I am working in a part of the city where bacterial sexually transmitted infections (STIs) are unfortunately endemic. They are easily prevented by condom use, yet for a wide variety of social reasons, the majority of my patients who are at risk for STIs report to me that they use condoms sometimes or never. These same patients often present to the office not only to be tested for STIs but also to report bothersome vaginal discharge that may or may not be related to STIs. Condoms are readily available in my office — in a basket in each exam room, or in paper bags of 15 of them that we can give out, or even by prescription at the pharmacy on site.
I want to share my top five reasons I encourage condom use for my patients and others who are at risk for either STIs like chlamydia or gonorrhea but also for this bothersome discharge known as bacterial vaginosis.
Starting with the most obvious/boring/basic/duh. If you have sex with someone who has one of these infections, or HIV, or even HPV, you greatly reduce your risk of being exposed to their infections by correctly and consistently using condoms with those partners. Great for casual encounters, someone you don’t want to or can’t talk to about their risk factors for STIs, or someone known to have these infections.
2. Less Mess!
Let’s face it, male-bodied people are messy when it comes to sex. Their ejaculate can get all over you if they pull out or if they come in you or during other sexual play. It’s nice when you wrap it up that if you/he removes the condom appropriately after coming, that mess stays put in that condom and not all over you/your sheets/car/bathroom/couch/wherever you are.
3. (Added) Contraception
If you are trying to avoid pregnancy and have sex with a male bodied person, using condoms for penis-in-vagina sex is a great primary or secondary family planning/contraceptive method. If you *always* use condoms correctly, this method is 98% effective — meaning that if 100 women are using this method correctly all of the time, only 2 of them will get pregnant. Of course, not using it correctly every time is less effective — but still 82% effective. This is great added protection from pregnancy if you use another method, like the pill, the patch, the ring, or the shot.
4. Fewer vaginal infections
That thin, white, fishy smelling discharge known as bacterial vaginosis can be prevented with good vaginal hygiene and by using condoms. This helps keep the environment of the vagina nice and acidic. Your vagina has this lovely acid-producing bacteria (the “good” bacteria) that can get disrupted by semen/cum, which is very basic (going back to some chemistry here…). If the semen isn’t hanging out in the vagina, it doesn’t have a chance to change the vaginal environment, so you can keep it acidic in there. (Then, don’t douche or use those other “feminine” products…more on that later!)
5. It involves your dude!
Unlike most birth control methods or things women/female bodied people do to keep ourselves safe and free from pregnancy, etc., condom use directly involves your guy. This may not always be possible, if he hurts you or wants you to get pregnant when you don’t, or he wants to have other control over you. But in a safe and healthy relationship, talking about condom use and safety can add intimacy and a shared commitment to your safety.
Now…the HOW of condom use is another thing. If it were as easy as telling people WHY we probably wouldn’t have such high rates of STIs and unplanned pregnancies. So, that’s for another day.
I am a nurse-midwife practicing in full-scope (reproductive health and birth care) in a community birth setting in the Midwest. My clinical practice is an extension of my longtime commitment to social reproduction (a close cousin and friend to intersectional -- perhaps synonymous to, depending on who you talk to!) marxist feminism and reproductive justice activism.
I write anonymously to protect my job security and make clear that these are my personal opinions, and to make clear that I am also a professional whose personal opinions can also be separate from the care I provide. (While I personally believe in abolition of the prison industrial complex, I still have clients that are cops/married to cops [etc.] and maintain respectful, compassionate clinical relationships with them.)
I was called to midwifery circuitously, through my love for reproductive rights and an interest in providing abortion care. Then I met midwives and learned about the intertwined legacy of midwifery and abortion, and I fell in love with birth. In my practice, I have worked as a primary care midwife in a Federally Qualified Health Center and campaigned fiercely for true midwifery in a hospital setting rife with obstetrical violence (and lost that fight!). I have learned how to bring midwifery care from the belly of the beast in a large teaching hospital that functions in many ways as an assembly line of medicalized birth. I have also had my heart broken by my own midwife when I realized that my dream job in home birth was actually a nightmare in many ways. I have found healing through communities of midwives that work to support each other through the traumas of toxic healthcare workplaces.
I am constantly learning, working on my personal and professional growth, and striving for accountability, particularly as an anti-racist that benefits from white privilege.
Midwives of the Revolution is meant as a nod to Marx and Engles's writing on the process of social revolution, as well as an aspiration to be among the midwives fighting to transform the perinatal health system in the context of the struggles for reproductive justice. The social revolution it will take to win reproductive justice will have to involve birth workers, other health workers (unionized, and not; professionals and not), educators, abolitionists, environmentalists, and of course childbearing people and families.
I love the way that Marx's collaborator Engles (a brilliant philosopher and activist in his own right) describes the dialectical process of childbirth, which, for me, also undergirds my commitment to bodily autonomy and reproductive justice. To paraphrase, some of the events that midwives are called to may be "violent" or forceful, like childbirth -- not unlike revolution and social struggle: The fetus is negated by the neonate, who can only be brought about by the force of childbirth. The midwife facilitates that transition, as force (or social struggle) facilitates the transition from one form of social relations to another.
Scolding the philosopher Duhring, Frederick Engles defends the social force required to fundamentally transform society: "Force, plays yet another role in history, a revolutionary role; that, in the words of Marx, it is the midwife of every old society pregnant with a new one, that it is the instrument with the aid of which social movement forces its way through and shatters the dead, fossilised political forms."
(Anti-Duhring, found here: http://www.marxists.org/archive/marx/works/1877/anti-duhring/ch16.htm#087)