SARAH VERBIEST

Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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Smiling Mother Playing With Baby Son At Home

Black women and their babies have suffered centuries of injustice. Black women’s voices are co-opted, but not heard. Change must happen.

Facts are facts, Black women living in the South face historic, ongoing challenges to their health and wellbeing. While we can argue that all women in the South could have better health outcomes, the reality is that Black women and their babies have suffered centuries of neglect and injustice. Further, Black women’s voices are often co-opted, paraphrased, summarized but not heard. There are insightful and important solutions, strategies, and stories out there that most of us never take the time to hear. Change must happen.More Link

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OR: A brief history of why I hated doctors for so long, and why I finally stopped.

xo-jane-logo-660x400“Your blood pressure is a little higher than I’d like. It’s 120 over 90. If it isn’t lower by the time I next see you, I’ll have to take you off the pill.”

I am 20 years old, and sitting in the office of a woman I’ve been seeing as my primary care doctor for about three years. In my teens, when I finally aged out of the pediatrician’s office I’d been going to my whole life, my father’s then-girlfriend had recommended this doctor with the highest praise.

My pediatrician had had an obsessive fixation with my weight. It began when he instructed me to start my first diet when I was eight years old, showing me a colorful chart that explained what size I should be, and pointing out that I was near the top end of the average for my height and age. He wanted me to lose, I believe, one and a half pounds. Maybe as much as two. Every visit — even if I went in because I had a cold, or I had sprained my arm tree-climbing — began and ended with discussion of my weight, and I what I was doing about it.

My pediatrician was the first doctor I ever despised. So I was cool with it when I was told I couldn’t see him anymore. And given that I would soon need someone to give me my first pelvic exam, I was relieved to get such a strong reference from my father’s girlfriend, someone I knew and trusted.

It didn’t work out quite as planned.

My new doctor was never the kind, warm, supportive practitioner that was described to me. She was terse, and often cold; she did not have much patience for questions, and usually seemed in a hurry to finish our appointments. When I went in for that first pelvic exam, I was terrified, as this was before you could look up the details of the process on the Internet, and my dad’s girlfriend was as unforthcoming with her experiences (deeming such matters inappropriate topics of conversation) as my own mother was blasé (she would unflinchingly share every facet of the experience, but always with the hand-waving caveat, “It’s no big deal, you’ll be fine”). I had no objective narrative.

I was shivering on the table under a tiny paper robe, 18 years old, when my doctor came in, my chart in her hand. She frowned down into the folder full of papers and inquired, “If you’re not having sex, why are you getting a pap smear?”

“…Because I’m 18 and I thought I was supposed to?” I had read this, numerous places, that women were supposed to start getting pap smears at 18. I didn’t see anything that said it was only for women having penis-in-vagina sextimes.

She sighed lightly, like doing a pap smear was a waste of her time. I tried to chill out. But the tone for the visit was already set.

Back to the beginning of this story: it’s true that by 20, I was going in to these appointments already tense and braced for a bad experience. I was young, and though I no longer lived in South Florida, I was still on my father’s health insurance. It had genuinely never occurred to me that I could just find a different doctor whom I might see in Boston, instead of trying to fit in physicals on trips home. I suppose I thought changing doctors only happened in extreme circumstances.

When my doctor threatened my birth control, I panicked. My stomach sank and my heart began racing. If you’ve ever been a sexually-active 20-year-old with a pathological phobia of pregnancy, you can imagine my freakout. I mean, I was ALSO using condoms, but I didn’t altogether trust them, so the idea of losing the pill seemed like a terrifying risk.

I gulped and tried to keep it together. “Why?”

“The pill can elevate blood pressure in some people. You’re very young to have blood pressure near the borderline range. I’ll have to take you off the pill if you can’t get those numbers down.”

Notably, this was the end of our conversation. She never actually gave me any suggestions for lowering my blood pressure. Nor did she suggest alternative methods of birth control we could try. She instructed me to lower a number I didn’t understand, apparently through sheer force of will, or else she would take my birth control away entirely. I left the appointment believing those were the limits of my options.

After that experience, I did go back for one more appointment with her, but following that I peaced out of her office for good — although I carried away with me a newfound fear of having my blood pressure checked.

I kept my distance from doctors as much as possible for a few years after that. I went to a Planned Parenthood clinic in Boston for annual physical exams, but only so they would give me birth control pills. I paid for it all out of pocket, strolling past the bulletproof glass and the two sets of doors you had to get buzzed through, blissfully ignorant that just a couple years before, abortion opponent John Salvi had shot and killed two people, and wounded five others, at two family planning clinics in the Boston area. I thought it was just, you know, a cheap place to get the pill.

My experiences were slightly better at Planned Parenthood, but I never saw the same person twice, and thus never had much of an opportunity to build a relationship with anyone.

Eventually, in grad school, I got my own health insurance, and established myself with a regular primary care doctor. She was nice enough, but not long out of medical school, and her bedside manner was a little wobbly. She was fond of saying, “So, what are we doing about our weight?” like clockwork at the end of every appointment (who is “we,” exactly — could I be fat because YOU are eating too many donuts?). She liked handing me pamphlets about nutrition and calorie restriction, although she never once asked me what my daily diet was actually like. When I inquired about why I might be getting pain in my right shin when exercising, she was incapable of discussing possible causes or treatments beyond “lose weight” — and when I noted that, were I to take her advice, exercise would probably be a necessary component of doing so, she stared at me blankly.

xoJaneAuthorSome of her efforts were hilariously ham-fisted. Like the time she inquired as to whether I had ever considered gastric bypass surgery, literally at the same moment as she was scraping my cervix. (Even today, I wish I’d had the muscle control to have shot the speculum right into her face. HULKGINA SMASH. As it was, I only laughed maniacally.)

My health insurance changed again, and I chose a primary care doctor at random from a large book in my employer’s HR department, mostly because I had walked past the clinic where he worked many times, and it was conveniently located.

I had avoided male doctors ever since my pediatrician. I’d bought into the idea that male doctors are always terrible and patronizing to their lady patients. Given my prior experience, I didn’t take much convincing on this point. But there weren’t any women doctors accepting new patients at this particular clinic, and I thought, well, I’ll just go with this random guy for now, and change it later.

Dr. R was soft-spoken, warm, and had a kindness about him that put me right at ease. On my first visit, I explained that I would prefer not to be weighed as a matter of course every time I came in, unless it was necessary for some specific purpose — like to get the correct dose for a medication. I was willing to be weighed when needed, but my lengthy history of dieting and disordered eating meant the experience of getting on the scale caused such psychological upheaval that I would rather only do so when I really HAD to. I was literally trembling when I asked if he would be okay with this.

Dr. R, ever calm and measured, cocked his head to one side and asked, “How familiar are you with your body? Do you feel like you notice when things change?”

Familiar with my body? What does that even mean? At the time, I was sewing many of my own clothes, so that seemed pertinent. I explained that I knew my measurements intimately, and would notice if they changed, because it would affect my sewing. “If you wanted to MEASURE me every time I came in, I would be FINE with that!” I was selling this idea hard.

He laughed and told me that weighing individuals on every visit was mostly about tracking unexplained changes in weight, because that could indicate a problem that might otherwise go unnoticed. However, he said, “I think I can trust you to report any changes in your size.”

The shock and relief I felt took me days to process, and it wasn’t just about not having to be weighed all the time. The notion of being trusted with my body was utterly foreign to me. I was in my mid-20s, and still partly convinced that I had no right to govern my own body, that I could not understand my own health, that only doctors could unravel those mysteries and I had simply to accept whatever they told me about myself. This is a common experience for many women, especially women who are fat, but I hadn’t realized it had affected me so deeply until that moment.

I had never before met a doctor before who thought that my impressions of my health and wellness were as valuable as his own. This wasn’t a one-off thing, either. Over the decade that I saw him, Dr. R and I would routinely have discussions in which he would offer his own expertise, but then ask me how I felt and what I thought, and always in a manner that was sincere and interested. It wasn’t that he just went along with whatever I said, but he made me feel like I had the right to give input as the occupant of the body in question, rather than being dictated to, a passive and obedient patient.

In short, it felt like he and I were collaborating in my health, that I was an active participant in my own care. This was such a precious and magical gift, after all those years of thinking of my body as an aberrant monstrosity I was fighting, rather than an inexorable and valuable part of me.

I couldn’t have articulated any of this before I started seeing Dr. R. I didn’t know why I hated going to the doctor, why I sat in every waiting room feeling sick and powerless and grotesque. When white coat syndrome — a relic of my earlier experiences that I’ve not yet overcome — caused my blood pressure to surge when I first entered the exam room, Dr. R would recheck it at the end of my visit when I was calmer, to get a more accurate reading. He explained that using a too-small blood pressure cuff for your arm measurement can give a false high reading. He never made assumptions, but rather asked questions, posed hypotheses, ran tests, and worked to get the most accurate results possible. He preferred to operate within reality, and not vague generalizations. He believed me. He trusted me.

To put it simply, Dr. R treated me like a person worthy of dignity and respect, every time I saw him.

And that is what I said to his former PA last week, when she told me he had died a couple months ago.

I knew he had been sick. Dr. R had gone on medical leave a few years back, and then returned to work for a time, and then gone on leave again. Cancer.

His PA explained she didn’t have it in her to call every one of his patients to let them know, which I totally understood. I realized I was crying. Embarrassed, through sobs I told her that he was the first doctor I ever knew who made me feel like I had the right to be involved in my own health. I told her it really changed me, made me relate to healthcare in general and my body in particular not as things I tended to out of a begrudging sense of miserable duty, but because I was worth taking care of.

I wish I had told him that. He probably never planned it, or intended it — he clearly wasn’t trying to be an activist in the exam room, or to give me revelations, or build me up or anything like that. He was just doing his job. It was just how he worked. And just being himself was enough to help people.

Compassion is not a prerequisite for practicing medicine. Obviously. Medicine has its share of practitioners who relate to their patients as bodies on an assembly line. And I can even understand this, given the state of healthcare in the US, and the fact that virtually no one is getting the support they need, on either side of the desk. Primary care doctors and nurses often work impossibly hard to help more people than they can feasibly handle, and patients often suffer as a result. Doctors and other medical practitioners are not bad people, but they don’t always have the resources to be the kind of professionals they would like to be, and years of working in difficult circumstances will make anyone a little jaded.

Early on in confronting my doctor fears, one of the first revelations I experienced was when someone suggested that your doctor is technically your employee — if you don’t like the job she’s doing, you can fire her and find someone else. This idea helped me to learn to advocate for myself, but it also set me up to think of that relationship as adversarial; I was always waiting to be challenged, and in the panic of the slightest misstep, I would often have to decide whether to fight back (and come across as noncompliant) or lay down and let it go (and hate myself later).

And then I met a doctor who was truly, authentically compassionate and committed to asking questions, and testing and validating the facts, rather than moving forward with sweeping assumptions. And I realized that I didn’t have to hate doctors, or going to the doctor’s office, and I didn’t have to hate dealing with health stuff. I didn’t have to see it as a fight. I didn’t have to expect to feel dismissed or attacked. I didn’t have to feel guilty or broken or wrong or bad.

I could just, you know, try to be healthy. 

Lesley Kinzel is the Deputy Editor at xoJane.com. This blog was originally posted on xoJane.com on July 21, 2014. Click here for the original posting.

 

During my teenage years, my girlfriends always provided good advice. From who to date and what outfit to wear to school, to what colleges to apply to and how to bargain shop. They did not have a say, however, in my figuring out when to have children. Planning for my reproductive future was always a tricky subject. Between talks with my dad about the consequences of being a teen mom, and the dirty looks given to my fellow students who got pregnant as teenagers, it was a distant goal and definitely not something I intended at a young age. However, there is far more talk today about reproductive life planning, especially among young adults.

RLP-Infographic-WebReproductive life planning is a readiness tool to help women and men of reproductive age develop and work towards their personal goals for having or not having children. Almost half of all pregnancies are unplanned – in North Carolina that is more than 50,000 pregnancies each year. A baby’s vital organs and tissues develop very early in pregnancy, often times even before a woman knows that she is pregnant. The healthier a woman is before pregnancy, the more likely she and her baby are to be healthy during and after pregnancy.

Research has shown that nearly 50% of all medical conditions that complicate pregnancies and negatively impact birth outcomes can be traced back to the preconception period. Since women are likely to go to their friends for advice (like me), experts have determined that providers and consumers should become knowledgeable about reproductive life planning. For instance, providers are now encouraged to ask one key question during each patient encounter, “Are you planning to become pregnant in the next year?” And there are more programs than ever before like the North Carolina Preconception Health Campaign, which educates consumers and providers on counseling strategies that can be used to start the reproductive life planning dialogue.

Planning how many children you want (if any at all), or when you intend to have them, may seem far-fetched. In reality though, there is so much planning that happens day to day, why not consider your reproductive future? You may feel that these decisions are beyond your immediate reach or that you have little control over this aspect of your life. Trust me, time passes quickly and before you know it, if you are a sexually active individual, you could become a parent. So why not plan for it (or plan to delay it) until you and your partner are ready? Your plan could help you consider what form of birth control to use or whether to wait until marriage before having sex. Think of it as your overall guidepost to help you spell out your life goals. It could help you answer questions like what are your plans for school or career, and your plan for finding a life partner. And, how would having children fit into those plans?

Of course, we all know that plans can change. Your reproductive life plan can change too, however it is never too late to start planning or to modify the plan you have. Even if you have children already, your plan can help you think about any other future children you might want. You can also speak with your health provider about how early you can start to try to get pregnant again. Research has shown that waiting 18-23 months is the safest interval between births. Given the high numbers of unintentional pregnancies and the related complications during pregnancy and beyond, health providers are now having more of these conversations with their patients.

Had someone given me a reproductive life planning guide when I was younger, or even asked me about my life plans, I would have paid attention. If nothing else, I definitely would have passed it along to my girlfriends so that I could finally be the one to offer up some sound advice!

Re-Posted Blog from Every Woman North Carolina.

Kweli
 
Kweli Rashied-Henry, MPH is the North Carolina March of Dimes State Coordinator for the NC Preconception Health Campaign, and a Leadership Team member for the Every Woman Southeast Coalition.

October 15th always takes me by surprise.  As a recurrent miscarrier – 7 pregnancies, but only 1 live birth – I’m prepped for Mothers’ Day and all the feelings that can evoke.  I’m used to putting on a brave face for pregnancy announcements and baby showers. But October 15th gets me every year. 

You see, October is National Pregnancy and Infant Loss Awareness Month, and the 15th is designated as Pregnancy and Infant Loss Remembrance Day – the day when you are supposed to light a candle at 7pm to help create a wave of light around the world.  I love that this day exists.  Oh, I don’t love the reason it exists, but I love that there is acknowledgement of the loss – the loss of hope; the loss of the future you envisioned; the loss of a child, whether or not you got to hold that child in your arms.

Yet, did I participate?  When all of my lovely friends – my fierce mama tribe – were posting infographics like the brilliant one from Australia on Facebook and tweeting reminders to light a candle at 7pm, did I also post?  Did I light my candle?   No, I didn’t.

I’ve never been a good public griever.  I don’t usually cry at funerals (though I bawl like a baby at weddings).  I learned early not to calculate due dates until I was past the first trimester and grew more numb with each miscarriage, instead throwing myself into becoming pregnant again, parenting my daughter and, ultimately, the adoption of my son.  The shame and secret nature of the loss became internalized – I wasn’t really infertile, as a colleague oh-so-helpfully pointed out, I was just subfertile.  Acknowledging or memorializing my body’s failures seemed like a waste of time.

Infertility, which includes recurrent miscarriages, affects one in eight couples in the US.  It’s a disease that affects women and men from all walks of life – rich/poor, young/middle-aged, all races and ethnicities – although, since treatment is rarely covered by insurance, we usually only hear about the experiences of relatively well-off women and their families.  Those of us working in maternal and child health spend a lot of time thinking about how to help ensure all women and men are able to create and actualize their reproductive life plan, but what we usually focus on is preventing mistimed pregnancies through the provision of education and access to contraception.  While that focus is important, I think that we must also become comfortable talking about infertility and how that affects reproductive life planning, helping people access the limited diagnosis and treatment resources available, and acknowledging people’s loss and helping them find support.

October 15th comes around again in 363 days.  This time, I’ve got my candle ready.

Candle

Want to learn more?  Check out these resources:

RESOLVE: The National Infertility Association

“Infertility is More Common Than You Think” infographic

Stirrup Queens’ Blogroll

 

 
Erin McClain, MA, MPH, is a Program Coordinator for the Every Woman Southeast Coalition and a Research Associate with the Center for Maternal and Infant Health at the University of North Carolina at Chapel Hill.  She is a bio-mom, an adoptive mom, and an unofficial, self-proclaimed tour guide to the “Land of Infertility.”

On June 13, 2014, I had the opportunity to attend Tulane University’s 2nd Biennial Black Women’s Health Conference (BWH) in New Orleans, Louisiana, representing the Every Woman Southeast Coalition (EWSE), and connecting with one of our coalition members in Louisiana. The full conference agenda can be accessed here and click here to view the recorded highlights from the conference sessions.

1As an exhibitor, I had the opportunity to connect and speak with different conference attendees, sharing resources and information about Every Woman Southeast. People truly appreciated our newsletters’ topic areas, which prompted a few attendants to speak about their own health experiences as it related to the newsletter themes. Additionally, it was great to connect with other organizations and agencies that were represented at the conference. Many professionals in the health, social work, and criminal justice fields were very interested in learning more about EWSE, and were appreciative of the fact that we were represented there with useful and informative resources to share. Everyone LOVED the Birth Control after Baby and the Taking Care of You: Your Post-partum Health and Visit Booklets.

As a conference participant, I had the chance to listen to the dynamic keynote speaker, Dorothy Roberts, and had a chance to get her to sign a copy of her latest book, Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-first Century. Dorothy Roberts delivered a powerful presentation, illustrating the thread of inhumane historical medical practices (e.g. “the father of gynecology”, J. Marion Sims), the racial stereotypes and racist structural policies that impact black women and their families, and the connections to current poor maternal health outcomes of black women. I was also able to attend a couple of breakout sessions that focused on black infant and maternal health disparities, factors that influence black women’s decisions to pursue counseling, and understanding the historical exploitation of black women’s bodies and its effect on black women’s health.

2Earlier in the week, I attended a week-long training as part of my professional development with the CDC’s Public Health Prevention Service Fellowship. A half-day was dedicated to topics in health disparities, which included keynotes from former CDC Medical Officer Dr. Camara P. Jones MD, MPH, PhD, who presented on levels of racism and health disparities, and from Environmental Justice Officer at the CDC, Dr. LaToria Whitehead, PhD, MPH, who presented on environmental justice and her work with the CDC. One of the points that stood out to me most was how Dr. Jones defined health equity and described “achieving health equity.” She stated:
…Health equity is assurance of the conditions for optimal health for all people. Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. Health disparities will be eliminated when health equity is achieved…” (Source: Jones CP 2010, adapted from the National Partnership for Action to End Health Disparities).
Another highlight of the training was that I had the opportunity to co-facilitate a discussion during a breakout session for the viewing of the Unnatural Causes Episode Two: When the Bough Breaks documentary.

I mention the above experiences because it ties back into my participation in the roundtable discussions during the BWH Conference roundtables session on racism-based stress and pregnancy outcomes of African-American women. During this session, the presenters also showed a video clip from the Unnatural Causes documentary and led a discussion as well. The most poignant component of both discussions was when audience members shared their personal stories about their pregnancy, experiences with healthcare providers, and spoke about their experience with racism in general. Since we only had a short amount of time for discussion during the breakout session I facilitated, our discussions centered more on people’s reactions to the disparity of poor birth outcomes between college-educated black women and high school drop-out white women, and opportunities for public health professionals wanting to become involved in work that seeks to address these disparities.

On the other hand, the roundtable discussion during the BWH conference centered more so on ways to address the issue of infant mortality experienced 3by African Americans. This led to a very long and dynamic conversation and feedback to the facilitators. Some of the roundtable participants were very shocked at the fact that racism is a huge factor in poor birth outcomes, some believed that this was not new information and that the black community has always been aware of the overall health impact of racism and oppression, and other participants expressed criticism for how the documentary failed to leave room to show examples of how black women have organized historically and in the present-day to address such issues with poor birth outcomes.

The stories, perspectives, and solutions that were presented by participants of the roundtable discussions at the BWH conference made me reflect back on the points presented during Dr. Jones’ presentation when she pointed out the importance of being willing to talk about and address historical injustices when engaging in health equity work with communities, and the racially-gendered policies that impact black women’s health as presented by Dorothy Roberts. It also prompted me to reflect on the importance of facilitating an emotionally charged topic and having information readily available for participants.

Attending this conference was very meaningful, in terms of sharing the EWSE resources, connecting with other health professionals and organizations, and to get a pulse on how information pertaining to black maternal and infant health disparities is received by the communities most impacted.

For a few examples of black maternal health initiatives spearheaded and/or organized by black women, see below:

Mommy in Chief,” is MadameNoire’s original web series that explores the ups, downs, and everything in between of being a modern mom. The series offers a fun, inspiring, and practical take on parenting for mothers in a variety of life stages and child ages.

Black Women’s Health Imperative’s CEO and President’s Call-to-Action on Black Women’s Maternal Health

Mocha Manuel an online resource where black moms go for information and inspiration for pregnancy, parenting and beyond!

Black Women Birthing Justice is a collective of African-American, African, Caribbean and multiracial women who are committed to transforming birthing experiences for Black women.

Birthing Project USA is the only national African American maternal and child health program in this country.

The Black Maternal Health Project by Women’s eNews on Pinterest is a social media resource page with resources and information from breastfeeding to childbirth culturally geared towards African American women.

Angela D. Aina, MPH is a CDC Public Health Prevention Service (PHPS) Fellow serving her two-year field placement with UNC, Center for Maternal and Infant Health.

**The statements in this blog post  are those of the authors and do not represent the official position of the Centers for Disease Control and Prevention (CDC).**

GetTestedLogo-Pink-High-ResSexually transmitted infections and diseases remain a major public health challenge, especially among women in the southern United States. Young women between the ages of 19 and 24 bear the brunt of these infections, and though many are asymptomatic, the sexual health effects of these can range from physical discomfort to infertility, ectopic pregnancy, Pelvic Inflammatory Disease (PID), cancer, and even death. There are a number of STIs out there, but the ones that occur most commonly in women, based on recent data from the Centers for Disease Control and Prevention (CDC), are chlamydia, gonorrhea, genital herpes, and HIV/AIDS.

What’s more, women of minority races and ethnicities are most greatly affected by STIs of all types, not only in the South, but across the US. For example, Alaska Natives and African Americans are five and eight times more likely to be diagnosed with chlamydia than European Americans, respectively. Socioeconomic, cultural, language and gender barriers tend to limit the ability of some young women of color to receive information about STIs, including HIV, to access culturally appropriate health care, and to reduce sexual risks. A lack of well-funded prevention programs specifically designed to address women of color further limits the capacity of some these young women to protect themselves against sexually transmitted infections. Thus, the burden of protection tends to lie with each individual woman.

Many of us remember from our sex education classes that abstinence from all sex — vaginal, anal, and oral — is the best way to prevent the transmission of STIs. However, there are several alternative means to reduce the risk of contracting an STI during sex:

  • Always use a barrier contraceptive: Use a new condom during every sexual encounter, even during your period. Other forms of contraception, including the pill, patch, ring, diaphragm, sponge, implant, intrauterine device, and rhythm method do not protect against STIs.
  • Get tested and treated: If you suspect or notice any symptoms of an STI, see your doctor immediately so you can be properly diagnosed and treated. Abstain from sex until you have been checked, and if you are diagnosed with an STI ask your partner to be tested and treated as well, to prevent reinfection.
  • Get vaccinated: In the case of HPV, a vaccine exists that can reduce your risk of contracting the strains of the virus that cause cervical cancer. The CDC recommends that all women between the ages of 21 and 65 receive routine screenings needed to protect against HPV.

There are many that will say that pursuing a monogamous relationship with another person is protective against sexually transmitted infections and diseases. However, in addition to factors such as poverty and access to quality STI services, a woman’s ability to negotiate safer sexual practices is what will affect her sexual health. A woman’s relationship status with her male partner, in particular, has been identified as an important predictor of her sexual health. Even a woman who has only one partner may be obliged to practice safer sex, because it may be his behavior rather than her own that increases her risks for STIs.

In all, the greatest thing any woman can do is to know the facts for herself. Know what the symptoms are and speak to a health care professional about any and all concerns. An STI can seriously affect a woman’s sexual, reproductive, and overall health, and can even threaten her life. Taking the necessary precautions to protect yourself can help ensure a safer, healthier future for both yourself and your partner.

Amanda Zabala is a graduate intern at the Center for Maternal and Infant Health. She is currently attending the University of North Carolina at Chapel Hill, Gillings School of Global Public Health, and majoring in Maternal and Child Health.
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