Jul 312017
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Earlier this year, HEART partnered with researchers at UIC for a clinical study on Muslim American women’s health knowledge, practices, and desires for improved care. We surveyed 730 self-identifying Muslim American women ranging from ages 18 to 45. Check out some of our crucial findings below, as well as our recommendations for health care improvement on personal, community, and institutional levels.

sexual health knowledge and behavior info (2)

Nov 182016

by Nadiah Mohajir

wedding-964415_1920Sex is described as many things: it can be an act of passion for some, physical gratification for others, a necessity for procreation, an act of worship for people of faith, or some combination thereof. It is also a word and experience that is often loaded with many emotions: joy, love, and all too often, fear, shame, and stigma.

One of the challenges of beginning this conversation is that historically, sex and sexuality have been seen as uncomfortable subjects across most racial, ethnic, and religious communities. In Muslim communities, the strong notions of privacy and modesty are often conflated with the shaming of feeling sexual desire, which creates an environment hostile to open discourse, let alone operating outside of religious code. This lack of open, nuanced conversation has long-term consequences: it instills shame and unhealthy attitudes toward sex, which many women carry into their sexual relationships, both within the framework of marriage and outside of it. Read more here.

Sep 162016

sunset-801933_1920Recently, marriage and relationship advice videos by well-known and revered scholar Yasir Qadhi have been circulating the internet. Called the “On the Rocks: Common Marital & Intimacy Complaints” series, these videos are 5-10 minutes long with sensationalized titles such as:

  • It’s the #1 Thing Husbands Complain About: Watch How YQ Shuts it Down
  • What so many Men want to know will SHOCK the Ladies. It Could Also End the Engagement
  • It’s Hard to Believe there is a Solution to the in-laws Conundrum. It’s so Simple you will Cry.
  • How YQ Addresses this Common Bedroom Frustration, You’ll want to Give Him a Standing Ovation!

I subscribed to watch these videos and was sorely disappointed with how these videos not only lacked practical advice (ie I still don’t know how to solve the “in-law” problem he’s talking about), but they also were laden with gender stereotypes, shame and stigma around female sexuality, and they continue to reinforce unhealthy sexual relationships between the husband and wife.

I soon discovered I was not the only one to be sorely disappointed in this series, when I came across a post by a woman who refers to herself as the “Salafi Feminist,” and so I invited her to share her thoughts on our blog as a guest post, which you will find below.


by Zaynab bint Younus

When one sees Muslim leaders attempt to take on serious and relevant issues to the Muslim Ummah such as sexually dysfunctional marital relationships, one truly hopes for the best. Alas, well-meaning though they may be, there becomes glaringly obvious a lack of knowledge and understanding regarding female sexuality.

A few claims that are being made and circulated en masse (and dangerously so) are the following:

  • Muslim women (especially from ‘conservative, practicing families’) do not really experience sexual arousal or any feelings of intense sexuality before marriage.
  • Women’s fitrah (natural state) is such that they are automatically less sexual than men.
  • Muslim women are intimidated and scared by even discussions about sex prior to marriage; if a Muslim man wants to discuss it with his fiancée, he shouldn’t lest she run in the opposite direction.
  • Women don’t ‘need’ to orgasm as much as men do; their sexual feelings are minimal and what they truly seek from sexual encounters is not necessary physical pleasure, but emotional connection.

Not only are all these claims inaccurate, but to perpetuate them on a massive public forum – and by an individual with significant influence over large numbers of Muslims – is extremely dangerous due to the fact that the Muslim community already suffers from a horrific lack of knowledge and awareness about sex and female sexuality.

Despite the fact that Islamic texts fully recognize women’s sexual needs and in fact protects them as a religious right, many male Muslim leaders perpetuate cultural stereotypes about the nature of female sexuality and falsely pass them off as Islamic guidance. Such ridiculous ideas include the belief that women have a lesser need and appreciation for the physical aspect of intimacy; that they do not experience intense sexual arousal prior to marriage; and that the very idea of sex is disturbing and unnatural to them, or that they are unable to comprehend the true nature of intercourse before marriage.

In all fairness, even Western cultures and scientific thought has long held faulty and inaccurate beliefs regarding female sexuality (most famously, the views of Sigmund Freud and the Victorian phenomenon of ‘hysteria’). However, it is also true that Western society has moved along with considerable speed with regards to knowledge of female sexuality than many Eastern (and Muslim) cultures have. It must still be kept in mind, though, that the amount of studies and research collected on female sexuality is dwarfed by those about men, and that there remains a great deal to be discovered about female sexuality in general.

Going back to the claims being publicly taught, there is first of all a severely erroneous conflation between the reality of culturally ingrained attitudes about sex, and the actual innate physical desires and needs that women have for sex.

While it is absolutely true that many Muslim cultures teach women unhealthy negative attitudes about sex and equate female sexual desire with being dirty or impure, this in no way actually reflects the physiological need for sex that exists in the female gender as a whole.

No matter how much cultural brainwashing women receive regarding their sexuality, most women will still inevitably experience feelings of sexual arousal at some point in their lives – and for those who do, it will generally first happen before marriage.

Furthermore, the arousal a woman feels can and does reach strong levels of intensity, including orgasm; for example, in a wet dream. This was acknowledged even by the Prophet Muhammad (God’s blessings be upon him), who confirmed Umm Sulaym’s question regarding female wet dreams.[1]

Even outside of wet dreams and masturbation however, women can and do feel intense sexual stimulation – anything from wearing a new pair of jeans or sitting on a massage chair. This is not to be crude, but simply realistic.

Nor are such experiences purely involuntary; many women are curious about their bodies and are actively aware of what stimulates them both physically and mentally (after all, the brain is the most powerful sex organ). Sexual curiosity exists in women just as it exists in men; since many girls mature physically and mentally faster than boys, they can be ahead of the game when it comes to being curious about sex.
Whether it’s reading romance novels (and anyone who thinks that girls read romance novels just for the emotional fluff is fooling themselves) or magazines like Cosmopolitan, girls crave information about both the romantic and the explicitly sexual.

Communication about sexual issues is another matter, one tied much more strongly to the aforementioned cultural brainwashing about intimacy than the idea that women have an inherent and instinctive fear or aversion to sex. Advising Muslim men to ‘just pray Istikhaarah, ya akhee’ (just pray the Prayer of Guidance, oh brother) instead of respectfully discussing or asking questions related to sex with their fiancées is harmful and, quite frankly, insulting to both the man and the woman. We should not be perpetuating attitudes of embarrassment, shame, and stigma about sexual issues but rather, encouraging men and women to approach the topic with respect, dignity, and honesty. It may be uncomfortable at first or awkward, but then, all positive growth and change is by necessity.

It is necessary to say here that a great deal of work needs to be done in training Muslim men and women on how to discuss matters related to sex and marriage in a respectful, dignified, and mature manner.

There is one final issue – the idea that women are innately ‘less sexual’ than men. While there is no denying the biological differences between men and women, including sexually, there is a big difference between recognizing the difference, and claiming that women simply aren’t as sexual.[2] More accurate would be to state that what men and women find sexually appealing and arousing, how they react to such stimuli, and the levels at which they respond to such urges differ greatly – but do not take away from the inherent sexuality of women.

It is also a fallacy to say that the sole or primary benefit or reason that women engage in sex is for an emotional connection; rather, while some women do enjoy sex more because of the emotional connection, it is not a necessary component of their actual satisfaction or orgasm. In fact, the vagina – specifically the clitoris – has thousands more nerve endings than the penis, which means that its orgasm can be correspondingly much, much more intense than the male orgasm, and contradicts the belief of those men who are convinced that women don’t really ‘feel it.’ [3] (Not to mention that women are capable of different types of orgasm[4] [5] [6] [7] [8]and multiple orgasms.)

It is worth noting that, once sexually aroused, women have a much stronger need to orgasm than men do. If they are stimulated and left unsatisfied, it causes extreme emotional upset (and significant physical discomfort). Should this become a recurring pattern, where husbands reach climax but make no effort to ensure their wives’ satisfaction, women often end up angry and resistant to being sexually available.

Psychologist Haleh Banani mentions as well that women who are emotionally unsatisfied in their marriages yet are sexually fulfilled have higher rates of remaining within that marriage than the other way around. If that doesn’t underscore the point well enough, I don’t know what will.

The claim that women have fewer or less intense desires, or a somehow less important need for orgasm, is in fact an unhealthy way of minimizing female sexuality and its priority in a relationship. This takes place both amongst Muslims and non-Muslims and is a sign of how misogyny permeates our attitudes such that we automatically do not consider women to be of equal footing even in bed (and God help any woman who shows any sign of initiating sexual interest or contact!).

While the argument may go on to rage over who is ‘more’ sexual (keeping in mind that new studies continue to emerge on the topic, with sometimes paradoxical results), there is no benefit to be gained from pushing the view that women are simply less sexual beings.

In fact, it does the opposite, by telling men that they do not have to consider their wives’ sexual needs to be as important or necessary (the caveat that ‘a woman’s right to sexual satisfaction is guaranteed in Islam’ does nothing to change the final message). It is also implying to women that they should give up hope of true sexual satisfaction because it’s unrealistic and biologically unnecessary for them to experience it (but hey, all women really want are snuggles and warm fuzzy cuddles, right?).

It is high time that we begin to provide qualified individuals in the Muslim community who can discuss sex – and especially female sexuality – from a more nuanced and accurate perspective. Otherwise, Muslim leaders who take it upon themselves to talk about the subject are simply contributing to the already terrible state of Muslim intimacy, and the continued struggles of Muslim women seeking satisfaction and fulfillment in their own marriages.

What truly needs to be encouraged, emphasized, and taught is the importance of men and women alike to improve communication with their spouses about matters of intimacy. From there, it should become much easier for husbands and wives to become comfortable with their own and each others’ bodies; and for husbands to understand the various factors affecting women that may be significantly responsible for obstacles to sexual fulfillment. Just as men have their own unique preferences, levels of libido, and so on, so too are the tastes and desires of women varied and vast.

To truly seek an improvement to the sex lives of married Muslims, the first step should not be to make sweeping generalizations of female sexuality that are based on androcentric perspectives. Rather, it must be recognized that championing outdated ideas causes a great deal of harm to both men and women. A more nuanced and accurate understanding of female sexuality must be collectively pursued in order to see significant positive change in Muslim marriages.

Zainab Bint Younus (aka The Salafi Feminist) is a Canadian Muslimah who believes strongly in reclaiming the rights of women through the Shari’ah, and empowering ourselves through the Qur’an and Sunnah.

[1] Umm Salama (Allah be pleased with her) relates that Umm Sulaym (Allah be pleased with her) came to the Messenger of Allah (Allah bless him & give him peace) and said, “O Messenger of Allah, Surely, Allah is not shy of the truth. Is it necessary for a woman to take a ritual bath after she has a wet dream?” The Messenger of Allah (Allah bless him & give him peace) replied: “Yes, if she notices a discharge.” Umm Salama covered her face and asked, “O Messenger of Allah! Does a woman have a discharge?” He replied: “Yes, let your right hand be in dust [an Arabic expression said light-heartedly to someone whose statement you contradict], how does the son resemble his mother?” (Sahih al-Bukhari 130)
[2] http://www.theatlantic.com/sexes/archive/2013/06/turns-out-women-have-really-really-strong-sex-drives-can-men-handle-it/276598/
[3] http://www.science20.com/science_amp_supermodels/would_female_orgasms_kill_men
[4] http://www.independent.co.uk/news/science/women-do-experience-two-different-types-of-orgasm-study-reveals-9191884.html
[5] http://blogs.discovermagazine.com/seriouslyscience/2014/03/12/really-two-kinds-female-orgasm-science-weighs/#.VPYF33zF84c
[6] https://monicasbox.wordpress.com/2012/07/15/11-different-types-of-orgasms/
[7] http://www.womenshealthmag.com/sex-and-relationships/types-of-female-orgasm
[8] http://www.buzzfeed.com/alisoncaporimo/different-types-of-orgasms

Sep 162016

magnifying-glass-633057_1920One of HEART‘s activities is to help design research studies to collect data specific to Muslim communities. Our hope is to be able to have a deeper understanding of the reproductive needs of Muslim women in order to be able to offer:

  • more targeted and enhance programming
  • recommendations to medical professionals on how to make their services more culturally competent
  • recommendations and tips to Muslim women on how to effectively navigate health services and advocate for themselves

HEART, in collaboration with researchers at the University of Illinois at Chicago, is conducting a study to explore the knowledge of Muslim women on reproductive health, and their perceptions and experiences of visiting a physician or women’s health care provider for reproductive care services. If you are a Muslim woman who lives in the United States, and are between the ages of 18 and 45, please participate in this study today by filling out a brief anonymous survey that should take 5-10 minutes of your time.

Take the survey today!

Jun 242016

originally published on patheos.com

By Sameera Qureshi

Woman hygiene protection, close-up“Raise your hand if you’ve ever faked fasting when you’re on your period.”

I posed the question and then looked around the room of 25 seventh grade girls and saw that 80 percent of them had their hands raised. Some were looking directly at me, perhaps hoping that I’d understand why, while others had their gazes directed down towards the floor.

I was not shocked by the results of this particular group or the many others I’ve run on sexual health education with Muslim girls and women. There is a great amount of shame and stigma around many topics related to sexual health, especially that of menstruation. For something that has been endowed to girls and women as a blessing — the ability to create and sustain life within our own bodies — it’s shocking how often this topic is shunned from discussion circles within our communities and not to mention in our homes.

Speaking from my own experiences, growing up as an only female sibling with two brothers, I too have been guilty of acting shamefully during menstruation. To use the term shamefully is to mean that someone looks down upon themselves as lesser than, unworthy, and even dirty for menstruating. For many years during my menstrual cycle, I would wake up for suhoor (the pre-dawn meal) and fajr prayer, pretend to pray and breakfast with my family — despite the fact that I was absolved from fasting due to my period.

There were times when my mom would vouch for me not being at the suhoor table by saying that I was sick or had a headache. I’d go to the basement to eat food during the day. As an adult, I’d head out of the house to eat while running errands or at work. While some of these practices may be seen as maintaining modesty during menstruation, they were all done under the auspices of shame rather than empowered decision making.

Had I known that menstruation is empowering, indicative of a new spiritual layer as an adult from an Islamic perspective, and that there were many ways to still connect with God — my experiences would have been quite different. I could have chosen to act differently than in the shameful fake-fasting way.
During the girls group, we dove into the religious perspectives of menstruation — namely, the rights that have been given to women during their monthly cycle. Girls and women who are menstruating are absolved of the obligation to pray and fast. What many girls especially don’t understand is that they can and should continue to worship in other ways during their menstrual cycle.

Generally speaking, when girls are taught about menstruation (typically from family members or friends), the “do’s and don’ts” are emphasized more so than “here are your other options.” Having spoken with and taught many teenage girls, it would be safe to say that a vast majority of them feel uncomfortable approaching their mothers and families members about menstruation.

If this topic is not spoken about or broached by parents, it is unfair to expect that girls will initiate the conversation themselves. Parents not talking about a subject often implies that it’s not to be spoken about. And thus, many of these girls learn by osmosis through their peers, the Internet or trial and error about physical, emotional and spiritual self-care during their menstrual cycle.

However, this information is not always accurate nor complete, to say the least. Nor does it afford them the opportunity to ask questions after they have digested the information.

Menstruation is not only physical in nature, despite this aspect being focused upon the most — it has a spiritual and emotional dimension as well. Girls and women need to learn self-care strategies around all three aspects of menstruation, especially during Ramadan, the holiest month of the year.

Body image, self-worth and having a healthy sexual identity are impacted by how a girl understands menstruation. Understanding one’s monthly cycle is empowering and leads girls and women to feel as though they are in control. This can trickle over to additional areas of sexual health self-care — understanding the importance of regular gynecological check-ups, seeking information about safe and healthy intimacy, exploring the concept of healthy relationships and so forth.

If young girls do not feel empowered or confident enough to seek information about a normal biological cycle in their body, it will be challenging for them to reach out in other realms of sexual health.

Not to mention, many Muslim women suffer silently from menstrual and/or sexual dysfunction and aren’t quite sure who to turn to for support. If we empower girls from a young age and arm them with a plethora of information and resources, we are creating pathways that makes it more than permissible to discuss any sexual health related matter with trusted adults.

The shame that girls and women feel around menstruation is not solely limited to this segment of sexual health. Speaking of sexual health, our communities are in a dire state on this topic. Apart from menstruation, we also don’t speak about sexual violence, creating safe and inclusive spaces for LGBTQ community members, what healthy relationships consist of, consent-based education and ensuring that our institutions and mosques have policies and protocols in place to protect survivors and hold perpetrators accountable.

While it is not incumbent on us to all be doing this work at the community level, it is our responsibility to become educated on these topics and at least practice creating safe spaces within our own family and friends circle. This includes men as well as women.

It’s time that both men and women place aside any shame related to menstruation and sexual health topics. Our faith tradition is rich in stories about honest and detailed questions that Muslims would ask of the Prophet (peace and blessings be upon him). We’ve definitely lost this within our own communities, and our faith tradition has been overshadowed by cultural stigma and shame.

So let’s use this Ramadan to become empowered to seek sexual health information as a means to enhance our spiritual, physical and emotional well being. Let’s not fake fasting anymore.

Sameera Qureshi is the Director of Education, Canada for HEART Women & Girls. For the last several years she led sexual health and sexual assault awareness programming for the Muslim community in Calgary and other Canadian communities. Most recently, she has moved to Washington, DC, where she hopes to continue similar programming.

Jun 242016

by Amber Khan

beads-1234666_1920Every woman remembers her first period.  It is a fateful moment as it signifies the transition from girl to woman.

For some, they are prepared for this moment.  They are even looking forward to it.  And when that day arrives, they are eager to share the news with their mothers, as they know it will be met with praise and excitement.

For others, it may be one of the scariest and most confusing times in their life.  They were never aware of this unavoidable development.  And when it arrives, they are lost as to what it means and who to tell.

As two women recounted from their childhood:

“I woke up and was covered in blood.  My clothes, my sheets, my mattress – all stained.  I screamed.  I thought I was dying.  I have never seen so much blood in my life.”

“I was playing outside, running around with my sisters.  When I came inside I saw bloodstains all over my pants.  But I never fell or got hurt – I didn’t understand where it was coming from.”

Undoubtedly, approaching this topic with our children can be challenging. For some parents, they have successfully found a balance between education and sensitivity.  However, for many others, they struggle.  The idea of celebrating this event contradicts their religious and cultural understandings of menstruation.  They prefer, instead, to shy away from the topic altogether, leaving their daughters alone and in the dark.

But one mustn’t stress over the perplexity of this situation.   We are blessed to have the example of the Prophet (peace and blessings be upon him) to show us how to do it right.

Umayyah bint Qays (may Allah be pleased with her) was a young girl who had not yet reached puberty.  She joined the Muslim army on its way to Khaybar. The Prophet (pbuh) had her sit on his she-camel, just behind his luggage and they rode for some time. When they stopped, Rasul Allah (pbuh) descended and had his camel kneel down, whereupon Umayyah got off as well. To her mortification, she noticed that the luggage she’d been sitting on was smeared with blood – her first period.

Umayyah sat back on the bag, leaning forward to try and hide the bloodstain.

Rasul Allah (pbuh) noticed both her actions and the bloodstain and said gently, “Perhaps this is menstrual blood?” Umayyah nodded in confirmation and Rasul Allah (pbuh) suggested kindly, “Attend to yourself, then take some water, put some salt in it and wash the bag, then return.”

Umayyah followed his instructions and was once again seated upon Rasul Allah’s camel.

After the Muslims were victorious at Khaybar, Rasul Allah (pbuh) chose a necklace from amongst the spoils of war and summoned Umayyah.  He placed it around her neck with his own hands. She wore that necklace until she died.
(Al-Muhaddithat; al-Tabaqat al-Kubra by Ibn Sa’d.  Nadwi, M. K. 2007. Al-Muhadithaat: The Women Scholars in Islam. London and Oxford: Interface Publications, pp. 59).

Certainly, the lessons behind this tradition are astoundingly beautiful.

    1. Despite that it was her first period, Umayyah knew where this bleeding was from, revealing that she was taught such knowledge prior to her menstruation.
    2. Shyness is a natural quality to the reproductive process. Umayyah tried to hide the stains, however, her shyness did not prevent her from learning and obeying the Prophet’s (pbuh) teachings.
    3. The Prophet’s (pbuh) reaction to the situation displayed both proper knowledge and delicacy when dealing with an impressionable, young girl.
    4. The Prophet (pbuh) recognized the significance of menarche and therefore he presented her with a special token to symbolize the mark of this occasion.

We can also learn what he (pbuh) did not do to Umayyah

  1. Ignore the situation out of her (or his) embarrassment
  2. Shame her for what had happened to the luggage.
  3. Find a woman to deal with the situation.
  4. Downplay or ignore the pivotal moment of menarche.

Sister Umayyah’s necklace, which she wore everyday until her death, was a constant reminder of that day, of that moment.  She felt proud to wear it around her neck for others to see.

How many of us can say we are proud of our menarche?  That we would want to be reminded of it?  Or do we think of it like the damaged luggage bag – ruined with attempts to hide it?

For many parents who did not grow up with a positive menstrual experience struggle with breaking that cycle for their own daughters.  Surely, it requires them to step out of their comfort zone full of cultural and social stigmas.  But if done correctly, it will leave their daughters as Umayyah was left – confident and educated in her body and her inner self.

As one similar young woman recounts:

“I was in school and had to the go to the bathroom.  It was there where I saw traces of blood.  I smiled.  My mom said this day would be coming and it finally happened. I couldn’t wait to tell her.  When I finally got home, I shared every detail.  She hugged me and said, ‘This is a special day for you and me.’  It was one of the happiest days of my life.  I felt like my mom.  I felt like a woman.”

Here are five tips on how to promote openness and gentle conversations with our daughters about menstruation:

  1. Start “the talk” early.  Waiting until your daughter has her first period is too late.  Prepare her for what’s coming so she’s not alarmed.
  2. Encourage honesty with privacy.  It’s common for parents to teach our daughters to lie about when they’re menstruating to protect their male relatives’ discomfort.  This not only encourages sinning but also enforces a negative stigma to a natural event.  Rather, brainstorm together ways on how to honestly yet privately disclose to others’ inquiries about why they aren’t fasting or praying.
  3. Teach sons about menstruation. Menstruation may directly affect females but it has an Islamic impact on males as well. Therefore, talking to your sons about menstruation will have a positive influence on all their relationships in life – as brothers, sons, husbands, and fathers.
  4. Talk less, listen more.  Puberty can be a very confusing time for any child.  Giving them a platform to share their thoughts without hearing a lecture or feeling judged will not only make them share with you more but also feel comfortable to come to you first over other sources.
  5. Don’t shy away from education. Shyness has its place.  It is our natural disposition to feel shy when near transgression.  However, it is unnatural if it prevents one from learning a topic, no matter how sensitive, that will benefit us.   Therefore, be the example to your child and proactively seek knowledge about such sensitive matters for your own education as well as to better explain it to your offspring.

Amber Khan is a trained physician and Director of Education – US for HEART Women & Girls. She lives with her husband and children in Michigan.

Jun 242016

By Nadiah Mohajir

two girls black silhouette and red sunsetLast week, The New York Times published a Mona Eltahawy article with a sexy headline: Sex Talk for Muslim Women. The article chronicled the author’s journey to sexual freedom: growing up in a conservative household, Ms. Eltahawy always knew that sex outside of marriage was not an option, but the older she grew, the more of this vow of abstinence began to feel like a burden. After years of struggling with the guilt and shame that accompanies many women who have sex outside of marriage, Eltahawy says she now enjoys her sexual liberation.

Mona’s story is not unfamiliar to me. I have heard countless stories of women – young and old – who find that their vow of abstinence has shifted from a spiritually motivated choice to a decision laden heavy with resentment. I fully understand and empathize with their sexual frustration. Read more…

Jun 242016

by Shannon Staloch

pregnancy-466129I’m always turning off lights at births.  Sometimes, it’s comical. I’ll walk in to check on the mom, and the lights will be on, lamps, overhead lights, etc. As I leave, I shut them all off with the exception of a candle or two, or a soft lamp.  An hour or so later, I come back to check, once again, lights are blaring. Again, I leave under the cover of night.  It might seem a silly thing for a midwife to focus on, but in fact, it’s essential to the hormones of labor.

Oxytocin is the queen of labor hormones. It is secreted in the posterior pituitary gland. Due to the role it plays in orgasm, birth and breastfeeding, oxytocin is often referred to as the love hormone. During orgasm, it is released and contributes to the bonding that occurs between partners after orgasm. In birth, it is the hormone that causes the uterus to contract in a strong and rhythmic fashion.  In breastfeeding it causes the milk to eject from the milk ducts.  These three acts are all acts by their nature, deeply imbued with love, hence the love hormone.

Ina May Gaskin, the famous American midwife, is famous for saying that if a woman doesn’t look beautiful in labor, someone is doing something wrong.  Indeed, the women I attend in labor glow.  To get through a natural labor, a woman must moan, sway her hips, and go deep inside. Many parallels then, can be drawn between sex and birth. Hence, why I am always turning the lights down, it is my attempt to render an intimate and cozy environment, an environment akin to sexual intimacy. Oxytocin is also produced in greater quantities in the dark, when it’s warm, and with familiar people. Some doctors and nurses, recognizing this fact, will also turn down lights and whisper when in a laboring woman’s room.

My midwifery practice is culturally, racially and religiously diverse.  It is more often (not always!) with my Muslim clients that I often see a lack of sexual health and knowledge. Sadly, it seems that in many Muslim homes, young girls are not properly educated about their bodies, nor are they taught to revel in them or celebrate their strength. The link between sexuality and birth begins early in life. It begins with educating young girls about the functions and anatomies of their bodies.  Time and again, I have conversations with women about their menstrual cycle, and am frequently left jaw agape at the utter lack of knowledge of this simple function of a women’s body. Women with college degrees, born and raised in affluent California, have no idea that they are fertile for a short time every month and that there are clear signs from their bodies, heralding that fertility.

Not only that, the lack of conversation, curiosity and knowledge about the female body and its’ functions, seems to convey a sense of shame and embarrassment at the body itself. Recently, I visited one of my clients who had had a C-section. She was just a few days postpartum, and over the phone, had expressed concerns about her baby’s breastfeeding. I am a board certified lactation consultant. I know that mothers with C-sections often have difficulties in establishing breastfeeding and time is of the essence in getting breastfeeding straightened out. When I came to visit, her shirt was buttoned to the top button and she refused to let me observe a breastfeeding session. The baby was obviously hungry, but the shame was so intense that she went against her motherly instincts in order not to expose herself.

In contrast, I recently attended the birth of a fifth time mother. During labor, she was free to move around and change positions. She moaned softly with each contraction, and her face was soft and flushed. Her husband was by her side, holding her hand, supporting her squatting, giving her a back massage, and offering her sips of water throughout the entire labor. She would occasionally look up at him and ask for a kiss. The room was dimly lit, familiar to her, and warm. The baby was born easily and smoothly not long after I arrived. Once she and baby were checked out, I tucked her in and watched as the baby found the nipple all by itself. Her older kids were anxiously waiting outside the door, and even though some of the boys were teenagers, she felt comfortable allowing them in to witness the normalcy and the brilliance of the reproductive functions of the female body.

Birth is linked to sexual health. The more a woman can get in touch with her sexuality and cultivate a positive attitude towards her sexual health, the easier it will be to accept the grand bodily changes of pregnancy, the intensity and physicality of the birth, and to then nurture and nourish her baby through breastfeeding.  Below are six ways to improve your sexual health, and therefore improve your chances of a healthy birth.

    1. Become aware of your pregnant body.  The pregnant body is a thing of wonder, constantly changing, growing, expanding, all the while, growing another life. It’s easy to wax poetic about it. It’s also easy to feel uncomfortable while living inside it. For some women, the burgeoning belly is an announcement of their sex life, and they aren’t comfortable with that.  Because there is so much in the body that calls our attention during pregnancy, it’s an opportune time to get in touch with your body, if you aren’t already in the habit. To the best of your ability, embrace the changes your body is undergoing. Take the time each day to stretch, move, swim, and just marvel at the wonder of your body.
    2. Pay attention to your sexuality.  Does your desire increase or decrease during pregnancy? Because of the changes that occur during pregnancy, many women find arousal and desire increased during this time.  And many don’t!  Where do you fall on that scale?  Are there ways to express your sexuality other than intercourse?  Simply becoming aware of your desire is a huge step in connecting to your sexuality.
    3. Think about the messaging. What messages have you been given about your female body?  When you first menstruated, was it celebrated or shunned?  Were you told to pretend you weren’t on your menstrual cycle?  Were you taught it was dirty?  Or were you lovingly guided to embrace and accept the changes of adolescence?  Although it may not seem like it, these messages can have an impact on your birthing and breastfeeding. Journal some things that stand out, and if necessary, reframe the messaging.
    4. Move your hips! It is said that belly dancing originated in the Arabian Peninsula during births.  Women would surround the birthing women and move and sway their hips rhythmically, in order to show the birthing women how to move through her contractions.  Getting comfortable with this sensual movement is indeed helpful during the pain of labor contractions.  Circling the hips releases tension, and helps to send the contractions straight to the cervix, right where they need to be in order for labor to progress!
    5. Get the straight talk on vaginal exams.  For many women, the thought of vaginal exams makes them squeeze their knees together.  Talk with your doctor or midwife before hand about how you would like them performed, if at all!  Vaginal exams are not always necessary and can be triggering for women who have had unsolicited sexual experiences in the past.  They can also be uncomfortable.  You can request that your provider go slow, allow you to breathe and center yourself before the exam, and talk you through each step.  Prenatally, you can ask your provider under what circumstances exams are necessary.
    6. Baring it all.  You’ve made it through the birth, but now there’s all this breastfeeding! In the West, we live in a society that has sexualized breasts.  I traveled to Senegal when my oldest was a baby.  Even if they were covered head to toe, I was surprised at how easily women breastfed in public. These women weren’t worried about whether or not a square inch of their breast might be exposed; they were more concerned with taking care of their babies needs. Indeed, walking the streets of Senegal, I rarely heard a baby cry despite there being babies everywhere!  Think of ways in which breastfeeding, possibly needing to show your nipples and breasts to a healthcare professional, might affect you.  If it seems difficult, brainstorm ways in which you can get comfortable with this function of the female anatomy.

Female sexuality and healthy birth are linked in a complex and intricate manner; there cannot be one without the other. Let’s stop shunning the relationship between the two and strengthening its connection. The future of birth and babies depends on it.

Shannon Staloch is a mother of three. She has been serving families in the Bay Area as a licensed midwife and lactation consultant for nearly a decade. She also supports families through workshops in holistic health and nutrition. Her website is www.homemadefamilies.com.

May 042016

By Nadiah Mohajir and Hannah El-Amin

Breast pump and bottle of milk on the windowsillTo breast feed or bottle feed? Perhaps one of the most emotional – external and internal – dilemmas facing new mothers these days. Every few decades, new research comes out promoting the benefits of one or the other. I was born to a generation of mothers who were told that bottle feeding was superior to breast feeding, while my daughters were born to a generation of mothers who were told the opposite: that breast is best. In fact, we now live in a time during which workplaces, public spaces, and society in general are being encouraged to not only embrace breastfeeding, but enable and make it accessible and easier for all mothers who want to commit to the practice.

While there is always room for improvement for breastfeeding to be even more accessible and acceptable, it is hard to deny that it’s a great time for breastfeeding moms. One cannot also deny the benefits of breastfeeding: research shows that babies who are breastfed have greater immunity, decreased risk of obesity, increased IQ scores, along with benefits to the mother with decreased rates of certain cancers. Additionally, breastfeeding is highly encouraged in Islam and has spiritual and religious benefits as well. It is indeed true, breast is best. But what many breastfeeding advocates forget to add to that well known slogan, is that breast may only be best, under ideal circumstances. In other words, is breast really best if it comes at the expense of mom’s mental health? Moreover, has breastfeeding become the standard for what defines a “good mother?”

Despite the increased accommodations many work and public places are making for breastfeeding moms, keeping up with pumping can be exhausting. Add in work and home obligations, other older children the mother may have in addition to the baby, sleep deprivation, unsolicited advice from others implying that the baby is not getting enough, and anxiety and depression, not being able to keep up with breastfeeding often adds to a mother’s feelings of inadequacy, and pushing moms to great lengths to keep up with what is “best” for their baby. What results, more often than not, is that mothers – who already have this enormous responsibility to love and care and raise their baby to the best of their ability – conflate the pressure with keeping up with breastfeeding to being a good mother.

Motherhood and all that comes with it is not meant to be easy. Yet, doctors are seeing too frequently mothers who are coming in not only sleep deprived, but those dealing with chronic nipple pain, around the clock pumping, and severe anxiety and depression. A number of women have shared with me – both in my personal capacity and professional capacity – the guilt they are carrying with them when they realize their bodies (and sanity) can literally not sustain breastfeeding. Many have shared that they question the return on investment – despite continuous pumping, their bodies are not producing enough to sustain their baby. As told in this article, many also shared their regrets: that perhaps the hours spent pumping may have been better spent bonding or playing with their babies.

And so it is important to consider the following question: While breast is indeed best, does this theory consider the realities of being a new mother, especially if the mother is juggling multiple obligations such as work, home, and other children? My experiences with breastfeeding were different with each of  my children:

  • My oldest was born when I was just 23. I left my job and focused on being a mom. I exclusively breastfed her for a whole year. She hated breast milk through a bottle.
  • My second was born four years later, as I was finishing up graduate school. I began breastfeeding her and bottle feeding her breast milk. She went back and forth from bottle to breast beautifully, with no issues. Yet, we quickly discovered she had a milk allergy, and so her pediatricians gave me two options: special formula, or eliminating dairy from my diet. I decided to introduce her to the formula to get her used to the taste, while eliminating dairy from my diet. That dairy-free diet resulted in me losing so much weight I was under 100 pounds and had no energy by the time she was 6 months old, due to the dairy-free diet and my excessive pumping. I eventually gave in and switched her to formula full time.
  • My third was born when I was 31. He had horrible acid reflux and therefore cried most nights, and I had two older children in two different schools therefore was spending a lot of time in city traffic, and was also working close to full time. He was on breastmilk and formula from the beginning, and weaned himself when he was close to six months.

While anecdotal, these experiences demonstrate that it’s important to consider the unique circumstances with with each baby. It is no surprise that what I was able to offer at 23 as a stay at home mom was different than when I was older and had additional responsibilities. Often times, when mothers come to me and share their guilt of not being able to keep up with  breastfeeding, I encourage them to reflect on the following questions:

  • What are the other obligations I am juggling along with breastfeeding (work, other children, housework, volunteer obligations, family obligations etc)
  • Is my baby loved? Is my baby safe and happy and healthy? Am I bonding with my baby in other ways?
  • Is keeping up with breastfeeding/pumping interfering with my physical and mental health?
  • Is keeping up with breastfeeding/pumping interfering with my baby’s physical health (not gaining enough weight, etc)
  • Is keeping up with breastfeeding/pumping interfering with  my ability to meet the needs of my other loved ones, such as my husband or other children?

Many times, the answers to these questions lead to the mother asking: is breastfeeding worth it? The science is clear: the benefits of breastfeeding are incredible and doctors and public health campaigns should definitely promote it to increase the numbers of breastfeeding moms. Yet, it’s important to also remember that often times, these messages are promoted in such a way that breastfeeding becomes synonymous with good mothering. And while there are many benefits to breastfeeding, the most important one being nutrition, let’s remember that at the end of the day, nutrition is just one aspect of good mothering, and there are many options available to nourish an infant and many ways to bond. It’s important for health care providers, nutritionists, lactation consultants and mothers to work together to find the balance that is best for the baby – and mom – at hand.

Finally, if you find yourself struggling, but want to keep with the goal of breastfeeding exclusively, consider these:

  • Know you’re not alone. Find a friend you can talk to who’s been there or local or online parent support group.
  • Find a way to break free for a bit. Even if it’s just going out for a walk, especially early on when feeding demands are highest.
  • Make feedings pleasant. Indulge in a show. Keep some treats nearby. Light a candle. Put your feet up. Listen to audiobooks or music.
  • Take care of yourself first. It’s ok to let you little one wait a couple minutes while you finish eating. Nourishing yourself means nourishing him/her.
  • A little help can go a long way. Consult with a lactation consultant if you have ANY discomfort. Breastfeeding isn’t supposed to hurt. Insurance often covers this.
  • Treat yourself. You’re saving a ton by nursing. Treat yourself to that hands free pump, or something totally unrelated to nursing. Pumping can be passive and less stressful with products like Milkies, Freemie and other cool gadgets.
  • Be proud. Know that you should feel nothing but pride for whatever amount of breastfeeding you’re able to accomplish. You’re doing a great job. Know that you can choose to ignore and advice or criticism that doesn’t come from a professional.
May 042016

By Anonymous

For the past few years, I have struggled with pain associated with vaginal intercourse. I visited doctors but none could provide me with the answers I was looking for. “Have more sex, it’ll open up…it is supposed to hurt…try different angles.” The advice was never helpful and only reinforced my worry that there was something wrong with me. I was unable to find help or an escape, but I wasn’t necessarily looking for one. I was content not having my vaginal issues resolved because I wasn’t in a hurry to have children. I was able to enjoy other sexual activities and had a patient and loving partner. I knew I would have to figure it out eventually and waited until I had the emotional and financial capacity to dig deeper for the answers I was looking for.

A few weeks ago I visited a new doctor. She had me hold a mirror as she took a look down there and pointed out the problem. “Now sit still, does that hurt? Hmm have you ever touched yourself before, you are pretty fidgety. Oh there it is – I see what the problem is. Can you see that – you have two tiny holes instead of one big one.” A septate hymen. Clear and visible to me and the doctor – a nostril in my vagina.

As the doctor typed on her computer, I sat uncomfortably still trying to process what she was saying. “We’ll need to see what’s going on through an MRI and given how difficult it is for you to be touched, we’ll have to knock you out for the procedure.” I nodded in agreement. There was no way in hell I wanted to be awake for this.

My doctor recommended me for physical therapy. The physical therapist took me in at around 8:20am. She had me walk, sit, lay down, move around until the big reveal moment when she herself poked around. I was watching her face as she observed my pelvic muscles and knew in an instant that this was complicated. I asked her what was wrong and to just tell me what she thinks honestly. “Honestly, my patients with just a septate hymen do not react like this. My patients with vaginismus do. Go through with the surgery and then talk to your doctor. We may have to bring you back for regular sessions. In the meantime, here’s a list of exercises I want you to do twice a day.” I thanked her and walked out.

As the weeks passed, I visited the hospital for various appointments. Each time I got back to my car, I sat in silence taking deep breathes, then drove to work in tears while jamming to Adele on blast to get all my emotions out of my system. You see, you can’t talk vag in the office. Sure, you can talk about how you caught a cold, or need to get a root canal – that’s all work appropriate. But to bring up your vag problems is awkward to discuss with anyone really.

Being that I’ve been married for a few years, I often get asked if I want to have children or if I am planning to have kids soon. You can plan all you want, but the reality is that nothing is in your hands. Even after all the treatment, surgeries, therapy and healing – Will I be able to have kids? Will I be able to experience vaginal intercourse without the pain? Only Allah knows. All I know is that this is so freaking hard and I can only try my best. I am exhausted and emotionally drained and want it all to be over. I want to not have to worry about missing work for my medical appointments or budget a portion of my salary for medical expenses. I want to not have to hold back tears whenever anyone asks me if I like kids. I want to let myself be vulnerable with the ones I love and not have to show that I have everything under control. I can’t wait for the day when I can finally be excited about the possibility of being pregnant. About the possibility of painless sex! And surprise my patient partner with the news of our own little one. I want a lot of things in life. But I’ll make do with what I have for right now. My story, this space to share it and your duaas, iA.

The author of this post has chosen to remain anonymous.