FOREWORD

It is one of those mornings. I’m running around like a maniacal octopus, reheating rice and black beans for the kids’ lunch, cutting up watermelon, and yelling—there is a lot of yelling. I forget to eat breakfast and rush out the door, eyeliner streaked under my left eye, looking a bit more like a wide receiver than a gynecologist. I thank my lucky stars my husband made me that cortado I had to sadly chug instead of savor as I scurry out of the house. Mondays are not always like this, but sometimes the challenges of staying up late to deliver babies and deliver organic hot lunches to my kids collide.

Motherhood in all its delicious baby cuddling, babbling first words, and potty success joy is hard. It’s damn hard. It has helped me to become a better doctor and human, though. After the birth of my first babe, Maika, I was so fortunate to be able to stay home for 14 weeks to nurse and love her. That period of time in some ways was more challenging than my ob-gyn residency (think 4 years of 30-hour shifts without sleep and well-coiffed, scalpel-wielding women screaming in your face about proper suturing technique). Ob-gyns are trained to deal with hemorrhages, seizures, and ruptured uteruses; no one trained me to strap a 9-pound crying burrito to my chest while cooking dinner and trying to heal from a C-section. To be fair, it helps that crying burritos tend to be supercute. Caring for women, guiding them along their reproductive journey, and delivering their babies came a bit more naturally for me than looking after myself during pregnancy and the breastfeeding years that followed. Boy, was I surprised to find I wasn’t more prepared to be a mom myself after so many years of coaching others toward motherhood.

Talks about vaginal lumps and bumps, weird periods, cervical mucus, pain with sex while breastfeeding (yes, that’s a thing), and genital warts are just normal parts of my every day. Some of my favorite phrases include “Your uterus is shaped like an upside-down pear” and “The herpes virus has so much stigma attached to it, but it’s just a virus; no one gets embarrassed confessing they have had chicken pox, right?” I can honestly say that most of the time those conversations don’t feel like work, even though it’s actually my job. I strive to be a source of well-curated medical information while still being an open, caring soul. It’s incredibly rewarding. From the time I first told my friends that I wanted to be an ob-gyn, it was like the floodgates opened. All the things they had been dying to ask someone, secrets they feared would horrify, embarrass, shame them, suddenly flowed freely. There was a calming relief once the words came tumbling out. I can’t tell you how many times a day I hear, “I have never told anyone this before, but…” How overjoyed are these women when I tell them I just treated someone else with the same complaint last week! It’s unbelievably comforting to discover you aren’t alone in your abnormal Pap test or urinary dribbles. Feeling a sense of community with all the other newly sexually active women and their recent diagnoses of HPV is kind of reassuring.

I can remember hiding in the produce aisle at ShopRite while my parents paid for my tampons mixed in with a cartload of half-price cabbage and chicken drumsticks, petrified of being associated with those cotton sticks. I felt like a pariah in gym class, having to change those damn things. I mean, this was the reality that 50 percent of my classmates were dealing with, and it was as if we were all standing alone on our solitary islands of period embarrassment. I don’t know how my daughter will feel about feminine hygiene products, but I hope by the time she needs them, being open about periods won’t be a point of shame. I hope she’ll never call me crying from her shower in college because she’s confused about contraception and has no one to turn to. I hope she’ll know how to talk about female anatomy in a way that is factual and respectful. I hope that she and her peers will have been educated about reproduction with an approach that is far less mysterious and vague than what I learned in eighth-grade health class.

Whenever I think I have discovered a new and impossible patient misunderstanding about the workings of the female body, I am consistently amazed that an even more outrageous anecdote crosses my path. I don’t know who perpetuates these myths, but they have somehow managed to withstand time and the Internet! So many women don’t know that babies and urine come from different orifices. That sentence has a bit of shock value, but it’s a common misconception that I dispel for many first-time moms. I once had a patient swallow condoms thinking that was how they prevented pregnancy. I have discovered entire heads of garlic hidden in patients’ vaginas as a naturopathic cure for yeast infections. I have learned more than one culture uses a potato as a makeshift pessary—a sort of a plug placed in the vagina to keep the bladder or uterus from falling down after childbirth (admittedly, I may have explained this term to my husband on one of our first dates. I knew he was a keeper when he didn’t run away screaming after this conversation!). A woman in her late forties who had already gone through a full battery of tests for pelvic pain came to me only to discover she was actually 18 weeks pregnant and not, in fact, going through menopause with irritable bowel syndrome. I hope I’ve been able to handle those confusing moments for patients with grace and compassion. I remind myself to stand in my patients’ shoes, with years of old wives’ tales flooding their minds and the cultural taboos surrounding our vaginas overpowering their natural instincts. It’s been a slow road, but more and more women are taking charge of their reproductive health, and it sure is making my role in the whole process smoother.

It’s wonderful that Women’s Health magazine has a platform and amazing writers to put this information out there in a way that is accessible and, frankly, an open book. I am fortunate to have been asked to work with this team that advocates for women and is even willing to publish this helpful guide with the word “vagina” in big bold letters on the cover!

Empowering women to have a strong voice in their health benefits our society as a whole. There’s little to be gained from shrouding the facts of female reproduction in secrecy, as if too precious to be spoken aloud. Sitting beside you on a crowded subway train, maybe the passenger to your right or left once had her uterus swell to the size of watermelon to accommodate a baby, once bled for a month after a miscarriage, once cried herself to sleep fearing she had cervix cancer, once had milk spray from her nipples, once had to stand at the pharmacy counter and say “Plan B” out loud, and she came to me and told me her story. Those stories help other women. Being an ob-gyn has a lot to do with prescribing the right meds to fix your itches and soothe your sore parts, finding you help when the multitasking of new motherhood feels like an overwhelming, tearful burden, but it has a lot to do with storytelling, too. I’m so lucky women trust me enough to tell me theirs.

Michelle Tham Metz, MD