Im pleased to welcome you to tonights event. Discussing the latest book everything below the waist. She is joined tonight joint tonight in conversation by jaclyn freedom. I want to let you know about a few events we had coming up. Our fall season is in full swing right now. This friday at 3 00 p. M. Mean girl. The culture of greed. The la times and many others. It explores a womens right to choose how she gives birth as well as the copious issues within the industry a Public Health surrounding childbirth. She is joined by jaclyn freedom. A self proclaimed pleasure activist. What you really want which i hope is a spice girls reference. And unscrewed and we have these titles at the register for sale as well. She also has a popular podcast. It is crucial discussing one of the most important aspects of feminism. They caught a must to weed must read for any woman. I could quote more but all of that reviews are in agreement they say read this book the information is essential to health the Healthcare System must change. On that note i will let the authors do the talking. See back hi everyone. Good evening, thank you for being here. Thank you to Harvard Bookstore thank you to the Harvard Book Store for having us. I am going to read a little bit from the introduction. Problem with medicine is empowerment. In california a woman returns to the clinic where she have an iud and suited to have it removed because in her words i went from a happy go lucky 31yearold to her depressed walking zombie in just three weeks. They tell her she doesnt think its a good idea tells her to wait six months. Says what happens when you have an abortion. After making her case and be denied multiple times to patients shaking with anger turns the request into a demand. The clinician rolls her eyes and takes that device out. In somers point, new jersey a woman having her second baby as nine out of 10 centimeters dilated. Feeling the urge to push when the obstetrician enters the room asks about the womans previous delivery and tells her shall need a csection this time. When the woman asked questions they threaten to call court legal people if she doesnt sign a consent form for surgery in minneapolis a 46yearold woman at a renowned Medical Center has robotic hysterectomy. Two days later she tells the nurses of concerning symptoms. Pain, elevated heart rate. She wakes up in pain so unbearable that she calls for an ambulance. She emerges from emergency surgery with a colostomy bag. Woman needs medical care woman is ignored woman has to fight. We surrender your modesty and trust are opinions. We expect science expertise. The first u. S. Woman to get a medical degree. They would exert on the profession. He lectured in 1859. Today half of our medical students are female in the dignity in the medical realm is no more secure. No more as our health. Even as the Life Expectancy has risen over all. I trend that has been worsening for three decades. In a quality of the years we are living is worse for men. And worse than the previous generation. They entered adulthood at greater risk for the development of chronic illness. In 42 percent of counties the Life Expectancy is decreasing. Shocked, i was too. Havent we come a long way from the dark days when Cervical Cancer was the number one cause of cancer in women. Havent we conquered professional pregnancies. And dont women had more power now. To try to explain at one can one can pass the international differences. In the lack of guaranteed healthcare. Black women are more likely to die of Breast Cancer and disease. The stress caused by the daily wear and tear of being a woman of color in 21st century america. They feel more prescriptions than men. Women concluded a 2017 article in glamour. Not necessarily your own. But the chemicals. Research funding is also a problem. Ten to 20 of the population. Another problem has emerged in recent years. Women are more vulnerable than men. With the prescribed drugs. They were all manufactured by the pharmaceutical industry. It came into vogue in the 2000s. The 80 in women were done unnecessarily. They are more often recommended. More likely to be prescribed into a depressants. We are also more likely to get the prescription for opioids. We are prescribed to more drugs and recommends more surgeries in general. We enter a lot of surgery on our organs. Major surgery that carries shortterm and longterm risk to baby and mother particularly for future pregnancies. There is a statistical threshold. In Public Health authorities agree at a rate of 32 percent. The trend raises questions not only of emotional help but consent. There are more csections than vaginally births. They have a de facto bands against vaginally births if theyve had a previous csection. Alisas been getting more attention recently. Why practice standards vary widely across states. Even individual hospitals. Seventy mothers are dying in childbirth. In my countries with better at outcomes employment more midwives. I asked questions about fertility treatments to contraception. So the way miscarriages are handled. Covering up the system by passing normal functions and moving the organs is generally the treatment protocol. Hopefully that open up some avenues of conversation. I have a lot of big structural questions to talk to you about. I do want to start their because its probably on everybodys mind. One of the uncomfortable but necessary experiences one has. As the feeling of not knowing who to trust about medical expertise. You hear stories of people following in folk remedies that are actually terrible. Obviously there are many stories in the book about the medical industry giving us terrible outcomes i wonder if you can maybe give folks a little guidance on how to know what trustworthy information looks like or the trust where the conveyor of information. What signs to look for either information our person that purports to be an expert. Whether they are medical or focus or not. I think that such an interesting place to start. The question of expert and expertise historically, its only about a hundred 50 years that medical doctors had have the different experts. To start there i think its interesting to put that in context. Weve along Human History and hundred 50 years as a blip. And in our culture they have what scholars call authoritative knowledge. Journalists go to doctors to get the expert quotes. I think there might be some people in the room who value our bodies ourselves project. And one of the really important things that the Health Movement did in the 70s was lets look at the history of how medical doctors came into power and the authoritative knowledge and control information. In the conflicts of interest in the biases. In the history of medicine is all wrapped up in patriarchy. And white supremacy. And racism. Its an ugly history. I think one of the great things that the feminist Health Movement did. Wait, lets look at our own bodies and talk about the experiences. Their experiences. Because what were reading and textbook is just one source of information. And so today when no other information. It was difficult to get pictures of vaginally birth. I cant even imagine. And now we have this internet. What are the sign that youre going to a trustworthy information source. How did you know who to trust. And what sources are trustworthy. This massage therapist who i found she is doing something that most physicians dont recognize. You can barely find any literature about this. And yet i was directed to her by women who told me things like ive have a horrible awful. Since i was 13 and i went to this person she removed my uterus and told me exercise to keep the uterus in the right place. That is really powerful information. Is it evidence based medicine no. So many people are not finding everything i need to treat their problems. From the authoritative sources. They are doing all sorts of things. I think the bottom line is that we actually dont know what works for everyone if someone finds something i say great. One of the things that we lost i think that 70s spirit of hang on who are the experts and what are the points. I think we lost a little bit. I dont think that is a bad thing. It keeps coming up on my twitter feed. Am scared of the scams associated with of possibly harmless treatments. If you want vaginally seam and it doesnt seem to be hurting you go ahead. Its another thing to buy some elaborate outfits out of some great cost to you. Its actually not really can help you. It feels like they will either skim you or harm you i think it is important to look back. There are the things called medical reversals. We could talk about somebody thinks in the birth and maternity process. They were told for decades. The cut will prevent bad tearing. And the women who were that doesnt make any sense. If you cut a piece of material and then you pull up on it. Tears more. They attended women and let them move around it took decades it took micro crime. It shows very differently what women wanted all along. We are still seen we are still dealing with this. We could talk about a lot of things. Who is benefiting us. And when to switch gilt gears and talk about the pill. One of the things id like to do when i read a new book as i like to look at the index. The listing starts on here. We were talking this morning about it also. The interaction from the pill and womens bodies are the history of every issue in this book. Almost entirely, i think. I think the pill is really interesting because it has been a difficult conversation. I want to preface this by saying life in the 60s when the pill became available was completely different. You cannot walk to the corner store and buy condoms. You needed a ring on your finger to get a diaphragm. It was a completely different world. I gave women control over their lives. There is a lot of research now. And Mental Health. The hormonal contraception. We have a lot more information about it. One thing i noticed is that there had been a couple of books in recent years and thinking of in our control. The reaction to those works in the feminist medium was surprising to me. It was very negative especially for hollys books. Not to say that theres not problems. The reaction was outside. The defense was really interesting. People assumed she was into abortion. But meanwhile we cant seem to have this conversation about the fact that we have this hormonal contraception. The impacts on the quality of our lives. I think weve had enough conversation about it. The lowest with the localized dont make me put it back in. It made me feel like my vaginae was not part of my body. I thought i was just a crazy person. And i was on the pill for like seven years mainly for my acne. I think thats one of the things. There is a lot of discussion about attachment parenting. All of these conversations how do we have these Difficult Conversations about what we know and what we dont know. And all about the anxiety that we head about our bodies without turning on each other. Like the pill is a literal lifesaver. Both of those things are true. And neither one is more true than the other. The pill liberated wonder woman and a lot of ways that are real. In a way that doesnt have us squabbling with each other. I think we can handle all of the information. There is so much defense of these technologies. Dont touch my blank thats my choice. Are we in adults. Can we talk about how cesareans are negatively impacting women. We have a rising Maternal Death rate in this country. One of those is repeat the cesarean deception. And then if we Start Talking someone may say that csection save my life. We can still talk about it. The bigger picture. You love your copper iud. I want to say even when its not proven yet. I did this big story about the contraceptive implant. They have filed adverse reports. It started as a small number. I am having the same problem. We are talking this morning about the leap story. How many of you needed the story about leaps. We were looking at changes in the cervical cells. There was all of these designations. One what level your displeasure might be. One of the treatment if you had cis to its recommended that you get the cells removed. It doesnt matter what it stands for. It involves the excision of cells. I thought an amazing story in cosmetology. I was research that i wanted to do. She talked to a significant number of people who lost orgasmic capabilities following this procedure. Never got it back. Or didnt get it back for three years. And she talked to some experts who said there are nerves in the cervix. Thank you for that 70s. The uterus has a role. There is a lot more anatomy the uterus does things during orgasm. At the level of antidote in putting together it was irresponsible. If i have something that is dangerous in my body. My going to get cryotherapy. What was so challenging to meet with some gynecologist saying what is what if this is a side effect we saved her life. The journalists rightly points out. And they did research to figure out how to do the Prostate Cancer to figure out how to not affect mens sexual response. How do we have a leap safely. They were unaware there were those nerves in the cervix. Its not that the leap is not possible no one is thinking about the actual woman as a human. Outside that she have cancer or no. There were more overlapping things. How poorly educated they are. There was a study that i found. Most women who get Breast Reconstruction after cancer are not informed that they may lose nipple sensation. It is whether it will look and feel real to someone else instead of you may lose sensation. It just rhymes so much with that. Medical science as a whole. They dont conceive of us as having an inherent Human Dignity and that our sexuality is something of value. It has not been a question of scientific inquiry the pill is the most researched drug on the earth. Further response. There has been very little. It is because they actually designed those studies with 20 questions about how it would be affecting their sexual response. One of the responses to this leap article. Is like hang on. We had studies showing there is no effect on sexuality after hysterectomy. It only follows women one or two years. Guess we have these studies. What was the initial question and what are people looking at. I plan to ask you 20 more questions but i also want these fine people who came out tonight i know you have noticed the cameras. Your voice will mostly be on the video but your face may not. Who would like to ask a question. We saved her life because we did the procedure. Thats how we used to talk about csections in that same way. That experience is measurable. And that is directly related to what were seen. I was just wondering i come from the Public Health world. How can we start to see this when youre talking about a woman who has a trust that has been broken with the system. And she wasnt told that this was gonna affect the relationship. When they break trust with the system. I know you have talked with a lot of people. I should add. One specific thing i forget what the issue is here in the book but there is some issue where especially trans men who has similar biological issues have that broken trust even more. They are less likely. I think that is such an important i know youre in the Harvard School of Public Health. But i think it is a big question. Who is say no to the hospital for sure. They are so distrustful of anyone that has a conflict of interest. Do it by yourself, youre better off. The research pretty clearly shows that when you have a skill dependent with you. You can be at a birth center. I understand why that trust has been broken. And then they couldnt get a vbac and had to have another necessary. Now theyre theyre having their third pregnancy. And now they had two you had two kids to take care of. No doctors helping me. Im just gonna do it. That is the reality of the broken system. I think the consequence of the patient not obtaining true autonomy. If someone said look, i know the risk, i know the risks of having two prior csections but i cannot have another planned csection. We should support her, via physician or midwife. If they have the choice in true and fraudulent consent. I still choose this. We dont call child protective services. We dont try to get a court order. These are extreme cases. They are happening. Over here. You are outside of the scope of my understanding. I cant answer that. I dont know. I have read that girls as pain his pain is taken less seriously. Select is just theyre looking at every point of contact that women had it is annoying or undermining. They have a really killer periods and are put on the pill to regulate the cycle. It does not regulate. The way we have talked about that has been very misleading. I dont know if sherilyn pryor is in the room. Dr. Pryor i know has done a lot of research on breaking research and you could probably talk more about this. Looking at the benefit we typically talk about periods and physiology. All of these things. We dont think of it as giving up something. Every month you are getting a shot. If you think about it is giving you something. What is that doing. Thanks for coming. And you want to say anything more. Im here for my 50th medical school reunion. I thought it was important to know that the use of the is related to significance bone loss. Give the system a chance. I want to say also. The pill is prescribed a lot to treat pcl as. What was pointed out to me by a lot of experts. If you do that youre not treating the underlying pathology. Its not officially that. There is still a disease process. People turned 35 we havent helped them. Incorporation you very much. I wonder what you think about this. With the Mental Health aspect. Women had to stand up for rates. The religious rights wants to take away our birth control. Its clear if youre paying attention for a long while. I think it has. I think thats the big reason we feel like we can talk about it. We feel like we cant talk about abortion. How can be better. We are hanging onto clinics for dear life im one of the discoveries i have. Was a network of people who are learning menstrual extraction. As laypeople. Maybe there do less maybe there midwives. They are teaching each other how to get an abortion at home. It has advanced so much they are getting pills. One of the people i talk to as a midwife who is now based in canada and she is really arguing for midwifery to reclaim abortion as part of their practice. A world where and wait and wait 18 room. It is an outside the system thing. Which could other places for it. It has been a movement for them to do that in their office. Making it truly private but this midwife also said this is something that midwives always did. They did verbally. But now we have this technology. It is not surgery. It has not been surgery for four decades. We still talk about abortion as surgical and nonsurgical. We dont want to talk about what it actually is. Its important for us to head vision beyond breakout of the way that it is streaming. I would add to that just briefly. Not just what were trying to defend. The way we went is not my trying to offend. The best outcome is status quo. And if we get part of the way there. This is actually the right moment that we need them. One more, i see a hand up. Thank you for doing the book and all of your work. There are some areas like silicone gel breast implants. Were looking at the work of early activists. Here we are 15 years later. There is a whole host of other problems. There are more physicians willing and not to plastic surgeons. Willing to enter in to these conversations. No longterm safety data. In this morning i thought a local physician modeled this kind of we can learn so much from the women that we care for and in his case it was from the midwives he backed up. He told several stories. He gave some great stories. We are trying to get this new bravery bill passed. Once its at the website. They should refer physicians to that short presentation to role model how you can be positive about opening these conversations and able other people to say maybe were doing things not the right way. They go up against the gynecological establishment. The conversation has to happen. In your book is can help that said thank you. The original authors in founders. Thank you. I will add a question to that. I ask a lot of people. And i developed for unscrewed which is if i were a genie and give you three wishes that could change anything in particular in the world that would make a feminist revolution in healthcare what are the three changes you would make. I think at the heart of it, that we look at how much we value the female organs. If we start from there we get better contraceptive options. We get more support for that physiological birth. I think this country needs more midwives. Been very vocal about that. And then we would see more Supportive Care in the transition to menopause. To judys point i think that the experts that the stories i trust the most are that they are a piece of the puzzle. They dont have all the tools. Your journey and what works for you is patient centered madness said that is thats how the discourse is can a change. That was right around to the beginning of the question. Jennifer block think you so much for joining us. [applause]. Book tv is television for serious readers all weekend every weekend. Join us again next saturday beginning at 8 00 a. M. Eastern for the best and nonfiction books. Host the professor at the Massachusetts Institute of technology and he is our