A little under two years ago, pregnant, but not yet aware of it, I celebrated joining the 3% of Black women in the United States who are tenured associate professors. Less than 12 hours later, I entered another, smaller minority: the 1-2% of women who experience ectopic pregnancy and tubal rupture as a result.
I first started having reproductive health complications during graduate school, when my physician noticed fibroids growing in my uterus. I was training to become a counseling psychologist and sex researcher, so I had more knowledge than most people about what was happening to me. It still wasn’t enough.
My doctors suggested I “wait it out.” As the symptoms increased ― fatigue due to iron loss from heavy periods that complicated my sex life and leakage that embarrassed me on more occasions than I can count ― I researched and tried many nonmedical options. For nearly a decade, my days were peppered by endless medical appointments, multiple birth control regimens, alternative remedies like herbs and acupuncture, and two unsuccessful surgeries. Not to mention my failed search for a Black woman doctor.
From age 14 to 29, my sex life was healthy and thriving. Arousal came easily, my desire was probably above average for most women, and I was well acquainted with my body’s orgasmic potential. I took for granted that it would always be like this, and I chose to study sexual wellness to help others realize a good sex life, too.
By the time I hit 30, I was physically and emotionally exhausted, frustrated, and unable to enjoy sex like I had previously.
At 32, I graduated with my PhD, got a job as a faculty member in my field, and started my race on the tenure track, all while suffering with the very symptoms I studied. My partner-turned-husband was incredibly patient and understanding ― my physicians, less so. Despite my education and research in sexual wellness, I could not get my physicians to understand how frustrating it was that I had gone from having a passionate and fulfilling sex life, to struggling with one that was unfulfilling.
As a Black woman, I wondered if the gendered-racist stereotypes about our sexual and maternal health contributed to the unhelpful interactions I was having with my healthcare providers. That is, did they see me as someone deserving or worthy of sexual pleasure?
After trying everything else, I knew I could no longer avoid an open myomectomy ― an invasive surgery where they remove fibroids through an incision just above the pubic mound. Once the fibroids were removed at 34, I felt free again. Six months later, I was pregnant with my son, which would have been impossible without having the surgery.
After giving birth (with an amazing Black woman physician), I was “new mommy tired,” but my energy and libido began to rebound, and I thought I was healing well. Then, two years later, as I lay close to dying on my bed, bleeding internally, the paramedics my husband called to save me failed to provide emergency care. Three of them stood in my bedroom, looking down at me as I lost consciousness. My husband screamed at them to help, but they didn’t touch me.
Terrified when the paramedics did not intervene, my husband picked me up and rushed me downstairs, running out of our home barefoot. Only then did one of the EMTs tell him to place me on the gurney, rather than in the back seat of our car.
As I briefly came to while an IV was inserted, I heard one of them say, “Man, he picked her up like she was a feather.” Knowing the many ways Black women experience health-related discrimination, to this day I wonder how my race and gender influenced this withholding of care.
Luckily, perhaps as a function of my educational privilege, once I arrived in the emergency room, my medical care significantly improved. My attending physician diagnosed the fallopian tube rupture, but remarked that I wasn’t reacting the way she imagined someone in my condition would.
She noted, “Patient is stoic.”
With the IV fluids helping to stabilize me, I told her, “I am a psychologist, and I handle crisis well.”
The full truth is I handle crisis well because I am a Black woman, and I’m never sure if anyone will care whether I am suffering. Stoicism is a survival strategy.
I received emergency surgery and six units of blood. I lost a fallopian tube and the embryo that was growing in it, gained three extra scars on my abdomen, but I survived. My sex life, however, was back on life support.
The way my attending physician later described it, there is a cliff at a certain point of blood loss where survival is unlikely. I had been on that cliff, and the fear and grief of that trauma reverberated in my sex life.
As I physically recovered that summer, I spent nearly every day researching what had happened to me. Was there anything I could have done differently? Was there anything I could do to prevent it from happening again? Research suggested that even an orgasm could cause another rupture to my scarred womb if my HCG levels remained high. I felt so afraid that my husband and I had a sexless summer. It took two months before I was ready to take that chance, and once I did, I wasn’t physically the same.
I study good sex for a living, and I wasn’t having it. There was occasional pain from scar tissue and adhesions when I was in the mood, but my desire and arousal were so low that I often wasn’t even interested. My health providers hadn’t warned me about these surgical side effects, but as a psychologist I understood how trauma works.
With the support of a great Black woman therapist, I decided against a medical approach and chose a psychological/behavioral one. I didn’t trust that physicians could or would help me anymore. I knew that it would take curiosity, creativity, and communication to have any chance of recovering my sexual self.
First, I had to get honest with my husband about things that used to feel really good that no longer did. Certain positions no longer worked for me after surgery. We needed to use more lubrication and take more time to help with arousal. Introducing toys that provided more vibration to overcome some of the numbness from the scarring was especially important ― shout out to the rose toy! And expanding my view of sex made a big difference; I had to remember that sex can be so much more than penetration.
Recovering your sexual self after reproductive trauma is not a switch you flip. It is a practice you participate in with patience and an open mind, and perhaps a caring partner. Meditation and yoga helped me release the frustration and fear, listening to sexual songs and audio erotica increased my capacity for sexual fantasy and arousal, sexual communication helped us both get what we needed for sex to be good again, and learning new things (sexual and nonsexual) allowed me to find ways to enjoy pleasure.
The World Association of Sexual Health sees sexual pleasure as an integral aspect of sexual health and a human right, but too often these rights are only supported for those with the most privilege. Medical science takes too narrow a lens on Black women’s sexual lives and the complexities of our sexualities. My research team and I are publishing sex positive research on Black people to create the evidence base I needed my medical providers to have. But in 2023, I shouldn’t be one of a handful of Black scientists studying the sex positive aspects of Black sexual wellness.
Now, I see each scar as a reminder of my survival and the survival of so many Black women with similar stories. My body still carries scars, but I am committed to studying sex in ways that help everyone realize the health benefits, joy and pleasure that can come from sexual liberation.