When Things Don't Go To Plan

featuring entrepreneur & outdoorswoman Alexandra Gabrielle

brought to you by femtasy

Any of us who love going outdoors are comfortable with being prepared in the face of the unexpected. Alexandra Gabrielle, an entrepreneur and outdoorswoman, is certainly no exception. And when something unexpected happened this past winter-- an unplanned pregnancy-- Alex was put to the test in navigating unknowns to determine what was going to be best for her and her body. Not once-- but many times throughout the process.

Alex wanted to have this conversation because, frankly, we don’t talk about preparedness enough with it comes to sex. Not the way we do when it comes to safety outdoors. And the reality is that you can be completely prepared and still encounter times when things just don’t go to plan. But knowing the potential risks and options well in advance can always help you to make better, less-stressful, more informed decisions. 

We know these lessons from being out in nature-- but we rarely apply this logic to our bodies.

Alex is sharing her story with the hope that we all begin to seek out more information from our bodies when possible, and ask our medical systems to do the same.. so that no matter where we are-- the backcountry, the couch, or somewhere in between-- that we show up feeling more ready for whatever comes our way.

A note that this episode covers discussion of unplanned pregnancy and abortion.

Featured in this Episode:

Alexandra Gabrielle

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Hosted by Laura Borichevsky.
Cover artwork by Hailey Hirst.
Music by The Wild Wild, UTAH, and Vesky, licensed via MusicBed.

TRANSCRIPT

Note: This transcript was lightly edited and created using a transcription service. As such it may contain spelling errors.

Laura Borichevsky (narration):

Just a quick head’s up before we dive in: this episode contains conversation detailing unplanned pregnancy and abortion. Okay, here’s the show.

Alexandra Gabrielle:

There's so many things that you put yourself into when you are kind of more of an outdoorsy person that having these kinds of medical issues going on, that you don't know about due to complications from procedure, can be scary.

Laura Borichevsky (narration):

That’s Alexandra Gabrielle. She’s many things-- an entrepreneur, an outdoorswoman, an often-solo traveler, and someone who’s pretty comfortable talking about sex. So on many fronts, she’s used to tackling logistics, getting organized… being prepared in the face of the unexpected. Which is how I’ve always known Alex, in fact: as someone who is grounded and well-thought out. It’s a part of how she shows up in the outdoors and in her community.

And it’s how she showed up in this conversation, too. Because when something unexpected happened this past winter-- an unplanned pregnancy-- Alex, again, was put to the test in navigating unknowns to determine what was going to be best for her and her body. Not once-- but many times throughout the process. And in some ways, it seems like this became more than strictly a personal or medical journey for Alex. Because the reality is that so many of those unknowns came about from a void of information, even for someone who is as curious about and prepared to manage her sexual health as Alex. And--- let’s be honest-- when you don’t have all of the facts, or the system itself is working against you-- it’s challenging to be prepared. Which leads to even more unknowns, more anxiety, more feeling like you were underprepared when in fact-- you did everything you could with the information you had access to at the time.

Alexandra Gabrielle:

Thinking about the number of times in situations I had been in… I had gone to Arches and hiked like a couple of days prior to that. And I remember being short of breath, hiking up there, and the person I was hiking with, we kept stopping and they were like, “You're okay.” And I'm like, “Whatever, it's my asthma acting up.” Even though it felt nothing like asthma-- I was not having an asthma attack, but dude, if I would have fallen at Delicate Arch and fallen into the bowl. If I would have fallen on a hike up there, Search and Rescue would have had to come get me from that situation. Like it could have been a lot worse than it was.

Laura Borichevsky (narration):

Alex wanted to have this conversation because, frankly, we don’t talk about preparedness enough with it comes to sex. Not the way we do when it comes to safety outdoors. And being prepared with our sexual health goes far beyond contraception. The reality is that you can be completely prepared and still encounter times when things just don’t go to plan. But knowing the potential risks and options well in advance can always help you to make better, less-stressful, more informed decisions. 

We know these lessons from being out in nature-- but we rarely apply this logic to our bodies.

And-- here’s the thing-- unlike the outdoors, there are *so* many details about sexual health that we don’t have basic access to, have been told is inappropriate to talk about, or have been left to believe is standardized when we are in fact is so unique to each of us as individuals.

Alex is sharing her story with the hope that we all begin to seek out more information from our bodies when possible, and ask our medical systems to do the same.. so that no matter where we are-- the backcountry, the couch, or somewhere in between-- that we show up feeling more ready for whatever comes our way.

So, let’s get to it. I’m Laura Borichevsky, and this is Sex Outside.

Alexandra Gabrielle:

I want to plan for going outdoors and going on trips, but my body and like what I'm doing is sort of like, I want to be more cautious about and making sure I can be prepared with it.

Laura Borichevsky (narration):

Alex uses a cycle tracking app as well as an app to document her sexual encounters. It’s a part of her birth control method so that she can stay more in tune with her menstrual cycle, know when she’s likely to be ovulating, and keep a record of any sexual partners she’d had. 

Alexandra Gabrielle:

So I had met somebody on an online dating site. We kind of clicked and decided to meet up. I normally track my periods through my cycle app on my phone. And I had been up at that point, but I didn't track till after we had our sexual encounter. And I went to a log the new sexual partner, and I noticed that I was ovulating. So right then there, I was like, “Oh crap. I might've just put myself in a bad situation.” You have to give it a little bit of time before you actually find out. So I waited two or three weeks-- to whatever my next cycle was. And of course I missed my period. I got an early detection pregnancy test and it confirmed my suspicions.

Laura Borichevsky (narration):

It’s not uncommon for many folks who menstruate to be unaware of their body’s general cycle-- let alone when they may be ovulating. And although an online search or a quick look at an infographic might lead you to believe that every person’s menstrual cycle is the same length, that’s not true at all. Which is exactly why apps and other record keeping to track menstruation are a useful part of birth control for those who are trying to avoid pregnancy. In addition to identifying when your body might be ovulating, it also can help to determine more readily if your body’s cycle is off its regular schedule-- which could be a sign of many things, like stress or another form of a hormonal redistribution or imbalance-- or it could be an early indicator of pregnancy, like it was for Alex.

Alexandra Gabrielle:

I'm not in the position right now where I want to have kids. And birth control is really expensive. I'm on birth control on and off, but I've also had a lot of side effects with birth control. So I figured this was the best way to do it, was stay on the pill and also track my periods. And it just helps to know too, if something weird is going on in my body, if it's not pregnancy related. So tracking my ovulation and logging my periods and sex partners is just, I think, an important part of being a healthy, sexually active adult.

Laura Borichevsky:

Well, and I know like part of the theme for this like conversation that when we first talked about this as an episode, that's like revolving around this conversation and your story and perspectives is like being prepared and how oftentimes we take, you know, people who like to go outside, for instance, love to take seriously making sure they’re prepared to the best extent possible-- like knowing where you're going and having the proper gear, trying to think ahead for all these things. And oftentimes we don't mirror that same behavior in our sex lives. And so like, it's cool to hear the different tools that you have at your disposal and that we all could have our disposal to lean on, or even know about.

Alexandra Gabrielle:

Absolutely. And especially with pregnancies knowing earlier on makes the process a little bit easier. There's Plan B there's the R4 pill, I think that's what it's called, that you can get from Planned Parenthood or a physician that is like a Plan B, but is the in-between of like full abortion phase and then contraception phase. So knowing in advance just generally helps out with a lot of things. So I try to plan and I try to be proactive, especially with sexual health. I want to plan for going outdoors and going on trips, but my body and like what I'm doing I want to be even more cautious about making sure I can be prepared with it. Like you said. Yeah. The prep for outdoor activities and just being responsible to make sure that you're not putting yourself in a bad situation.

It's something that you should be doing with your sexual health as much as possible. Not everybody has the same opportunities and abilities to do that. But if you can, a little thing, like an app of just logging, when you start a period logging app, it's super simple like when you have a new sexual partner, if you used protection, if you didn't use protection, because I forget, like I look back at the years and I was like… “Was that?... Okay, that was the one that happened.” They just forget that things happen. That it's just nice to have like a little sex journal along with a life journal with every other thing.

Laura Borichevsky (narration):

After Alex received confirmation of her pregnancy, she came to the decision that she needed to have an abortion. One of the things many of us lean on, or aspire to lean on, to feel prepared is medical insurance. And while the right plan can provide support for many different things, abortion is one that gets wildly complicated right from the beginning and is often not covered, even though it’s a medical procedure-- one that we consider essential to have access to.

Alexandra Gabrielle:

I was employed at the time and had really good insurance, but I live in the state of Utah, which I think it's the state to state thing. It also can be the package that your employers purchase. There's a lot of different factors of what is covered with your insurance and what is not. And I thought I'd be good. I went through like, “Okay, great. I can go get this taken care of right away” the second that I got that confirmation from the pregnancy test. And then I found out that my insurance did not cover abortions unless it was for a medical reason. So had this great insurance, but didn't do anything for me.

Laura Borichevsky (narration):

To Alex’s point about health care and abortion coverage-- she’s right, there are a lot of factors that go into whether abortion in the United States is covered or not, even if you have really great health insurance. Firstly are state laws, which vary widely when it comes to whether abortion is considered legal at various points and undoubtedly impact both private employers’ decisions around their plan options and selections. While abortion itself is not federally illegal or banned thanks to the 1973 Supreme Court decision in Roe v Wade, the Hyde Act which was passed in 1977 states that federal money can’t go toward abortion services-- thus, in over half the US states, tax credits from Medicaid and the Affordable Care Act (known informally as ObamaCare or the Marketplace) are considered to be a part of that... which means that in those states, there are few exceptions where abortions would be covered. Currently, only 10 US states have opted to utilize state funds to pay for abortion-related services in public programs like the Marketplace and Medicaid. Which ultimately means that a whole lot of these services are being paid for out of pocket in some way, or not happening at all.

And if you’re scratching your head listening to all of this-- that’s very reasonable. The reality is that there is a *lot* of confusion around whether abortion is covered in various health care plans and to what extent it’s covered from state to state. And because most people don’t plan on getting an abortion to begin with, it’s rarely something that’s asked about or researched proactively, especially if you have a plan that already covers your other basic health care needs. 

So-- back to Alex. Even with cost and insurance hurdles in front of her, she *was* able to follow through with the abortion as planned… though accessing the service itself turned out to be another challenge.

Alexandra Gabrielle:

I ended up going with the pill option-- Misoprostol or something like that. It's a combination of two pills over the medical procedure abortion. And that still was almost $600. I think for the pill, just to get two pills to do this on top of the ultrasound, if you go with Planned Parenthood, most of the time, they don't charge you for the other things that they do beforehand, a urine and a blood pregnancy test and the ultrasound test as well. But the pill itself is really expensive if you're a self-pay and not everybody has $600 just laying around. Thankfully my partner in that situation was able to help with the cost because that's not something I could even afford working full-time and having really good insurance to just drop $600 randomly on this on top of, like I said, paying for contraception on a monthly basis and bills and stuff like that.

It's just, that's a lot of money. They think there's one Planned Parenthood in Salt Lake, but not every Planned Parenthood offers the same option. So it's not one that offered that option. So I actually travel out of the state in order to do that. And thankfully for me in Colorado is really close for, it was just a couple hours of drive. But again, transportation that if you don't have, if you're relying on public transportation, you don't have the option to get in your car. There's no public transportation here to get you to another state to go through that whole process. That it's, it was a lot like it really kind of opened my eyes to see a lot of the things that we're still not as progressive with that. I thought we were, like I said, I was like, I thought I had health insurance.

I thought I was prepared for the situation. And even with all my prepping and planning, it still didn't me for the fact that I'd have to travel to another state or the fact that I'd have to pay for it or just with it at all, just having to deal with the situation at all. And that was really hard to be like, you're expecting somebody in a situation to pay $600 and drive to another state to be able to do something. And it puts people in the position where they're having to wait because they can't afford it. And then that pushes you past the timetable, for you to be able to do the cheaper option. And now you're into a more expensive option of having to go through an actual medical procedure, which is a lot more money, a lot harder on your body and mentally a lot more draining than having to kind of do it outside of the office where I can be in the comfort of my own home when I'm actually going through the process.

Laura Borichevsky:

Can I ask you what it was like to take the pill?

Alexandra Gabrielle:

It's kind of just like taking my birth control pill, like the pill itself. Wasn't different. It's pretty small. There's two pills, actually, they give you. So the first pill like Misoprostol or something like that. And so that stops the pregnancy. It stops anything from developing any more past that point. And then within 48 hours, you're supposed to take the second pill. They encourage you to wait about 24 hours before you take the second pill. And then that one is going to essentially cause you to have a period and your body flushes it out. So there's some like cramping and stuff. I've always been told to do it at night. And that's when I did it. It was like right before bed. So that if I was having really bad cramps and stuff, I'm not as aware of it as if I did it in the middle of the day.

So I did it overnight and just woke up and peed. And like I said, it was like a normal period kind of event that happened. But that's also, it was, we'll talk about later, I'm sure, didn't go as planned and everything didn't work out, but it wasn't a super painful procedure for me or process. And like I said, emotionally, it was nice to be able to do it in my own home where I didn't have to think about everything that was going on that I could just, like I said, it just felt like a period just seemed like, okay, my period finally came after a month.

Laura Borichevsky (narration):

Traveling to access abortions is something that many of us have heard about but potentially have thought that it doesn’t apply to your own situation. But it might. In fact, a recent study in 2014 from the Guttmacher Institute showed that nearly one fifth of abortion patients in the US traveled more than 50 miles one way to access these services, and this population was most likely to cite the reason for their travel being that that was the clinic closest to them. Other studies linked to this research show that greater distance to abortion facilities often also comes along with greater out-of-pocket expenses, delayed care, and more negative mental health impacts from the experience.

The other factors to layer on top of all of this is the fact that more states are continuing to introduce legislation that makes abortion illegal-- and thus more inaccessible to folks living within those states. 

For Alex, being based in southern Utah, she was already aware she would need to travel to get the services she needed, which helped her to focus on her decision making process when it came to getting an abortion to begin with. 

Alexandra Gabrielle:

Yes, I was okay. Yes, mentally. I knew this was a decision that I wanted to make, and that was the best option for me at the time. But there's still the doubt in your head of am I making the right choice? Even though everybody around me in my immediate like support group was very supportive. Do they really think that like, do they think something differently and are they going to look at me differently from this point on physically, I was pretty exhausted after. So that kind of just took a toll on me too, just being physically tired and will the emotions and the feelings about like, okay, well now it is actually over. Am I okay with this decision? You can't just be undecided for a while, especially with something like this, like my indecision would have been a decision. It would have gotten to a point where it was no longer a decision on my part.

So having to be confident about my decision was necessary in this situation, whether it was either direction I was going because after a while, there would have only been one option really socially in the state of Utah that I would have been able to make that having you choose earlier on it was just like, “I've got to get this done because I don't have forever to just be thinking about this. It's like something I have to decide pretty quickly.” And that's what makes it a little harder. Cause it's just like, was I making a rash decision in the moment because I needed to make a decision and I didn't get to think about it as long as I wanted to, or was I making a decision that I already knew that I wanted that in my gut I knew that I wanted to make anyways.

And like I said, most of it wasn't my own unsurety if I was okay with my decision, but the judgment of other people thinking they know better for me, like having a conversation with my mom about this, where it's like in her head, she knows better for me. And that's not the decision that I should have made and just questioning with myself of like, well she right. Or am I right about this decision? So I think a lot of it was those kinds of questions and uncertainty and feelings that deep down I knew that's what I wanted to do. And I'm okay and comfortable with the decision I made, but will I always be okay with that decision while I always be comfortable with that 35 year old me, am I going to be like, okay, with that decision a 45 year old me, am I going to be okay with that decision?

And what are the people around me that I care about deeply think about my decisions and how that’s going to affect my future relationships with them. And it's kind of like every decision in life, you don't really get to have that option to know. You just have to make a decision at this moment. But yeah, it was kind of like, you know, even in a year where I'm like, I might be a little bit more financially stable and in a serious relationship, I'm not, I'm thinking back now like, Oh, darn like, was that the right choice? I could have been here with this as I have gone through and had a kid at that point in time, like this is where that kid would be. And like I said, I kind of weighed those choices out before I made my decision and I kept track of things the way I did so that I knew in case something did happen, I was ready to make that decision, but it's still, it's still cuts to me. It kind of always weighs, weighs on you.

Laura Borichevsky (narration):

So as you heard from Alex, it can feel reall complicated to decide to choose an abortion, even if ultimately it’s the right decision. Compounding this is time-- which there usually isn’t a plethora of in these situations. Thanks to keeping track of her menstruation, Alex had more time than most-- but it still wasn’t long.

Alexandra Gabrielle:

For the pill. It has to be within I think, eight weeks, eight weeks or less, um, where you're still in the period where you can take the pill, but you don't have to do a medical abortion. So if you don't find out right away, and then you don't have the money to pay right away, that can push you into a trimester or whatever that you're having to go with. A more expensive option that you weren't prepared for in the first place that, yeah, we, thankfully I was lucky to be in the situation to have somebody that was supportive and willing to help with the situation. But like I said, it just made me realize how bad it kind of still is, how difficult it is for people to still do this. Even though it's still technically legal in the United States, it's not accessible still

Laura Borichevsky (narration):

All of these details-- and because it is still so difficult for folks to access abortions in the United States-- it’s important that we talk to each other about our experiences… when we can, when it feels safe, when it’s helpful. Because within all of this confusion and shame surrounding abortions, there is also a huge gap of information when it comes to these procedures.

Alexandra Gabrielle:

It's on taboo, but it's so not openly discussed about-- like the different types. Like I didn't even know there was another option to have the medical abortion or having a chemical abortion as they call it. I didn't know that there's another option besides plan B until going in that a lot of these things just aren't talked about a lot. So it was the same thing with me. It was, I don't know anybody to talk to about this. Cause I don't know anybody that's been in the same situation, but once they did have it and I started talking, you mentioned a friend that had some complications too. I've talked to another friend who said the same thing that they had some complications or they knew somebody that had complications that it was refreshing after the fact, but it would have been nice to know some of those things beforehand that that's kind of, you know, why I'm happy to have this discussion about it.

Cause it's just something that just doesn't get talked about. We don't really read a lot about it unless you're going into the situation of having an abortion. The only time we probably talked about this with sex ed in school, like that's the last time the conversation about abortions came up and even that is not a detailed conversation about what that actually entails and what that means and the different types and the different processes that you have to go through. And the mental and just emotional hormonal changes that I went through during that period of time. And he said, it was like the next day. It was just like, “Holy crap.” Like I didn't realize my hormones were so imbalanced during that time. Because again, I'm just like, I don't have money for that. So I'm just going to leave it alone and wait until something else happens.

Laura Borichevsky (narration):

Alex mentioned complications because she *did* have some as a result of her abortion. It’s something that according to published studies isn’t incredibly common-- approximately 2 percent of folks who have medically-sound, safe abortions are likely to experience complications (and of those, less than one percent were considered to be major)-- and yet, it’s still a possibility that can have significant outcomes and, in the vein of being prepared, it important to be aware of.

Alexandra Gabrielle:

The bleeding could last up to four weeks afterwards, just because, like I said, it's just like a period where your body is shutting the inner ear and then lining. And the rate that that's happening is in effect straight. So I was somebody that had really rough periods prior to that. So I was like, whatever this is going on for a long time, it's not that big of a deal. And then I hit almost a six week Mark or so, and the bleeding was still happening. I was getting really fatigued. I have a dog, I couldn't walk my dog. And I was just, there's also bad, like odor and kind of discharge smell for a while. We, you get, and I was like, maybe there's something else going on. Like this isn't a normal period. So having things that are happening, that aren't exactly the same is understandable, but the discharge scared me.

And then, like I said, the lack of ability to just do anything anymore. Part of what the things decided was just like, if you're having a large amount of bleeding to contact the medical provider, if you're having these symptoms for a while, I was like, “they're not bad enough. They don't seem too out of the ordinary”, but I'm just getting the feeling that something's still not right, because I was still clotting. That was the thing that kind of really got me was I was quoting still like six weeks later and I'm like, that's weird. That's happening. It was a long time. I waited quite a bit of time before I went to the doctor. And when I did go in and thankfully had a provider that was really helpful. I told them what had happened, that it's in blood work and saw my hemoglobin, which is really low.

So normally females are about 10 to 13 is where your hemoglobin level was supposed to be minus out of five. And the resting heart rate was like 160 beats per minute. So I was like functioning, but they're like, how are you functioning right now? Like how did you walk in here and are doing all these things? And they did an ultrasound. And at first that didn't show anything. And thankfully, like I said, I'm very happy with the doctors at the hospital that I went to because I've gone in for other vaginal complications before. And a lot of times they just kind of blow you off about it. And this one is a little different, but they decided to do a trans vaginal ultrasound. So they actually go in with the scope and there's where they saw that there was some blockage in my cervix and decided to take me into surgery.

30 minutes later, they came back in the room and we're like, we're calling our, Oh our team. They introduced me to the surgeon, who'd be doing it and told me that he’d be doing a DNC to remove the remaining of my lining that had shattered my cervix to dilate enough, to let all of that out. So I knew something was wrong, but I didn't know exactly what was wrong. And when they told me it was kind of scary because I was by myself. I don't have any family here in the first place, but all of my friends were gone too. And it was the first time I was ever going to be put under anesthesia. And it was kind of like nerve wracking at first. Cause I'm like, I don't know what's happening here. This is a lot scarier than I thought it was going to be.

I grew up in a very strict religious household and upbringing. So my parents didn't necessarily agree with the choice that I made and I couldn't call them to tell them that I was going to have to go through this because that means telling them what happened prior to this, that caused a situation to happen. So it was all scary, all happened kind of quickly though. The surgery also seemed to go just as quick, where I was out in, in, in no time and woke up and everything was better. I've been a lot better since then. Everything's kind of leveled back out, but it was, it was scary there for a second. I'm just not knowing what's going on in your body. Not knowing if you should see anything at that point. I had lost my job. So I had lost my insurance. So I didn't have the option to have coverage for these things where I'm again, thinking about the cost that all this is going to be, that I can't afford that great.

It solves this problem right now, but it creates another long term problem for me, by not having a bunch of medical bills and expenses to take care of, to make sure that I'm not going to die. So that definitely took me by surprise too. And kind of the weird part is like I took the pill to avoid having a surgery. Again, this was a way less invasive and complicated surgery than having a medical abortion, but there's also just everybody's body is different. Everybody reacts to the pills differently. I have a very small cervical opening, so it didn't dilate enough that it needed to, and not everybody is going to run into that problem. But you never know until you're kind of in those situations or if you get a good doctor, that's going to like tell you things about your body and that what's going on is not normal or is not the picture S cervix and vagina that you saw in your sex ed classes growing up. I never thought it was going to have one either. That's what most people hope for and think too, is that you're never going to be in that situation until you are in that situation.

Laura Borichevsky (narration):

Something that Alex and I spent some time talking through was how she looks at all of this through the eyes of someone who loves the outdoors. Because the reality is that, while she was able to seek medical attention immediately when she realized that she needed to, she-- and many of us who love to spend time in nature-- are not always close to treatment or care when it’s urgently needed.

Alexandra Gabrielle:

Thankfully, I was close enough to my house where I was going on that hike, where I started to feel like there's something definitely wrong is the heart racing feeling and kind of the shortness of breath. But the number of times that I go places where I don't have cell phone service, where I'm out a little bit farther, that if I would've passed out in that situation, I could have fallen in my hat. I could have fallen off the side of a cliff. Like, thankfully I was super close to home that I didn't have to worry about that, but it could have been a lot worse than it was

Laura Borichevsky:

Totally. I'm so glad that you were close to home. Yeah. Like the number of times that you go, like a lot of us do, it's just good to know. And like you said, you like to be prepared. Like you track a lot of stuff about your body and your like sexual history on an app. Right. Because you also like to know more about yourself and be prepared. And if someone, if our education systems have informed more of us had like been equipped with that knowledge in advance about like, Oh, there are some potential things that could come up with an abortion and there could be complications with the symptoms you were already identifying. I imagine you would have thought a little bit different.

Alexandra Gabrielle:

Yeah. Cause they warned me of like, if you're going through a pad more than one pad, every four hours or something like that, get help. If you're having like clots larger than lemons, go get help. But the other things like, Oh, if you're short of breath, if you're getting dizzy, I was still vomiting a lot. And that wasn't something that they said that could be potential, but the bigger potentials of like, here's what happens if this goes wrong? Here's the, like, long-term pre-dental of, you're going to have to go through a surgery to be able to complete this process was not kind of given to being said, it was just minor things of like call us, but not explaining exactly why I need you to contact them or the serious ramifications of the situation. Because like, I may have made a different decision about what I want to do if I'd have known those things. Because the other parts of my body that made that surgery a little bit more complicated and higher risk, I also didn't know about at that time. So having those pieces of information and analysis that necessarily they would've changed my decision entirely, but the process that I decided to go with it might've changed that if I would've known those things upfront, that just again, don't talk about various

Laura Borichevsky (narration):

Something *else* that we don’t talk about very often, if ever, are the shapes, sizing, and wide variety of positioning that our internal body parts can come in-- especially uteruses. And it’s something that is not only so unique to every individual, but also incredibly connected to our overall health, our pleasure, and the decisions we might choose to make for ourselves.

Alexandra Gabrielle:

Pulled once before that I had it tilted cervix and that's kind of the basis of what they told me, but going into surgery, they explained the fact that you're a little bit of higher risk because you have a retroverted and retroflexed uterus. So what that means is my uterus tilts backwards and then kind of hooks a little bit to the point that it actually touches my rectum, like the outer walls touch each other, which I didn't even know. That was a possibility at that point in time. But because of that, they're cleaning, they're like gathers of risks that we might go through your uterine wall. And if we do, we're going to rupture or bowels, it's touching because it's close and looking up pictures of what that looked like later. I was like, how was nobody talking about these two things are so drastically different from each other of what, like your typical again, picture perfect female reproductive system looks like in every book that you ride and in every planned Parenthood of what that looks like versus what mine looked like and what other people's can look like too, because there's other options where they're tilted forward rather than back.

And that affects things like drastically. So it, as I found out later, I was like, Oh, that explains why I liked some other positions and why certain positions I don't like, but finding out those little pieces about my body and not until I was in a situation where it kind of was like, Oh, we might kill you because of this. Would it be a situation that I would like to know beforehand? Like go to a great to find that out when I've gone for my like yearly pap smear and when I was like 25 or whatever, or I went to get birth control or anytime I did anything where they're looking and I was like, you didn't know that? Or is that something that is not that important in the grand scheme of things? It was just some information about myself that I wish I would've known.

Like I said, it just explained a lot of situations and would have helped me have some of the like sexual injuries that occurred because of certain positions. I would have been nice to know cause they wouldn't have been happening if I knew that beforehand, but the retroverted and retroflex things. And like, those are words I never heard of and relationship to my vagina. And it would've been nice to find those out beforehand, but it was cool to find them out at all, just in general and the number of people that I had a conversation about the tilted cervix saying, and they're like, “Oh my God, I think I have that too, because X, Y, and Z”. And I'm like, “yeah, there are tons of people do” like tons of women have this. And we don't even know that it exists.

Laura Borichevsky (narration):

Not only do so many folks not know about the different configurations, tilts, and flexes that a uterus can create within the human body-- we have also often been told that it doesn’t matter, both verbally and non-verbally, through silence in exams and in public sex education courses as well as a lack of visual display in clinical offices. The reality is that, like Alex mentioned, not only are there many different positions that a uterus can take, but its position can also change over time depending on whether or not a body experiences pregnancy or labor, as well as other possible life events. Our show notes and some online research can introduce you to the many different shapes and tilts a uterus can take, and the next time you go to a gynecological exam, consider asking your clinician if they can tell you how your uterus is sitting.

Alexandra Gabrielle:

The diagram that I found when I like look that up. Cause I'm like, what does that, what exactly does that mean was a great diagram that I'm like, why is this not in more places? Like I've been told it was tilted, but knowing it can be tilted in multiple directions and even there's the outliers of not the four traditional direction, but in everything. That's like, can explain a lot about complications that you're having or things that are going on in your body procedures that are going to be harder. Like yeah, if it's tilted and you're going in to get an IUD that may be a longer, more difficult process because it's stilted and it's just like, Oh, it's stilted. We'll move along from this because you don't need to know. Or it's not important to me. It's just, it's important to know those pieces of information about you.

And it's weird that I can understand their slave set is stigma around abortions, even though they're no longer illegal, but basic information about like what our reproductive system, I don't understand why that's not more readily available. I haven't been in college or high school in quite a few years and maybe they're teaching it in sex ed nowadays, but I have a feeling it has not changed very much from when we were in school and those things aren't being discussed. And it's not like the information is not out there. It's not like that diagram didn't exist where I went to go look it up. It's just not being shared. It's not being discussed.

Laura Borichevsky:

Yeah. Well, and like to the point of being prepared, it would be so nice. Like now next time you go to have any kind of a procedure or going to like talk to, you know, a new doctor, who's going to be looking at your like reproductive parts. You can be like, Oh, Hey, just so you know, you know, I have a retroverted retroflex uterus, like, just so you're aware of when you start going and that's nice. And like you said, as well, like, you know, in terms of like having penetrative sex too, like that also now you're more informed when it comes to pleasure, which is like all of these things like do really add up to something important to you.

Alexandra Gabrielle:

Yeah. And I'm very curious too. I kind of want to ask my doctorate after we're done with this conversation. If it affects the ultrasounds that I have done, because my cervix and my ovaries are tilted in different direction. Like I said, they didn't see anything wrong from a regular ultrasound that they had to do the trim vaginal. And again, most people aren't going to do the second one because it costs a lot of money to do that. And think I had something that was just like, Nope, you're what you're explaining. There should be something there that we're seeing. I wonder if that, like I said, the other two times I've gone in complaining about really bad pains and stuff like that. And they do an ultrasound. I'm like, Oh, there's nothing wrong if they're even looking at anything because of the fact that it's so tilted, like I'm curious, but I just like little things like that where I don't know, because there's so much information about my body that I don't know about. And like I said, I don't know what ultrasounds are seeing, but if you're going through my stomach and I'm minds tilted more towards my, but I don't feel like you're going to see what you'd be seeing in a normal, supposedly normal uterus.

Laura Borichevsky:

Yeah. Something that like, we feel a standard or the medical community's standard, or we've been told a standard, whether that's real or not. And it also goes to like, you know, we talk, I think there, there are so many conversations about how different everybody's bodies are, like both how they look on the outside, like different foods, like all the different things that like is all unique. And then also like as soon as you were like, Oh yeah, like learned all these things about different like types of positioning and tilting and like all this stuff, I was like, Oh, of course. Cause like everyone is just made so differently and it all fits together differently. So like, yeah. I think that's also something that's really cool.

Alexandra Gabrielle:

Yeah. I mean, it's really cool. Like I said, it was really cool for me. Like we talked about in the past the anal sex thing, but I was like, Oh, that explains so much to me. Honestly, when I found that out, that is touching. Cause I'm like, that makes sense. That's why it's like, I think it's a little bit more pleasurable for me because I can feel it not just in my butt, but in my vagina as well. And I was like, Oh, that like, that makes sense now like that out, because I'd have conversations with people and they're like, no, it hurts. I don't feel anything anywhere else. But there, and I was like, really? Like, you don't feel like touching and like, no, what are you talking about? And I was like, Oh, that IX, that might explain why I feel that way about it again, not necessarily, but at least gives me some type of thought process of why those white people reacted from even why people like different things. It's like maybe there's some medical and scientific reasons behind that.

Laura Borichevsky (narration):

So clearly-- there’s a lot to learn about our bodies. And the more we learn, and ask-- the better we can be prepared. But there’s even more to it than that. Because even when we’re prepared, things can still go sideways. Not everything in life-- or with our bodies-- goes according to plan. And if or when that happens, Alex has some thoughts she’d like to leave you with.

Alexandra Gabrielle:

You may not be alone as you think in a situation. And that's what I kind of learned that even though I felt like I was really low and I didn't feel comfortable talking about it. And even then even talking about it, it didn't make the situation better, but it helped to process and kind of go through it. And I get, it's easy to say, just get on birth control or don't have sex, but I've been on a lot of birth controls and I was on birth control during it. So that's easier said than done. He's soaking at yourself in a bad situation. It doesn't mean you're a bad person and you're making bad decisions because I'm somebody that is pretty proactive about my, my sexual health. And you can still get in a bad situation. Doesn't mean you're a bad person or you did something wrong.

Even if it was the fact that I just didn't want to have a kid, right. Then like that's a choice that I should be able to have. And that it shouldn't be so difficult of a process to go through or hard to find access to things. I think that's something on everybody's local government level. We should be working on trying to improve is accessibility to things. Because as travelers, you don't always know where you're going to be. Think that I'm stationary right now, but this is something I'm thinking about like, Oh great. If this would have happened a year ago or just what I normally do of traveling through the winter, I could have been in Mexico or Thailand or like just some other part of the United States. So try to be as proactive as you can, even, you don't think something's being a possibility, make sure you know where the closest hospital is to you and what services are offered there.

And you don't want to be tracking that all the time. It's not necessary, but having a good idea, like I said, just the basics of where you are in relationship to services that you might need. If you're going into a situation like me where I was, I wasn't a hundred percent sure there's something wrong, but I was still bleeding and I was still having some weird things going on with my body. I'm happy that I didn't go in a situation where I was super far away, but I had been going in those situations where I'm out in the middle of nowhere, canyoneering places, don't put yourself in that situation until you get checked up and make sure everything's good because it can run really badly. If you do a lot of times, I'm traveling alone that there's nobody else to call for me either. But if you are feeling that and you are, you want to go out, try to not go alone so that if something does happen, somebody else can get you help there. Just, just talk. I mean, sex outside podcast is going to be great for that. I'm just getting people a little bit more open to the conversations of talking about sex.

Laura Borichevsky (narration):

Thank you so much to Alexandra Gabrielle for her time, honesty, and conversation in this episode. If you want to see more of Alexandra’s work, adventures, and beautiful photography, you can find her on Instagram @alexandra_abroad. We’ve also linked the studies mentioned in this episode in our show notes, along with *so many other* helpful resources, so make sure to go check those out.

And don’t forget-- you can catch full episodes of Sex Outside every other week on Thursdays, and on the opposite weeks, you can hear brand new Nature Quickies, which are short, 5-minute dives into specific, practical topics about our bodies and the outdoors-- so stay tuned to catch a new one next Thursday. In the meantime, please consider supporting the show by leaving us a 5-star review on Apple Podcasts, making sure you’re subscribed, or by sharing this episode with a friend you think might like it.

We also have a pretty great merch shop online. There are shirts, stickers-- even underwear. To see what it’s all about, head over at sexoutsidepodcast.com/shop.

Music is by the Wild Wild, UTAH, and Vesky.

I’m Laura Borichevsky. Thanks for joining us. Until next time!

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