Taking Charge of Your Fertility

'Taking Charge of Your Fertility' contains empowering practical information for every woman, whether avoiding pregnancy or seeking it. It is the logical follow-on from the classic 'Our Bodies, Ourselves' and is just as ground-breaking, says Catherine Redfern.

, 1 June 2004

You’d never imagine such a boringly-named book could be so exciting and revolutionary. It’s hard to know where to start explaining how important and useful this book is. If I say that its in the same league as Our Bodies, Ourselves, the ground-breaking feminist health book from the seventies, perhaps that would help.

It’s hard to supress my enthusiasm for this book, and frankly, that’s because it’s a total revelation. It’s a myth-busting, enlightening, practical, empowering, feminist journey of discovery. Reading it brings home how outrageously little we women know about our own bodies. Yes, even those of us who consider ourselves relatively knowledgable about these matters. Okay, so most of us understand the process of menstruation, what causes pregnancy (um… I think) and we’re aware that about half way through our cycle we ovulate (although depressingly, many girls and women still aren’t even aware of this basic information). So far, so good, right? Well, that’s okay, but there’s so much more to it than that.

This book is all about self-knowledge and empowerment

This book is feminist because it is all about self-knowledge and empowerment. It also sits firmly within the area of feminism which offers natural solutions to health issues, avoidance of medical intervention unless necessary, and the presentation of the normal working of women’s bodies as a natural miracle to be embraced rather than supressed (witness the increase of women stressing the positive aspects of menstruation, for example). Like Our Bodies, Ourselves it’s all about giving control over women’s bodies to women instead of (or at least as well as) the medical profession. In a way, it raises similar issues as the ones surrounding the rise in cesearian births. On the one hand, you could see the rise in cesearians as an unneccessary intervention into a natural, normal process, part of the medicalisation of women’s bodies. On the other, you could see the choice not to give birth vaginally as a fundamental right, one that feminists should argue for. But whatever your view on medical intervention, the bottom line is that this book is all about knowledge and choice – and you can’t get much more feminist than that.

Taking Charge of Your Fertility (TCOYF) is, pretty obviously, about fertility. So why, unless you’re trying to get pregnant, would you be interested in this? For many of us, fertility is something to be avoided, suppressed, or even scared of – why should we bother thinking about it at all? Well, think about it. Like it or not, fertility is something which dominates many of lives, whether we’re trying not to get pregnant, trying to get pregnant, or simply experiencing menstruation (it is estimated that most of us will menstruate around 500 times in our lives). Women’s bodies are cyclical; we regularly go through changes (that this fact translates into “moody”, “changable” and “untrustworthy” in the mass media simply shows how male bodies are considered the norm whilst women’s are seen as abnormal purely because they do change and regenerate). So don’t dismiss this book as something boring which only those women having difficulties conceiving would be interested in. TCOYF is also about revealing what goes on inside every woman’s body, and is as relevant for those trying to avoid pregnancy or figure out what’s going on with their periods as it is to those who are trying to get pregnant.

I’m going to try to explain the basic principles of the book, but please note that I am not a trained professional and you must read the book itself for more information. I’m not an expert and I cannot personally vouch for the methods described as I haven’t used them. But I hope the feminist implications will become clearer after I’ve explained it a bit more.

You can use this knowledge to help get pregnant, avoid pregnancy, or simply be aware of what’s going on inside you

The core of the book is dedicated to teaching the “fertility awareness method” (FAM) (more technically, the “sympto-thermal method”), a technique for observing your body’s fertility signs so you can tell how fertile you are on any given day. Yup, your body is giving you obvious daily signs about how fertile you are, and you can use this knowledge to help get pregnant, avoid pregnancy, or simply be aware of what’s going on inside you. No doubt your mind is already filling with negative thoughts of the “rhythm method” and Persona (a fertility prediction device that suffered bad publicity a couple of years ago when some women fell pregnant while using it).

Throughout the book, Toni Weschler is at pains to emphasise that the fertility awareness method is NOT the rhythm method. The rhythm method is essentially a mathematical formula based on the length of past menstrual cycles. In contrast, the sympto-thermal method is based on you observing your own body’s signals every single day. It also combines up to three different methods of observation to act as a triple-check. It is based on sound scientific principles and if used perfectly, has a high success rate as a method of birth control. The UK Family Planning Association gives the fertility awareness method a success rate of 98% (a failure rate of 2%) if used perfectly – which is the same as the condom!

The important thing is that if FAM is used for birth control, users must be totally dedicated to doing it properly. Because of this, it is best practiced by couples who are 100% committed to following the technique, especially as it involves meticulous record-keeping. Also, as a method of birth control it does not protect against sexually transmitted diseases, so it’s recommended that it is used by monogamous couples. In other words, anyone can use it as a method of pregnancy achievement, but as a method of birth control it’s not suitable for everyone. Despite this, you have to admit that the prospect of a scientifically proven, reliable, trustworthy and natural method of birth control without side-effects is genuinely astonishing[1]. A couple of months after reading the book, I am still in a state of shock that such a thing exists.

So what fertility signs are observed? Well, after ovulation, your body releases a heat-producing hormone called progesterone. Your temperature rises after ovulation and falls back down again at menstruation, until the next time you ovulate. So by taking your temperature every morning and plotting it on a graph, you can actually have dramatic visual evidence of what’s going on in your body and you can tell when you have ovulated.

By plotting the signs on a graph, you can have dramatic visual evidence of what’s going on

Secondly, your cervical fluid, which can be felt at the vaginal entrance or at the cervix changes throughout the cycle. You can learn to identify what it is telling you. In fact, what many women believe is a sympton of some kind of vaginal infection is actually totally normal cervical fluid. Ok, in this aspect the book is not for the squeamish as it goes into great detail about this aspect (including pictures!). But as Weschler points out, if you are trying to get pregnant you are going to have to go through a lot more disgusting things than having cervical fluid on your fingers – changing nappies and dealing with baby sick, for one! So this is one of the things readers will just have to get used to.

Thirdly, throughout the cycle, the cervix changes position, consistency and shape; again, you can learn to identify what it is telling you. The book says it is optional to observe this sign, but the other two (temperature and cervical fluid) must be observed.

By combining the evidence of the signs on a chart, you can identify when you have ovulated and therefore when you are fertile and when you are not. If you want to get pregnant, you can use this information to time intercourse (or turkey basting time, depending on your chosen method!) for ovulation. Weschler explains how couples often believe they are infertile, resorting to expensive, invasive and often traumatic fertility treatment when in fact the problem might just be that they are simply timing intercourse at the wrong time of the month. If you’re avoiding pregnancy, you can tell when it is safe to have intercourse without getting pregnant and when you must use a barrier method, abstain, or engage in one of the myrid other forms of sexual activity instead.

There’s much more this book has to offer in terms of self-knowledge. By tracking the various fertility signs outlined in the book,

  • You can pinpoint almost to the exact day when you have ovulated
  • You can tell which days you are not fertile; when it is virtually impossible to get pregnant; or when is the best time to get pregnant
  • You can predict when your period will be
  • You will know in advance if you will have a “late” period, thus avoiding panicing about possible pregnancy.
  • You can find out within around 18 days after ovulation whether you are pregnant or not – you won’t have to wait until your next period doesn’t show up.
  • You can tell if you are showing early signs of miscarriage.
  • You can tell if you have had a miscarriage.
  • You can tell when you are going through menopause.
  • You can identify any potential fertility problems.
  • If you’re pregnant, you can predict your real delivery date instead of one based on a mathematical forumla.

Unless you’re already an expert, I guarantee that you will learn something new from this book. For example, did you know that the 28 days menstrual cycle is a myth? Typical cycle lengths vary between around 24 and 36 days, and less than 15% of cycles are exactly 28 days! Secondly, contrary to popular belief, ovulation does not “always” occur on day 14. Women’s cycles are individual, and they can change. Ovulation can be delayed due to stress, travel, illness, weight gain or loss. Sometimes your body might not even ovulate during the cycle and you will have a “fake” period (an “anovulatory” period). With the information in this book, you will be able to see if this has happened.

She positions the fertility awareness method as the missing piece of the women’s health movement

What I found fascinating to learn is that the period of time between your last period and ovulation can be delayed and extended for quite a long time, but once you have ovulated, the period of time from then until you menstruate again (the “luteal phase”) is usually the same length to the day, between around 12 to 16 days. Why is this useful? Well, if you know when you ovulated, and you know your normal length of time between ovulation and menstruation, you can tell very quickly if you are pregnant. In theory, you could tell within around 18 days from ovulation that you are pregant, and confirm this with a pregnancy test. If avoiding pregnancy, the implications for a speedy abortion are obvious.

Weschler is well aware of the feminist implications of her book. She writes in a way that is inherently feminist, with chapter headings including “Enriching Your Self-Esteem Through Knowledge About Your Body”, “The Politics of Natural Birth Control” and “Fertility Awareness: What You Should Know and Why You Probably Don’t”. She writes simply yet thoroughly, claiming “knowledge is power”. In a special epilogue to the revised edition, she positions the fertility awareness method (FAM) as the missing piece of the women’s health movement, saying that it has revolutionary consequences. She writes:

I believe Fertility Awareness is drawing the women’s health revolution full circle, and that its growing popularity may one day result in its being seen as important as the technological advances and gras-roots movements that have lready come before it. This is because, as so many women are now learning, FAM is a truly liberating tool for understanding and maintaining basic reproductive health… In fact, as we enter the twenty-first century, a growing critical mass of women have finally discovered that it is probably the most empowering information that women can be taught about the miraculous workings of their own bodies.

Interestingly, she argues that FAM as a method of birth control encourages couples to share responsibility for contraception. “Unlike most methods,” she writes, “FAM offers men the opportunity to lovingly and actively share in the responsibility of contraception.” Although this is certainly possible, I’m not convinced that there is anything about the method which inherently encourages shared responsibility. She cites an example of a man who checks his partner’s temperature every morning and charts it for her, whilst she simply relaxes in bed. This is obviously a great thing, but in the end it is still the woman who will have to check her cervical fluid and/or cervical position. Inevitably, it is still the woman’s body which is the focus and which has to be checked daily, so the man could still refuse to get involved at all. The only thing that is conducive to shared resonsibility is a partner who is caring enough to get involved. If you have a partner who is ignorant enough to refuse to use condoms, switching to FAM for birth control is hardly going to challenge his selfishness.

She argues that FAM encourages couples to share responsibility for contraception

However, you can’t blame Weschler for this, and to be fair she does try to promote shared responsibility and gives many examples of men who get deeply involved in the whole process. Towards the start of the book she discusses the politics of birth control, explaining the irony that women are only fertile for a maximum of two days every cycle while men are fertile every single day, yet it is women who bear the brunt of birth control methods and women who suffer often traumatic side effects in order to protect themselves from the 100-300 million sperm a day which the average man produces (and if that doesn’t make you want to run screaming away from the nearest man, I don’t know what does). Like Germaine Greer once said, heterosexual women love men despite their fertility, not because of it.

It’s also interesting that FAM is practiced by both feminists and anti-feminists. It is certainly promoted strongly by some religious groups who feel that any contraception is wrong, not to mention abortion (of course they seem to be conveniently ignoring that FAM is a method of contraception and a very effective one at that). Weschler is aware that many of the method’s users may be religious, but she emphasises that people use FAM for many different reasons and the book does not have any religious tone at all. In fact, as I explained above, the book has a strongly feminist undertone.

The method’s ability to fit easily into both the feminist and anti-feminist agendas is interesting in itself. But it could be argued that the method is inherently feminist because it means women have to get to grips (literally!) with their own bodies. It also gives them the knowledge to interpret what their bodies are telling them. I keep coming back to knowledge and information, but this really is the main point. If you’re anything like me, you’ll find reading this book truly amazing and you’ll be furiously wondering why you never knew any of this. FAM just could be the women’s health movement’s biggest and best secret. Who knew?

[1] Ok, at this point I have to point out that a natural, side-effect free method of birth control already exists: just avoid intercourse when having sex. Yes, there is more to sex than just intercourse! Can I get an Amen?

Catherine Redfern likes graphs, charts and statistics almost as much as Dave Gorman.

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