Tampon wars: the battle to overthrow the Tampax empire

The long read: For decades, one company has ruled the world of tampons. But a new wave of brands has emerged, selling themselves as more ethical, more feminist and more ecological

The Queen of Tampons, one of several nicknames, is a jubilant woman called Melissa Suk. Four years on the throne as the associate brand director of Tampax, Suk holds court at the head office of the multinational consumer goods giant Procter & Gamble (P&G) in Cincinnati, Ohio. From there, she oversees an empire spanning 70 countries, filling bathroom cupboards in cities, towns and villages across the globe. When it comes to tampons, Tampax is the undisputed overlord, with a 29% global market share. (P&Gs nearest rival in the sector, Johnson & Johnson, still has less than 20%.) Last year, more than 4.5bn boxes of Tampax were bought worldwide. And yet, somehow, there are still corners of the earth untouched by Tampax. If your potential territory is all of the worlds bleeding vaginas, there is always opportunity for further conquest.

On a recent chilly afternoon, I met Suk, beamed in from Ohio on to a giant screen in a meeting room in P&Gs European headquarters in Geneva. The multinational occupies a vast white block with blue glass windows, a design best described as hospital chic. Perhaps because the conglomerate owns so many cleaning-product brands, every surface had an antibacterial gleam and every staffer appeared to have just passed through a delicates cycle, shining with corporate hygiene.

In the gamut of P&G meeting rooms, ranging from mountain-view to bleak, we sat in one in the death-zone category, a basement chamber that contained the ghostly echoes of dial-in codes gone wrong. One wall was plastered with a mural-style photograph of the P&G dream: a woman holding a baby wearing a P&G Pampers nappy, while doing the laundry using P&G Ariel washing powder, next to a sink on which sits P&G Fairy washing-up liquid. Now that its been done by Sport England in a recent This Girl Can advert, they could also include a tell-tale Tampax string descending between the womans legs. Altogether, it is the ultimate commercial vision: a life in which brands are so braided into our existence, and that of our mothers before us, that their presence is as invisible and unquestioned as love.

Though it was dawn in Cincinnati, Suk was undimmed. She held a pink breakfast milkshake, her blond bob was immaculate and she spoke of her millions of customers her subjects in the very brightest of voices: We have a commitment to let her live a life without limits, whether shes on her period or not. And: Weve really played a role to teach her what is a tampon, how she should use it and why she should use Tampax. From a day of listening to Tampax staffers and watching their presentations PowerPoint is P&Gs love language it was clear that the Tampax-buyer is never a consumer or a client or a user. Shes she. Like a friend, just one whose name you dont know but whose menstrual cycle you are deeply familiar with.

The Tampax team know her intimately. Like all big brands, they run a rolling programme of focus groups, talking to hundreds of women every month. They want to know how she feels about her tampon, whether shes using it right, what would make it more comfortable, more convenient. They are led, always and exclusively, they like to say, by her needs and desires. What they dont say, but is implicit, is that they are also led by the need and desire to sell more tampons.

For Tampax, like any longstanding empire, has inherent weaknesses. Over the past few years, according to market researchers Euromonitor, the global consumption of tampons has been in steady decline from a high of 17bn boxes in 2007, down to 15.9bn in 2018. Back in the meeting room, Suk rattled off five contributing factors to this drop-off in a way that suggested this list was a feature of many panicky Cincinnati brainstorms:

1) Period cessation.

2) Abundance of options.

3) Education of the form. (In other words, women having misconceptions about tampons.)

4) Concern over ingredients.

5) Concern over sustainability. (Probably the lowest, noted Suk.)

Never mind about 3, 4 and 5 for the moment. In No 1, Tampax is facing perhaps its greatest existential threat the growing number of women choosing not to have periods at all. Last year, the faculty of sexual and reproductive healthcare of the Royal College of Obstetricians and Gynaecologists issued an updated guideline, stating that there was no health benefit to taking a week-long break from the pill to have a sort of faux-period. Women simply no longer need to shed blood if they dont want to.

In threat No 2 abundance of options Tampax is reckoning with the possible fate of any long-time ruler: the rising howl of revolution, a potential coup. Over the past few years, an array of new tampon brands and period products have appeared on the market. Obeying some unwritten law, they all seem to have cute, single-word names Lola, Cora, Callaly, Ohne, Freda, Flo, Thinx, Modibodi, Flex, Flux, Dame, Daye. And they all want to topple Tampax, offering women what they see as more ethical and ecological options to replace Tampaxs single-use plastic applicators and a marketing strategy that often emphasises discretion, as though a period should be something to hide. Its ripe for the taking, said Celia Pool, co-founder of Dame, about Tampaxs hegemonic grip on the market. A brand like Tampax has dominated for so long with such hideous messaging and hideous products in such a personal area of a womans life which they use every month.

So far, the startups strategy seems to be working. People are leaving the big brands, Roshida Khanom, category director of beauty and personal care at the market research company Mintel, told me. Women are switching their loyalties and trying these new disruptors. The disruptors, meanwhile, have their eye on a vast consumer base about 2 billion people, if you calculate that around 26% of the global population is of reproductive age and therefore likely to be menstruating. Periods, seen afresh, present a seductive retail opportunity: a naturally occurring regular event that requires a monthly purchase and continues for approximately 40 years. Get a customer signed up early and then for life and shes locked in for about 480 periods, 8,640 tampons, at least 1,500.

No wonder much of Tampaxs communication is geared towards pubescent first-timers. On its UK website, next to first tampon stories and a tampon quiz, theres a teen chatbot called Alya who has a 90s-Disney, skater-girl vibe and a long wave of jaunty red hair.

Hey Girl, shall we chat? asked Alya. Im Alya, here to answer your body and puberty questions.

Alya, I replied, Tampax has dominated the menstrual market for years: can it hold on?

To be fair to Alya, it was not in her programmed brief to answer such a question, but she gave it a go anyway: Did you mean: What are TAMPAX made from / Can a tampon fall out / Can I skip this puberty thing / None of the above.

None of the above, Alya, none of the above. But thank you for trying. Well find out for ourselves.


Many girls dont use tampons straight out of the gates. For the average 12-year-old, fresh to the questionable joy of periods and yet to have sex, there is a certain caution around inserting an object into your vagina. Some never use tampons at all, particularly in countries where they are considered taboo. This includes much of Asia and many religious societies. Like many, I started with pads, which in the early 90s were a very different class of item to the winged, body-contoured products of today. I recall waddling to assembly convinced that the squeak of the quasi-nappy I had stuffed in my pants was audible to the entire school. At some point, my older sister suggested there might be a better way. And so it begins: a marriage-length relationship with a rolled wad of cotton and rayon that you put inside yourself, with a string attached so you can yank it out again.

The tampon, a late chapter in the story of menstruation, is a significant upgrade after centuries of women making do with homemade efforts old rags, sheepskin, cheesecloth sacks stuffed with cotton, pieces of fabric pinned into pants. In parts of the world, including the UK, where many women cant afford menstrual products, makeshift options are still used. Bespoke period products came into existence shortly after the first world war, when nurses realised that the cellulose-based bandages they were using to dress wounds were better than cotton at absorbing blood. Kotex introduced the first mass-market sanitary pad in 1921; it had to be held in place by a belt. Ten years later, Earle Haas, a Colorado-based doctor, invented and patented the first cardboard applicator tampon. (For those unfamiliar with the form, an applicator is the telescopic-tube mechanism that inserts the tampon into the vagina. Non-applicator tampons, or digital tampons, are pushed in by hand. Oddly, depending on which brand reached a territory first, most countries have an in-built preference for one or another so the vast majority of US consumers use applicators, while most German users dont.)

Haas, possibly to his eternal regret, sold his patent in 1933 to a Denver businesswoman, Gertrude Tendrich, for $32,000. P&G adore Tendrich, the original #girlboss, who started Tampax the same year, and was the companys first president. P&G only acquired the brand in 1997, but have internalised the backstory with the zeal of the convert and an eye to the Insta-buzz around female founders. Were extremely proud, Suk told me.

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A Tampax magazine advert from 1942. Photograph: John Frost Newspapers/Alamy Stock Photo

New tampon brands often say dismissively that the tampon has barely changed since Tendrichs day, and that Tampax has failed to substantially improve the form in nearly a century an accusation that provokes polite fury in Tampaxs global director of research and development, Amy Krajewski: I dispute that, yes! she told me. I spend all day every day of my life specifically on Tampax. Hundreds of people do! Krajewski pointed to the brands official timeline as proof of their efforts: there was the dramatic switch from cardboard to plastic applicators in the 90s, the introduction of a pocket form and the more recent addition of a LeakGuard braid to the tampon string, intended to prevent a saturated tampon from staining your underwear.

Despite these improvements, viewed internally as epoch-defining gamechangers, a century of Tampax is more a story of shifting marketing tropes than major product innovation, the same humble tampon packaged up in a cornucopia of ways: Tampax Radiant, Tampax Pure, Tampax Pearl, Tampax Compak, Tampax Pearl Compak. There are the different absorbencies, strictly regulated and coded by colour: Lite (purple), Regular (yellow), Super (green), Super Plus (orange) colours so familiar to anyone who uses them that you reach for a box without thinking, a commercial allegiance at work that is likely inherited. (Many women I spoke to use the same product as their mother or sister, a particular brand passing through families like an antique clock.)

Like any decades-old company, Tampax has had to change the story it tells about itself to suit the era. Welcome this new day for womanhood, read one of its first adverts, from a July 1936 edition of The American Weekly: This summer you can experience a comfort and assurance of daintiness you have never known before. Daintiness went out of fashion pretty fast, and from the 60s onwards menstruating women were, according to print advertising, happily engaging in all manner of period-unfriendly physical activities, including waterskiing, fencing, horseback-riding and wearing tight white on the beach. Until 1972, TV adverts for menstrual products were banned in the US (and as late as 1993, agony aunt Claire Rayners advert for Vespre Silhouette sanitary towels was removed from UK television after hundreds of complaints). But in 1985, a defining moment in Tampaxs history occurred when a pre-Monica Courteney Cox became the first person to say period in a US commercial. Shes in an extremely tight leotard working out, said Suk, after delightedly showing me the video. And basically would not be able to do that in a pad.

Over the decades, Tampaxs promotion of the discretion of its products seemed to give corporate endorsement to the idea that a period was best kept secret. Youll love the Quiet Easy Reseal Wrapper, goes the current marketing blurb for Tampax Radiant. As a narrative, it seems increasingly at odds with the times. Why should we hide tampons up our sleeves on the way to the bathroom, or worry that someone might hear us unwrap one once were there? (In a recent Saturday Night Live sketch, Phoebe Waller Bridge riffed on all the possible items a copy of Mein Kampf, a neatly folded Confederate flag, a dog shit within which you could more acceptably conceal a tampon and its associated deep shame.) For years, major period brands, including P&Gs sanitary towel Always, have advertised absorbency by using a bright blue liquid, as if to deflect us from what would actually be soaking a pad. Blood, it seemed, could openly seep from grazed knees and shaving cuts, but not from a womans bits.


In the annals of menstruation, 2015 was a very big year. Early on, two viral events took place: a woman called Kiran Gandhi free-bled as she ran the London Marathon, and Instagram had to apologise after briefly removing a photo, posted by the poet Rupi Kaur, of a sleeping girl bleeding through tracksuit bottoms. Mounting political energy consolidated into various campaigning groups: in 2016, Gabby Edlin founded Bloody Good Period to help refugee women access period products, and in early 2017, the Red Box Project launched its campaign for free period products in schools. (It won: as of 20 January this year, the government will provide menstrual products to all schools and colleges across the country.) Protests against sales taxes on period products spread rapidly Australia and Germany, among others, have either reduced or eliminated the tax. (The UK still adds 5% in VAT, but set up a tampon tax fund in 2015 with the pledge that the raised money would be spent on womens charities. So far, beneficiaries have included an anti-abortion charity, eliciting a new wave of protest.) In a final symbolic flourish, late last year, a period emoji in the form of a crimson droplet was finally added to the iPhone menu.

In the midst of this newly charged menstrual atmosphere, period startups multiplied, selling products ranging from organic cotton tampons (Lola, Cora, Flo) to absorbent pants (Thinx, Modibodi) to a reusable applicator (Dame). All proclaim their high ethical standards. Flo gives 5% of its profits to womens charities, Freda partners with Bloody Good Period, and Dame says it is the only period brand to be climate positive, offsetting twice the carbon it produces. The founders do these things for their own sake, but also because theyve read the research: consumers, especially younger ones, increasingly want to buy brands that come with a side of values, a wrapping of morality.

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Tampax has had to play catch-up. In such moments, multinationals can resemble the Im-your-mate teacher with a tone-deaf enthusiasm for trends to which they are fatally late. (Womens empowerment and period pride are in, you say? Well see you there, just after weve intensely focus-grouped the issue and come up with a hashtag.) Always had already launched its #LikeAGirl advertising campaign in 2014, which revealed that girls can, in fact, do everything. And in 2019, P&G launched a period poverty campaign which involved them donating a single product that is, one tampon or pad for every pack bought within a set time bracket. (The most uncharitable thing Ive ever encountered, according to Edlin of Bloody Good Period.)

Tampax updated its products too, launching, in 2019, its first organic cotton tampon and, in the US only, its first menstrual cup in 2018. At Tampax we didnt invent the menstrual cup, we just want to perfect it, was the marketing line, in cute acknowledgement of its lateness to the party, given that cups were first invented in the 1930s. Finally, to cover any ethical gaps still left exposed by their own brands, P&G acquired an American purpose-driven period startup called This is L.

Is it so bad that P&G jumps on the bandwagon if the bandwagon involves more sustainable products and allows women greater choice? None of the startups and campaigners I spoke to were convinced. They co-opt activism, said Affi Parvizi-Wayne, the founder of Freda. Edlin suggested a full boycott of P&Gs products. They move to protect themselves, rather than to change, said Celia Pool from Dame. These big brands might dominate for now, but thats not to say theyre going to dominate forever. It was a David and Goliath situation, Pool added. And we all know who won that one.


For a startup to successfully dismantle the Tampax empire, it needs an industry-changing idea. Daye, founded in 2018, believes it has it. Its innovation, freshly launched, is a pain-relieving, CBD-infused, biodegradable cotton tampon, a phrase that could have sprung from some kind of Silicon Valley word association game. Daye is like a startup created in a lab, a model of contemporary entrepreneurialism. There is a young female founder, the dynamic 24-year-old Valentina Milanova, who has the wide smile and unwavering stare of someone who, rather than disposing of their early 20s in cheap bars and toxic romance, raised $5.5m in funding from big-name investors including Index Ventures, Kindred Capital and Khosla Ventures. There is an office in a converted biscuit factory in Bermondsey. (Biscuits becoming CBD tampons is a fairly succinct summary of the history of British business.) And there is a highly ambitious growth strategy. Daye currently has about 15,000 customers. Within the next five years we hope to be servicing 1 million customers per month, Milanova told me. A lot of women have period pain.

The startup founders backstory is the modern-day fairytale. Milanovas is powerful: she grew up in Sofia, Bulgaria, started menstruating at nine, thought she was dying, kept her periods secret for years, suffered terrible menstrual pain and began researching the subject. After learning about the properties of industrial hemp, she created various products at home, before hitting on the idea of coating tampons in CBD oil. (Will you get high? a male friend asked me, fascinated, when I said I was trying it out. No, is the short answer, but according to Dayes initial trials with more than 200 people, the pain relief provided by a CBD tampon kicks in within 20 minutes, compared to the 40 minutes it takes for painkiller pills to work.)

One recent sunny morning, I visited Daye in their biscuit factory and Milanova showed me round the open-plan room of 19 young staffers who had the keen-eyed look of people doing jobs their parents dont fully understand. Along the corridor was the designated clean room, where a man in a white hazmat suit was inching around a hunk of machinery that coated the tampons in oozing brown CBD oil.

Back in 2018, when she was pitching to investors, Milanova encountered attitudes ranging from awkward to stunningly ignorant. One wondered why she was putting 18 tampons in a subscription box, given that he had never known a woman have a period for 18 days. Milanova had originally wanted to attract an all-female investor base, but quickly realised this was unlikely. Even though femtech, the uncomfortable term for any business that relates to the health or well-being of half the population, is now fashionable, startups in this space can still struggle to attract funding, as more than 90% of the decision-makers in venture capital firms are male. Its really important that those decision-makers, who will still be [predominantly] male for quite a long time to come, open their minds to the fact that femtech is not a niche, said Leila Rastegar Zegna, founding partner of Kindred Capital and one of Dayes early backers, with commendable diplomacy.

Milanova doesnt just want to make a new kind of tampon, she wants to change the whole culture around menstruation. Like many of the other new brands, much work has gone into Dayes tone, which is humorous and blunt where Tampax is euphemistic and prudish. (Yes, period poo is real, is the title of a recent blog post on Dayes website.) Many of the brands share this kind of forthright language bleed red, think green is Dames tagline; no more shoving tampons up our sleeves, proclaims Freda. In an article on its website, the period-tracking app Clue questions why we associate periods with a specific gender, arguing that it would be more accurate to talk about people who menstruate, or menstruators rather than women.

What the new tampon startups also have in common, but dont talk about quite so openly, is the fact that beneath the reusable applicator or CBD coating, their fundamental products the tampons themselves are extremely similar. While Tampax has its own tampon factories and machinery, the vast majority of Europes new-brand tampons are made in one of a handful of factories. (The two leading ones, I was told in hushed tones, are in Slovenia and Spain.) The secrecy is not unusual all companies protect manufacturing information. But many of the brands didnt seem to realise that within these factories, their tampons were most likely being made on the same machines. A Swiss manufacturing firm called Ruggli has a near-monopoly on tampon-making machines, so almost every new-brand tampon, whatever its particular design or added feature, is a Ruggli tampon. We all try and make it sound like theres something proprietary, Parvizi-Waynethe of Freda told me. But ultimately, its like a white T-shirt. Its the same product. We cant fool ourselves that this is something different.


The Ruggli factory sits on the edge of Koblenz, a small Swiss town on the banks of the Rhine. Swiss precision is one of its taglines, looping tampons in with the other prides of Switzerland, watches and private banking. More than 40 people work in the white-block facility adjoining a field which, on a recent afternoon, stank of manure. In the lobby, there was a sunken rhombus-shaped pit brimming with tens of thousands of tampons. Our tampon pool! said Valon Maliqi, head of sales and marketing, with a proud smile. The equivalent of a menstrual ball pit is not the only surprising interior decor decision at Ruggli. On the walls hang a series of pictures of naked torsos made up of green and yellow dots, with the pice de rsistance a large pair of exposed breasts saved for the boardroom.

Maliqi is the kind of tampon-engineering enthusiast who, ahead of my arrival, had neatly laid out a long row of tampons next to the sandwiches on the boardroom table. He was keen to showcase the full suite of tampons that Ruggli machines can make, and kept leaping to his feet to draw on a whiteboard the minor variations they create for different brands: tampons with holes in the head, tampons with wavy grooves (to draw the blood down the tampon), tampons with blue lines. When I asked him what the blue lines were for, he adopted an expression that suggested there was not a great deal he could say on behalf of their utility. There is, after all, only so much you can do with a wad of cotton and rayon.

On a tour of the factory, Maliqi kept half-closing doors, anxious of the highly proprietary nature of Rugglis machinery. I tried to reassure him that it was unlikely I would be able to sketch in my notebook the design secrets of a mechanism that takes a team of engineers six to 10 months to build and costs up to 2m Swiss francs (1.58m) to buy, but if you are in possession of a near-monopoly, you cant be too careful. A Ruggli machine will last for many years, a resilient piece of hardware that is the opposite of the disposable, mass-volume product it makes. The company sells fewer than 40 machines a year to about 30 tampon manufacturers worldwide, but that equates to roughly 50% of the worlds tampons being made by Ruggli machines. Its clients include multinationals who own multiple machines that run 24 hours a day and shoot out 120 tampons a minute. They never stop them! said Maliqi with some excitement.

On the factory floor, I was introduced to a finished tampon machine, in the process of being tested. It was a fabulous beast, a vast L-shape of gleaming steel, the size of an outrageous sofa or a studio apartment in an overpriced city, an inventors fantasy of visible interlocking cogs and pistons, tubes and belts, all working in rapid synchrony. At one end, a ribbon of white fabric and a spool of string were being fed into the machine, while at the other end, fully fledged, plastic-wrapped, applicator-fitted tampons were popping out and being closely inspected by a serious man wearing a black Vans T-shirt, black jeans and heavy boots.

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A 1970s Tampax advertisement. Photograph: Hera Vintage Ads/Alamy

Everyone on the factory floor, I realised, was a man. Ha ha, yes! said Maliqi. In the engineering department we have some women. He paused. Most of the time in that meeting room, its men sitting there and talking about tampons. Which we never use! Neither of us were sure what to make of this. But in marketing, its a lot of women. They have huge power.

It is the marketing department, after all, that promote the wavy grooves, the holes in the head, the blue lines, the reason to buy one thing on a shelf over another thing. In the end we are not very interested in these products, we just do the machines, said Maliqi, when I asked him for a little too much detail on the thinking behind the wavy grooves. (The grooves and the holes in the head, it turns out, are essentially pointless, because blood soaks the tampon from all directions, not neatly from top to bottom.) But Maliqi did have a more concerted interest in some of the wider trends around tampon usage that might affect his business the fall in consumption, the rise in alternatives and the deep and growing mistrust of tampon ingredients.

The main ingredient of a tampon that is not 100% cotton is rayon, or viscose, made from dissolved wood pulp regenerated as cellulose fibres, a process that involves chemical treatment. It is these chemicals that tend to worry consumers, and newer tampon brands play on this fear: Most tampons contain synthetics treated with chemicals and cotton sprayed with pesticides, reads a statement on Dames website. Women use 12,000 tampons in a lifetime and the vagina is highly absorbent. You do the maths. (There currently is no maths, or science, that proves rayon tampons are harmful, although the late-90s scare around the presence of dioxin, a likely carcinogen, in tampons still lingers.)

Sinister mentions of chemicals and pesticides is the kind of talk that drives P&G wild. I take it personally sometimes. I have to remind myself, they dont know me, said an agitated Amy Krajewski, head of R&D for Tampax. She told me about the millions of dollars P&G spends on testing and monitoring its products, resources that small startups dont have. We hold ourselves to a very high standard. Wed never intentionally put anyone in harms way.

Except for when they unintentionally did. In 1975, P&G made a super-absorbent tampon called Rely that had to be removed from the market five years later due to its association with multiple cases of toxic shock syndrome, a potentially life-threatening condition caused by bacterial infection. Yes, there was that debacle, said Cheri McMaster, a brand communications manager at P&G. But as a result, she argued, P&G is now one of the leading experts in TSS. They fund scientific studies and publish data. As another P&G comms manager, Ania Bielecka, said with a casual brutality: We have a team of toxicologists that will be testing for a year, and within the same year there will be an Instagram company that will appear and disappear.

Back at Ruggli, Maliqi made the point that cotton isnt the spotless substance we might like to imagine. To make cotton seductively white and free of all the things you might find in a field bugs, dirt it needs to be treated in some way. And, as Maliqi said, You need to ask yourself: where is this cotton coming from? India and Pakistan are two of the largest cotton producers in the world, and many reports have revealed the extent to which their cotton industries rely heavily on child labour. Not only that, for every 1kg of cotton, you need 10,000 litres of water, all to help make a product that comes enclosed in a non-recyclable plastic applicator.

Still, if people are willing to pay more for organic cotton tampons (between 4 and 10 a box, compared to 2 or 2.45 for 18 Tampax Compak), then brands will make them, and Tampax will make them, too. Upgraded versions of a basic product are a quick route to profit, and most founders I spoke to had major financial goals. Flos founder, Tara Chandra, told me she hoped to become a 100m company in five to 10 years; Milanova has her eye on those 1 million customers. Most of all, they all wanted to see Tampax fall. At the heart of all startups you have big lofty ambitions, said Dame co-founder, Celia Pool. And your big lofty ambition is to take a slice of that persons pie.

Almost every founder mentioned, longingly, the berserk trajectory of Californian startup Dollar Shave Club, launched in 2011 to sell razors and shaving products through monthly subscriptions. After attracting multiple backers during four rounds of investment, the company expanded rapidly. It was a business model that seemed perfectly translatable to period products: facial hair growth, like a period, is an unavoidable bodily function that requires regular purchases. But then, in 2016, Dollar Shave Club was bought by Unilever for a reported $1bn. It was a financial win for the founders, but if the original dream was to take a slice of the pie, perhaps the more realistic vision is the one where the pie simply eats you alive, and pays you handsomely for the pleasure.


The fate of most of these period startups, closely aligned to the fate of most startups in general, will be to disappear. A lot of dollars will be burned, Rastegar Zegna, Dayes investor, warned. Or gained, if it is bought out by Tampax. In the meantime, Tampax will continue its imperial march, armed with the knowledge that new markets are often found in places previously inhabited by fear. It is called education of the form: part of its duty as the world-leading brand is to show consumers, and potential consumers, the benefits of using its product.

Suk pointed to market research that suggested African American and Hispanic women were less likely to use tampons, partly because of a notion, she said, that a tampon could break a womans hymen. You are statistically more likely if you are an ethnic woman in the US, said Suk in language that landed somewhat awkwardly, to try a tampon five or six years later than your Caucasian counterpart. Never mind the delay for the woman, thats six years of lost sales.

In response, Tampax launched its #LiveRadiant roadshow campaign, curated for black women by black women, which visits historically black colleges in the US, such as Texas Southern and Clark Atlanta. Tampax staffers turn up with a menstrual advocate, Cece Jones-Davis, and an obstetrician, Dr Kiarra King, who answer students questions while they distribute free samples of Tampax Radiant, the brand specifically created for black women (which boasts a softer, quieter quilted wrapper that can be re-purposed as an absorbent pocket for your used tampon). A television advert tagline Anything But Basic shows a young black woman hurling her little plastic envelope into a bin from the far end of a bright white sofa.

Your average startup doesnt have the resources to run a roadshow or a TV commercial, but they do have an ability to switch tack faster than a giant multinational. In the future, most intend to broaden their offering beyond tampons. Many were coy about sharing their plans, but some Flo and Freda for starters are already making the logical sidestep into incontinence products. The difference between a sanitary towel and a pad that absorbs wayward urine is zero, and yet, historically, the latter market has been dominated by the unappetising Tena brand, which you assume is only bought by ailing ladies in support stockings until you realise, having had kids, that you can be legitimately young and healthy and still have significant issues with your pelvic floor.

Many of the new brands look to the future of their customers, too, and the fact that they will not always have periods. The menopause approaches, another area of womens health previously shrink-wrapped in shame but now becoming commercially ripe. Following the menstrual example, the menopause is now undergoing its own cultural rebranding. Multiple books have been written (The Good Menopause Guide, Confessions of a Menopausal Woman, Making Friends With the Menopause, and so on); Mariella Frostrup made a BBC documentary; Gwyneth Paltrow made a Goop video. I dont think we have in our society a great example of an aspirational menopausal woman, said Paltrow, presumably nominating herself, the high priestess of expensive aspiration, for the job.

For a tampon brand, it is only logical that you would want to cover the whole hormonal journey, as one founder put it to me. Why stop selling when the bleeding stops? The menopause offers ongoing and diverse opportunity. From a business point of view, its amazing, said Parvizi-Wayne, founder of Freda. A menopausal woman is likely to have more money to spend and more time to spend it. The symptoms insomnia, anxiety, loss of libido, headaches, hot flushes are numerous and, as Parvizi-Wayne put it, every single symptom in its own right is an unaddressed market.

If you see the world as a set of addressed or yet-to-be-addressed markets, it changes things a little. I started to wonder what was left to address. Death? No, thats been done: there are a host of nifty death startups, offering cheaper funeral services and probate advice. Your mind? Done, too and Im paying for it already (along with more than 1 million other subscribers, I have the Headspace app on my phone). Disconnection our only hope has long been monetised, and again, Im shelling out for the privilege (the Freedom app, which disables the internet, is probably my most-used software). It makes sense that the only markets left are the ones weve been historically reluctant to talk about. Lets face it, an investor once told Parvizi-Wayne at a meeting, taboos have become sexy. A taboo, seen another way, is just a market still invitingly unsaturated.

This article was amended on 11 February 2020. An earlier version mistakenly stated that Gillette was owned by Unilever. In fact it is owned by Procter & Gamble.

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Read more: https://www.theguardian.com/society/2020/feb/11/tampon-wars-the-battle-to-overthrow-the-tampax-empire

An MRI scan reveals what I thought was a migraine to be something darker

My signs of lightheadedness, headaches, lightheadedness and confusion, which I have actually constantly thought about part of my migraines, are a sign of something more threatening, states Eva Wiseman

T he method to make a scary movie frightening is to keep the beast concealed, and this is how I’ve begun to feel about my brain. Considering that I was a teen my migraines have actually started in the very same method, with a white mark on my vision, as if I’ve looked too long at the sun. The mark grows up until I can hardly see, and after that the headache comes, and after that, well. In June, I woke with the familiar blind area, however that afternoon it had not altered, nor had it vanished a week later on, or a month. Ultimately I had an MRI. Prior to I cruised into the area tube, I selected the Beach Boys to play through the earphones; as I closed my eyes to prevent the claustrophobia, the opening notes of In My Room, the noise of an ancient broadband connection simply behind it. The next day I got a call from the neurologist. Instead of a migraine, he stated, with unknown graveness, I ‘d had a series of mini-strokes. When whatever feels alright, #peeee

It’s odd to be revealed proof that something’s incorrect with you. The sensation advised me of a comparable unlikeliness 5 years earlier– when all proof stated I was pregnant, however up until the kid really showed up in blood and drama, the medical diagnosis stayed to me a kindly theory. This time the oddness is a various shape to that growing bump– ghostly, uncertain. I’m composing this with one eye shut, as the blind area stays, exposed now to be where the capillary to the eye has actually been completely harmed. I am seeing the scar of a stroke, its stain. A tired dribbling moose if I focus I can make out its shape. Because very first telephone call I asked the medical professional, if I had not understood I ‘d had these strokes, how would I understand if I was having another? Well, he stated, you may feel … and after that he calmly rattled a list of signs– lightheadedness, headaches, lightheadedness, confusion– which all explained the information of my every day life and a number of the qualities that keep me charming.

So my daily has actually ended up being a BBC drama, where every episode is weighted with the possibility of murder, however there is no body. And though the skyrocketing shots of cliffs and sea appear threatening, it’s simply landscape and weather condition– if you turn the colour up it might be a postcard from the past, and if you had not check out the sneak peek in the paper, you would not understand there was any death at all. My cliffhangers are the weekly medical facility tests to find why something like this is taking place to somebody like me, in order to avoid another stroke that may be less small, and every one features its own kindly physician and a brand-new understanding of a part of my body I ‘d considered approved.

My heart, for instance, which I’ve primarily trusted for pounding and love, has actually collected ominous brand-new significance. In a dark space a cardiologist spoons me and, together in a type of love, we see his screen to see if the organ consists of holes. My brain, previously a helpful and benign good friend, a mate, seems like a slipping existence. It provided the blind area like a ransom note in the post, a hazard and a tip of the power it wields. What could it shut off next? My capability to smell urine from a hundred rates? My choice for a dark chocolate biscuit? A discomfort that will alter me?

It’s tough to exercise how to process this news, both for me and my pals. It’s bad, isn’t it, however okay bad. It’s like I’ve been shot, however someplace ridiculous, like in the earlobe or little toe. It would be simpler for them if there was an apparent injury, a cast they might sign. It would be simpler if it was something that was taking place today, present tense, instead of something that has actually occurred, past, just selecting to expose itself now. If I, it would be much easier. felt something. I have headaches, however I constantly have headaches. I am exhausted, however I’m constantly tired. All of a sudden I am being dealt with the method I was born to be dealt with– my partner provides a dressing dress to me on the stroke of 7, putting a cool hand on my head. At a current health center visit he raised me on to the bed when I passed out, and later on at my demand did an impression of the method my face went right before. As I approach completion of my 30s, I discover my last vice is severe compassion.

My concerns about what takes place next are less technical more existential, as I think about a future of never ever rather understanding. Like a moms and dad that moves their household out of the city after bingeing on stories of stabbings, am I predestined for a bubble-like life, where every headache sends me spiralling into the web? As somebody who has actually constantly taken care to acknowledge, for worry of falling under those ancient holes of diet plans and remorse, that we ought to live quietly inside our altering bodies, I am now struck daily by the detach. In between what my brain informs me and what it actually indicates. In between what I see and what I can’t, and in between the method I feel and the method I am.

Email Eva at e.wiseman@observer.co.uk or follow her on Twitter @EvaWiseman

Read more: https://www.theguardian.com/lifeandstyle/2019/nov/03/an-mri-scan-reveals-what-i-thought-was-a-migraine-to-be-something-darker

Fragrance sensitivity: why perfumed products can cause profound health problems

An intolerance to made fragrances can result in migraines, breathing concerns and long-lasting authorized leave. Should they be prohibited in public areas?

I f you flew abroad this summertime, you most likely went through an airport’s duty-free fragrance area. Maybe you stopped briefly to spritz yourself with a costly fragrance you had no intent of purchasing, prior to making the required journey to WH Smith for pricey crisps and bottles of water.

For many people, the wafting smells of fragrance counters are not an issue. For some, the journey through task complimentary is a choking, cloying experience.

Research released this year discovered that a person in 3 grownups declare to have actually experienced health issue brought on by fragranced items, whether fragrances, cosmetics, laundry cleaning agents or soap. The research study discovered that scent level of sensitivity triggered migraines, breathing concerns and watery eyes. More than 4,300 individuals from the UK, the United States, Australia and Sweden reacted, consisting of 1,100 from the UK. Speaking with the New Scientist, the lead scientist, Dr Anne Steinemann– a teacher at the University of Melbourne– characterised scent level of sensitivity as a health care epidemic of which we do not yet understand the scale. She recommended that scents need to bring clear labels about their components.

Increasingly, airports are acknowledging the issue, with Helsinki , Vancouver and Copenhagen amongst those providing perfume-free paths for guests with scent level of sensitivities. Lawmakers are likewise reacting to the requirement for fragrance-free public areas: most healthcare facilities and schools in Halifax, Nova Scotia, restriction workers from using fragrance, while in Oakland, California, city authorities ask locals not to use aromas to public conferences. And you can ignore splashing yourself in Old Spice prior to slipping into your weekly encounter with the Almighty: a church in rural Seattle made headings in 2013 after presenting fragrance-free zones .

One day, all public areas might be scent-free. It is bad news for the fragrance producers, however great for individuals such as Lesley Heidinger, a 46-year-old call-centre employee from Edmonton in Canada. Heidinger has numerous chemical level of sensitivity (MCS), an obscure condition characterised by increased level of sensitivity to a large range of chemicals, a number of which are typically discovered in soap, cleaning agent, sanitiser gels and fragrances. She can endure natural aromas, consisting of most necessary oils, however artificial scents are irritating. If Heidinger breathes in an associate’s aroma, her sinuses will end up being inflamed, she will cough and wheeze and it will cause a migraine that can last for days. Other reported signs of MCS consist of muscle discomfort, disorientation and fatigue.

“It’s a continuous fight,” Heidinger states. She has actually been off work for much of the year, as her signs have actually been especially bad. Her companies have actually executed a scent-reduced zone around her desk– indicating that associates in her instant area have actually been asked not to use scents– this does not use to common areas. “I do not understand if individuals understand the genuine effect of it,” she sighs. “It makes me extremely ill. Having a migraine for a week is truly undesirable.”

Heidinger is likewise conscious smoke and the scent from cleaning powder and material conditioners. Things got so bad that she needed to offer her flat, since it had a shared utility room, and move someplace with its own washer-dryer, so she would not be exposed to the odor of other individuals’s laundry. On a current flight to Italy, Heidinger needed to change seats due to the fact that the lady beside her was using fragrance. “I might smell it as quickly as she took a seat. I simply stated: ‘I can’t sit beside you.'”

Heidinger’s MCS is clinically acknowledged: she has actually been detected by her physician and gets special needs advantages when she is not able to work. Not everybody is satisfied with empathy and recognition by medical experts. Online online forums for individuals with MCS have lots of stories of not being taken seriously by physicians, while there is argument within medication about whether MCS is mental or physiological. A United States research study in 2011 discovered that just 30% of physicians surveyed had actually gotten official training about MCS . The NHS site does not release treatment standards for MCS.

“These individuals are orphans of standard medication,” states Dr Apelles Econs, an allergic reaction professional at the Burghwood Clinic in Surrey. As individuals with MCS are intolerant of chemicals, instead of adverse them, allergic reaction tests typically return unfavorable. “They might be informed they’re picturing it, and described psychiatric associates to see if they can handle the condition,” Econs states. “But, in truth, the root of the issue has actually not been dealt with correctly.”

“It’s an under-recognised condition,” concurs Prof Howard Hu, a leading ecological health professional at the University of Washington School of Public Health. (MCS is in some cases described as ecological disease, as patients are activated by external chemicals in their living and workplace.) Hu thinks the medical neighborhood’s viewpoint on MCS is altering. “There’s some good research study coming out … In my viewpoint, the proof is excellent that there’s something neurological going on that’s activated by a smell and causes a waterfall of occasions in the brain that manifest as these signs. Is it mental or physiological? It’s someplace in between– the tools we need to examine these conditions are still quite primitive.”

Until more is understood about MCS, providing fragrance-free public areas would be a welcome relocation. “It would be amazing, due to the fact that of how ill being exposed to something makes me,” Heidinger states. “It’s actually demoralising not to be able to go to delight in and work life to its maximum due to the fact that of this. It’s not an enjoyable method to live.”

Read more: https://www.theguardian.com/lifeandstyle/2019/sep/15/fragrance-sensitivity-why-perfumed-products-can-cause-profound-health-problems

‘CBD lubricant is a bestseller’: cannabis oil products are booming but does the science stack up?

Its been hailed as a wonder ingredient, added to everything from ice-cream to hummus. But is CBD more than just a wellness trend?

Last month, Lisa Jenkins went for a walk alone around her local park for an hour, the first time she had done so unaided for 13 months. Jenkins was diagnosed with cerebral palsy at the age of three. Now 46, she struggles with vertigo and dizziness, as well as muscle spasms and poor mobility. An Access to Work grant means that she can get a taxi to and from her job in advertising, but for the last three months she hasnt needed one. The difference? She believes, a few drops of grassy-tasting oil under the tongue each morning.

I have been using a 5% CBD oil for six months, she says. I previously took Duloxetine [an antidepressant medication also used to treat nerve pain] which was initially helpful, but my muscle-freezing episodes came back and I stopped taking it. I was also prescribed Valium, but you cant take that during the working day. A friend suggested she try the legal cannabis derivative. She has since been taking it every morning before work, using more during the day if her muscles become tight. Within an hour of taking those first three drops, my muscles relax, she says. The stress in my head calms down. The longer I take it, the better things seem to be.

Jenkins is one of an estimated 1.3 million UK consumers who spend a total of 300m a year on cannabidiol (CBD) products. The oil contains one of the non-psychoactive chemicals found in the hemp plant not the illegal mind-altering THC (tetrahydrocannabinol) that gets you high and has been on the shelves of specialist health food shops and hemp dispensaries since 1998. Its 21 years since the British government first issued a licence for a cannabis extract to be developed for use in clinical trials.

But in the last few years, it has leapt into the mainstream, acquiring the ubiquity of vitamin C and the social status of something much sexier. Most commonly consumed as an oil dropped under the tongue, CBD is also available as gummy sweets, capsules, body salves and e-liquids to vape. A CBD gold rush has led to an explosion of infused products, everything from soft drinks, tea and coffee to ice-cream, toothpaste and shampoo. You can get vaginal suppositories containing CBD (weed tampons) that are said to help with pelvic pain; CBD-infused deodorants and sexual lubricant (said to promote relaxation and increase blood flow); even CBD hummus, perhaps to snack on after your lubricated endeavours.

For CBD evangelists, it seems there is no health problem it cant help from chronic pain, depression, anxiety and skin conditions to insomnia. Many report that CBD improves concentration, memory and general mood, as well as reducing stress levels. But the products cant legally make such claims; in the UK, CBD can be sold and advertised only as a generic food supplement. We never use any medical terminology, says Johan Obel, director of popular online CBD retailer the Drug Store, standing in front of a huge, gold-framed artwork of a nerve cell in its central London store. If people come in asking for advice on a specific issue, we tell them to do their own research. (He adds that their sexual lubricant is by far one of our bestsellers.)

The boom in CBD-infused products on the high street is reminiscent of short-lived fads of recent years, such as our brief fixation with chia seeds, turmeric (rendering lattes highlighter-yellow) or spirulina. Only, CBD does not seem to be going anywhere. On a recent walk through London I visited a cafe serving camomile and CBD lattes, passed a yoga studio advertising CBD classes, and a bar serving CBD-infused cocktails. The CBD acronym, with its suggestion of something illicit, is catnip to anxious consumers in need of something they cant quite put their finger on.

Most years there is a golden product a Holy cow, can you believe how much of this were selling? thing, says Al Overton, buying director at Planet Organic. There was the year of quinoa, the year of manuka honey, the year of the goji berry. Now its CBD. We have been selling CBD products in our supplement section for just over two years, and its been our fastest-growing product in that time. The majority of interested customers are female especially those who feel that conventional pharmaceuticals arent working for them. He thinks its too soon to tell how much of a fixture infused foods and drinks will become. We see oils and capsules as more of a sophisticated and long-lasting trend, but it is early days with the edibles.

I have been using CBD oil on and off for two years myself, finances permitting. Its expensive: a bottle of 1,000mg (10%) CBD oil from Love Hemp, costing 49.99, lasts three weeks on average. I started because I wanted something to help with crippling period pain and associated symptoms, including anxiety. I love the taste; a bitter, herbaceous blast, like a joint dipped in strong extra-virgin olive oil. More importantly, when I take CBD regularly I notice that, when the dreaded week of cramping and gut chaos arrives, my perception of the pain shifts; I am aware of the sensations and their cause, but am less agitated by them. It feels as if the message of pain is being delivered in a different language. But does the science back me up?

***

Between 2002 and 2012 there were nine published studies on the use of CBD for the treatment of pain. By 2017, there had been 30. Almost all have shown potential benefits. However, with their small participant numbers, along with the fact that those participants are mostly rats, it is hard to make reliable claims about the human response. Very few of the claims for CBDs effects have actually been, or are being, tested, says Dr Sagnik Bhattacharyya, of Kings College Londons (KCL) psychiatry, psychology and neuroscience unit. Scientists there have been investigating whether large doses of CBD could help treat severe mental health problems. We have carried out a couple of studies where we show that a single 600mg dose of cannabidiol can normalise brain function in key regions we know are abnormal in people with psychosis, he says. KCL now has funding to carry out a large-scale trial to test whether CBD could be useful in treating young people at high risk for developing psychosis. If successful, its new trial will provide definitive proof of CBDs efficacy as an antipsychotic treatment, and pave the way for clinical use.

toothpaste
There is currently no evidence to show what regular low doses, like 30 or 40mg a day, are doing. Photograph: Ilka & Franz/The Guardian

Meanwhile, Great Ormond Street hospital (GOSH) has published research showing that CBD has potential as a treatment for epilepsy, particularly for children with the severe, drug-resistant form known as Dravet syndrome. The study showed that CBD reduced seizures by nearly 40% for the 120 children who took part in the trial. Prof Helen Cross, consultant in paediatric neurology at GOSH, said: The results of this study are significant, and provide us with firm evidence of the effectiveness of cannabidiol. This drug could make a considerable difference to children who are living with Dravet syndrome and endure debilitating seizures.

CBD has also been shown to be helpful for decreasing the myriad symptoms of anxiety. In 2011, scientists from Brazil conducted a trial with people with social anxiety disorder. Participants were split into two groups; one received a single 600mg dose of CBD, the other a placebo. All subjects completed a simulated public-speaking test which involved choosing a topic from a pre-selected list on which to deliver a speech, directed at a television camera as if addressing a large audience. Those who received the CBD dose before the task experienced considerably reduced anxiety levels compared with the placebo group. Preliminary evidence from another trial, completed this year by scientists at the University of Colorado, also suggests that CBD may be helpful to those who struggle with anxiety-related sleep disturbances.

But there is currently little robust evidence to support the claims CBD users make for the oils, coffees and hummus available on the high street. So, if over a million people are finding these work, are we witnessing a global placebo effect?

***

The doses used in clinical trials tend to be much higher than you can buy commercially. Its usually between 600-1500mg, either as a one-off or repeated dose, says Dr Chandni Hindocha, a research fellow with University College Londons clinical psychopharmacology unit, and part of a team researching whether CBD can help treat nicotine and other addictions (the results are promising so far). Hindocha emphasises the need for more research into dosing ranges. There are no observational studies about the lower-dose products people are taking right now. We have no idea how much theyre taking and why theyre taking it.

In the clinical trials Hindocha has worked on, most participants cannot differentiate between a 100mg dose of CBD and a placebo. If most people are getting something like 50mg of CBD in a bottle, we need to think about what is going on, she says. In her opinion one-off doses of CBD in popular edibles are unlikely to have any effect. We know that the beneficial effects of CBD usually come from building up levels of it in the body, she explains, but this is with the high trial doses. There is currently no evidence to show what regular low doses, like 30 or 40mg a day, are doing.

But what about the vast amount of anecdotal evidence for its efficacy, particularly in helping with chronic pain? Dee Montague, a press officer from Newport, Wales, was diagnosed with endometriosis in 2018, 18 years after first going to the doctor. The impact on her life has been striking. I played roller derby for eight years but had to quit due to the pain and fatigue. I am completely exhausted by the time I get home from work and can barely function.

toothbrush
The majority of interested customers are female especially those who feel that conventional pharmaceuticals arent working for them. Photograph: Ilka & Franz/The Guardian

She finds that CBD helps. In 2018,she began to experiment with an oil. It took a week of regular doses to make any difference, she says, but she was pleasantly surprised. I found my cramps were far less intense. My sleep improved slightly, which made a real difference to my quality of life. She then switched to a skin balm, because the guidance is to avoid taking CBD oils within two hours of other prescribed medication and she relies on daily medication for asthma. Montague has now been using a CBD-rich skin balm for a year, applying it to her stomach and pain spots on her legs every morning and night. The 100g jar she buys contains 1,000mg of CBD; Montague admits it is hard to know exactly how much CBD she is using each time, and does not view it as a cure or painkiller, as such. But the side-effects are nonexistent compared with opiates, she says. I feel far more in control of my pain and day-to-day life.

CBD works by affecting the function of our endocannabinoid system (ECS). Made up of neurons (nerve cells), endocannabinoids (cannabis-like substances the body makes naturally) and cannabinoid receptors, the ECS is responsible for regulating the bodys systems to maintain homeostasis: keeping our internal temperature, blood sugar and pH levels balanced, along with the amount of water in the body. It tells the body when to start sweating (to cool down) and when to stop. Everything from chronic pain to migraines and epileptic seizures have been linked to ECS deficiency.

It is thought that when we introduce a new cannabinoid into the body, such as CBD, it binds with these receptors and, like a molecular power-up, increases the amount of natural cannabinoids in the body. CBD has also been shown to bind with receptors for serotonin (our feelgood molecule) and GABA (the molecule that calms the nervous system), increasing the amount available to the body offering a potential explanation for CBDs reported calming effects.

I asked Hindocha whether stories such as Montagues suggest that such small doses could be having an impact? It is very interesting, she says, because there is an argument that low doses of CBD could potentially affect inflammation in the body. One complicating factor is metabolism. When someone takes CBD oil, much of it will be broken down by the liver, Hindocha explains. Without knowing about their metabolism, we have no idea how much CBD theyre really absorbing.

***

Before you can consider how much youre absorbing, you need to know how much youre taking in the first place: this year a major study by the Centre for Medicinal Cannabis found that 38% of CBD oils contain less than half the amount of CBD stated on the label. Almost half (45%) of the products contained more than 0.2% of THC (the Home Offices legal threshold) and, therefore, were technically illegal in the UK.

Browse the CBD shelf in your local health shop and youll find a huge variation of strengths on offer; but a higher CBD content means a higher price. Holland & Barrett sells a 10ml bottle of oil by Jacob Hooy containing 5% CBD for 29.99; Boots stocks 10ml bottles by Dragonfly containing 11.1% CBD for 70. One of the strongest products available is by Love Hemp: a 10ml bottle with 40% CBD, for 259.99. Love Hemp suggests a maximum daily dose of 200mg; while it is thought impossible to overdose on CBD, most producers offer guidance on dosing. I notice that none of the infused products carry warnings about maximum doses, age limits, or driving.

Hemp can be legally grown in the UK with a government licence, but is an incredibly small sector. It is estimated that only 810 hectares (2,000 acres) of hemp are currently cultivated in the UKs 42m acres of agricultural land. When I visited a couple of rough-and-ready CBD outlets in London which, as well as oils, sold whole hemp flowers in clear plastic bags, it made me nervous about where it came from. I was routinely assured the flowers contained less than the legal 0.2% of THC. But how can a layperson, without access to a lab and a scientist to test it, really know?

The nice man running one of my local CBD shops a modest outfit selling oils, e-liquids, balms and bongs offered me tea and lots of convincing chat, but agreed that dosing essentially comes down to experimenting. The smell of his shop instantly, rather thrillingly, transported me to the top of the multistorey car park in Bishops Stortford, the locus of my teenage experimentation with marijuana. Perhaps that whiff of transgression contributes to CBDs seductiveness? Even if we know it wont get us high, its wellness with an edge.

The Drug Stores Obel tells me that nearly all the CBD products in the UK originate from the same wholesalers; the extraction equipment is too expensive for smaller companies. It takes a long time to figure out how to do it properly only a few people actually have the knowledge, he explains. In most cases, producers simply add the extract to their carrier oil of choice and put a new label on it.

Obel says the majority of his customers are women aged 40 and above. The audience for a recent in-store event, a panel discussion on the impact of stress, was 80% female. From what we have seen, women want to self-educate and be responsible for their own health. They want to seek more options than those offered by traditional medicine, he says. He does not believe the boom in CBD-infused high-street products like chocolate, tea and hummus will last: We believe everyday products with CBD added will fade away. Products in which CBD is the actual active ingredient, or where CBD serves a specific purpose in supplements or cosmetics those will most likely remain.

***

That we currently have no idea of CBDs full potential is at once incredibly exciting and frustrating. Without more dedicated research, the commercial market will remain something of a wild west. Meanwhile, people will continue to inform themselves, spending their money on products with, it seems, woolly efficacy. The costs will remain prohibitive to many. Meanwhile brands will continue merrily infusing their teas and ice-creams with nominal amounts of CBD, knowing that people will pay extra for the buzz cannabis brings.

I am now thinking more carefully about my own experimentation. Unless I pay close to 300 on a regular basis, for the highest strength of CBD oils commercially available the only products that come close to what is being clinically tested it strikes me that I may be experiencing a placebo effect. Then again, with the research in its infancy, I might not. So I will finish the bottle I have. Beyond that, the question is: how much am I willing to pay for a maybe?

A touch of grass: high-street CBD, taste-tested

Buddha Teas CBD Matcha Green Tea Blend (18 bags), 16.99

Buddha

They say Our innovative process ensures that the CBD in our tea bags actually ends up in your tea.

CBD count 5mg per bag

Our verdict The taste is very subtle and the bags can rip, but I was surprised at how easily I fell (and stayed) asleep Im normally a very light sleeper.

Themptation Hemp Chocolate Spreadables CBD vanilla spread, 165g, 5.05

Themptation

They say More seeds than sugar, more hemp than any other ingredient, packed with 10mg of organic CBD oil and vanilla.

CBD count 10mg

Our verdict This is so delicious and wholesome-tasting, its hard to separate that feelgood factor from any CBD effect. Definitely moreish; keep away from kids.

Aussie calm the frizz Shampoo, 300ml, 3.99

Aussie

They say Our miraculous formula, with Australian hemp seed extract, will tame your mane in next to no time.

CBD count Some cannabis sativa seed extract.

Our verdict Foamy and minimally scented, this resulted in noticeably softer, smoother hair. Was that the hemp? I liked it more than other Aussie shampoos.

Wunder Workshop turmeric x CBD Raw Chocolate Bliss bar , 40g, 6.99

Wunder

They say With cacao from Peru; turmeric from Sri Lanka; and boosted with CBD.

CBD count 16mg

Our verdict I liked the taste definitely got the turmeric but no obvious relaxing effect.

Nooro raw, vegan oat CBD bar in Cacao & Coconut, 45g, 2.95

Nooro

They say Our CBD is sourced from a small independent UK grower.

CBD count 25mg

Our verdict Pleasant initially, but followed by a soapy aftertaste. Quite sickly.

BumbleZest ginger, turmeric and CBD shot, 60ml, 3.15

BumbleZest

They say A natural fiery drink with a lemon base, designed to be taken as a health shot on the go.

CBD count 2.5mg

Our verdict One tester found it very acidic, quite unpleasant, made me sneeze. Another loved the fieriness: I felt energised and set up for the day. Or it could have been my morning swim.

The Marshmallowist limited edition marshmallows, 15 for a box of six

The

They say Crafted from organic CBD-infused mallow whipped to create a super-light texture. Do not exceed two marshmallows per day.

CBD count 10mg per marshmallow

Our verdict Great flavours (choose from cocoa, blood orange or grapefruit), very fluffy, not too sweet, these started life on a market stall and still have that premium feel.

Drink 420 CBD infused elderflower & lime or wild berry drink; 250ml, 2.29

Read more: https://www.theguardian.com/lifeandstyle/2019/sep/14/cbd-lubricant-bestseller-cannabis-oil-products-booming

My breast reduction: why I had the surgery that helped Simona Halep win at Wimbledon

The operation released me from persistent headaches, and back and neck discomfort. Absolutely nothing about the procedure was simple

T hree days prior to Christmas 2015, when I was 19, I had my breasts decreased in size. Sitting alone in my flat after the operation at Ross Hall health center in Glasgow, I challenged my scars for the very first time, and I sobbed.

It was not the very first time that I had actually sobbed over my body, however these were not the tears of an unpleasant, disappointed teen. If I had actually been through a fight and had actually emerged triumphant, I felt as. Holding those stitched-up breasts, a workable 32E below a 34GG, I was lastly, gloriously me.

After Simona Halep was crowned the 2019 Wimbledon champ, I questioned if she had actually felt the very same after her surgical treatment 10 years earlier. Halep, then a 17-year-old increasing star, had actually felt that her chest was impacting her video game, and chose to have her breasts decreased from a 34DD to a 34C. “It’s the weight that difficulties me,” she stated at the time . “My capability to respond rapidly– my breasts make me unpleasant when I play.”

Although she informed Sports Illustrated in 2015 that her breast-reduction surgical treatment had actually been her “greatest sacrifice” for the sport, Halep has actually stated she has actually never ever been sorry for the choice. “I didn’t like them [her breasts] in my daily life either. I would have opted for surgical treatment even if I had not been a sportswoman.”

Today, as a 23-year-old reporter, I still feel the magnitude of my choice, and its effect not simply on my body, however on my psychological health and every other element of my life. I no longer require to conceal my body under layers of clothes or sleep in a specific position to prevent stress. I can stay up directly without bring in stares, or allegations of being attention-seeking. Many liberating of all, the operation released me from persistent headaches, and back and neck discomfort that had actually led me to take pain relievers every day.

Breast-reduction surgical treatment is performed under basic anaesthetic, usually by surgeons in personal practice. The operation normally includes eliminating excess fat, glandular tissue and skin, and improving the staying breast tissue. The nipple is moved, developing a scar that, for many females, runs vertically and throughout the breast crease in an anchor shape.

u-responsive-ratio”> Simona Simona Halep … states she never ever regretted her choice. Picture: Laurence Griffiths/AFP/Getty Images

The operation can eliminate as much as a kg from each breast, and takes in between 90 minutes and 4 hours, depending upon the degree of the decrease; a two-night health center stay is suggested. It is likewise costly: about 6,500, according to the NHS , omitting any assessments or follow-up care.

Despite all this, the variety of individuals having the treatment is on the increase. In 2018, 4,409 females had their decreases spent for by NHS England, up from 4,354 in 2017, 4,188 in 2016 and 3,959 in 2015. The British Association of Aesthetic Plastic Surgeons’yearly audit in May discovered that it was the second-most-popular treatment for females (after breast enhancement), with 4,014 females in the UK having actually paid to have their breasts minimized in the previous year, a boost of 7%in between 2017 and 2018.

That many ladies are prepared to carry the expense themselves is testimony to the life-altering capacity of the treatment. A 2010 research study by Georgetown University Hospital discovered that numerous breast decrease clients reported an enhancement in their persistent headaches and migraines following decrease surgical treatment.

Patient fulfillment is high: in 2012, a 10-year retrospective analysis of 600 successive clients at a single organization in the United States discovered that more than 95% of them would decide to have the surgical treatment once again. It concluded that there was a verifiable enhancement in the client’s lifestyle, despite their weight and size or just how much breast tissue was gotten rid of.

“I do not even think about a breast decrease to be a cosmetic treatment– it’s an extremely useful operation,” states Chris Hall, an expert cosmetic surgeon in Belfast and a member of the British Association of Plastic Aesthetic and reconstructive Surgeons (Bapras). “The physical advantages, how clients feel emotionally later on and the enhancement of their lifestyle are all well-documented. The eligibility requirements set, which has actually been significantly tightened up over the years, makes it nearly difficult to get the treatment on the NHS .”

The NHS requirements are supported by the Academy of Medical Royal Colleges, that includes the Royal College of Surgeons and the independent assessors the National Institute for Health and Care Excellence. A client needs to have had a constant BMI of less than 27; their breasts need to be of “huge disproportion to body habitus”; they might or need to have “intractable intertrigo” (swelling brought on by skin-to-skin friction), “asymmetry higher than one cup size” and “substantial mental distress”.

But numerous females who have actually looked for to have their surgical treatment covered have actually suffered disparities and absence of openness over how to certify. Amy Hill, a 23-year-old individual fitness instructor, was at first declined for a breast decrease in spite of a bra size of 28KK. “I disliked my breasts– they were a consistent stress on me,” she states.

Getting a bra was difficult. When she went to Bravissimo, an expert store with the motto “motivating big-boobed women to feel fantastic”, they informed her that they didn’t make them in her size. “I sobbed in the altering spaces.”

For the finest part of a year, she used a swimsuit top. “It was all that would fit me. I would constantly draw in undesirable attention: individuals believed they were phony. You might constantly see them. They were huge.”

When Hill was informed that she did not satisfy the requirements for a decrease– “they informed me they didn’t impact me psychologically sufficient”– she blacked out, she states. “I was so desperate for it. For somebody to reverse and inform me ‘no’– it ravaged me.”

But she kept pressing. “The entire procedure was stressful and so long. I would wait 3 months for a consultation for them to then inform me something they might have informed me on the phone. I was going to quit, however my mum had actually had [the operation] And informed me that I required to simply keep attempting when she was my age. She stated that it wasn’t as difficult for her as it was for me.”

Hill ultimately had a breast decrease on the NHS in 2016, when she was 21. In healthcare facility, after her operation, a nurse didn’t think that her breasts had actually formerly been as big as she stated. “She made me leave the bed to determine them,” states Hill. “Everyone else in the ward was commenting that I could not have actually perhaps been the size I stated I was; that it was difficult.

“I was so ashamed, I sobbed. I felt a bit shamed by individuals for disliking my breasts, and wishing to eliminate them.”

But Hill has actually not been sorry for the operation for a minute. “Before, when I went to the health club, I needed to use 3 bras. Now, within a year of starting training as an individual fitness instructor, I’m opening a health club of my own. I was extremely fortunate to get the treatment.”

The eligibility requirements vary in every sector of the NHS, implying that females looking for the surgical treatment are practically at the grace of a postcode lotto, states Russell Bramhall, an expert at the Canniesburn cosmetic surgery system in Glasgow Royal Infirmary. “I can not keep in mind the last time I did a breast decrease on the NHS. Whatever has actually got tighter and tighter; we operate in an inadequately moneyed state system.” The recommendation procedure and long waiting times can likewise be a barrier.

In my case, I was best to compare my journey to a fight. I campaigned for my operation to be carried out by the NHS for 4 years. NHS Scotland acknowledges breast decreases under its remarkable recommendation procedure for treatments that are not dealing with an underlying illness procedure, and thus just offers them on extremely unusual celebrations. Clients should be described a scientific psychologist after evaluation and go through the choice of a medical commissioning group.

I was anticipated to strip and stand at every assessment, prodded and poked by male medical professionals, trainee medical professionals and nurses. I felt I had no option– it was as if by choosing to have the surgical treatment, I had actually quit my right to personal privacy.

At one consultation, a young GP printed off NHS recommendations on breast decreases after Googling it. At my psychiatric assessment, a female medical psychologist asked me: “When you state you believe individuals are gazing at you on the street– are you not looking at them initially?”

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Amy Hill … had a breast decrease on the NHS. Photo: Amy Hill

After a stressful, invasive and embarrassing battle with my GP and NHS Scotland, I wound up spending for the operation myself. The system successfully presses females looking for breast decreases into the economic sector, state Bramhall and Hall.

Ann(not her genuine name ), a 22-year-old trainee living in Scotland, desires a decrease operation for her 36FF breasts, however can’t pay for to go personal. “I wish to like the method my breasts look, however I truly do not, despite the fact that all my sexual partners like them. There have actually been times when I have actually felt so disappointed, I have actually thought of the physical and mental relief of simply slicing them directly off my body. They do not make me feel more womanly, so I do not believe I ‘d feel less of a female without them.”

Ann discovers that clothing never ever fit appropriately, and bras cost far more than those in basic sizes. Many of all, she states, “my back injures– however not enough for the NHS”.

Bramhall states that along with the physical issues connected with big breasts– “pain in the back, shoulder discomfort, infections, bra straps cutting, impetigo-like thrush under the breast”– the effect on individuals’s psychological health and lifestyle is typically ruled out. “A typical psychological sign in my clients is low self-confidence and bad body image. They do not have self-confidence socially, and when they run out their clothes with their partners. I get females all the time who explain not feeling comfy in swimsuit or summertime clothes– the quantity of enjoyment they get in summertime is decreased. Individuals use loose clothes all the time to camouflage their look. It’s not taken into consideration at all.”

Those who can’t manage personal surgical treatment might be lured by less expensive choices that are not constantly safe or well-regulated. Bapras members report seeing clients who had post-op issues after cosmetic treatments outside the UK, where eligibility requirements are frequently more lax or perhaps nonexistent. In a lot of cases, having unmanageably big breasts is related to health problems such as weight problems, due to the failure to workout, and stress and anxiety and anxiety, due to low self-confidence and self-image (which can change into body dysmorphic conditions).

Hall states the NHS requirements can reject surgical treatment to those who require it most. “A great deal of the requirements are based upon bad proof: for instance, it is really difficult to preserve a BMI of listed below 27 for 2 years with big breasts. You can’t work out. They look larger if you are slim. If you are a size M, your breasts can weigh the equivalent of 2lb of sugar on both sides.”

Both specialists acknowledge the pressure that the NHS is under, leading it to prioritise injury and cancer cases. “The NHS does not have an endless pit of loan,” states Hall, “however what Bapras would like is openness and harmony. We would like the exact same eligibility requirements throughout the nation so it corresponds, no matter where you live. If the NHS chooses that nobody is getting a decrease, then it ought to inform us that there is no cash, which it isn’t going to money it.”

It speaks with a broader concern in females’s health concerns not being taken seriously that every year, countless ladies are spending for a treatment that certainly enhances their health and lifestyle. I had actually had problem with the choice to look for surgical treatment, questioning if it was anti-feminist to wish to alter my body– however my decrease ended up being the most empowering choice I had actually ever made. It was not practically making my breasts smaller sized– it was a course to a life of self-confidence, devoid of pain.I got autonomy over my body, however I needed to defend it.

Read more: https://www.theguardian.com/lifeandstyle/2019/jul/15/my-breast-reduction-why-i-had-the-surgery-that-helped-simona-halep-win-at-wimbledon

Breast v bottle? Motherhood is messy enough without picking sides | Hadley Freeman

Its among lifes paradoxes that this dispute will rave most loudly when a female is at her most susceptible

M y experience with breastfeeding was as unwinded as it was totally irregular. I had a C-section, which suggested I remained in medical facility a couple of nights to recuperate, which indicated in turn I was familiar with among the night nurses. Every night, she made the effort to teach me the essentials of breastfeeding, assuring me that I was doing simply marvellously.

When I got house, a pal who, like me, had twins, informed me that if I wished to maintain my peace of mind I ought to get some assistance a number of nights a week (our subject for today is feeding, however synchronising the sleep patterns of newborn twins will one day be my magnum opus). I was fortunate sufficient to be able to manage this, which suggested that somebody routinely pertained to my house and, once again, assisted me breastfeed. She unhesitatingly revealed me how to make formula when I informed her I desired to do blended feeding– breast milk and formula– since my body required a break. As an outcome, I experienced none of the anguished feelings I ‘d seen a lot of pals go through about feeding. This is since I was blessed with luck (conference the nurse) and advantage (having the ability to manage aid), neither of which ought to be the identifying aspects about how a female feeds her infant.

Last week it emerged that the National Childbirth Trust’s (NCT) president, Sena Talbot, has actually resigned, irritated that the organisation initially referred to as the Natural Childbirth Trust is openly supporting moms and dads who utilize formula. “The proof is truly clear that breast milk is much better for infants than formula milk,” she informed the Guardian . “We need to utilize that details to make certain that females are completely notified when pregnant, so that they can then choose what option is ideal for them.”

This stimulated a multitude of commentary about the “war” in between breast- and bottle feeding moms and dads, a framing that is false and unhelpful. A lot of moms will attempt both. The polarised language with which such options are typically talked about– the lactivists versus the formula feeders! the natural birth evangelists versus the C-sections!– does not show most ladies’s truth. Motherhood is untidy and withstands remaining within the lines of one’s own expectations, not to mention more comprehensive ideological arguments.

But this does not stop supporters on both sides recommending otherwise, and it’s one of life’s more regrettable paradoxes that it is when a lady is at her most tired and susceptible that these arguments will rave around her most loudly. No doubt, formula business have actually utilized doubtful marketing techniques , however breastfeeding advocates can likewise be guilty of exaggeration and psychological blackmail.

Talbot’s remark is a classic of the category: not informing ladies breast is finest is avoiding them from making the right (“notified”) option. This relies on worldwide population data as opposed to private requirement. Yes, breast milk has some advantages over formula– however are they actually worth a mom ending up being desperate as her child drops weight since she can’t feed him with her broken and bleeding nipples? Plainly not, and the much-vaunted benefits of breastfeeding are specifically minimal when we’re speaking about moms who can pay for the NCT’s antenatal classes, moms who will most likely have access to tidy water and a steriliser. Supporters talk passionately about how females who are unsupported stopped breastfeeding earlier than they ‘d like, which this threats postnatal anxiety. They do not appear to think about that possibly this has less to do with breastfeeding itself, and more to do with it being energetically offered to ladies as the maternal perfect.

I never ever went to an NCT class since pals’ stories recommended that the organisation’s assistance of brand-new moms frequently blurred into advocacy of so-called “natural parenting”. (When one buddy asked an NCT group leader about discomfort relief throughout giving birth she was recommended to “attempt noise”, an idea that would have led to me making the noise of hysterical laughter.) If the NCT is now giving up ideology for a more sensible technique that is plainly a good idea, due to the fact that investing maternal options with a frightening however unclear ethical measurement is harming to infants and ladies.

The reality is, ladies in this nation aren’t offered enough breastfeeding assistance, thanks not least to austerity: over the last few years, a minimum of 44% of regional authority locations in England have actually been impacted by closures or cuts to breastfeeding services . Those who desire to offer it– or get it– feel under hazard and dig their heels in more difficult. When my sis had her very first child in Switzerland, the regional council scheduled her to meet a feeding specialist weekly. In Britain, who can moms rely on for routine, complimentary, non-ideological guidance?

When I had my infants, I seemed like Alice toppling into Wonderland, beleaguered on all sides by mystifying and frequently inconsistent recommendations. I was lucky to discover 2 females who taught me to trust myself and ignore the rest, who understood that females ought to invest less time attempting to determine up to the expectations of others, and more time asking themselves what they in fact require. This is the least we ought to offer all moms, and the only escape of the bunny hole.

Comments on this piece are premoderated to guarantee the conversation stays on the subjects raised by the post. Please understand that there might be a brief hold-up in remarks appearing on the website.

Read more: https://www.theguardian.com/lifeandstyle/commentisfree/2019/may/04/breastfeeding-v-bottle-motherhood-hadley-freeman

Dont tell women to shut up about childbirth. Sharing stories saves lives | Suzanne Moore

Giving birth is bloody uncomfortable. Why reject it? Its likewise the experience of a life time, states Guardian writer Suzanne Moore

Mumsnet may be accountable for a lot of doubtful things– penis beaker , anybody?– however will it in fact end the mankind? Will it stop us recreating? This appears a little extreme however obviously by sharing stories about giving birth there, ladies are terrifying other females into “a pathological horror of giving birth”, states a professional. Catriona Jones is a speaker in midwifery at the University of Hull who studies “tocophopbia”. She recommends social networks is partially to blame for this fear-with-no-name (which, obviously, now has one).

Let’s break this down, shall we? Women worry giving birth since pressing out another human being through a little opening in your body is to be divided asunder. They fear the discomfort that preceedings it: labour. They fear the discomfort throughout the real pushing-it-out bit, and frequently have little concept about the discomfort that follows. We “feel the worry and do it anyhow”– simply as that dumb mantra informs us to.

The worry is logical. This is not a workout in fiction when ladies inform each other birth scary stories nowadays. They are informing the fact.

My mom explained giving birth to me therefore: “I was sitting beside your nana on the sofa. I felt a twinge, and she stated, ‘It’s time to pop upstairs’– and you were born.” She likewise stated there was no have to “make any sound”. That expression returned to me when, off my skull on pethidine, I was bring to life my 2nd kid, I believed I remained in a field of huge cows mooing; then I understood these deep, groaning sounds were really originating from me.

For my sins, I have had one natural birth, one on screens (with stated beautiful pethidine), and a caesarean. My experience is that I recuperated far more rapidly from vaginal shipments than caesarean ones. Anecdote is not information, however, and basically I feel females need to have the option.

Choice can not be made in a vacuum. And this is why females talk with each other. You may get the odd sadist who gets a kick out of explaining torn perinea, infection, the destruction of their whole “undercarriage” (!). You likewise find out. In theory everybody desires a low-lit birth swimming pool. In truth, when the shit strikes the fan– or often the birth “partner”– one is eliminated that hi-tech, medicalised births are to be had.

The feminist discourse around birth looks for just a smidgen of control. Ladies need to not need to plead for discomfort relief or caesareans, anymore than they must need to ask to keep whatever as natural as possible. Severe discomfort makes us feel out of control– everyone. To get ready for that, it is needed to understand exactly what alternatives are readily available.

This is not sharing “scary stories”. While children might be stunning, let’s not pretend birth is. It is full-body scary. Why reject it? Who understood that once the infant comes out you still need to provide exactly what appears like a huge internal organ– the placenta? Who really wishes to be sewn up in the most delicate part of your body, while being informed you do not feel it, although you do?

The ecstasy might soothe, however this does not imply you will not be sent out house in discomfort, greatly bleeding– whichever method you have actually delivered. All the squidgy toys and soft infant blankets and consumable cuteness is a big rejection of the blood-and-guts experience of birth. It is informing that numerous female obstetricians choose optional caesareans.

They state you forget the discomfort of giving birth. Yes and no. You primarily question how you survived it. Exactly what I remember is the discomfort after giving birth, which in fact is exactly what much discussion on Mumsnet has to do with. Females feel harmed, aching, cut, fretted about ever making love once again. They fear incontinence and the loss of the capability ever to feel satisfaction once again, along with absolutely deserted by medics. They are implied to be pleased, however their bodies feel broken. They feel that nobody informed them it would be in this manner, and they hesitate.

This does not sustain worry: it fuels action. How else would the scandal of vaginal mesh have been made popular? The truth of an NHS extended to it restricts is: inadequate midwives, too couple of anaesthetists on call, and ante- and postnatal care lowered to six-minute slots. In this context, then, worry of giving birth is not ungrounded, or to be treated with a little CBT.

I would state to any ladies: yes, it bloody injures, however it’s normally just a day approximately from your life. If it does not go as prepared, do not blame yourself. The very best strategy is the one where both you and the kid live at the end of it. It is the experience of a life time. Please do keep talking if you feel psychologically and physically traumatised. You are not spreading out worry. Since females sharing their facts, nevertheless bloody untidy these are, is in fact how we alter things.

Suzanne Moore is a Guardian writer

  • Comments on this piece are premoderated to guarantee the conversation stays on the subjects raised by the author.

Read more: https://www.theguardian.com/commentisfree/2018/sep/13/women-childbirth-stories-giving-birth-painful

In these dark times, embracing laughter is an ethical choice | Charlotte Wood

Laughter has optimism embedded in it. It allows us to see that, while we are all human and we fail, we can change

Because we live in such very dark times, Ive been thinking about laughter and art.

If you feel as I do, some days youll see no hope for humanity. Weve destroyed much of the planet already and seem hellbent on continuing that destruction. People all over the world suffer unspeakable violence and deprivation. We in affluent countries seem unwilling to share our wealth with others, and we spend our time and money on pursuits that wreak ever more environmental destruction.

At the same time, those of us in wealthy nations suffer ever-rising levels of anxiety and depression. Australians have the second highest rate of antidepressant use in the world. What can simple laughter possibly do to counteract all of this?

It might seem a trivial thing to be talking about, when the world is in such trouble. You might expect that Im about to advocate fiddling while our planet burns, urging you to enjoy a kind of nihilistic amusement at what weve done to ourselves. But nothing could be further from my mind. The embrace of laughter in our art and in ourselves is an ethical choice that we can and must make; Im idealistic enough to suggest that if we think seriously about laughter and what it means, we might even begin to save our planet.

The first question, of course, is what do I mean when I use the word laughter, as opposed to comedy, or satire, or even humour. The distinction is a little difficult to make but its an important one for me, because I dont think comedy can save the world. I dearly wish it could.

What I mean is something beyond, and broader than, comedy. I mean a sense of lightness, of joy, the sense of possibility that comes when laughter enters a work of literature, whether its manifest on the page itself or merely as part of the writers process. For laughter is a sharp instrument, as it turns out, capable of performing many crucial, and I think profound, functions.

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Daniel Lapaine and Toni Collette in Muriels Wedding.

Photograph: Alamy Stock Photo

Ive been drawn to thinking about laughter lately because for the past three years, since publication of my novel The Natural Way of Things and for the preceding three years during which I wrote it Ive been thinking and speaking so much about anger. That book concerned our societys punishment of young women for speaking out against sexual mistreatment, and it was published in 2015, a couple of years before the #MeToo movement exploded across the globe. It took me a long time to accept my own anger about the degradation of women in our culture. I dont consider that I personally have been oppressed in any significant way, other than in the ways all women are and that is a mark of my privilege and the many forms of pure luck that have visited me through my life. But on behalf of my gender and the inequality we continue to fight, angry I certainly have been. I still am.

It has taken me until deep in middle age before I learned that anger could be a productive creative tool. Creative anger, as I think of it now, is the kind of fury that can be channelled and harnessed. It burns slow and low, as fuel for producing art full of charge and fire and power.

But while it can be artistically productive even absolutely liberating when anger is not balanced with other energy sources it is also, in my experience, completely exhausting. If I want to keep working, writing purely from anger would be impossible.

But more importantly, Ive come to realise that, for me, laughter by which I mean this sense of lightness and pleasure and optimism might in fact be productive angers most effective, most powerful friend.

Laughter as pain relief

Laughter and pain are inextricably linked in life, as anyone who has made a black joke at a loved ones deathbed knows. A friend of mine whose brother died as a small baby tells me that when her father sat the other children down to tell them this horrific news, she and her brother and her father too began to laugh. They roared laughing, in fact. And then they cried.

Just before my own father died, when my siblings and I were teenagers, he told us not to feel guilty if we found ourselves laughing about his death. Inappropriate laughter, he so compassionately told us, was a natural impulse, of which we must never be ashamed.

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Laughter can be a psychic expression of disbelief a refusal to accept that what is happening can actually be happening. Photograph: Joe Raedle/Getty Images

So what is it, this human instinct to laugh through tears? Maybe its a pressure-release valve. Maybe its a psychic expression of disbelief a refusal to accept that what is happening can actually be happening. Or perhaps laughter at terrible times simply releases some badly needed chemical, some pain relief for the soul. Whatever the reasons, of course laughter and hurt are inextricably linked in literature as in life.

When I think of this, I think of Amy Blooms sassy, bittersweet literary voice, or George Saunders tender absurdist stories, or his frolicsome spirit at work in the devastating Lincoln in the Bardo, where ghosts who do not understand they are dead live and yearn in the graveyard alongside President Lincolns lost son.

But its not only in the subject matter of books that laughter can be found but in form and language, even grammar and punctuation. I recently heard the Irish novelist Anne Enright articulate this beautifully, in describing the narrative voice of Gina, the heroine of her novel about marriage and infidelity, The Forgotten Waltz.

I tend to shift tone from paragraph to paragraph and sentence to sentence, and even sometimes on either side of a comma, said Enright. You get a kind of ironic shift or lift, or you realise something was a bit of a joke but youre not quite sure what the joke was. Gina is full of jokes, which isnt quite a sense of lightness, its almost a sense of hurt, expressed as lightness irony being a kind of distance you have from yourself or the situation. That remove, that disconnect, is not always a joyful one but its quite a powerful one.

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Hillary Clinton is greeted by supporters at a town hall meeting in New York during the 2016 presidential election campaign. Photograph: Andrew Renneisen/Getty Images

Enright seems here to be talking about voice itself as a manifestation of laughter through hurt; language itself as a form of analgesia.

Hurt is present, too, in aspect of laughter laughter as defiance, as resistance.

Laughter as resistance

Here my thoughts turn most immediately to satirical writing to dark political comedies like Joseph Hellers Catch 22 perhaps, or Kurt Vonneguts Slaughterhouse Five. But in thinking about social critique and laughter Im just as likely to turn to Jane Austen, and the way her wit so sharply exposes the injustices of the class and gender restrictions of her era. In contemporary Australian literature, I think of the work of Wayne Macauley, with his strange, black novels about social alienation in the late capitalist era. And I think, too, of Michelle de Kretsers dazzlingly sharp scalpel, and the incisions she makes into privileged, well-meaning progressive thinking on race and class and power in books like Questions of Travel and her latest, The Life to Come.

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In thinking about social critique and laughter Im just as likely to turn to Jane Austen. Photograph: Allstar/BBC

Satire is often perceived as a rather chilly art form; some might even say cynical but I think its important to note that the best satire is born of deep idealism. As the British writer Anita Brookner said, Satire depends on strong beliefs, and on strong beliefs wounded. Both Michelle de Kretser and Wayne Macauley have echoed this in recent statements of their own. De Kretser, in a conversation at the Sydney Writers festival this year, raised the adage that if you scratch a cynic youll find a wounded idealist. When I interviewed Wayne Macauley for my book The Writers Room, about the often bleakly funny version of Australia to be found in his fiction, I asked him, Have you ever been idealistic? He answered, Im incredibly idealistic. Thats the problem! If I didnt think about all the potential Id be very different. But I do have idealism ridiculous, ludicrous idealism when I think about it.

Aside from satire, though, theres a less obvious, more surprising form of laughter as resistance, one that I first noticed in the fiction of Kim Scott. Scott, a Noongar man and two-time Miles Franklin winner, is very much aware of a sense of humour as a powerful weapon in his work. Its wielded not as satire but a form of playfulness. I asked Scott about this, about his books capacity for joy even while speaking of monstrous cultural destruction and the most dreadful abuses of Aboriginal people.

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West Australian Indigenous author Kim Scott, whose novels include That Deadman Dance, Benang: From the Heart and Taboo, and who has twice won the Miles Franklin literary award. Photograph: Pan Macmillan

This is what he said about the humour in his first novel, Benang: I knew what I was doing. I was trying to make fun of some of the really shitty stuff it defuses some of the hurtfulness thats in there, I think, by playing with it. And it also seemed gutsy to play in that context. It seemed courageous not only because it was difficult to sort of psych yourself up to do that. But because it might also be seen as an unworthy way to deal with nasty shit like that, to play with it. It is a source of such hurt and damage, you know, what are you doing playing? Its not an appropriate response. But it seemed very necessary.

Along with music and dancing two other forms of laughter, Id suggest these bubbles of optimism and joy play out again and again in Scotts work.

Laughter as courage, as taking charge of your own history and pushing back against oppression by saying no I decide what material I get to be playful with this seems to me not only a profound statement but a very beautiful one.

This sense of play brings me to my third point laughter as a generative, creative force.

Laughter as a creative force

Just as anger can be fuel for art, laughter does the same work in a different way. It can operate sometimes as a key change in a dark work, bringing lightness into gloom and providing a balancing energy. I hope, for example, that the darkness of my novel The Natural Way of Things is ameliorated for the reader not only by little blasts of beauty but by moments of comedy and lightness. In this way, laughter can provide a breathing space for the reader, a moment to gulp some fresh air and sunshine before plunging back into the hard stuff.

But there is also, in the creative process itself, a very important role for play, for mischief. Its this form of humour, or laughter, that I think provides a crucial creative energy for art. A while back I wrote a PhD thesis on the cognitive processes of creativity. One of the nine processes I identified in a small longitudinal study of five writers was what I ended up calling overturning or disruption. This process is evident in a writers urge to change tack, to throw a spanner in the works. Its that part of our creativity that behaves like a mischievous imp, moving through a narrative and flipping over our carefully constructed ideas and orderly scenes. For me, this is an essential and hugely energetic part of creativity. It often comes from a sense of boredom with the work as it stands, even sometimes especially if the existing work is perfectly well-made.

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There is also, in the creative process itself, a very important role for play, for mischief. Photograph: Alamy Stock Photo

One of the writers in my study described a kind of rogue spirit entering the work: I reckon the impulse to muck things up is a massively good impulse, she said. When I get that little voice in the fiction, its often the start of the real idea. Its the part of you that wants to make a silly face during a job interview. When that [impulse] comes it can be really good, because you think, Oh, this is digressive and has nothing to do with anything but it actually turns out to be key.

In my own experience, some of the most important creative discoveries Ive made have arisen from this playful, experimental urge to simply poke a hole in something, or blow things up. George Saunders alluded to this urge when talking about the structure of his masterpiece Lincoln in the Bardo.

Speaking of the moment he decided to sample bits of real historical texts, edit them, rearrange them and insert them into his book, he said this: That was [a] moment of excitement and a little bit of transgression something about the almost suspect nature of that got me excited. Ive learned to trust that feeling. If Im being a little dangerous or a little naughty or a little transgressive then I know to go in that direction. I think many artists will recognise this sense of transgressive excitement in the creative process. Its like knocking over a glass of water to see what will happen. Writing against the grain of ones existing beliefs or instincts or knowledge often causes a sudden surge in energy that can turn out to reframe and inform and charge whole works with surprising new power.

Laughter as truth telling

Humour has always been used, very effectively, to puncture inflated emotions or overturn pious ideals. I think the kind of laughter I most enjoy in contemporary novels is that where the characters are behaving badly especially if they are women. In popular culture, representations of women to a large degree still fall into those two restrictive categories so clearly identified by Anne Summers more than 40 years ago in her landmark book, Damned Whores and Gods Police.

In this world, for a writer to encourage good women to behave poorly seems to me an extraordinarily liberating act. One of my favourite writers is Alice Thomas Ellis, an English writer who died in 2005 at 72 after producing a dozen novels. The New York Times described Thomas Elliss fiction as unflinching dissections of middle class domestic life and they are. Often, what shes unflinchingly dissecting is the minutiae of relationships between women.

Another writer I greatly admire is Elizabeth Strout, the Pulitzer-prize winning author of Olive Kitteridge, among other books. Strout has said some interesting things about truth and laughter. When she first began writing, for a long time her fiction was rejected. After enduring this for many years, she says, she had a hunch that it was being rejected because she wasnt being altogether honest in her work. There was something she was avoiding writing about. Strouts rather unconventional response to this hunch was to enrol in a stand-up comedy class. In a recent interview, she said shed always known that people laugh at something when its true. In the years her writing wasnt working, she thought, I must not be saying something truthful. I thought, what would happen to me if I had to stand there and have an immediate response from the audience? What would come out of my mouth? It was like putting myself in a pressure cooker.

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A sketch of the author Elizabeth Strout. Illustration: Alan Vest

She took the class and the final exam was to perform at a New York comedy club, where she found her comic voice, sending herself up as this really uptight white woman from New England I was just such a white woman and so much from New England that I didnt even know that about myself until I began to make fun of it. I was finally realising, oh, this is who I am. After that, she began writing about an uptight white woman from New England, and her work took off. People laugh at things that are true, Strout reminds us.

The most electric thrill of truthful recognition comes, it often seems, when whats being revealed is something shameful or ugly in human behaviour.

When we reveal the things that show us to be smaller, less worthy than we thought, were making ourselves vulnerable. At points of revelation like these, laughter is a very powerful tool of connection. It allows us to see that we are all human; we are all children; we all fail. Theres a sense of shared relief immediately attended, I think, by a shared forgiveness.

Laughter as a call to optimism

My friend the writer and critic Tegan Bennett Daylight has taught creative writing for many years at universities. The first thing she tries to teach her students is to laugh at themselves. I ask them to cultivate a sense of humour as they write, she told me. In a clear echo of Strouts stand-up discovery, she said, When were laughing at ourselves were being honest about who we are were telling the truth. Theres something profound in this. The ability to laugh at ourselves reflects a crucial flexibility and openness in our thinking. Laughing at yourself means acknowledging your fallibility. It shows you know you might be wrong.

I think this self-questioning is also embedded in a writers capacity for humour, even when its not visible on the page. In this form, the laughter is like an underground river of possibility and goodwill, flowing along beneath the work: you cant see it, but you feel the strength of its current beneath you as you read.

Is it too much of a stretch to believe that this lightness, a sense of the possibility for joy, can allow us to face ourselves, to pause and question our own certainties? It seems crucial now to develop the ability to examine our most deeply held beliefs anew. And to discover that sometimes, were wrong.

I think that if we can do this, we must. If we can overturn an expectation, seize the power to play with dangerous material, if we can use laughter to tell difficult truths and harness it as a powerful creative force, all of this means we can imagine a moment to be different from what we thought it was. If we can imagine a moment to be different, then we can imagine a world to be different.

Laughter has optimism embedded in it. As an ethical choice it is a refusal to accept that what weve already done is irrevocable, that the damage looming before us is inevitable, that the world is unchangeable. It shows instead that just maybe – a new world might be there to be made.

Further reading:

  • Lincoln in the Bardo, by George Saunders
  • The Forgotten Waltz, by Anne Enright
  • Catch 22, by Joseph Heller
  • Slaughterhouse-Five, by Kurt Vonnegut
  • Some Tests, by Wayne Macaulay
  • Questions of Travel, by Michelle de Kretser
  • The Life to Come, by Michelle de Kretser
  • Benang, by Kim Scott
  • Olive Kitteridge, by Elizabeth Strout

This is an edited version of a speech delivered to the Bendigo Writers Festival

Read more: https://www.theguardian.com/culture/2018/aug/19/in-these-dark-times-embracing-laughter-is-an-ethical-choice

Women are turning to birth control smartphone apps for a reason | Dawn Foster

Contraception technology isnt foolproof, but doctors must realise why we find the idea so appealing, says Guardian columnist Dawn Foster

Amid the targeted ads in my social media feeds, a war is playing out: two apps aggressively vie for my attention, stalking me from the sidebars of my browser and comprising every third photo in my Instagram feed one offering to track my ovulation and get me pregnant, the other offering to do the same, but promising I wont find myself in the family way.

The latter seems to be winning the war, with quirky gifs and videos showing young women waking up and gleefully taking their temperature, inputting digits into their colourful app, and being told they can throw barrier contraception to the wind that day. Its sold as being hyper-scientific, with the founders and developers formerly working at Cern, and without a single side-effect: unless, of course you count unintended pregnancy as a side-effect.

The novelist Olivia Sudjic, writing for the Guardian, revealed her shock at getting pregnant within months of starting to use the Natural Cycles app, and found many other women had too. In bare bones, the app is simply the Vatican-favoured rhythm method repackaged in shiny, Silicon Valley jargon and a slick interface. And the rhythm method doesnt have the greatest reputation as a diecast means of preventing pregnancy: the Catholic church recommend it for married couples both trying to plan and delay pregnancy, but with the very clear message that couples employing it should be open to the possibility of new life. Happy accidents can bring as much joy as planned babies as a Catholic, I back the churchs teaching that sex is about far more than pleasure, and also comes with responsibility and consequences for you and your family. I could use the app to try to avoid pregnancy but would have to accept pregnancy as a possible outcome of any bedroom antics.

But other women are perfectly entitled to want a contraceptive less prone to chance and failure, and deserve the truth about the app sold as super accurate. Its unreliable because our bodies are unreliable: fertility waxes and wanes with an assortment of biological factors, and tracking ovulation is never an exact science.

Its this fact that makes the marketing behind Natural Cycles so insidious: the science is pushed hard even though the founders are physicists, not gynaecologists. Id no more listen to a physicists advice on my fertility than I would let a mechanic cut my hair. To use the app correctly, women must record their temperature at the same time each morning, immediately upon waking, before sitting up . Many things can throw off the accuracy: oversleeping, having a fever, being hung over, insomnia, taking your temperature shortly after waking, irregular periods and polycystic ovary syndrome. According to these criteria I couldnt have recorded a single day accurately in the last week Ive had heat-induced insomnia, slept late, woken early, had a mild hangover, and woke one morning with a slight fever. Trying to remember all of these conditions, when the apps marketing tells you it is reliable, gives some clue as to the reason why so many women are unhappy.

But its not surprising that promises of natural birth control are so alluring. The side-effects of most forms of contraception are maddening. Friends on the pill have had their weight explode, their mental health suffer, and their skin return to teenage form, with migraines drastically worsened by daily hormones. My experiences with doctors echo those of most of myfemale friends with dysmennorrhea, endometriosis and polycystic ovary syndrome: for years my complaints were dismissed as though I werecomplaining about a mild discomfort. Only when my periods lasted three weeks out of four, I was seriously anaemic from blood loss and repeatedly lost consciousness with pain was I granted a referral to a specialist that led to an operation and a diagnosis of adenomyosis, a severe form of endometriosis. One GP told me the contraceptive implant Id had in my arm for three years had been rendered useless by the epilepsy medication I took every day.

The backlash against birth control apps is growing. Yet, women do need more readily available information about their own fertility, as well as about the side-effects of the contraceptives they are prescribed. Technology appeals because the medical profession too often dismisses and fails women, and has ignored the concerns of many women disenchanted with the side-effects of hormonal contraception. No wonder Silicon Valley steps in, seemingly offering a natural and smart solution that looks and is too good to be true.

But doctors should ask why so many women would consider trusting an app over a medical professional, and researchers should look at why so many people are unhappy with the prescribed pills, injections and implants, and work to improve them. All of us emerged blinking into the light from a uterus: fertility should be taken more seriously, and women should be trusted when reporting symptoms and anxieties, rather than be treated as unreliable witnesses and hysterics.

Read more: https://www.theguardian.com/commentisfree/2018/jul/24/women-birth-control-smartphone-apps-contraception-technology

What does childbirth feel like? You asked Google heres the answer | Nell Frizzell

Every day countless individuals ask Google lifes most tough concerns. Our authors address a few of the commonest inquiries

T wenty-4 hours into my labour I might be discovered using a set of XXL hi-vis pants– the kind used by obese building employees as they repave freeways– pacing a little, rat-scuttled stretch of the River Lea, rubbing my nipples like kindling and murmuring to my partner in the stable, driving rain.

Six hours into my labour I was consuming a chicken bagel on a bouncing birth ball, seeing Dr No with my cousin; 48 hours into my labour, I got up, damp and light-headed, my waters broken; 51 hours into my labour, I was kneeling in a birth swimming pool in Homerton medical facility, holding a gorgeous, howling prune in my arms.

Like cheese sandwiches, the Milibands and snowflakes, no 2 labours are ever the exact same . The very same mom with the very same daddy in the very same space will have entirely various experiences with each kid, not to mention the distinctions from lady to lady. You might have a caesarean, you might have an epidural, you might provide in the restroom, you might be sent out house from the healthcare facility; you might tear, you might take no discomfort relief, you might be caused, you might provide early, you might require interventions; you might error the early indications, you might not.

But remember this: any labour that leads to a healthy child and a healthy mom is an excellent labour. Any lady who goes through any kind of giving birth is a hero. The blood, the guts, the self-sacrifice, the endurance, the body-shuddering pressure, the worry, the gore: no surprise guys needed to create war to relieve their sensational sense of insufficiency. Giving birth is an act of bravery, strength and endurance no guy will ever understand.

When I was pregnant, individuals appeared excited to inform me scary stories about the ladies they ‘d understood who had actually suffered significantly. Those experiences are legitimate and genuine and come from the females who experienced them. If you are pregnant, or thinking of getting pregnant while reading this, might I merely state: it isn’t really constantly like that. It can be extremely various.

Let us start with contractions, for that is most likely how things will begin. My buddy, the author Amy Liptrot, explained contractions as “an earthquake going through your body”. It is, for me, an ideal description. I was anticipating nuclear duration discomforts– exactly what I got, as my mom did prior to me, was a sensation like an HGV reversing into my lower back. They were seriously heavy weather condition and I keep in mind believing, 2 days in, as I held on to the windowsill, in the dark, my partner rubbing my back, my face versus the glass, “I am never ever doing this ever once again.”

They were unrelenting– a near-total block on idea, a thick black sound filling every inch of my body, an unshareable weight, a main focus for all the gravity in deep space. They weren’t precisely uncomfortable– stressful and simply frustrating. Due to the fact that they kept coming.

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alt=”Mother” with kid “src=”https://i.guim.co.uk/img/media/94a8761f31a48b839c8bd91dcec7c3b2cce79f6a/321_346_4999_2999/master/4999.jpg?w=300&q=55&auto=format&usm=12&fit=max&s=28e2eb3d0754676b63755151e4b8e966″/> ‘Anyone who births a kid, by whatever implies, deserves our appreciation and our assistance.’Photo: Sarah Lee for the
Guardian

Of course, individuals do experience amazing discomfort and if you are caused, your contractions will feel completely various. I discuss my own just to explain that contractions, like all aspects of labour, might not be exactly what you’re anticipating. If you perhaps can, do not withstand them, for they are efficient, essential and they do pass. I discovered this balloon metaphor rather handy .

My waters lastly broke after 2 days and 2 nights of contractions. I felt all of a sudden light, glowing, made from something like glass– whatever was sharp and brilliant however likewise shining. As I strolled through the health center I felt each breath entering like something white and icy.

I had actually been sent out house two times that previous night, hunkered over like an animal, a towel over my go to shut out the world, heaving, groaning, sweating, impatient, pulsating. I had actually withstood contractions pushing a bed, under a shrieking fluorescent bulb, 2 screen belts throughout my stubborn belly. I was not prepared. I needed to go house. I have actually never ever been so dissatisfied.

When I returned that early morning, light-headed, my pyjamas damp, not able to sit, strolling like sand, the midwife analyzed me to find that I was completely dilated. I have actually never ever felt such relief.

“Nell, can you feel anything in your bottom?” the gorgeous, clear-faced midwife asked me as I lay naked on a bed mattress next to the window. Did she suggest the contractions? This pulsating heaving pressure in my lower back? “Do you indicate my pooing bottom?” I asked, bleary-eyed. She did. I felt absolutely nothing till, dragging my method into the toilet for a wee, I all of a sudden felt the desire. I went out of the toilet, into my birth space, naked, sweat-soaked, eyes half closed. “My bottom,” I revealed, “is now included.”

Pushing out an infant, the last, was– and please think me when I state this– terrific. After 2 days of contractions– a sensation that I was getting no place, the nearly intolerable wait stressed by the relentless crashing waves of pressure– to understand that I was lastly going to leave was dazzling. Unexpectedly, I didn’t care where I was, who was with me, exactly what occurred. I might have pressed that infant out in the middle of a Lidl parking lot.

As I knelt in the swimming pool, grasping my partner by the fists, following the breathing directed by the midwife, I understood in some way exactly what it took. This pressing recognized, inherent. Not unlike a shit, obviously, however in some way sensational in its scale. I might really feel the limbs, the corners, the structure of my infant moving down through my body.

My limbs were simply ribbons hanging off this giant, pulsating tube. I was a volcano, a kid, a stiff blank in the centre of a moving world. I felt an appear my vulva. I felt with grim approval that I had actually torn my vaginal area into a doily; I had actually been too excited and ripped it apart. “That was simply the seal around the infant’s head,” my angel midwife stated, from someplace behind my arse.

I pressed. I felt a head then it escaped. If the child was out, I asked my partner. He handled, in some way, to keep a straight face. It was not. Lastly, out it came, in 2 massive heaves that turned my face puce: a Francis Bacon painting of hot purple contortion so furious I had to dip it in the water around my body for relief.

Childbirth seems like whatever to everybody. Wolves gnawing at your entrails, blue medical hairnets, a rumbling ocean, white sound, sandwiches in plastic packages, teeth-chattering nerves, the ripping apart of your hips like tectonic plates, the leak and click of equipment, lightning down your spinal column, the pale blank hum of a medical facility light, the onion sweat of animals, panic, darkness, fatigue, a mist that ends up being hail, leaving your body, thinking in your body, a beleaguered body, a body pulled from your body.

There is no bad labour and no excellent labour. Anybody who births a kid, by whatever implies, deserves our appreciation and our assistance. They need to feel happy; that’s exactly what giving birth must seem like. Pride.

Nell Frizzell is an independent reporter for the Guardian, Vice, Buzzfeed, the Independent, Vogue, i-D and Time Out

Read more: https://www.theguardian.com/commentisfree/2018/jul/18/what-does-childbirth-feel-like-google