A: Tons, actually! From natural processes such as menstruation to medical procedures such as abortions, the goings-on of our reproductive systems – particularly in those of us assigned female at birth – may make us more susceptible to infections.
And when reproductive healthcare systems do not provide the proper education, screening, pain management, treatment, and aftercare in the face of these infections, there is a chance that they will progress into sepsis. Sepsis is an extremely severe yet often preventable condition that would take significantly fewer lives if communities and healthcare systems collaborated to better provide women, other gender minorities, and sexual minorities with the emotional and material support needed to maintain their sexual health.
🤒 First things first: What is sepsis?
Sepsis occurs when your immune system overreacts to a bacterial, fungal, or viral infection. While the infections themselves might be asymptomatic (COVID-19, for example, is a type of viral infection that is not always accompanied by symptoms), there are telltale signs of sepsis that should always be treated as medical emergencies. If sepsis is not treated in a timely manner, it can evolve into septic shock in as few as twelve hours after the initial infection; in the case of septic shock, the chances of tissue damage, organ failure, and death increase significantly.
⚖️ Are some populations more impacted by sepsis than others?
Sepsis can have many different origins. Often, the harmful infections that cause it infiltrate your body through the bloodstream. Events that puncture your skin – like traumatic injuries, surgery incisions, or catheter insertions – may increase your risk of infection because each puncture offers a new gateway for germs to enter your body. Our immune systems are designed to detect and fight these germs, but for people whose immune systems are weaker or less developed (infants, children, the elderly, and people whose preexisting chronic diseases already require their bodies to work overtime), the immune system might spot an influx of germs and “freak out”, releasing chemicals in the body that cause a widespread inflammatory response.
Those assigned female at birth have a disproportionately high risk of sepsis, but this risk is often ignored. This is not because they are less capable of fighting off infections; in fact, there is strong evidence that females naturally have stronger immune responses than males. It can instead be explained by healthcare inequities that increase the chances of women being exposed to infections while simultaneously increasing the barriers that women must clear to receive proper, compassionate, and timely responses to these exposures. This trend is most pronounced in reproductive healthcare, a system and space that (somehow) invasively handles and ignores female bodies at the same time.
Join this Nerdy Girl in exploring how reproductive health – and, by extension, the movement towards reproductive justice – is directly related to the prevention, awareness, and treatment of sepsis.
🩸 Periods
→ A sepsis snapshot: Toxic shock syndrome (TSS) is a type of bacteria-caused sepsis. TSS can happen to anyone, but it is most associated with tampon use. When tampons are not changed out at the recommended intervals, bacteria can get trapped in your vagina (a warm breeding ground for these bacteria to flourish), making their way into your uterus and potentially spreading to other organ systems. There are many reasons why a tampon might stay in your body for too long, you might, for example, work in a busy environment that limits bathroom breaks. Or, like countless women, period poverty may mean that you do not have access to a renewable source of tampons (or, worse yet, you may resort to using “makeshift” tampons that are not sterile to begin with, such as newspapers or socks).
→ What can be done?: Sex education in primary and secondary schools that includes lessons on menstrual hygiene, especially with regards to changing tampons and menstrual pads. At a systemic level, free access to menstrual products in public spaces is essential to combatting period poverty, which will in turn reduce the number of risk behaviors leading to TSS.
🤰 Pregnancy and Postpartum
→ A sepsis snapshot: In the U.S., maternal sepsis account for 13% of pregnancy- and childbirth-related deaths and 15% of maternal admissions to the intensive care unit; underlying and underscoring this tragedy is the fact that nearly 100% of these cases could be prevented through the early detection and care of infections in birthing people. Cesarean (c-) sections are major abdominal surgeries, and as mentioned before, any surgical incision can increase your risk of infection. Though far less common, vaginal births can also increase the risk of exposure, since foreign bodies are more able to pass through the cervix as it dilates (makes itself bigger to allow a baby to travel through the birth canal). Another potential cause of sepsis is prolonged labor: when a birthing person’s “water breaks”, a membrane inside their body ruptures, and the longer this membrane stays ruptured before the baby is born, the higher the chances are of infection.
The risk doesn’t stop there. Mastitis is a painful inflammation of breast tissue that most commonly occurs in people who are breastfeeding or chestfeeding (due to plugged milk ducts). In the absence of the proper antibiotics, education on how to relieve plugged/clogged milk ducts through milk expression and other methods, and compassionate postpartum care overall, mastitis can quickly progress into sepsis.
→ What can be done?: In short, we need to listen to pregnant and breastfeeding people. Many of us are programmed to believe that severe pain is part-and-parcel of giving birth, but when someone expresses pain or discomfort during the birthing process, it is essential that healthcare providers diligently scope out the root causes. Before childbirth, sepsis screening should be a mandatory part of prenatal care (and covered by insurance!), and after childbirth, families should be matched with lactation consultants who are well-versed in breast and chest health and can curb infections in their tracks.
🤲🏾 Miscarriage
→ A sepsis snapshot: A miscarriage, sometimes called a “spontaneous abortion”, is the sudden loss of a pregnancy before the 20th week of gestation. Miscarriages cannot be singularly defined – some happen in an instant, others are prolonged, and many are physically and emotionally painful – but it is most often marked by pregnancy tissue passing from the vagina. In some cases, some of the pregnancy tissue does not properly pass through the body and gets trapped in the uterus, triggering the immune system and leading to infection. Septic miscarriages occur when this trapped tissue – or any heavy bleeding caused by the miscarriage itself – is not fully cleaned out of the body.
→ What can be done?: Before and above all else, we have to eliminate the stigma surrounding miscarriages. Society continues to shame and blame people who miscarry at the micro and macro levels – from family shunning to jail sentences – even though miscarriages are often not preventable, and they are not anyone’s fault. It’s no wonder that so many cases of miscarriage go unreported; the key danger in this is that unreported miscarriages lead to little-to-no aftercare. And inadequate aftercare increases the chance that infected tissue will linger in the uterus undetected.
💊 (Induced) Abortion
→ A sepsis snapshot: Like miscarriages, medically-induced abortions empty your uterus of pregnancy tissues. Abortions done in well-vetted clinics are effective around 99% of the time, and it’s exceptionally rare to need a follow-up procedure. However, just like miscarriages, induced abortion procedures might miss some tissue, potentially leading to inflammation and infection in the reproductive organs and bloodstream. For the many people who – for a host of logistical, legal, and other reasons – cannot peacefully make their way to a Planned Parenthood to safely terminate their pregnancies, an abortion done in a non-sterile, non-professional environment (or an environment where physical and mental aftercare is not prioritized) may be the only option. In cases like these, incomplete abortions, medical errors (such as accidentally wounding a patient), and unclean operating conditions transform the risk of septic abortion from near-zero to much, much higher.
→ What can be done?: We need to legalize abortion. And we need to advocate for a local, national, and global funding source dedicated to training clinicians and equipping healthcare sites with the tools needed to safely provide this (often urgent, sometimes life-saving) service.
💦 Sexually Transmitted Infections and Diseases
→ A sepsis snapshot: It should first be stated that the chance of an STI or STD leading to sepsis is quite low. However, it can still happen, and the social taboos that might be attached to these conditions may lead to infections going undetected or untreated for much longer than they should. Furthermore, immune-weakening STDs like HIV can make your body more susceptible to other infectious diseases – diseases that might be more sepsis-prone – over time.
→ What can be done?: Another call to strike out stigma and shame! More specifically, incorporating practical tips on pre-intimacy preventative care and post-intimacy aftercare into health education at schools, in doctors’ offices, and through public campaigns could help alleviate some of the infection-related anxieties that anyone might have when embarking on new sexual journeys with their sexual partners.
📢 In Conclusion
A world with safer, more consistent, and more accessible reproductive healthcare is a world where preventable injuries and deaths caused by sepsis will notably decrease. Such a world can only be built when communities and systems alike release any misconceptions they have that natural reproductive processes and reproductive decision-making are meant to be morally scrutinized, dismissed, or subjected to laws created by people who do not have to live with the outcomes.
In solidarity and with love ✊🏾🩷,
Those Nerdy Girls
Additional Resources
Sepsis and Pregnancy-Related Deaths
