believe all the areas you rooted into. It was...
Amy C. Willis:It was vast
Bianca Sprague:It was vast where you'd just be like, oh shit. Here's a whole nother tunnel. What is this? Because if you opened about this conversation, you now have to open about this conversation, but did you have an area that you found the most profound or, um, that you were like, oh, wow. Or that felt like the most titillating, I guess, or...
Jennifer Block:Yeah, well, I have to say, I guess I, I certainly went into it with questions, um, and with an open mind and as a human who had already written a book about maternity care. So I, I came with my, my, you know, priors as they say as well. But one thing that really surprised me that I wasn't like expecting to learn, um, was when I got into really talking about surgical training. With, with OBGYNs and pelvic floor specialists and pelvic surgeons.
Bianca Sprague:Right.
Jennifer Block:Um, that was something I was really, I did not know about. I was, I was kinda shocked I didn't know more about it. Um, cause I kind of heard like murmurings when I was working on "Pushed", you know, uh, like maybe I'd heard a surgeon kind of complaining about another surgeon, you know, like couldn't handle a, you know, a a a woman having her fourth baby after three c-sections, like couldn't handle all scar tissue. Like, but when I was working on"Everything Below the Waist" and, and I, I talked to, I found some really. Open, forthcoming, excellent surgeons who really took time to sit down with
me and explain like A:the differences between how OBGYNs go through their training and what kind of surgical training they get, and then what they did. You know, the, the surgeons who I met who had gone on to do fellowships in pelvic surgery or the abdominal surgeons who became specialists in pelvic, like when they sort of explained to me how complicated and intricate the anatomy is and how long it takes to become proficient . And then when we looked at like, the differences between an ob gyn, uh, medical training and a, a surgeon's training, that was kind of shocking to me. And my dad is a general, he was a general surgeon. He's retired. So, you know, I kind of heard him complain about it too over the years, but I always just thought it was, I just chalked it up to sexism and like general surg- surgeon, you know, uh...
Bianca Sprague:Ego?
Jennifer Block:Ego , yes. um, , you know, like I'm familiar with that in my family. So, you know, I was like, oh, whatever. There're just, you know, and, and you, I think that is part, I think that is part of it. But there are real differences in how much surgical experience and training one gets when they're in an OB G one residency, which makes a lot of sense because they're doing a million things that are not surgical. Yeah, I think there's like one. Really important consumer takeaway. It's that when you're in an OBGYN's office and they recommend a surgery, they can only do a certain amount of surgeries. So they don't do really complicated fibroid removals, typically. They don't.
Bianca Sprague:No.
Jennifer Block:You know, um, I mean, I did a whole investigative report about the contraceptive implant Essure, and, um, I just learned now there, there have been almost 60,000 hysterectomies directly related to that implant. Yeah...
Bianca Sprague:That's zero surprising to me.
Jennifer Block:Because they, um, were causing so much sickness. And the thing that I still haven't quite sorted out is how many of those hysterectomies could have been, maybe some of the uterus could have been saved. You know, that's all, that was all even debated among the OBGYNs and surgeons I talked to, cuz, cuz of the nature of that device. But, um, but certainly a lot of women went to their OBGYN and said like, get this device outta me. And they said, well, I can take your, you know, I could take everything out , but I can't really, can't really help you beyond that because it's, it's in there. And that's unfortunately what a lot of women here when they have fibroids and they, they could be getting less, um, radically altering surgeries and, and the anatomy too. I think I was really interested in the anatomy. and I was really excited to talk to these, to, to sit down with these surgeons, um, and really understand And, and the, the pelvic floor therapists. Not just the surgeons Yeah. But pelvic floor therapists, the, the pelvic pain people, the, the surgeons. Like, it's kind of, you know, it's just a neat job that I have. Cause I really got like a sense of how that all worked together in a way that I hadn't been able to, um, when I was writing "Pushed". So that all kinda blew me away.
Bianca Sprague:I wanna shout out to the pelvic floor physios and all the people who do such nurturing care around creative solutions to solve for pain and excessive bleeding and incontinence and all, all of you, we, we adore you And it's listening to you talk, it feels like, um, Like the, the medical teams, like on the fronts, like at wars that are like, let's just do what we can. And just like, you know, that quick triage, trauma care, kind of like, that's how all women's bodies seem to be handled. Unless you have somebody who's like, wants to dedicate their life to studying mucus or to like finding alternatives for, you know. But unless you have those people that actually like, see something, um, important about women's bodies, um, or folks with uteruses, like until we're seen as having those have value or to that like the removal of like, I had a hysterectomy cause that was the only option posed to me. And I wished, I wished I'd given it one more year. I'd spent six years investigating and I, I, I couldn't find somebody that cared about it. And so, you know, I needed my quality of life back. I thought it would give me that because that's what was promised and it was the worst fucking thing I ever did. Um, because it didn't do what it was supposed to do. Like my endo is still a problem and my symptoms feel exactly the same. And you know, I, all the pelvic floor people did what they could and I'm grateful for all of you. But then they just send you to the pain clinic, which is literally, like, in Toronto you wait forever, you go in. I like blew my mind. It was just like banks, it almost looked like chemo set up, like there's rows and rows of people. And I went in and they were like, so we're really excited, but we have to present to you. And it was a ketamine lidocaine drip that you go in. And I was like, that's just legal heroin. And I was like, but could I drive? Can I work? Like, like what? And they were like, no, but you won't have any pain. I was like, no shit. If I did heroin, I wouldn't have any pain too. I was like, lidocaine. And if they looked at my chart, I'm allergic to both of them. So I was like, why am I here? And this was your option for endo- pain is just keep me on lidocaine indefinitely with an iv. So it's so fascinating. But if we just cared a little bit more or we, we didn't see it as like, once you take out the uterus, everything will be fine. Because it's not, it's a critical part of a, of our, of our endocrine system, of a, it's structurally important. Like I was like, what happens now? And they're like, well, you're , your intestines will fall into there. Your ovaries are somewhere in there. And I was like, this cannot be acceptable. Like what?
Amy C. Willis:Yeah. How is this the best, best case scenario?
Bianca Sprague:Yeah.
Jennifer Block:I'm sorry. I'm sorry that happened. Um, yeah, I mean I think you're, you're totally right that at the heart of all this is like, do we value these organ systems and physiological systems and structural systems? And I think that's like the big question. And I think we kind of, we we here, have an idea,
Bianca Sprague:we know the answer
Jennifer Block:...is like, no, we haven't valued them because they've been sort of disposable. Like there are other problems too, like with endometriosis. There was of course not enough research, you know?
Bianca Sprague:Yeah.
Jennifer Block:It was probably just dismissed as hysteria, first decade, centuries. Um, and when there started to be some theories about it, like nobody did the, it just didn't, it didn't get the attention, it didn't get the research. And a lot of these things don't have like, even codes in the, in the system, so you know, to get the proper excision surgery for endometriosis, which very few surgeons do, at least in the US I don't know much about,
Bianca Sprague:Same in Canada, does the same...
Jennifer Block:...but you know, that was another hole, like rabbit hole. I went down, what are you supposed to do as. person in the system with without unlimited resources. Yeah. And even Lena Dunham, the comedian, um, um, they've had hysterectomies, they, they, with all their resources, you know, they either didn't know. So it's like there's so many factors here. And, um, and then at the end of the day, you're a person, you have symptoms, um, that are debilitating and interfering with your life and work. And there are only certain, so many solutions that are being presented to you. There's, you know, you don't have like 10 years to bleed. Yeah. I've, I've. There are people in my life who have also had hysterectomies in the last few years in the doula world, in the birth world, in the research, you know, and like they were like, I was dying. Like I was literally dying from blood loss. I had to do something and nobody else, nobody had any answers.
Bianca Sprague:Yeah.
Jennifer Block:Even after delving into all that, I still don't have all the, uh, and all the answers, but endometriosis, it's so interesting because, you know, it, the way things so often happen is that they get sort of just thrown in the, uh, bucket in the OBGYN bucket because it, oh, it happens to happen in that area. So it's an OBGYN thing, and then nobody else looks at it, and it turns out endo, probably P C O S or these like systemic, Diseases that are auto-immune and there's all these, it's affecting all these different systems in organs and, but only, you know, because it kind of has centered the symptom is there. Yeah., it's like, oh, it's a female disease. It's a, so we're kind of battling all those areas of like health system dysfunction and sexism and medicine. And, and again, the problem that I think still exists, which is that at the end of the day, it's like, do we value, do we value the uterus as much we as we value, like the testicles or , you know?
Bianca Sprague:Yeah.
Jennifer Block:Like, would we do this to men? I, that's always the, the feminist, like you could just always fall back on like, what if this were happening to men? Yeah. And it were, well they, they were, their sexuality. Like, would they just be ed out willy-nilly? No.
Bianca Sprague:Well, they work really hard to, to save, like if they wouldn't just take out the full like scrotum and testicles. Like I know I've had friends who have had issues or cancer or trauma or injury and they like repair and preserve and save as much as they can and they'll just take out one or they'll just like find some solution for the vast deference. Like they'll do all these things and we're like, Ugh, just take it all out. It's fascinating.
Jennifer Block:Right. And even prostate, even prostate screening, they, they, they kind of like, there was an over, there was a, there was a problem there where there were, there were overscreening over-diagnosing prostate cancer. More men were having surgeries then really needed to, and were becoming impotent and in incontinent because of those surgeries. And the, I feel like the medical system responded much more quickly to fixing that problem.
Bianca Sprague:Yeah.
Jennifer Block:...you know, , it took a decade, whereas with problems in, in women's health, it takes much longer. And we're still...
Bianca Sprague:yeah we can't catch up to it.
Jennifer Block:Right.
Bianca Sprague:Yeah. It's just, it's a, it's a bit of a runaway train. Um, did you find that you changed how, this is a personal question we're gonna get personal with you, Jennifer Did this research or the fact you were ongoingly, kind of like uncovering the insidious in medicine, did it change how you engaged with the healthcare system or managed your own health? Or, or like discussed it when your loved ones come to you and say like, Hey, this is an issue. Um, do you find your whistle blowing comes out in your personal life?
Jennifer Block:I don't like to proselytize and I don't, uh, you know, you have to live with the decisions that you make as a person, right?
Bianca Sprague:Mm-hmm.
Jennifer Block:So I would never wanna. Push someone to do something or not do something. Um, because I wouldn't wanna be responsible, like, so... Bianca Sprague: Yeah. But certainly I, I, I sometimes am the person, people come to like, you know, one of my friends was, and like, , what do I do? Do I get the Paxlovid and, you know, , um, and I don't always know the answers. Um, uh, so like, no, it hasn't, you know, and, and in a way I'm even more reserved cause I'm like, my books are out there, you know, like I have cousins and they, you know, they've had babies and they don't, they don't ask me and I don't, they know my, they don't what my book is. They also know how I gave birth. So I would say that definitely my early education and maternity care, I'm sure influenced the decisions I made when I, when I had my baby. Um, because I, I came from a pretty medical family, my aunt was the only person I knew who had gone to a midwife and had her babies, uh, at a birth center. And I was, I remember she, I was a teenager when she had, um, both her kids and I was like insanely blown away that she like, cut her own cord and, you know, did it without drugs and was like, you're crazy. Um, but I, I, at the time I thought like, that's why would I do that? You know...
Bianca Sprague:yeah
Jennifer Block:...haven't we figured, hasn't science figured out a better way? You know, , um, and certainly, certainly working on "Pushed". I, I definitely came to that issue with a very open mind. I did not have, aside from my aunt, I did not have prior biases toward , toward midwifery or, or, um, you know, physiological birth. But by the end of it, I certainly decided to, uh, do everything I possibly could to stay away from the hospital.
Bianca Sprague:Interesting.
Jennifer Block:I had, I was having a, um, you know, I was 36, so probably considered a geriatric pregnancy... Bianca Sprague: Mm-hmm., you would've been...at my age. I was having a perfectly fine pregnancy and I had one baby. And, um, and I, you know, I only wanted to be in the hospital if I, if there was some reason I needed to be there. And I, I, you know, I, if I had had a c-section because I really needed a C-section, that would've been okay with me. But yeah, I also, um, you know, I really didn't want one that I didn't need. And I, I have to say, I, I had like this added pressure of like, Jennifer Block who wrote, "Pushed", can't have a push birth and have a, you know, terrible, awful c-section like that. That's gonna be terrible. So, um, I wanted to do everything in my power to have a, um, good birth and have an intact body as much as possible, after it. And I wanted to be with my baby. I don't wanna be separated from my baby. And so I gave birth on a farm, not the farm, but, um, I gave birth with one Um, I, I, I wanted to be with one of the midwives who actually had, has a whole chapter devoted to her and "Pushed", um, and she agreed to be with me. And I, you know, had to figure out how to, uh, be in Wisconsin for my last few weeks of pregnancy. Um, but I did, and my, my kiddo, uh, came out, uh, after eight hours in the tub. He did it.
Bianca Sprague:Oh, glorious.
Jennifer Block:Yeah.
Bianca Sprague:Yeah. Congratulations. That's, that's amazing.
Jennifer Block:There was, there, there's no way that that would've ever happened without my, um, you know, that definitely, that definitely changed the course of my, um, my reproductive life. I'm sure.
Bianca Sprague:Yeah, for sure. Yeah. It's, um, it's hard like we agree and at Bebo Mia, we, you know, we just want people to like have the real story and there's, you know, I love that you said you would never wanna sway somebody because um, these are complicated choices that people need to make when it's about their body and there's so much happening that's, you know, when we actually look at the mind and body as a connection, um, that they're complicated, which I think Endo is one of them. Like, I made a decision recently, I went in for a tiny procedure with a doctor and I felt like so violated. It was like a skin removal thing and I had this like, it was like the kind of straw that broke the camel's back that I was like, I actually never wanna have somebody come at me with a scalpel on my body again. Um, cuz it's never served me. And I'm like, It was, it was, it was a profound, this like TSN turning point for me last year. And um, and I just was like, I actually have some really clear boundaries now around medicine that I need to stop looking to the medical system to solve problems that I believe are more complicated for me as a woman on this planet. Um, and that I, I hoped that they would have the solution to like a pain or like why this is happening in my body, but really, like I actually don't think they have the answers, and I don't think anybody really like has the answers outside of like, this is what happens with trauma and like your body and the environment and pollution and stress and like, you know, this is just, these are the weird things that are happening. Um, and that they might not actually be fixed. I felt like I was always on a quest for the answer, and so it kept it like unfinished instead of just an acceptance of it. Um, and, and then, and a lot of my pain stopped that. I was like, there isn't an answer someone's gonna tell you. This is just like a little bit what? So it's been a really cool, um, experiment. I was like really quiet in a little bubble and I just told Amy and my wife and I was like, you know, I think this is something I'm chewing on and just for me yet, I would never tell some of my friends like, actually, I don't think your doctor has the answer. I'd be like, go do all the things you need to do. I, Ihad exorcism and I saw a witch and I saw a doctor, and I saw a naturopath. And I like, I did my journey and that's where I landed. But you gotta go do yours. Jennifer Block: Everyone's, And there's way, I think there's way too much judgment and, um, you know, there's, there's too much prescription. Like, everyone's doing it like, oh, you try this, have you? And people, nobody likes to hear that, right? Like, they post on Facebook to tell their circle that they've just had this new diagnosis. They're just trying to like, share right. And connect. And, but the way don't wanna hear is, well, did you try the celery cleanse? Like , you gotta, you gotta, oh my God, you gotta call this woman. I'm, I mean, you know, there's like, great, there's a place for like, hey, this person has this specialty. My, you know, but, but nobody wants to hear that. Oh, I have the answer because no, what, what the answer for you? It may, it may have been the answer for you. It may have just been like, luck and it's certainly not gonna be the answer for someone else, right? Yeah.
Jennifer Block:So, yeah. Yeah. Um, the other thing I was thinking of as you were talking, like, uh, and the, the ways that I have been changed, like I do, um, when I know that something isn't, um, evidence-based and I'm in a doctor's office, like I, I, I am kind of that patient now. So like I, I was going to this, uh, this GP, um, who also had this breast specialty, like, so she's like in a breast clinic and blah, blah, blah. And um, I'd always just like withstood the exam, like the breast exam. But I, the last time I went and I, and I stopped going to her, I found a different doctor cuz uh, I was...
Bianca Sprague:because of this
Jennifer Block:...sorry. I was like, you know what, I don't, I don't need the breast exam. I, I think I was breastfeeding at the time, so I was like, I touch my boobs all the time. I really don't need.... Bianca Sprague: yeah like, I, I'm sorry, but I just, I know the literature on this. I know that this is not the way you're gonna find something. Like if I, yeah, I don't want myself to find out. So I am kind of annoying that way.
Bianca Sprague:What's funny that I had the reverse, which at around the same time that I was like, I think there's parts of the medical system I need to break up with, like officially and like, no, like trauma. I'm here for you if I need medical imaging. Hello medical system, but like source as a source a solution to these like invisible, complicated problems. No, you're not that. And one of them was actually the opposite was I had this like pain in my breast, but I couldn't tell if it was a muscle pain or there was a lump. Like, because the sensation of me touching it, I couldn't tell what kind of pain it was. And so I went in and I said, Hey, while I'm here, um, at an appointment I'm paying for, could, could you just like check this breast? And I just, can you tell if it's like my rib and intercostal muscle? Like I was very clear with my instruction, not can you do a breast exam? And they're like, oh, well it says in your chart you had a breast exam, whatever five years ago and we do it every 10 years. And I was like, okay, no, I understand. I actually just need you to tell me. And they start telling me the research around over. I was like, I, I actually, like, I just, I'm not actually gonna do anything about this. I just can't quite tell if this is my, my muscle or my breast because it hurts to touch. And they were like going on. I was like, I actually just would like a professional to feel me up here because my wife doesn't know what any of these words mean and I can't tell. And I, it took me so much work to get the doctor to be like, oh yeah, you should maybe see a chiro. It feels like your rib is out. And I was like, thank you. That's all I needed.
Jennifer Block:So funny. It's again, an overcorrection, right? If that was never the intention of, of evidence-based medicine was to deny someone, right. Something they're asking for. And also just, I mean, I don't know. This is where my dad, being an old school doc trained doctor kind of comes in handy because, you know, he's like, You have to put hands on the patient sometimes, like that's, that's the healing. It's just, just giving someone the attention and, but literally diagnosing things. Like, I, I went to the hospital a few years ago because I thought my kidney was exploding and, um, , you know, I went like four hours sitting in the emergency room, having various things done, and I was on the phone with him and he's like, has anyone touched your back? I was like, no, no one's touched me except to like, put an IV in and to, you know, take my pulse. He's like, are you telling me no one's touched your back? No one is, or your abdomen, no one has given you a physical exam. It's like, Nope, . And he's just like, went on a rant about doctors and, you know, everyone's so focused on the machines and the tests and, but like clearly you just needed some expert hands on you,
Bianca Sprague:Yeah, and because I was losing sleep about it, like it was something that I'd lay there and I'd be like, Am I ignoring cancer? Like all this stuff. And I was like, for my peace of mind, I needed your hands on me and you were telling me to wait five more years, so I'm gonna be now 47, and then I'll be allowed to go get my mammogram. And I was like, I, I just am asking for a very clear thing. And the same thing happened back when I had a uterus, r i p uterus. You were beautiful. Um, and I could feel the fibroid out of my cervix because I checked my cervix every day. I work in reproductive health, like, and I, and they kept sending me and they wasn't showing up on ultrasound. And then I went in and I had lost so much blood that they were debating blood transfusion. And I was like, I was like, I don't want a blood transfusion. They're like, well, you're like literally bleeding to death. And I grabbed a medical student in the, in the er and I was. Go get a speculum and I'm gonna walk you through this. And he's like, oh, I'm a medical student. And I was like, I actually don't care cuz nobody's coming here and I've been lying here for six hours. And he was, and I was like, so I was walking him through my cervix. I was like, this, this is the cervical os, can you see? Can you feel a thing? He's like, yeah, it looks like a pee is at the bottom. I was like, great. Now go rush and tell, like yell for a staff doctor. And they rushed in and I was rushed for surgery and I had a prolapse, fibroid and I, they were like, nothing's showing up on your ultrasound. And I was like, boy, go get, go get a speculum. I'm gonna teach you how to do this. And like...
Jennifer Block:he's gonna tell that story, hopefully. Hopefully that was a pivotal moment. His medical education...
Bianca Sprague:the time the dyke grabbed his scrubs and like bossed him through, through their cervical assessment, he probably never seen a cervix in his life. And I was like, okay, so here's where you're gonna go.
Jennifer Block:Amazing.
Bianca Sprague:Posterior part.
Jennifer Block:That's a great story. I mean, sometimes you have to be an advocate, sometimes you have to be an advocate.
Bianca Sprague:But nobody had ever touched it, or looked and I kept going. They're like, we'll send you for an ultrasound. We'll send you for a ct. I was like, just use your eyes and fingers. Use these, these, you'll figure it out cuz I can feel it.
Jennifer Block:Yeah. There's an art that's lost, you know, that's being lost.
Bianca Sprague:Yeah.
Jennifer Block:Yeah, for sure. And that's like part of the journey, right? Is like finding those gem practitioners who are like still humans and...
Bianca Sprague:yeah.
Jennifer Block:You know, or not just gonna like go by the book and, and really interpret the book wrong. I mean, you are not supposed to send someone away for five years when they're presenting you with a possible breast lump. That is not the intention of guidance that you get a mammogram every 10 years, whatever it is. Like that's...
Bianca Sprague:I know, I know. It's bonkers. What, what did you think was kind of like, if you could choose, what would you say would be the first, like the starting place to unraveling this, this shit ball of like where research has informed this or the narrative or the media or the like, there's all these factors. If you could start as a teasing it apart, untangling. Do you have an entry point?
Jennifer Block:Do you mean for a person, for a person's own health journey? Is that what you mean? Or...
Bianca Sprague:yeah, or like the conversation, like how do we move towards, um, the truth of like practice based or like understanding the gaps in research. I was simultaneously reading in, um,"Invisible Women" while I was, um, with your book and she, um, it's very profound. She takes all areas of just like the, um, invisibility of women in the data sets. Um, whether we're talking about like how we build transit systems and lighting structures to like, um, access to sports parks. But we always have this like, so girls in sports instead, she was like the osteoporosis rate down the road cost each, you know, each government 10 billion dollars. But if we had just, um, given them sports time , we wouldn't actually have all of these. She, it's. Profound.
Amy C. Willis:It's really excellent.
Jennifer Block:Invisible Women? I need to read that.
Bianca Sprague:It's a must like, like stop everything you're doing this afternoon, , and go get it. Um, because, you know, it was nice to hold it up because she's talking about, you know, with the medications and stuff, we actually don't do a lot of the research on women, therefore the data set is invisible and so we can't even like, all the, the consequences and side effects are based on, you know, male metabolism, male fat rates, male bone density, like all of these things. Um, and so I, I just, when I was listening to both, well, reading and listening to both of them, I had this like, ah, fuck, where do we even start? Like mm-hmm , where, where do we, because the media focuses on the wrong things again, just cuz it's needs to be what sells to people and doctors just get into habits really. Um, cuz the World Health organization's telling, especially when we look at reproductive health, like they're stating like, stop with the epidural rate being this high stop with the episiotomy stop with active management, stop with the Pitocin rate at this. Um, but doctors like, they're not even following the very clear instructions from the SOGC or ACOG or whatever the governing body is of the country. So, so I was curious, what if you could guess the entry point? Amy C. Willis: Yeah. Teeny tiny. No pressure question. No pressure.. How would you fix it?
Jennifer Block:I mean, I think the, one of the, one of the threads that needs to be pulled is like, uh, something that when people say it, sometimes they like get in a lot of trouble for saying it. Um, which is that like once you kind of break the spell that medicine is always right, right?
Bianca Sprague:Mm-hmm.
Jennifer Block:...like the, the, the infallibility of medical authority. Like once you kind of break that spell as a person and you become the. You know, re and really, it always, it, it has to be you making the decision because you're gonna live with it. Right? If you, I mean, I've interviewed so many people who feel regret because they just trusted someone else, which is why, again, you, we agreed we're never gonna tell someone what to do. Cause we don't wanna be that person who they trusted and then had something bad happen. Right? You, you have to be, it's you. This is the body that you have for the rest of your life on this planet, and you have to live with it. So, Once you kind of become like the decider , it can change a lot, you know, it can change your whole perspective. And I mean that, especially now at this time, um, with what we've been through in the last three years, like, it's a, it's a radical, dangerous thing to say sometimes, you know, it's, it's kind of like, uh, labeled anti-science even, which is absolutely not, you know, Cuz we know medicine is not always science-based. And also science is a constantly evolving, uh, entity, right? So, um, it's, but at the root of a lot of this is like the media's unwillingness to break that spell right. And not they, they've not covered stories because, oh, well we go to, we go to acog, we go to the experts will, they tell us it's fine. They tell us for a long time. They, they tell us that people who've had c-sections need to have another C-section. They can't have a vaginal birth. Right. Like whatever the dogma is at the time. Or, or if you don't have an episiotomy, you're gonna tear more. Right. Yeah.
Bianca Sprague:Yeah.
Jennifer Block:We go to the er's, they tell us that. So we can't publish a story that goes against that medical consensus. Right. I mean, that'll, that the, the way that the conversation is hampered and constricted by that, um, phenomenon, you know, it holds us back years from progress because yeah, we just are not allowed to have certain conversations. We're not allowed to question certain things. Um, and you know, these, like these examples I just gave, like, it took how many, it took decades. You know, it was like in the early eighties that it became very clear from a randomized controlled trial that was done by, uh, an American who moved to Canada , Michael Klein.
Bianca Sprague:Um, yeah.
Jennifer Block:That Epitomy was, you know, as logic would tell anyone, not, you know, not preserving, um, the anatomy. Uh, it took, it's still going on. App EPIs, like unnecessary app episiotomies are still happening all over the world.
Bianca Sprague:Yeah.
Jennifer Block:You know? Um, yeah. And so there's a kind of, you know, there's just, I think that's like a thread that, you know, and then when people tug it though, they get... it's a risky thing to do to tug that thread in your own personal life. Right. Um, to like say, to, to go against the decisions of all the other women in your family and get a doula and, you know, like, it's a, it's a profound thing to tug at that thread.
Bianca Sprague:Well, there's such a vested interest in keeping all those things quiet. So, I mean, Michael Klein's a great example. His book is great. It's called Dissident Doctor, if anyone wants to check that out. Um, but I mean, who knows about that book? Like nobody . Um, so everyone shut him up very, very quickly. Um, and it has been the concept throughout time. Um, Michel Odent is a really great resource for anyone who wants to maybe go explore some stuff in in Obstetrics and Gynecology. He's a French physician that I really hope lives. A little bit longer to keep contributing. He's very old, um, . And um, but his work is also really like, here's some questions that you could go in as an individual to feel really empowered in the system and maybe not listen to all the noise that might be fed to you, but you had, you know, those are really great points. But the media, it's interesting, like I really wish that, like an easy fix with the example that you had of the media is if they just took like one step above instead of the doctors who are, um, like it's too far down the ladder already, instead of going to, you know, the World Health Organization or something like that. Cuz the doc, there's no doctors that are upholding, they're not even upholding what they should be doing. Like the directives from ACOG are not actually what are happening in the hospitals. So if like, just like one step above, um, who's in because they're already in the practice based care.
Jennifer Block:Um, it's true and I think they're, I think that might be getting a little better that. Journalists are becoming a little more savvy about, you know, if you interview a private practice physician, that's a lot different than interviewing a physician who also does research. It's a lot different than interviewing, you know, a physician who's been a professor or has like published a lot of research or has been on guidance committees and again, like going up the levels. And also we, in America, were really in the US were really bad about, um, looking at what other countries do and having any respect for it. It, it's kinda hard. Um, or like we make choices like Sweden, it's so, you know. Oh yeah. We, we look up at them about, you know, X, Y, and Z, but not a, B and C because , that was wrong.
Bianca Sprague:Yeah.
Jennifer Block:You know? Um, so yeah, you're right, like the W H O and I mean, not that those entities can't be wrong too. They could be, but, but Right. Like going beyond just who, whatever doctor is sitting on the editorial board, you know?
Bianca Sprague:Yeah.
Jennifer Block:Um, who's like, Nope, that's been, that's the way we do things. That's just been the way it is and that's the way it's, um, and I, I mean, before I got my contract to write"Pushed", I tried, um, pitching many different angles of the maternity care care story to various editors at women's magazines and lefty publications. And I came up against a lot of walls because they, you know, I think that's what I came up against was just you're saying something that doesn't jive with, you know, the medical consensus. And also even at Ms one of, you know, one of my, um, editors was like, you know, she had, she was a little old, well she was quite a bit older than me and had her babies in the eighties. And she was like, I don't know what you're talking about. I had a midwife, I had a natural birth, I was in the hospital, you know, and she didn't realize that she was kind of like, she got lucky in this like golden age sort of before everything got really over medicalized. And while there was still a little bit of, you know, Lamaze natural birth movement and, um, she had pretty good births in the hospital, but she didn't, you know, she just was like, I don't know. I don't get it. What are you talking about?
Bianca Sprague:It's gotten worse in some respects. We had that com, we had Judy Rebeck join us last season and she was like a pioneer in feminism and reproductive justice. And she's the one who saved, um,
Amy C. Willis:Morgentaler
Bianca Sprague:Morgentaler with the garden shearers. He was gonna be stabbed as he was like legalizing abortion across Canada in the sixties. Like...
Amy C. Willis:he had a lot of death threats. Yeah.
Bianca Sprague:And she like saved him from getting stabbed by garden scheers at this rally. Like, she was like, she's this. Oh my God, she's so badass. I couldn't believe like I was fangirling like the whole time I was talking to her, but she kept having this like, oh man, I forgot about that. Like, we didn't have that with this activism, or we didn't have that around reproductive conversations. And um, and she was like, really? You know, you think this about women? And I was like, yes, Judy. And she's like, oh, it just wasn't a factor, you know? Um, cuz she's in her seventies now. Um, and so it, I mean there's a lot of things that have become more complicated and I think. The media's, um, like media's in access to digital content, um, has really complicated the situation as well as, you know, I think it does give more room though for, um, more creative planning, more creative self-management and guidance.
Jennifer Block:Oh, yeah. I, I definitely think so. I mean, there's like, you know, there's the double-edged sword. There's the, there's a lot of, um, misinformation. You know, there's a lot of stuff that doesn't you, you, you need to sort through on the internet. But the way that people have found each other, um, people with, have found patient groups. Um, the, the women who had been harmed by the Essure contraceptive, found each other on Facebook, organized on Facebook, um, shared names of doctors, you know, there, there's an ability to tap into networks and get information in a way that was very difficult, if not impossible before, and to get images and information. Um, I always love telling younger audiences that like, just imagine a world where you couldn't even go to the library and find an image of, you know, a woman giving birth in a tub. Like now you can go on YouTube and watch videos all day long.
Bianca Sprague:all. Day. Long.
Jennifer Block:...literally, I didn't even get an image like that, um, in a book at a library. There was no women's health shelf, you know? Um, so there's so much, yeah, there's so much more opportunity. But, but then it's still so complicated cuz you're still dealing with the system that you're dealing with and the resources that you have and it's like, you can know so much and talk to so many people and then at the end of the day you still are dealing with the body, the problem, the system, the, you know.
Bianca Sprague:Yeah, for sure. Yeah, it's, it's complicated and I think you, um, You did a, a beautiful job giving the opportunity for people to challenge what's in front of them. And I think that that's the gift that, um, makes, makes the book timeless because a lot of the information in there will change quite rapidly over the next five years, as you know. Um, but the concept of just like taking pause and not thinking you know, what's in front of you is necessarily the best thing that's for you and your body, like for the individual. And I think "Everything Below the Waist", um, was very brave to challenge one of our biggest oppressive forces of the patriarchy being our medical system. Um, and it's a gift to teach that to vulnerable folks accessing care, which, you know, are women and folks who identify as women. Um, and so thank you for that because it's, um, it was really, really wonderful and strong and clear. And, and I think it, it was a good battle cry for a lot of people in our community. Really felt that. And our book club loved it. And everyone of our students who goes through our program reads your book, so... Jennifer Block: oh, wow. Thank you so much for all, all those kind words. Um, oxytocin or whatever is flowing through me right now. I feel like I'm flowing. Um, thank you so much and thanks for inviting me on the show and, um, uh, thank you for dealing with my scheduling snafu. It was worth it. It was worth it. Um, so we highly recommend everyone goes and checks out Jennifer Block's book called Everything Below the Waist, why Healthcare Needs a Feminist Revolution. Thank you so much for joining us, Jennifer. And thanks Amy. Thank you for chiming in with your wise words.
Jennifer Block:All right, well, thanks so much. It's been really nice talking with you.
Amy C. Willis:Thank you.
Bianca Sprague:Thank you so much. You all amazing. Thanks. Thank you.
Amy C. Willis:Bye. Wanna keep hanging out with us? Find out@bebomia.com or head over to your favorite social media platform with the handle at Bebo mia, Inc. We will see you next time on the Hot and Brave Podcast.