Women sometimes get told that they cannot give birth at home with their first baby because they have an “untried pelvis”.

What if we told men they couldn’t have sex at home the first time because they have an “untried penis”

Just imagine a young couple going to see a health professional, to discuss their plan to have sex for the first time.

Doctor: Hello please  come in, what can I help you with?

Couple: Hello, we have been together for a while now, and we feel ready to start having sex.

Doctor: That sounds about right, I will arrange for you to go to your local hospital.

Couple: Actually we were hoping to have sex at home

Doctor: At home!! For your first time?? This isn’t safe.

Couple : Why? It’s quite a natural thing isn’t it?

Doctor: Yes it’s a natural thing, but lots of things can go wrong, because you have an untried penis. When you’ve had sex at least once in hospital, and we know you can do it effectively and safely then we’re happy for you to have sex at home. But for your first time, it’s much safer to do it in the hospital

Couple: What can go wrong?

Doctor: Well we don’t know how long it will last, whether you’ll be able to get a strong enough erection, maintain it for long enough, that’s one thing. It can also be very strenuous for the two of you, so we will need to monitor your heart rate, temperature and blood pressure. People have heart attacks whilst having sex you know? And you are both nearly 25, the risk of heart attack doubles after 25. At least if you’re in the hospital there are doctors available to intervene quickly should anything bad happen.

Couple: This sounds very worrying, but we really don’t like hospitals, the environment is cold and clinical, it smells of disinfectant, whereas at home we have the right atmosphere, smells, and all the comfort that we need.

Doctor: Well you won’t need be there the whole time, you’ll get started at home anyway, we don’t really want you to come in until you’re past the established arousal stage. Plus it can be quite a messy affair, you don’t want to ruin your furniture, do you?

Couple: So we will have to travel to the hospital, like, in the middle of it? Won’t this disrupt things?

Doctor: A bit, especially if you come to the hospital too soon, before you have reached the established arousal stage. When you come in, an intimacy midwife will assess your arousal and the strength of your erection. If your erection isn’t big enough and you aren’t yet in the established arousal stage, we will send you home and tell you to come back later. But once you’re settled in the hospital, you should be able back into the swing of things quite quickly, especially as our staff is highly trained to support the intimacy process, and help you if you struggle. Also you need to know that nearly half of first time couples who are planning for home sex end up transferring to the Intimacy Unit anyway.

Couple: We’ve had a tour of the hospital and we really don’t like the Intimacy Unit. The rooms are tiny, the beds are high and narrow, there are only bright lights and thin paper curtains, and no en-suite bathrooms.

Doctor: well yes for your safety is paramount that we can see what you are doing, and access the bed quickly and easily, in case something goes wrong, you see. It’s also safer for you to be in the missionary position for that reason.

Couple: This really puts us off,  and we’re worried we won’t be able to do it in there.

Doctor : Don’t worry if you fail to progress, we have a lot of technology at hand to help complete the process, like Viagra and penis substitutes.

I tell you what, since you’re both still kind of low risk, as long as you’re still under 25 by the time you have sex, we could let you go to our Natural Climax Centre, instead of the Intimacy Unit. It’s a home from home centre, with large rooms, double beds and mood lighting, and even one hot tub per room so you can get in the mood and relax. It looks more like a fancy B&B than a hospital! It’s staffed by experienced intimacy midwives, who are skilled in supporting physiological sex. So it will be just yourselves, a midwife, and a couple of reproductive students. They only use intermittent monitoring every 5 min during the established arousal phase. Of course if anything goes outside of the guidelines, we would suggest you transfer to the Intimacy Unit where we can monitor your heart rate continuously, as well as intervene with a penis substitute if you cannot finish by yourself. As I said before, as you have an untried penis, we don’t know which way it will go.

Couple: Regardless of the hospital location, we feel that having lots of people we don’t know watching us will be inhibiting. And we don’t want students!

Doctor: Oh don’t worry about that, all the staff are trained and completed used to it! They see it all the time, and you once you get back into the swing of things, you won’t be paying attention to what’s going on around you. Plus we are a teaching hospital, so we need to train our students.

Couple: We were also hoping to do it at a spontaneous time…

Doctor: Well yes, for low risk couples it’s ok to wait for sex to start spontaneously, but since you’re both nearly 25 your risk of heart attack is higher, so if we haven’t had sex by the time you are 25, we think it’s safer for you to come in at an agreed time so we can monitor your heart rate from the beginning, and intervene if needed. We start the process in the pre-intimacy ward, by giving you some Viagra orally, and if that doesn’t work we can give it to you via a drip which is more effective.

Couple: OK, doctor, we want to do what’s safest and not put ourselves in danger, so we will go for what you suggest.

Why did I write this?

Comparing childbirth to sex isn’t new.

The hormone that drives labour, Oxytocin, the hormone of love, is the same hormone that floods our system when we have fall in love or have sex, and because this hormone flows best in dark, private, unobserved conditions (think romantic diner atmosphere), it is generally understood that one needs a similar atmosphere to birth a baby that they needed to make the baby.

Sadly modern obstetric units rarely provide the environment for birth to unfold easily. This has been explained extremely well both in Tricia Anderson’s Out of the laboratory: back to the darkened room and in Marsden Wagner’s Fish can’t see water articles

In the book “the function of the orgasms” Michel Odent wrote a “Dear John” wedding night preparation letter from a woman to her fiancé, where she talks about the wedding night educator she has been working with and the wedding night plan she has been writing.

There is a particularly clever satire video which depicts an Italian couple trying to conceive in an hospital, it’s called “The performance“. There is another one in English called “Push”.

I have this wonderful role play that was written by Jill Alderton & Jill Oliver, for a home Birth Conference. It depicts a couple going to see their GP because wanting to have sex at home. I have adapted and rewritten it with the untried penis scenario.

Reading an article in the press today triggered me to write this new analogy.

There was the following quote

” Why could Meghan not have a home birth?

Meghan’s reported decision to abandon her home birth could have been down to an number of factors, an expert claimed.

Consultant obstetrician and gynaecologist Peter Bowen-Simpkins, told the Mail: “When you have your first baby you essentially have an ‘untried pelvis’.

“You don’t know what’s going to happen when the body prepares for labour and birth.

“If a woman is on her second or subsequent baby and has had a normal delivery before then it’s likely there wouldn’t be any problem at all.

“But you don’t know that’s going to be the case until you have your first baby.”

I got very annoyed reading this, for several reasons.

First, because it’s yet another example of what is wrong with the current maternity care culture in this country. It’s a fear based culture, one that treats birth like an accident waiting to happen.

Second, because it’s a symbol of the patriarchal culture within the maternity system. Birth is a natural physiological function for women. For a male doctor to state “she has an untried pelvis” is implying that women cannot give birth well by default.

It’s a bit like saying to a man who is getting ready for his wedding night “Here’s a dildo, just in case you can’t get it up-no pressure”

Reading about the untried pelvis made me wonder what would happen if we told men who hadn’t yet had sex that they have an “untried penis”.

So I decided to write about this, just to illustrate how supportive it would feel for men if they were told this.

Now I need to give a disclaimer. I know birth and sex are different processes. I know that bad sex doesn’t have the same possible consequences as a birth that goes wrong.

I’ve also been a doula and birth educator for long enough (I started working in this field over 10 years ago) and seen enough births to know that nothing is ever black and white, and that things can go wrong. I’m not naive. And I’m not suggesting everybody should birth at home.

I am also a paid up member of the informed choices society so I am NEVER going to push homebirth on anybody,  and I’m as likely to fiercely help a woman to have an elective cesarean if it is what’s right for her that I am to support a woman to birth at home despite “high risk” factors.

Also, language is important. The words we use can either inspire confidence (your labour is progressing really well) or cause anxiety and distress (you’re ONLY 3cm dilated).

This is why I dislike the expression “untried pelvis” so much. Because it implies that it won’t work. That we will let you “TRY”. It’s not very encouraging is it?

That’s why I wanted to make the analogy with the untried penis.