Specials | Pacific Wave - Wellness (Fall 2019)

Wellness — The Daily

The HPV vaccine double standard Social nudism and its benefits From country to community, maternal mortality affects us all

Wellness

SUPPLEMENT TO THE DAILY

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The Daily — Wellness

EDITORS’ NOTE

“Wellness” is a buzzword right now, and sometimes it can feel like something that’s just used to market fake vitamin supplements on Instagram ads. It’s a slippery word and a difficult concept to nail down: The idea of wellness can be reduced to personal health, or expanded and used to look at the way social groups are supported. However, wellness doesn’t have to be purely aspirational. It can be a concept we use to understand how our communities, friends, and

ourselves operate, and how we can better take care of ourselves.

This magazine tackles heavy issues, such as the irrationally high maternal mortality rate, the importance of the HPV vaccine, and issues of personal wellness as well as community, physical, and mental wellness. With this edition, we hope to provide insight into the diversity of experiences that members of our community can have with different kinds of health and wellbeing.

The UW, in particular, is an epicenter for health and wellness research. Our medical school is renowned, and our medical centers are expansive. In this way, wellness is a priority of our institution. It’s also a priority of our student community; though with busy schedules it can sometimes feel like a distant goal.

Being personally well, physically and mentally, is something of deep importance to us, but this magazine also tackles the way our urban community is unwell and how we all need to pitch in to fix it.

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Taylor Hammes The Daily

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table of contents THE DAILY Editorial Staff Editor-in-Chief Andreas Redd editor@dailyuw.com Pacific Wave Editors Alyson Podesta Charlotte Houston pacificwave@dailyuw.com Copy Chief Trevor Hunt Sam Steele copy@dailyuw.com Design Editor Jenna Shanker design@dailyuw.com Photo Editor Conor Courtney photo@dailyuw.com Illustrations Editor Abigail Dahl illustrations@dailyuw.com Cover Illustration by Taylor Hammes Abigail Dahl Illustrations by Christine McManigal

Advertising and Business Staff Advertising Manager Leo Haghighi Isaac Jundt admanager@dailyuw.com Local Advertising ads@dailyuw.com Publisher Diana Kramer dianakramer@dailyuw.com Campus Advertising campus@dailyuw.com

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The HPV vaccine is for everyone

College without health care

What nudism is really like

When pregnancy almost kills you

UTI treatment without stigma

Seattle’s safe injection sites

Sex work and its biased stigmas

Taking control of your sleep 3

The Daily — Wellness

The HPV vaccine is for everyone How we can combat dangerous stereotypes that the vaccine is just for women

By Emily Young The Daily There is only one viral STI that can be prevented with a vaccine. It is also one of the most prevalent and potentially harmful STIs, as it is the leading cause of several different types of cancer. Vaccinating oneself against this STI seems like a nobrainer: it’s prevention against cancer.

And yet, the most recent data (collected in 2015) shows only about 50 percent of UW students are vaccinated against it.

The infection I’m talking about is HPV, and most people who are sexually active and unvaccinated will contract it at some point in their life, whether they know it or not.

Until recently, the vast majority of research on HPV has focused on its connection to cervical cancer, which has led to a feminization of the virus as well as a feminization of its vaccine. This has had lasting effects on how HPV is perceived in society and has led to men being less encouraged to get vaccinated (and is thus protected) against it. This harms men by not protecting them from HPV and puts the

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burden on women to get the HPV vaccine.

When the FDA approved the first HPV vaccine in 2006, it was approved only for females, aged 9-26. It wasn’t until three years later, in 2009, when the vaccine was approved for males aged 10-25. Though only a short amount of time, this threeyear gap affected how HPV was portrayed at the peak of its publicity.

The first HPV vaccine in the United States, Gardasil, was advertised in commercials featuring girls and young women claiming they would be “one less” woman who battled cervical cancer because they received the new vaccine.

“Gardasil commercials … were focused on young girls, and sort of associating the HPV vaccination with female empowerment, so I think that campaign has had pretty long legs, and people still make that association,” Patricia Atwater, director of health promotion at Hall Health, said.

Professor of psychology and gender, women & sexuality studies, Nancy Kenney, described how no similar campaign was created when the approval for the vaccine was extended to males, resulting in

considerably less public knowledge of the vaccine’s benefits for anyone other than cis women.

In addition to publicity campaigns promoting the HPV vaccine as something for women, the gap between the CDC’s recommendation of the vaccine for females and males allowed for three years where the vaccine was covered by insurance only for females aged 9-26. This added to the perception that the HPV vaccine was for girls and young women, cementing it in the minds of the public that the HPV vaccine was just for preventing cervical cancer.

The ties between HPV and cervical cancer are not unfounded: Two strains of HPV have been found to cause 70 percent of cervical cancers. While cervical cancer was the second most common cancer among women in 2000, it had fallen to the fourth most common by 2018. While it will take more time and research to know definitively, this data suggests that the HPV vaccination is becoming an effective way of reducing the prevalence of cervical cancer.

The problem, however, is that most

Wellness — The Daily

people are only aware of the link between HPV and cervical cancer, and are more inclined to believe the infection and the vaccine are exclusive to women.

“Some people think [the HPV vaccine] is not necessary for boys because people are far more aware of the link with cervical cancer,” Dr. Rachel Winer, associate professor of epidemiology, said. “And cervical cancer is more common, but actually the number of oropharyngeal cancers related to HPV has been growing, and that’s a lot more common in men than in women.”

In addition to its link to cervical cancer, some strains of HPV can also cause oropharyngeal and other anogenital cancers (anal, penile, vaginal, vulvar, etc.). While anogenital cancers are relatively rare, oropharyngeal cancer is becoming more common in the United States, particularly among men infected with HPV. While rates of males getting the HPV vaccine in the United States is increasing, there is still a significant gap in the percentage of females (53 percent) and percentage of males (44 percent) who have been vaccinated against HPV.

It is clear that females are not the only ones who contract and suffer from complications related to HPV, which is one reason why it is important that the infection and the vaccine not be feminized.

It is also important that men be vaccinated against HPV in order to protect potential partners from contracting the disease, rather than only women carrying the burden of getting vaccinated.

In addition to gender disparities in HPV vaccinations, rates are low in general as a result of the association of the vaccination with an STI, which people see as taboo.

Some parents fear that getting their child the HPV vaccine will encourage risky sexual behaviors, despite research proving no correlation between HPV legislation and adolescent sexual behaviors.

“The reason why our vaccination rates for the HPV vaccine are below what they should be is because there’s a lot of hesitancy, both just because of general vaccine hesitancy and the link with sexual behavior is a negative,” Winer said.

Parents considering getting their children vaccinated, as well as young adults

considering the same, should know that the vaccine is approved and recommended for anyone aged 9-26, regardless of gender.

It does not matter, more or less, how many sexual partners one has had, and there is no indication that getting the vaccine leads to more risky sexual behaviors.

Cancers associated with HPV are listed as some of the most preventable cancers because of the existence of the HPV vaccine.

While most people will never know they have HPV, anyone who is sexually active runs the risk of being exposed to a harmful strain which could lead to cancer. Rather than taking chances, medical professionals advise that everyone take preventative measures against HPV by getting vaccinated both for the protection of themselves and their partners.

Reach writer Emily Young at pacificwave@dailyuw.com.

Twitter: @emilymyoung7

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College without health care The struggles of undocumented students “Sometimes our undocumented students don’t always know that they can get support, both on campus and off campus.”

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By Miranda Milton The Daily A month ago, three days into the quarter, I sprained my ankle in a lecture hall. I sat through an hour-long lecture with throbbing pain and increased anxiety. I had to get to Hall Health on one foot; I would have to miss my afternoon class; and I’d probably end up needing a few days of bed rest — resulting in more missed classes. I eventually got to Hall Health and collapsed into a waiting room chair. I got a series of X-rays, ended up on crutches, and left two hours later with an appointment set with a physical therapist.

Not once did I have to worry about having to pay out of pocket. I handed over my insurance card and didn’t give it a second thought. I’m lucky to have this privilege because health insurance for undocumented students is not a given.

Henry, who is using a pseudonym for fear of reprisal and is an undocumented student, said that when he gets sick, he tries to ride it out instead of visiting Hall Health. “I’d have to pay and I don’t have the money,” he said.

As explained by the Hall Health director of health promotion, Patricia Atwater, there are three types of health insurance.

The type my family has is employer health insurance, meaning my dad gets health insurance through his employer and puts all his children on the plan. If undocumented individuals are able to work in the United States, typically for ninety

days, their employer can give them health insurance. But for college students working minimum-wage jobs with no benefits, this isn’t always plausible.

Unfortunately, this is the only type of health insurance that undocumented individuals can receive. The other two types are Medicare, which is government-funded, and individual insurance, private insurance that people can pay for themselves but also requires proof of citizenship.

Under former President Obama, programs were in place to provide undocumented individuals with resources and opportunities to become citizens, which would make getting health insurance easier. The programs were called the Deferred Action for Childhood Arrivals (DACA) and “The Dream Act.” DACA offered temporary relief from deportation to give young immigrants a chance to work toward getting citizenship instead of being deported back to a country that many of them do not even remember.

But on Sept. 5, 2017, U.S. Attorney General Jeff Sessions announced that the DACA program would be “wind[ing] down.” The program wouldn’t be accepting new applicants, and current applicants could only get one more two-year renewal. Several courts fought back and two U.S. district courts ruled that the federal government had to keep accepting renewal applications from people who had already been receiving DACA benefits.

The Dream Act is a three-step pathway for any undocumented high school

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student, graduate, or GED recipient to get citizenship. The first step is “Conditional Permanent Residence” (CPR), a status a person holds for up to eight years if they fit the criteria. If a person maintains their CPR status and is enrolled in higher education, employed, or a member of the military, they can qualify for “Lawful Permanent Residence” (LPR), also known as a green card. The final step is naturalization. After maintaining an LPR status for five years, a person can apply for U.S. citizenship.

Now, with President Trump in office and these programs killed or suspended, Atwater has seen undocumented students become more hopeless and defeated.

“A lot of students seem to just have given up,” Atwater said. “It’s so overwhelming to keep up with what is happening, let alone figure out how it applies to you.”

Magdalena Fonseca, the director of Leadership Without Borders at the Ethnic Cultural Center, sees something similar in the undocumented students she works with every day.

“Sometimes our undocumented students don’t always know that they can get support, both on campus and off campus,” Fonseca said. “Too many times have I seen a student fall ill and have to drop classes or the entire quarter.”

But Hall Health has options for students who don’t have health insurance.

Atwater wants students to know that her

office is a great place to go to if they are feeling overwhelmed. Atwater helps students find affordable and local clinics off campus, like Neighborcare and Sea Mar. She also reminds students of the resources that are available to them on campus.

“Most students know about the one free visit a quarter, but we also have free unlimited medical advice from nurses,” Atwater said. Students can call or visit a nurse to get health care advice as many times as they want any time of day for free. This is a great resource for undocumented students who can’t pay for visits but are trying to fight an illness.

Atwater and Fonseca both stressed the importance of the mental health resources open to students like the Counseling Center and Let’s Talk, a free and confidential program that operates in several locations across campus.

“I have seen, post-[2016] election, an increase in our mental health and wellness referrals,” Fonseca said. “Specifically, with our undocumented students, there has been an increase in our students feeling unsafe and unable to focus on their studies.”

“There is definitely fear in the back of my mind,” Henry agreed, and while his school work wasn’t affected by the fear Fonseca talked about, he faced another barrier: lack of awareness.

“My schoolwork is affected by friend groups who have had privilege,” Henry said. “They’re already advantaged, and

they don’t understand, and I can’t explain it to them.”

Fonseca described one of the lows of her job to be “the lack of awareness” on campus, but she hopes to combat that issue by growing the Leadership Without Borders’ Undocu Ally training. This is a six-hour training session held every quarter to help faculty and staff better understand the federal and state laws and how they can help support the undocumented students on campus.

This training helps to create safe classroom environments for undocumented students while also informing professors of certain limitations undocumented students face, like requiring a doctor’s note for missed classes.

“We’re very proud of the fact that we have close to 500 ‘Undocu Allies’ across campus,” Fonseca said. “But it is still a very small percentage.”

Looking forward, Fonseca hopes that Undocu Ally training will become a requirement for newly hired UW faculty and staff so that undocumented students can experience a safe and supportive campus community.

Reach writer Miranda Milton at pacificwave@dailyuw.com.

Twitter: @mirandamilton99

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The Daily — Wellness

What nudism is really like

A body-positive space separate from beauty norms

By Charlotte Houston The Daily When someone talks about nudism, it generally brings up images of hippies, old men that we’ve seen when we’ve accidentally wandered onto the wrong side of the beach, or crazy sex-fueled cruises. In reality, that’s not the case for people who participate in what’s called social nudism, or naturism.

Nudism is not sexual, it’s not just for old men, and participating in it can actually improve your self esteem.

There are a lot of misconceptions about nudism, and one is certainly that the people there are trying to show off. Karen and Jim Lahey, long-time and active members of the nudist community, say this isn’t the case at all.

“A lot of people, when we meet them at booths, they say, ‘Oh, I can’t go because, look at me, I’m too ___’ whatever it is they think they are ‘too’ of. We tell them no, it isn’t how you look or how your body is, that’s not an issue.” Jim Lahey, who is a trustee of the American Association for Nude Recreation, said. “We’re not there to show off. You know, people think it’s exhibitionism. You’re looking at each other or showing yourself off and that’s not the attitude at all.”

Instead, at nudist parks such as Tiger Mountain Family Nudist Park in Issaquah, nudist activities generally include volleyball, swimming, and laying out in the sun.

And it’s not just for adults — families are in fact encouraged to come, which might raise some eyebrows.

“Nudist families are really great.

Teaching a child to love their body is very healthy,” Dawnzella Gearhart, the PR chairperson at Tiger Mountain said in an email. “They are taught at a very early age what is normal behavior. That somebody touching them without their consent is wrong, and they are usually comfortable

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telling someone that … Of course, there are people who visit our parks with ulterior motives, but they are weeded out quickly. We all watch and make sure everyone is safe.

We screen everyone against the sex offender lists and do a complete background check for everyone visiting the park.”

Most nudist spaces like this do background checks on sex offender lists or for other criminal backgrounds, which isn’t the case for other state parks where you might take your children. But isn’t it psychologically damaging for children to see their parents’ naked bodies? Research hasn’t found that.

For children who are exposed to parental nudity, studies have not found correlations with higher rates of sexual activity in adolescence, antisocial behaviors, teen pregnancy, or STIs. They have been able to find that exposure to parental nudity is associated with higher levels of self-acceptance. It is important to note that these studies do not speak to the possibility of abuse and they also do not express causal findings, so it’s possible these families are just more open in general.

I talked with UW psychology lecturer Ann Culligan to try and tease some of these issues apart. She admits that she doesn’t know much specifically about nudism, but teaches Psychology of Gender which deals a lot with body shame and the cultural norms that perpetuate it.

“I think if the impulse [to bring children into nudist spaces] is entirely driven by the goal to decouple shame from the body, I think that that is a really potent way to go about that,” Culligan said. “And I’m trying to speak very carefully because I can also see like a thousand different arguments of like how that could go wrong, how it could be abused, [and] what kind of negative situations could come up from that. But if you just take that impulse, at

it’s pure motives, I think that it strikes me as being very powerful.”

Another facet of nudism as a non-sexual space is that, according to both Gearheart and Karen Lahey, is that it creates a place for women to be.

“I had a women’s event a few years back, and one of the things that came out [in the women’s circle] is that a lot of other places that you go, if a guy hits on you or makes you feel uncomfortable, there’s al-

ways an excuse, and in a nudist venue, no, there isn’t. And you have a group of women and men there to back you up, and they’re out of there so fast it’ll make your head spin.” Karen Lahey, who is the secretary for the Northwest Region of the American Association for Nude Recreation, said. “Something that another woman said to me, a woman who is fairly well-endowed, was that one of the things that she liked about being a nudist is that it’s the only place she could go where a man would look at her in the eyes when he talked to her. That’s just the way the community works. They were more interested in who she was and less looking at her body.”

A recent study in the Journal of Happiness Studies looked at the relationship between body concept, self-esteem, life satisfaction, and a person’s participation

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in nudist activities. They found that participation in nudist events improved self esteem, body concept, and life satisfaction when compared to scores on the same survey taken before the event. A larger study also found that in comparison to people who had never or hadn’t recently taken part in a nudist activity, people who had taken part in these activities recently also scored higher in these measures.

For the Laheys, this certainly rings true.

“I’ve never been small. I’ve lost a lot of weight, but I always was more comfortable on a nude beach than a regular beach,” Karen Lahey said. “I felt like people were looking at what I look like on a regular beach, but on a nude beach I feel like people didn’t care what I looked like. I mean, there was just no judgment.”

Unfortunately, the body of research on nudism is very small, and experiments that discern whether nudism truly causes better self-esteem aren’t being done. The deeper I dove into this, the more questions I was left with. But here are some theories.

Something that initially puzzled me about these findings is the near paradoxical nature of it. In our culture, the media has reached the bare minimum of clothing that a person can wear on a billboard and be considered not nude. The most scantily clad models are now only covering the “necessities.” And yet, body image in our generation, having grown up seeing these images, is worse than ever. But here are these social nudists who bear it all, and that makes them feel better than the rest of us.

Nudity, in this context then, is doing something different.

“I think it speaks to the power of clothing and how we use clothing to … mediate our presentation,” Culligan said when I posed this conundrum to her. “You know, like the pieces of our body that we cover, the pieces of our body that we don’t cover — the fashion trends that then dictate what our bodies are supposed to look like. Like when you stop and think about the fact that what we’re ‘supposed’ to wear … it typically fits and ‘flatters.’ Sorry to use the word flattering. But it fits certain dimensions of a body that kind of leaves, I don’t know, 90 percent of other bodies out. And over the past century there’s been kind of one body type that has been universally upheld and fashion sort of revolves around that.”

In this way, advertisements are not only selling clothes to us, but they’re selling a body type too. In social psychology, there’s something called cultivation theory.

This speaks to the idea that things we have repeated exposure to, whether they be stereotypes portrayed in movies or the “ideal”

body type splattered all over billboards and your Instagram feed, becomes familiar. And what’s familiar to us becomes our reality. So what we see over and over again begins to be what we think is true. And when that’s the Eurocentric body ideal being loved and funny and in charge, that’s what we think is the only powerful body type.

However, for social nudists, they’re seeing body types that aren’t fitting into that small norm and they’re seeing them married, in families, being happy and human.

That’s their reality. The study referenced previously also concluded that “seeing others” naked was a more important predictor for positive body image than “being seen” by others. So it makes sense that people who are constantly seeing real bodies are a lot more accepting of their own.

“This is my hypothesis: that [going nude] is akin to recognizing any norm that we’ve just been kind of following without question and recognizing if I break this norm, nothing bad happens. I don’t die,” Culligan said.

The taboo of nudity is so strongly ingrained in our culture. We’re told our genitalia is private, and the only time you “show it off” is with a sexual partner, if then.

“Our parents clothe us. Little kids take their clothes off all the time and what do your parents do? They’re scandalized and they put their clothes back on and the more punitive parents punish their kids for taking off their clothes,” Culligan said. “And there’s so many rules about that basically boiled down to saying, ‘You need to be ashamed of your body.’”

But when we break that norm, throw shame back in its face, that’s a powerful feeling. It can make us question a whole bunch of other norms that we’ve been told to follow too, like, for example, whose body is “right.”

“I would kind of assume that almost everybody going in to a nudist situation [for the first time] is going, ‘I’m going to be the one with the bad body or the weird body or the unacceptable body … And then you get

there and it’s like, ‘Oh, everybody’s a little weird and everybody is pretty beautiful,’” Culligan said. “And all of our bodies mostly kinda sorta have the same parts. But I think that there’s probably something really liberating in … recognizing there’s no normal. You can’t look around at a group of people and go, you’re normal and I’m five ticks off of normal and somebody else’s three ticks off normal.”

If there’s something that does seem to be true about nudists, it’s that they are shameless. Though this can be thrown around as an insult, it actually seems admirable, as it’s freeing them from the norms that bind us. The norms that make us want to shave off weight and hair, cover up wrinkles and all the other “flaws” that advertisements tuck away.

For the Laheys, nudism has functioned as an important social community for them.

According to them, this is because the people involved in it are just more likely to be accepting.

“You’re not hiding who you are. There’s no artifice. You don’t have clothes to say how rich you are or how poor you are,” Karen Lahey said. “That’s just a certain personality type. Those people are more willing to be open with who they really are. It’s really easy to get to know people and you tend to have deeper conversations, they’re not so artificial, not so surface-level.”

Though more research is essential in figuring out just how powerful nudism can be, for both children and adults, there is certainly something healing about it.

If you are interested in taking a break from toxic norms and trying out a clothing-optional space in the area, Ladywell’s Spa and Hot House Spa and Sauna are both female-only spaces in Seattle. For the more nature-oriented folks, Denny-Blaine Park is a historically outdoor nudist space in Seattle, and Lake Bronson Club Family Nudist Park in Sultan, WA, and of course, Tiger Mountain, are two choices farther from home.

Reach Pacific Wave Co-Editor Charlotte Houston at pacificwave@dailyuw.com.

Twitter: @choustoo

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The Daily — Wellness

Photos by Conor Courtney The Daily Left: Sarah Benton and her husband, Craig, on their wedding day in 2005. Middle: Sarah and her newborn son, Ethan, shortly after his birth.

Right: Sarah as an infant in her mother’s arms in a picture from her childhood.

From the rawest edges of human existence

‘Mothers put themselves last.’

When pregnancy almost kills you

By Manisha Jha The Daily

This is the first installment of The Daily’s forthcoming series, “From the rawest edges of human existence,” on the rise of maternal death and injury across America. The title of this series refers to the 1973 Roe v. Wade decision that decriminalized first trimester abortion across all 50 states. Justice Harry Blackmun, a Nixon-appointed conservative justice who delivered the majority opinion, wrote, “One’s philosophy, one’s experiences, one’s exposure to the rawest edges of human existence, one’s religious training, one’s attitudes toward life and family and

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their values, and the moral standards one establishes and seeks to observe, are all likely to influence and to color one’s thinking and conclusions about abortion.” The physicians who brought forth the evidence supporting choice in Roe v. Wade were there when women inserted coat hangers into their cervixes, when women externally induced trauma on their abdomens, when women took baths in vinegar and douched with chemicals with the hope of miscarrying.

These physicians had been to the rawest edges of human existence and back, and

they believed they knew the way forward for maternal health in America. Despite growing bodies of research and legislation intended to reverse the trend, stress remains pervasive for pregnant women from a lack of cultural empathy and care. Roe v. Wade has been called into question on the national stage, America remains the only developed nation with no federal requirement for paid family leave, and women are frequently dismissed by their doctors when they say something feels wrong. This is pregnancy in America.

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Sarah Benton drove one hour from Renton to work in Seattle each day; she had been working full time while managing her back pain, swelling, and the general discomfort that comes along with pregnancy amid the sweltering July heat. On July 6, 2015, she recalls Ethan poking around inside of her belly at work, one month before his due date: “I remember saying to him in my head, ‘If you don’t stop moving, you’re gonna come out.’”

Minutes after she walked through her front door that evening following her long commute, onto the tile flooring of her kitchen, her water broke. Benton took a quick shower and her contractions increased in frequency. She and her husband knew they could waste no time getting to their hospital, located an hour away in Capitol Hill.

“We left Liam in the yard with the neighbor,” she laughs, recalling the day.

“How could you, Mom?!” jokes her older son, Liam, who is now 10.

She had dilated to six centimeters by the time she was measured in the hospital.

Within an hour, she was in the delivery room and “there he was.”

Ethan cried faintly. He had shallow breaths, and after he was placed back onto his mother’s chest after being cleaned and put in the warmer, Benton wondered aloud to the delivery room, “Does he look blue to you?”

Before anyone answered her, Ethan was whisked away to the neonatal intensive care unit (NICU). A neonatologist (a doctor who specializes in the care of newborns) came to Benton’s room to inform her that Ethan was having trouble breathing

and they were admitting him to the hospital, but she had to wait for vaginal tears from the birth to be stitched back up before she could see him in the NICU. Hours later, she was wheeled up to the NICU, still too weak to walk. Inside the darkened unit, she peered through the cool glass down at his tiny body. He only weighed six pounds and had a tube down his throat almost as large as Ethan himself.

“What did we say he looked like, Liam?” Benton asked her eldest son.

“An elephant!” Liam recalled.

As Benton stared down at her baby in the NICU under the purple lights not knowing when they would be able to go home, a second neonatologist asked Benton, “Has anyone told you he’s gonna be OK?” “No,” Benton answered.

“Well, he’s gonna be OK.” And he was. He was born with underdeveloped lungs, unable to breathe on his own, and jaundiced shortly after birth. But Ethan was fine, he received the treatment he needed without any delay. His mother, however, did not.

–––– For each American mother who dies in childbirth, there are an estimated 70 more who are severely injured. This means among the four million women who give birth in America per year, around 800 women die and around 50,000 suffer life-threatening complications that can leave them forever traumatized or disabled, and sometimes not knowing why.

Eleven days after Ethan’s birth, Benton realized she couldn’t breathe when she laid down to sleep. For days, she had been

Sarah Benton sits with her youngest son, Ethan, reading “101 Dalmations” in their living room. Sarah nearly died from pulmonary embolism after experiencing shortness of breath for several days after birth. She had no history of clots.

short of breath, but until then, chalked it up to exhaustion. She described a feeling similar to that of gravel creeping up her lungs, through her chest and into her throat. And when she called her clinic that evening, the on-call obstetric physician –– or pregnancy specialist –– told her to try to sleep it off.

Benton knew something was wrong, but she decided to trust the doctor. She remembered thinking, “Well, she wouldn’t have just told me to sleep it off if it was this concerning, so I must be missing something.”

At 8 a.m. the following day, Benton tried calling for help again. She remembers the woman on the line telling her that if she couldn’t breathe, she needed far more help than the obstetric clinic could provide. “You need to go to the emergency department,” she told Benton.

That morning, Benton and her husband, Craig, were awaiting the home health nurse to visit and put Ethan under the bili lights for treatment for his jaundice. Benton intended to drive herself to the emergency room, and when the home health nurse caught wind of this, she firmly told Craig that Benton was in no state to drive.

Craig stayed home with Ethan and Liam and a neighbor drove Benton to the emergency room. That day, Benton was hospitalized for postpartum preeclampsia, or maternal high blood pressure that occurs shortly after childbirth, and what was later found to be three blood clots in her lungs, also known as postpartum pulmonary embolism. This causes a sudden blockage in the lungs.

During his wife’s stay in the intensive care unit, Craig remembered thinking, “Am I gonna be on my own now?”

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Bottom left: Sarah Benton and her husband, Craig. Bottom right: Sarah and Craig on the day of their wedding in 2005. All other photos: The Bentons immediately following Ethan’s birth in 2015.

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The risks related to pregnancy are still too high for women across the world today, particularly in the United States.

According to the UW Institute of Health Metrics and Evaluation, in 2015, the maternal mortality ratio in Uruguay was 21.3 deaths per 100,000 births. The ratio in Turkey was 15.8, and in Iran, it was 20.8.

In the United States, it was 26.4.

A death is classified as a maternal death if it occurs during pregnancy or within one year after the end of the pregnancy (not including ‘accidental’ or ‘incidental’ deaths). Cardiovascular disease, hypertension, hemorrhage, and embolism, like Benton’s, are among the leading causes of maternal death in the United States.

Pulmonary embolism causes nearly 10 percent of all pregnancy-related deaths across the country.

The maternal mortality rate in Washington in 2014 and 2015 was nine per 100,000 births. This rate is much more on par with the rates of other developed nations in 2015, like 9.2 in the United Kingdom, 7.3 in Canada, and 4.2 in Italy.

However, this rate does not include suicides of pregnant women, of whom six died by suicide in Washington in 2014 and 2015.

Racial disparities account for much of the excess maternal deaths. Countrywide, the white pregnancy related death rate is

12.4 deaths per 100,000 births. For black women, this rate is 40 deaths per 100,000 births, comparable to the rates in Mongolia, the West Bank, and the Gaza Strip.

Economic despair, which is closely related with pre-existing conditions like diabetes, heart disease, and clotting issues, may be among the largest determinants of maternal injury, according to nurse manager in antepartum care at UW Medical Center Teri Bottoms. Bottoms has worked with the babies at the UW’s primary teaching hospital since she graduated at age 22 from the UW School of Nursing in 1980 and has seen her fair share of babies.

In making the decision between feeding their children, paying their rent, and paying for their medications, “mothers put themselves last. They put their children first, they put their spouse or partner first, before themselves,” Bottoms said.

“You have to walk a mile in their shoes and understand all of the challenges that that particular person has. You could do all sorts of wonderful education in the hospital but when the reality is that they can only buy box mac and cheese or Top Ramen for dinner — [food that is] high in sodium and high in fat with little nutritional value — it’s really hard to give folks the tools that will impact their [pre-existing diseases] in a way that’ll be positive for them.”

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Sarah Benton holds her newborn son, Ethan, following his birth. She checked into the emergency room unable to breathe 12 days following his birth with postpartum preeclampsia and three pulmonary emboli.

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In trying to make sense of the maternal mortality and morbidity crisis in the United States today, “Roe v. Wade is an interesting place to start,” Thomas Easterling, physician and high-risk obstetric specialist at UW Medical Center, said. Easterling retired at the end of 2018 after working with women with medically-complicated pregnancies at the UW since 1985.

Roe v. Wade, which decriminalized first trimester abortion in all 50 states in 1973, was decided based on the right to privacy protection under the 14th Amendment. According to Easterling, it was additionally argued that “the driving force was that a woman, no matter how good her care is, takes a risk with her life to have a baby.”

This risk, the justices decided, was too high for the federal government to feel comfortable forcing women to go through with pregnancy.

Indeed, Easterling, who went to medical school at the University of North Carolina in the late 1970s, recalls a strong gynecology and obstetrics team at the teaching hospital.

“There was a very active illegal abortion industry in North Carolina.” Because of this, these doctors were simply tired of taking care of women dying, or almost dying, from a botched illegal abortion, “and convinced the state that this was stupid,” that these deaths were unnecessary.

Ethan, who is now 3-years-old, points at a photo in his home of his older brother Liam, now 10, taken while Ethan was an infant.

Wellness — The Daily

Photo courtesy of the Benton family Sarah Benton’s son, Ethan, spent nearly 10 days in the neonatal intensive care unit after he was born one month before his due date in 2015.

–––– While poverty, access to abortion, race, and previous disease status can all aggravate a pregnancy into a life-threatening situation, Benton did not face these systemic challenges. She’s a white woman with a graduate degree who wanted and had the resources for this child and had no history of clots. She attended the UW School of Social Work in the late 1990s and got her Masters in Social Work at the UW in 2003.

Her sister, brother, father, and grandfather all attended the UW. Her son Ethan dreams of attending the UW, too.

While it may feel comfortable to believe all mothers in our community are giving birth safely, it’s just not true, even for those more privileged like Benton. All women in America face toxic amounts of stress when pregnant; Kim Kardashian was told she would be taking a significant risk to her life if she became pregnant again after her first child; Serena Williams made headlines after her doctors ignored her weariness of blood clots, and the athlete almost died as a result; indeed, Beyonce was on bed rest for a month before an emergency cesarean section to save her and her twins’ lives after she developed preeclampsia.

Even the most powerful and privileged women in the world cannot seem to deliver their babies without risking their lives.

But regardless of epidemiological reports and statistical averages, if any one of these new moms had not survived, it

The labor and delivery unit presented the Benton family with Ethan’s framed footprints. He was born weighing 6 pounds.

would have torn open the same hole in the universe that follows the death of any new mother. Benton, like tens of thousands of women in America each year, was pushed all too close to leaving her children behind.

Women in America are stressed out, not guaranteed paid maternity leave so they have time to fully recover, and not trusted to accurately depict their pain and apprehensions to doctors.

Benton now works with patients filing complaints at a Seattle hospital. In some ways, she sees this as the inevitable result of her own requests for help not being taken seriously. While Benton was given time off from work, it was not to focus on healing from her near-death experience.

Instead, she remembers the stress of her maternity leave; far from being relaxing, it was jam-packed with appointments for both her and Ethan.

“No one was looking at me and responding to me in a way that was affirming the nightmare that my family was in,” Benton said. “Maybe they could foresee that [everything would be okay], but we didn’t know that at the time.”

–––– Benton looks at a picture on a shelf in her living room of her mother holding her as a baby. Ethan, who is now three years old, tells me he wants to show me his books and guides me to his room, turning around every few steps to make sure I’m still following him. We sit cross-legged in front of his tiny bookshelf packed with everything from “Green Eggs and Ham” and “Thomas

the Tank Engine”, to “Hansel and Gretel” and “101 Dalmations”, classics that Benton read when she was a kid, handed down to her by her mother.

Ethan removes several of his books, pointing out the good guys and bad guys in each one before moving onto the next.

Finally, he settles on “The Lion King” and stares fondly at the front cover for a minute. He points at Mufasa, Simba’s dad, on the cover, and says, “He loves his dad.”

Ethan continues to explain how much Simba and his dad loved each other and concludes it was because Mufasa carried Simba in his belly. At this point, his mother is standing in the doorway, smiling at him. She corrects him, telling Ethan that it was in fact the lioness, Sarabi, who carried Simba in her belly before he was born. Ethan looks back down at the book.

He says that Simba loves his mother very much, too, and gives the lioness on the book cover a kiss before heading to the kitchen in the pursuit of candy with his mother behind him.

Reporter Ash Shah and Assistant Health & Wellness Editor McKenzie Murray contributed research to this article.

Reach Health & Wellness Editor Manisha Jha at pacificwave@dailyuw.com.

Twitter: @manishajha_

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The Daily — Wellness

Seeking treatment without stigma How to treat UTIs in today’s social climate

By Christine McManigal The Daily Last May, I found myself in the ER. Shortly before I checked in, I had painful urination and felt the need to go every few minutes.

I had what is considered the standard symptoms of a urinary tract infection (UTI). Within an hour, I began urinating copious amounts of blood. It was time to seek medical attention.

Blood in urine is a tell-tale sign that you may have a UTI. I was aware of this, as was my doctor and nurse. I expected them to take my urine sample and give me a prescription for antibiotics. As a part of my diagnosis, my doctor asked me when my last period was. I told him it had ended a few days ago. With that information, he told me that the blood I was seeing was residual period blood and attempted to discharge me.

I knew the difference between peeing when on my period and what I was experiencing. I was hurt that he was going to send me home without a way to treat my other symptoms. My nurse stepped in and advocated for me. After my doctor had left the room, she informed me that he was disregarding my test results and that I did, in fact, have a UTI. My nurse promptly went to a different doctor and explained the situation. Within minutes, I had a small bottle of Macrobid and within hours, my symptoms went away.

On my way out, my nurse pulled me aside. “Always listen to your body because you know it best. If something doesn’t feel right, it usually isn’t,” she said.

Listen to your body. It sounds so simple but it’s valuable advice.

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It’s becoming more difficult to treat something as simple as an infection.

Maybe it’s the stigma that’s wrapped around UTIs, and that’s why it’s treated like an STD. People assume that UTIs are the result of sex. Even my mother, a medical professional, asked who I had been “smushing” after she heard about my UTI. But here’s the thing: UTIs are incredibly common because you can contract them in really simple ways. If you’re an athlete, sweaty clothes can be the reason. Sometimes this is due to a flora imbalance down there. Your birth control can put you at risk and if you wipe from back to front, you’re really prone to getting an infection.

So what is a UTI? It’s an infection that can affect your kidneys, bladder, and urethra and 90 percent of them are caused

by E. coli bacteria getting into places it shouldn’t. A higher percentage of people with vaginas contract UTIs because our urethras are shorter than those of people with penises. So if some E. coli enter our system, it doesn’t have to go very far before it begins causing damage.

UTIs have some pretty recognizable symptoms. These include the constant “need to go,” a burning sensation, cloudy or bloody urine, and pelvic or back pain. If you’re experiencing any of these symptoms, see your doctor immediately. Untreated UTIs can cause long-term complications.

But there’s a catch. Say you had these symptoms and your doctor prescribed you some antibiotics. As of fall 2018, Nitrofurantoin, the most common drug used to treat UTIs, is now 400 percent more expensive than it used to be.

Nirmal Mulye, president of Nostrum Pharmaceuticals, which manufactures Nitrofurantoin, said to the Financial Times, “I think it is a moral requirement to make money when you can, to sell the product for the highest price.”

The World Health Organization listed Nitrofurantoin as an “essential” medicine for treating UTIs. So that little vial of antibiotics that you need? It now costs more than $2,300 instead of $500. Luckily, there are ways around this and to prevent contracting future UTIs. First, there’s Good Rx. I would recommend bookmarking the website on your phone or laptop and worshipping it religiously. This website hands out coupons than you can use at any pharmacy.

There are discounts for just about every prescription out there. With Good Rx, your Nitrofurantoin only costs around $17.

If you’re a few hours or days away from your doctor’s appointment and you’re feeling discomfort, head over to a drugstore and buy Azo. This over-thecounter drug is a symptom suppressant and relieves pain and urgency within an hour. However, Azo is a symptom reliever and does not treat the infection. Do still seek medical attention, a combination of antibiotics and Azo will have you feeling much more comfortable. If you take Azo, don’t be alarmed that your pee is suddenly dark orange. Azo tablets are rust-colored and the medication discolors your urine.

You’ve probably heard about antibiotics hurting your natural bacteria.

This is true; antibiotics can wipe out your digestive tract bacteria and it can also hurt

Wellness — The Daily

“Always listen to your body because you know it best.

If something doesn’t feel right, it usually isn’t.”

your natural flora. Women who are prone to UTIs and constantly take antibiotics can also get yeast infections due to an imbalance. If you’re taking antibiotics, also incorporate certain foods in your diet.

Essentially, eat for your vagina. These foods include yogurt, almonds, fresh fruit and vegetables, and avocados.

For myself, that first trip to the ER wouldn’t be my last. Every month for the next five months, I was visiting my doctor or going to Zoom+Care clinics. From my few months of hell, I learned that some things we know about UTI care are false. First of all, cranberry juice and supplements may not actually provide any benefits. If you have a UTI, just make sure to drink plenty

of fluids instead.

Second, cranberry supplements are expensive and come in large, hardto-swallow pills. If you want to take a preventative supplement, opt for D-Mannose instead. The molecule is a type of sugar that your body urinates out when consumed in large quantities. As the D-Mannose leaves your system, it latches onto any E. coli that may be present in your urethra and gets excreted out. Think of the supplement like drain cleaner, it’s cleaning foreign substances from your urinary tract.

UTIs are annoying to deal with and it’s even more aggravating that companies and social stigma make them harder to

treat. However, medicine is great. It’s not an opinion. It’s a fact. Just within the past 20 years, medicine and science have evolved in ways society never could have predicted.

But what hinders medicine is humankind. As a society, we are filled with stigma and prejudice, and a single opinion can easily set back years of hard work. Until we can fix these issues, we just have to be clever with the tools we still have, advocate for ourselves, and listen to our bodies.

Reach writer Christine McManigal at pacificwave@dailyuw.com.

Twitter: @clmcman

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The Daily — Wellness

Seattle’s safe injection sites

And the controversy surrounding them

By Chamidae Ford The Daily The opioid epidemic is not a new topic for Seattle residents. As students living in the U-District, it is hard not to notice how present opioids are in our city and within our community. While Seattle has been working for years to try and find a solution to the problem, there still seems to be little agreement on what is the best form of action.

Currently, in Seattle, we have safe syringe exchange sites. Many of these sites, including the one in the alley by Cafe Allegro, are run by People’s Harm Reduction Alliance. They work to reduce the spread of HIV, Hepatitis C, and other blood-borne diseases that can be spread through the sharing of syringes. At their locations, you can receive clean needles and dispose of used ones. Some sites offer testing for certain blood-borne illnesses, counseling, case management services, and much more.

These syringe exchange programs have been around since 1989 and have seen results according to the King County website.

Studies have found that cities that have exchange programs have seen a decrease in HIV among people who inject drugs (PWID) by 6 percent a year. Cities that do not have these programs have seen an increase of HIV by 6 percent a year among PWID. King County has maintained a low infection rate of only 3 percent among PWID for the last sixteen years.

Despite these statistics, the exchange sites were initially met with a lot of pushback when first introduced, much like the current controversy over injection sites.

Councilmember Jeanne Kohl-Welles, a supporter of the injection sites, talked

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a lot about how people’s fears are not necessarily the reality of what’s to come. One of the leading fears for many Seattle residents who are against the injection sites is that they will increase crime. Kohl-Welles disagrees.

“Studies have shown this isn’t the case,” she said in an email. “The same sentiments were voiced when the subject of needle exchanges came up over 20 years ago, including when the needle exchange opened up in Belltown. It’s doubtful that many people even know it’s there today.”

Media can allow the message to be distorted, painting injection sites as illegal centers that promote drug use and crime.

This is not Seattle’s goal. They are hoping to open Community Health Engagement Locations (CHELs) that look to reduce overdoses, remove the shame of drug use, and introduce drug users to services that can help them handle their addiction.

One of the first and most successful injection sites is Insite, which is located in Vancouver, B.C. Working as somewhat of an inspiration for Seattle, Insite has not seen an increase in crime because of the site.

Komo News went to Insite and interviewed their manager, Neil Arao. Based on their statistics, he says in the article, “There hasn’t been an increase in crime rates, there hasn’t been an increase in violence or anything in the community.”

Kohl-Welles mentions how every drug user is different and therefore they cannot all go to treatment right away and have it be a success. Many are facing complex issues they need to deal with in order to be ready for treatment.

“The goal must be to find additional ways to save people’s lives and reduce

the health care burden on individuals until they are ready and able to start treatment,” Kohl-Welles said.

Another argument against CHELs is that the concept of harm reduction and allowing a clean, safe space for drug users will end up promoting drug use. But CHELs mission is to be more than just a place to shoot up.

“CHEL sites are not party rooms but an extension of the type of harm reduction strategy used at the County’s needle exchange sites,” Kohl-Welles said. “They will not provide drugs to individuals or in any way encourage drug use. The sites will provide health services, support, and compassion to users.”

These sites are widespread throughout the world and have seen success, despite many people’s apprehension.

“In Europe, more people using safe consumption spaces ultimately seek out treatment resources to address their disorders and are less likely to participate in risky behavior such as sharing syringes, reusing syringes, rushing injections, and injecting in public spaces,” Kohl-Welles said.

When it comes down to it, drug users and addicts are people. The fact that they are suffering from addiction does not make them less human or less deserving of compassion and help. Regardless if we have the sites or not, people are going to use drugs and these sites would provide the safest environment to do so.

A large majority of the members of these communities are just trying to survive in a world that makes it very difficult to get back on your feet after you’ve been knocked down. CHELs could help drug users get past their shame and hopefully get help with their addiction.

Wellness — The Daily

Reach writer Chamidae Ford at paciďŹ cwave@dailyuw.com.

Twitter: @chamidae_ford

Abigail Dahl The Daily

People may argue that these sites could bring more drug users to the area.

But the reality of Seattle is there are very few neighborhoods these days that do not have some population of opioid users.

Despite these arguments, the future of safe injection sites is still very unknown.

The idea has been in the works for over two years and, while some hurdles have been cleared, no action has been made yet.

There has been pushback from citizens and from federal law enforcement. In September, Mayor Jenny Durkan said she would be moving forward with safe injection sites despite federal law enforcement deeming them illegal. In December, the Washington state Supreme Court struck down an initiative that would give voters the ability to block funding to the sites which will allow Seattle to go forward with their plans.

Seattle is hoping to potentially open a mobile safe injection site in 2019. That way it can be parked outside of public health clinics.

These vans could help combat the argument of opioid users congregating in certain neighborhoods at larger volumes and allow their services to be more widespread.

Whether you are for or against these sites, Seattle will be taking steps this year to implement them in our city. If you have any concerns or questions about CHELs, visit the King County website.

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The Daily — Wellness

Sex work and its biased stigmas An industry that doesn’t need saving

By Grace Harmon The Daily

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Wellness — The Daily

“I get a lot of heartache, like a lot, about [my job] from my family. But I don’t think they quite understand my reasoning, and even if I explained [to] them I don’t think that they would even be able to understand them …

I feel like I wear a scarlet letter every day.”

The stigmas surrounding sex work and sex workers have persisted too long and now hang in stale air. There are numerous arguments: How the majority of sex workers are underage; that decriminalization would lead to huge increases in human sex trafficking; or perhaps the most common one: that sex work is inherently exploitative to women.

There are many facets of our society that create a systemic stigma toward sex work and, let’s face it, sex itself. Sex workers are not in need of rescuing, and criminalizing the profession gets in the way of individuals who love their jobs and who would benefit more from an increased public understanding of their job. “[It’s] the best job I’ve ever had … I have control of my life, and I have control over my freedom and my time,” JD, a female sex worker in New York City, said. JD currently works as an escort and has been in the industry for over two decades. “And you know it sucks you have to work your ass off, but it’s easy to work your ass off if you like your job. We can sell our platelets, we can sell our blood, we can sell our organs, we can sell our hair, we can sell our sperm, we can sell our eggs –– and we can’t

sell sex. We’re going to do it anyway.”

As a country and a society, our behaviors and our beliefs don’t add up. Porn is only one form of sex work, but it’s a $10 billion industry and is used by a huge percentage of Americans. One study showed a clear example of how opposing sex work can be hypocrisy: 67 percent of men and 45 percent of women view pornography as acceptable, but about nine out of 10 men and one out of three women reported having used pornography themselves.

The idea of supporting or not supporting pornography, and other forms of sex work, often comes from our predisposed opinions of what the sex work industry is like and what we think it means to become a sex worker.

Pornstar Stoya once commented while on a podcast, “If you’ve been told your whole life that porn is inherently exploitative to women, and if you haven’t met any porn performers, then how could you know that’s not true?” While porn isn’t the only facet of sex work, this is not a job industry full of disadvantaged individuals without alternatives. This can be a very fulfilling career just like any other. Almost everyone

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has sex, but the fact that these individuals show a positive relationship with sex seems to make people really uncomfortable.

“I knew from a very early age, as soon as somebody had told me what this was, I knew that that was what I was going to do because I seem to have a gift for it,” Lilly Vrega, a sex worker in Michigan who has been in the industry on-and-off for over two decades, said. “I don’t have all of those negative feelings of shame about myself that other people have about sex, and I don’t think it has anything to do with the way I was raised because I was raised with all the same weird kind of morals that everyone in the area was raised with … I mean there’s gotta be some point where we say, ‘Hey look sex isn’t bad, it’s a biological function and its necessary for some people to have a regular schedule.’”

Vrega has been at the forefront of change in the sex work industry for decades. Having begun her career here in Seattle, she was a part of starting the first sex workers union and, with the infamous Seth Warshavsky, was the fourth girl to ever go live on the internet doing what is now known as “webcamming.” She advocates for the decriminalization of sex work, something that was done with great success in New Zealand. Enacted in 2003, this legislation didn’t significantly increase the number of sex workers in the country, nor the number of underage workers, and yielded reports of workers feeling safer saying “no” to clients as well as feeling more protected and supported by the police.

In 2014 a sex worker in Wellington, New Zealand, sued a brothel operator for sexual harassment and successfully won a $25,000 settlement. There is a limited ability for sex workers in the United States to take legal action in the case of harassment or assault as a result of criminalization of their profession. Tragically, one-third of all U.S. sex worker homicide victims in 2015 were transgender women. A study conducted in 2014 shows that the criminalization and stigmatization of sex workers can lead to the feeling of being less able to call the police and can “create a climate of tolerance of violence.” It also found, at the time, that the lifetime prevalence rate of any workplace violence for sex workers around the world ranged from 32 percent to 55 percent.

“I get a lot of heartache, like a lot, about [my job] from my family,” Vrega said. “But I don’t think they quite understand my reasoning, and even if I explained [to] them I don’t think that they would even be able

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to understand them … I feel like I wear a scarlet letter every day.”

All this begs the question of what the United States is doing right now. In an extremely quiet process last April, the Trump administration put the FOSTASESTA bill into place (Allow States and Victims to Fight Online Sex Trafficking Act and Stop Enabling Sex Traffickers Act, respectively). This act essentially stripped away some First Amendment rights on the internet by reversing the 1996 Community Decency Act which used to state that the publisher or owner of a site is not responsible for what a user says or promotes.

“Really the bill is about censorship,” JD said. “It’s really just about free speech and net neutrality … it was so quiet. It’s too broad, it affects startups, it affects tech, it doesn’t just affect the so-called human trafficking world but it affects everybody.”

In the name of supposedly suppressing human trafficking, which is still a huge problem, this bill has shut down wellknown websites like Craigslist Personals and other platforms which were used by consenting, adult-age sex workers for the solicitation of services and screening of clients. This is because the owner of a website or online forum is now essentially responsible for what is said or posted, and many web services have been shut down so that the owner doesn’t put themselves at risk for legal action.

FOSTA-SESTA claims to target human sex traffickers and individuals who create or post child pornography, but that isn’t the reality of its effects. Within two months of its signing, a federal lawsuit was raised by a group involving the Internet Archive and Human Rights Watch, accusing the bill of being “unconstitutional, too broad, and poorly worded.”

“In my opinion, in the last 22 years we have taken a huge step back as far as sexual revolution is concerned,” Vrega said.

“It must be a lot of very powerful people with a lot of money who want people out of their way. But day to day, from what I’ve noticed in the industry, I feel like five years behind when I first started as far as the oppression is concerned but we have a lot more people talking about it and there’s a lot more dialogue.”

While the New Zealand model shows the legal possibility of decriminalization and the protection it could provide workers, our own country is currently split on the issue. According to You.gov, Americans are split 44 percent for and 46 percent against

legalizing prostitution. Ideally, the number for legalization would be higher and will continue to grow. The most damaging view toward sex work, which sits at the heart of many stigmas, is the thought of desperation. There is an idea about the sex work industry that most individuals aren’t there by choice; that there is some force that made them choose that job like abuse that prevents them from leaving or doing it solely for the money. The problem is that these aren’t blanket truths and we could help both successful and disadvantaged individuals with decriminalization and a little less judgment.

“These are — not just young, but all ages — entrepreneurial women that are basically running their own businesses and have control of our lives, and we’re not being abused,” JD said. “This is another business and we’re totally on point and this is our world. We don’t want to hear any element that, ‘We’re struggling, or we’re putting ourselves through school.’ Most women in their 40s that [are] doing it are making the most money, it’s not just a young woman’s game. Like people, it’s a legitimate job with educated masters, Ph.D. people.”

It’s time we look at our own opinions of sex and where along the way these were ingrained. Where do we internally draw the line between good and bad sex, or a normal person and slut? These lines aren’t fixed for everyone and the assumption that a sexpositive person who works in the sex work industry is bad or damaged is destructive and ignorant. By having such a strong stigma about sex workers, we are getting in their way more than we are helping them. With decriminalization, sex workers would be able to access legal services and health care more easily, and perhaps not experience so much judgment. The path toward a career you enjoy shouldn’t be paved with insults and barriers, especially if being a sex worker could be much simpler by us taking time to consider how we formed such negative opinions.

“Maybe I’ve taken a lot of shit for being so open about it, but in the long run I think if every girl who really did this did it for the right reasons and spoke just a little more openly about it, if we could find the little ways to not be so scared and to tell people then it might start to really change how people view sex work,” Vrega said.

Reach writer Grace Harmon at pacificwave@dailyuw.com.

Twitter: @grace_viv

Wellness — The Daily

Taking control of your sleep How can you make your sleep more productive, and are we misinformed about it?

By Kendall Kitahara The Daily Sleep is undoubtedly an overlooked aspect of life, primarily because the effects of insufficient sleep are not as widely known as they could be. For college students, especially, sleep should be a priority; but in reality, it is often neglected.

“A lot of people don’t realize that they’re not performing very well because they have been sleep-deprived for so long that they don’t even know how it feels to be rested,” Stella Loichot, a health and lifestyle coach and nutrition and weight management specialist, said. “They don’t see sleep as something productive.”

Dr. Jennifer Watson, a psychologist, explained that people can see sleep as “negotiable,” but “the problem is that sleep and rest are just as important as activity and productivity.”

To convert sleep into something we are attentive to and not something that is overlooked requires good sleep hygiene.

Sleep hygiene is the “combination of behaviors and habits and rituals that are going to lead to more sleep and also to better quality sleep,” Loichot said.

Healthy sleep hygiene includes maintaining a routine, creating a comfortable sleeping environment, and not doing your work in bed.

Routines are especially beneficial to sleep.

“Routines provide environmental, behavioral, and emotional cues that prime you for sleep,” Watson said in an email.

“You don’t have to work hard to try to sleep, it happens more naturally.”

This method of actively doing the same things every night before bed will decrease anxiety and make you more comfortable in your space.

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The frustrating feelings of not being able to sleep can become associated with your bed according to Watson, so having a positive environment and routine associated only with sleep is conducive to good longterm rest.

Also, getting a healthy amount of sleep coincides with sleep hygiene. If you go to sleep in the early hours of the morning, this habit can be detrimental to your wellness.

“It’s actually pretty … true that the hours in the first part of the night before midnight are super important because that’s when we go into deep sleep and that’s the [stage] that allows us to regenerate and feel rested,” Loichot said. “If you are not in phase with … the earth and the night and day cycle, you get kind of disconnected and your sleep is going to be suffering from that.”

Wendy Lendrum, a psychiatric mental health nurse practitioner at the UW, also weighed in on the importance of adequate rest.

“Most people that I speak with are not getting the average number of recommended hours of sleep per night,” she said in an email. “It is expected that one would be tired and have poor memory retention if a person is only getting five hours of sleep per night.”

This reality of sleep deprivation is prevalent in many college students, which is why attention must be placed on its importance to health.

“Sleep hygiene is getting more attention lately partially because the research on the impact of poor sleep is getting more media attention,” Watson said.

Sleep hygiene’s attention means that we are taking active steps in trying to understand how to improve our sleep, but sleep

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is complex and requires more than just dipping your feet in the process and disregarding the constructive steps taken to improve it.

“If we really want to improve our sleep, we have to focus on everything else [other] than sleep,” Loichot said.

Worrying about sleep is a vicious cycle, and if one step does not fix all of your sleep problems, this causes more stress about not sleeping and the anxiety continues. Tapping into the crux of the stress in your daily life that makes it more difficult to sleep can help resolve sleeping problems.

“Don’t lose sleep over losing sleep,” Watson said.

When students are struggling to sleep, they may look up common steps to improve sleep. Some myths that students may read are not true and need to be debunked.

Snoring, for example, can be harmful.

“If you routinely feel excessive daytime sleepiness, wake up with headaches, a sore throat, it might [be] a sign of something more serious like obstructive sleep apnea,” Watson said.

Another myth is that many people think feeling colder temperature will keep them awake. But, this myth has an upside and a downside. A little cold air can help alertness, but too much will lead to more sleepiness.

“If you stay exposed to the cold … too much … it leads to your body temperature to go down,” Loichot said. “Then that’s when, because the temperature goes down … your body is going to produce more melatonin, and then you’re going to be even more tired.”

The classic method of “counting sheep” is also ineffective.

“The ideal thing is to do something that

is not going to require too much concentration and too much effort, and that is also not going to be getting you all excited,” Loichot said.

The weekend is a sacred time for students to relax and catch up on sleep, or so they think.

“It is not possible to truly catch up on sleep on weekends,” Lendrum said. “Sleep deficits are cumulative and unable to be reversed.”

All of the information you are trying to retain during the week is lost without the proper amount of sleep, according to Loichot.

“You can catch up in the sense that, because you’re so tired, you can sleep really well and probably longer,” Loichot said.

But “what’s been lost is lost.”

So, the idea that you can catch up on sleep over the weekends does not help you in the long run. In fact, throwing your sleep patterns off by having irregular hours of sleep is also detrimental.

I have definitely lost sleep over the fact that I could not fall asleep or fought the urge to sleep so I could keep studying, but the fact that I already have a solid and comfortable routine gives me the confidence in knowing that I am on the right track to further improving my sleep.

Sleep hygiene and the general concept of sleep are vital to our health, and little steps at a time can be taken to ensure a healthy lifestyle, beginning with sleep.

Reach writer Kendall Kitahara at pacificwave@dailyuw.com.

Twitter: @kendallyk1

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