Where is that secret women’s business I’ve heard about actually happening? I must have missed the memo. I’m sure the word menopause got lost off the list of topics not to be discussed on first dates or at dinner parties, or anywhere else apparently.

It’s not often the words vulva and prolapse appear in the first few minutes of conversation. There’s no mention of weather here as I enter the tasteful South Hobart home of Rachel Andrew and Colette McKiernan – I am quietly happy they have as little fondness for small talk as I do.

Ushered into the sunlit kitchen by a couple of confident and hairy hounds, their toenails tapping a merry tune on polished boards, I feel immediately amongst friends. There are the usual personal touches hinting at the people responsible for transforming this particular house into a home: colourful cushion covers, Tasmanian artworks, environmental books and informed wine selections. Then my eyes settle on a labia-esque tea cosy, complete with pubic hair trim and a trio of hand-crocheted women’s bits, all in a lovely timber frame and sitting proudly on the sideboard.

“Our wedding corsages,” Colette explains, laughing. I’m a little bit in love with these two already.

It is evident that what we are here to discuss is no side hustle for these women, but an obsession. Rachel Andrew and Colette McKiernan are not only partners in life, but partners in mission; they are the geniuses behind Vagenius, a ground-breaking women’s health training initiative aimed at general practitioners, developed here in nipaluna/Hobart, possibly right here at this kitchen table.

Where once there was an almost total information void with respect to women’s pelvic, mid-life and post-reproductive health, thanks to the new online learning portal developed bv Andrew and McKiernan, GPs now have life-changing women’s health resources at their fingertips.

The Vagenius training platform is divided into six approachable modules: pelvic organ prolapse, persistent pelvic pain, pregnancy and post-partum, problematic periods, perimenopause/menopause, and vulval pain. Designed to better equip GPs to provide relief, treatment and referral pathways, Andrew and McKiernan’s brainchild offers evidence-based and achievable options and case studies of real women. Given that they aim to reach all Australia GPs with the training, including those servicing rural and remote communities, an online format was determined the best way to do that.

. . .

Andrew and McKiernan landed, as many of us do, as outlanders in love with this place, Tasmania. Our instant and easy camaraderie is unsurprising, as there is something shared by all who find themselves here through choice. I don’t need to explain that feeling to anybody reading Forty South Tasmania – if you’ve got your nose in here, you get it.

Colette McKiernan gets it. Rachel Andrew gets it. Both are originally from the UK, but have called Tasmania home for many years. Rachel recalls on her first visit here in 1993, her Tasmanian driving companion bemoaning being “stuck in a traffic jam” with a total of two cars in front of them. She says her pervasive thought on that trip was, “How do I get to live here?”

Thirty years later that dream has been well and truly realised. There are handmade rusty steel cutouts of eastern quolls in their yard, locally roasted coffee beans in the kitchen, a beehive in the corner of the garden and, from their sitting room, a glorious view of kunanyi. They are passionate about our island’s community and the environment which supports us. They even met at the Taste of Tasmania!

. . .

So, how did women’s pelvises become the central professional theme in these women’s lives? I’m starting to understand that it might have something to do with the fact that there’s some serious work (that probably should have already happened) which needs to be done. I’m not someone who’s easily shocked, certainly not by a few crocheted genitals at least, but this has me saying, ‘What? Really?’ every few minutes.

Here’s a fun game if you’d like to play. True or false?:

• Until now, there’s been no Royal Australian College of General Practitioners-accredited clinical professional development for GPs to expand their knowledge of women’s pelvic health isssues.
• Fifty per cent of women who have given birth have some degree of pelvic organ prolapse (and most have no idea this is highly treatable).
• The second-most frequent reason women go to a GP is for back pain. Eighty per cent of women with back pain also have pelvic floor dysfunction, such as stress incontinence (also highly treatable).

Yes, all true, but here’s the kicker: The world of medicine only discovered clitorises in 2005.

No, that is not a typo. Unlike its male counterpart (first anatomically described by Hippocrates back when he was writing medicine’s Hippocratic Oath), the clitoris wasn’t fully anatomically described until 2005. It speaks volumes to the way women’s health issues have long been subordinate to men’s.

. . .

Being myself a middle-aged woman struggling with the hormonal vagaries of perimenopause, to say I’m finding it difficult to locate the information and help I need is a massive understatement. Where is that mythical secret women’s business I’ve heard about actually happening? I must’ve missed the memo. I’m sure the word ‘menopause’ got lost off the list of topics (sex, death, religion, politics…) not to be discussed on first dates or at dinner parties, or anywhere else apparently. There are many of us liminal creatures (half the adult population in fact), scratching around for information that might help us navigate the myriad symptoms and rapid changes that happen to our minds and bodies in mid-life. It is easy to feel alone, especially when even our most trusted experts, our doctors, don’t have the answers we seek.

Getting medical practitioners up to speed on current women’s health treatment is no small task. The simple virtue of womanhood and/or some letters after one’s name doesn’t necessarily qualify a doctor to comprehend and treat what happens to a female body after giving birth or to effectively chaperone someone through ‘The Change” (insert ominous soundtrack and claps of thunder). It’s a rare woman who’s not just a tiny bit petrified of these life stages and we could definitely use some guidance.

Rachel tells me about a Tasmanian woman who came to her only after visiting sixteen different doctors with pelvic pain and prolpase, none of whom knew about the highly effective options of pessaries and pelvic physiotherapy. She describes this patient as someone not demographically dissimilar to myself; a relatively well-off, educated and health literate, white woman with private health and access to urban services, so one can only imagine the obstacles faced by the majority of Australian women who fall outside of these comparatively privileged parameters. I sheepishly confess to Rachel that I didn’t know experts like her in the field of women’s pelvic health, even existed. The Tasmanian situation has some further ideosyncracies. You can’t just tell a rural woman in the cold Tasmanian winter that she can’t chop firewood because of prolapse issues for example.

Colette’s background in learning and development and her ability to translate often complicated medical concepts into simple English, helps remove yet another obstacle in accessing the knowledge which can vastly improve quality of life for many women. Colette’s skills, coupled with Rachael’s professional knowledge (and her experience in politics), mean they are not easily deterred by the mountain-sized task ahead of them. Maybe that’s why they chose this spot, where the mountain acts not only as a backdrop to their bee boxes and vegetables but as a daily reminder of the size of the undertaking. It’s an ambitious one certainly, but their mission is simple. Laughing her delightful, crinkley-eyed smile, Rachel says they are just, ‘saving the world, one pelvic floor at a time.’

In that Tasmanian way we ‘own’ contributions to the wider world as a collective (think Blundstone boots, Danish princesses and scallop pies), I feel proud that this tool for revolutionising the way GPs learn about women’s health was birthed right here on our little island. We have always punched above our weight. Rachael says her dream is “to have all Australian GPs able to say to any woman presenting with pelvic issues, ‘I know what that is, what we can do about it and who you can see.’” Together Colette and Rachel are making their dream a reality, which is what we do here in Tassie. Vagenius indeed.

. o .

More information about Vagenius, including courses and resources, can be found at www.vageniustraining.com:

Sonia Strong moved to Tasmania in 2005 and lives in the forested hills of the D’Entrecasteaux Channel. She has worked in conservation and alpine/marine park management, as a paramedic and recently, as a wilderness ranger. She is also a metalsmith, writer and painter. She has a deep affection for windswept and interesting people and places and is happiest when creating, immersed in a creek looking for sapphires, exploring wild places or in the sunshine with wine and friends. Sonia has published several children’s books through Forty South, including “Tazzie The Turbo Chook Finds Her Feet”. You can follow her on Instagram, @soniastrongartist. For more about Moss www.insidetheframe.com.au