Charting your cycles will offer you a unique opportunity to observe your body in a wondrous period of transformation. As they veer from less than 3 weeks to 3 months or more, you’ll always be on top of the hormonal turbulence within you. One day in your late 40s or early 50s, after having gone all summer long without menstruating, you may have the opportunity to impress a friend. You’ll be able to tell her that you know that you still have at least one more period to go, starting the following week. “How can you be sure?” she’ll ask. “I know,” you’ll say, “because it says so on my chart.”
CHAPTER 23
Enriching Your Self-Esteem Through Knowledge About Your Body
Once we are old enough to have had an education, the first step toward self-esteem for most of us is not to learn but to unlearn.
—ANONYMOUS
Hostile cervical mucus
Incompetent cervix
Inadequate pelvis
Senile gravida
Habitual aborter
Hmm . . . let’s see: defect, hostile, incompetent, inadequate, senile, aborter. Doesn’t that paint a pretty picture? Regrettably, the list above merely describes women with fairly common conditions, such as nonfertile cervical fluid, a weak cervix, a narrow pelvis, a pregnancy after 35, and a tendency to miscarry.
If you’d like to be further entertained, you can review the entire list of dubious medical terminology still used in women’s health today at www.tcoyf.com. You may think that this type of language doesn’t affect self-esteem, because most women aren’t even aware that these descriptions are recorded in their medical records. But many are matter-of-factly informed that they have the above conditions by well-meaning clinicians who seem oblivious to how offensive this terminology can be. These phrases reflect an antiquated medical system that is often insensitive to women and out of touch with their needs.
Instead of identifying with the above vocabulary, picture an altogether different scenario. Imagine growing up being told that your body is a marvel of biological beauty that will orchestrate amazing changes every cycle. Rather than thinking that you keep producing infectious discharges, you’d be able to identify healthy cervical secretions as a reflection of the remarkable hormonal system working within. Imagine going to the doctor and feeling knowledgeable rather than vulnerable. And instead of succumbing to douche commercials that diminish self-confidence by implying that women are dirty, you could simply disregard them, knowing that just showering with soap and water will keep you clean and feminine.
What if teenagers acquired practical knowledge about their cycles and fertility even before the first day they menstruated? Not only would it increase their self-assurance, it would enable them to identify both medical problems and normal biological occurrences, sparing them so much of the fear and confusion that comes with adolescence. And although FAM should not be promoted as a method of birth control among adolescents, the reality is that the practical knowledge it affords could reduce unplanned pregnancies in an age group that, unfortunately, still believes among other things that you can’t get pregnant the first time.
Imagine being able to utilize your body’s own fertility signs to provide you with a completely natural, safe, and effective method of birth control that promotes shared responsibility and communication between you and your partner. Or envision what it would be like to know your own hormonal symphony so well that you could zero in on the day that you want to conceive.
And if by chance you or your partner really do have a fertility problem, picture a dialogue of truly informed participants. Imagine you, your partner, and your doctor using your own charts to find the least-invasive strategy, before deciding that IVF is your first and only solution. Yes, it may be, but at least you would understand why.
On a more mundane note, wouldn’t it be nice to experience PMS in a whole new light, finally understanding why you develop symptoms on a cyclical basis? Knowing there are steps you can take to alleviate the various pains and discomforts will always help, particularly if you take preemptive steps based on conveniently predictable patterns. In such a case, your fertility charts could serve as a biomedical data bank, perhaps helping you stave off that particularly unpleasant bloated feeling three days before your period.
And what if menopause was finally perceived for what it is—an inevitable, natural transition in a woman’s life. If women were actually taught what to anticipate in the years leading up to their last period, they certainly wouldn’t feel so confused and mystified by all the new changes. In reality, women in their late 40s are hormonally similar to 13-year-old kids. Their bodies may create the biological equivalent of a Hollywood mystery, but, like their adolescent daughters, these women can eliminate the confusion and take control as they enter the last phase of this long and interesting journey.
There is a proverb that is as truthful as it is applicable:
Knowledge is power.
Unfortunately, so much of what people usually want to know is locked away in inaccessible databases of governmental, corporate, and academic bureaucracies. But there is also a wealth of eminently practical information that in many ways serves to define your womanhood, and that knowledge is available to you whenever you want. Yes, it does take a couple of minutes a day to access, but it requires no particular job connections, or even a computer. Fertility Awareness is certainly not high-tech. But for all of you who are of reproductive age, the education it provides can reveal an entire world about which you may know so very little: Yourself.
Epilogue
A History of Progress: Women’s Health and the Missing Piece of the Puzzle
Many anthropologists are aware of a universal tradition among the Bantu women of East Africa, passed down from grandmother to granddaughter, generation after generation. In order to teach their progeny about the relationship of cervical fluid to fertility, the elder woman takes a smooth stone to gently wipe the inner lips of her granddaughter’s vagina. She then explains to the maturing adolescent that it is in the secretions found on that stone that the key to her future fertility will come and go, magically, cycle after cycle.
Since Taking Charge of Your Fertility was first published 20 years ago, I have had the opportunity to hear from thousands of readers about the impact Fertility Awareness has had on their lives. What has been most gratifying to me is learning of their almost unanimous view that every woman should know its basic scientific principles. Not just to maximize their odds of conception, or to avoid pregnancy, but, perhaps most important, to finally demystify the everyday riddles of their own bodies.
Quite simply, these women have confirmed my own long-held belief that Fertility Awareness education could well become one of the most important chapters in the amazing multigenerational history of the American women’s health movement, a history that is worth briefly noting in order to put the information contained in this book into some basic historical context.
THE SEARCH FOR VIABLE CONTRACEPTION AND THE RAMIFICATIONS OF THE PILL
Of all the health-related struggles confronting women, perhaps the longest lasting and most universal has involved the often contentious issue of birth control. Indeed, it’s well known that various societies throughout history have acted to prohibit whatever contraceptive technologies were available to them, and of course the United States was no exception. In fact, it was only thanks to the courage of Margaret Sanger in the early 20th century that Americans first enjoyed the lawful and widespread availability of condoms and diaphragms.
Sanger herself was arrested and harassed, both for publishing newsletters that demanded such access and for opening America’s first birth control clinic in Brooklyn, New York, in 1916. (The clinic was abruptly closed by police.) Yet her actions struck a chord with women throughout the country, and by the early 1920s, the American Birth Control League, a forerunner to Planned Parenthood, had 37,000 members. The power of this and other organizations overcame both legal obstacles and resistance from the male-dominated medical establishment.
Of course, the most dramatic developments in modern contraceptive history came a couple of generations later, with the arrival of the pill. Ironically, it was the difficulties that women initially faced in exposing its dangerous side effects (many of which have since been resolved) that helped lead to the first truly organized movement devoted to women’s health itself. It’s no coincidence that less than a year after activists disrupted a 1969 U.S. Senate hearing on the pill, because not a single woman was called to testify as to her own negative experiences in taking it (!), the Boston Women’s Health Book Collective published the first mimeographed booklets of what soon evolved into the landmark tome Our Bodies, Ourselves.
By the time access to legal abortion was finally guaranteed in 1973, grassroots activism devoted to a variety of women’s health issues had taken hold, from the backlash against the overuse of radical mastectomies for breast cancer to the demand for more information about DES and its devastating effects on a generation of girls born to mothers who had used it. Yet given the well-publicized risks of both the pill and later the IUD, the movement as a whole remained most concerned with access to safe and effective contraceptive choices, and for many, this still remains one of the key women’s health issues today.
RETURNING CHILDBIRTH TO THE MOTHER’S CONTROL
The general tenor of the women’s movement of the 1960s would soon have a powerful impact on other fundamental areas within women’s health. In the decade or so following the release of the pill, a highly visible campaign began to spread in reaction to what was seen as the general overreliance on medical technology in the delivery room. Although most women had come to expect some form of modern anesthesia, many began to forcefully reject the routine use of labor-inducing drugs, surgical rupturing of membranes, forceps deliveries, episiotomies, and even the usual practice of whisking the baby off to the nursery as soon as it was delivered.
In 1972, Suzanne Arms’s book Immaculate Deception made perhaps the most persuasive call for rehumanizing the entire process of childbirth, including standard postpartum practices. Her book was a landmark that sparked great debate among both ordinary women and the medical community, in large part for her claim that the American hospital was often not the best or most logical place for childbirth to occur, and for her assertion that midwives should take the primary role over doctors in those routine births where medical intervention was not necessary.
As a result of Arms and other pioneers, many American women today actively plan the type of birth they want, including such decisions as whether it should be at home or in a hospital, with a midwife or an OB/GYN, using Lamaze or Bradley childbirth preparation, and finally, whether it should be experienced naturally or with drugs. And though most women today don’t necessarily choose to have a completely natural childbirth, the shift of decision-making power from the doctor to the mother appears to be one of the most significant ways in which women have taken control of a fundamental aspect of their reproductive lives.
THE “OUTING” OF MENOPAUSE AND OTHER FEMALE TABOOS
In contrast to childbirth, societal developments concerning menopause have been marked not so much by any definitive social movement or medical breakthrough, as by simply an increase in candid and informed discussion. The fact is that until the late 1960s, most women rarely if ever broached the topic of menopause with even their closest friends. But as in other areas, the standard practices of the medical establishment began to draw increasingly vocal criticism. Specifically, a few courageous activists began to object to the prevailing view of menopause as a disease that needed to be treated (either psychologically or hormonally), and soon many were attacking the routine use of hormone replacement therapy, which at that time seemed to have as many negative drawbacks as benefits.
Still, the real breakthrough came only in the early 1990s, with Gail Sheehy’s classic The Silent Passage. This work clearly struck a nerve with millions of women and swept away the notion of menopause as a taboo topic. Not only did many women begin to see it as a potentially positive gateway to a newly energized phase of life (as opposed to merely the symptom-filled conclusion to one’s fertile years), but more than ever before, women began to talk with everyone about their menopausal-related hopes, fears, and concerns, from their doctors and friends to strangers on talk radio. And thus today, hormone therapy and hot flashes are just two more typical subjects of media inquiry and women’s social gatherings.
Of course, menopause has only been the most notable example of a women’s health-related subject that has gone from taboo status to a mainstream topic of great general interest. Witness the formation of support groups for PMS and hysterectomy, the explosion of mass education and grassroots organizing for breast cancer research, or even widely popular books, which have explored everything from the history of menstruation to female anatomy. For those who remember the ignorance and isolation that prevailed just a generation ago, all of this is wonderful news.
THE PROMISE AND TEMPTATION OF HIGH-TECH FERTILITY PROCEDURES
Perhaps the most compelling topic in reproductive health, and the one that has probably captured the most attention of both women and men, has been the continuing advances in reproductive technology. From the birth of Louise Brown in 1977 (the world’s first “test tube baby”), to the popularization of IVF in the 1980s, to the most recent headlines on sperm micromanipulation, and even freezing eggs, the world has witnessed a staggering revolution in the potential options that are afforded those couples who are perceived as being infertile. Yet these high-tech advances are hardly reproductive panaceas. Their overall success rates remain fair but not great, and because of their high costs in money, time, and emotional energy, they are not an ideal choice for most couples.
Of course, one can assume that assisted reproductive technologies will continue to improve, and that in the future their physical and financial costs may diminish to the point that many people will come to view them as just another routine alternative on the road to a successful pregnancy. To the extent that these technologies present ever greater choices for those who truly need them, this can be seen only as a positive development.
Yet there is also a possibility that the progress to which I’m referring could have a very real downside—specifically, if future couples glibly turn to the latest technological advancements before seeking the knowledge with which so many of them could naturally become parents. And given the missed opportunities for self-edification that such knowledge would bring, this would be unfortunate, no matter how cheap and easy high-tech pregnancies become.
As we have seen, women over the last few generations have taken ever-greater control of their lives, and in so doing have often become substantially more in tune with their own bodies. Nevertheless, the progress they have made has been sporadic and piecemeal, with each new movement or breakthrough applying only to a relatively small part of life’s great menstrual mystery. Indeed, the advances made in both childbirth and menopause have dramatically improved their physical welfare, but it’s worth noting that childbirth usually occurs during the primary reproductive years of 20 to 40, while menopause arrives only in the decade or so that follows.
Likewise, women now have a variety of fairly decent alternatives for avoiding pregnancy, and every year yields new technologies and hope for those struggling couples trying to conceive. But birth control methods and high-tech fertility treatments reflect specific goals of different women at different times, and even though they are the flip side of the same menstrual coin, the pursuit of the final objective teaches women virtually nothing about how or when conception occurs in any given cycle.
Printed with special permission from Rosy Aronson.
Given the exciting evolution of the various women’s health movements discussed above, it’s worth briefly mentioning the historical development of the Fertility Awareness Method (FAM), which is a comprehensive body of knowledge that is applicable to all menstruating women, for the entire duration of their reproductive years. As noted earlier, Our Bodies, O
urselves was a major step forward, but even this amazing source paid scant attention to FAM’s initial development and validation, even though it had begun to gain a sizable number of adherents in Europe as early as the 1960s, the majority of whom used it as a form of birth control.
In fact, the first comprehensive studies to show the scientific validity of using both cervical fluid and waking body temperature as a way of accurately detecting ovulation occurred in the 1950s. Yet because Fertility Awareness would remain widely confused with the notorious Rhythm Method, it did not, alas, become a widely known contraceptive choice during that inspiring time in the 1970s when so many American women began to take so much of their physical well-being into their own hands.
By the time I wrote the first edition of this book in the mid-1990s, more and more women were beginning to hear that FAM was natural and effective. Of course, it still hadn’t achieved the grassroots impact that other women’s health movements had, yet I was ever more confident that it was only a matter of time.*
What most of my readers now know is that the Fertility Awareness Method is not a contraceptive guessing game or just a system for maximizing the odds of conception. Nor is FAM the exclusive domain of strict Catholics or flower children who grew up decades ago. They are thrilled to discover that it also serves as a wonderful window into all facets of a woman’s gynecological well-being, and that it is basic knowledge that every woman should possess, no matter what she ultimately chooses to do with it.
Taking Charge of Your Fertility Page 35
