Sunday, December 26, 2010

New Year's Resolution: Have Good Conversations

I recently told a friend about a salon I'd attended, and he said, "Salon? Like a hair salon?" No, my dear young readers. A salon, in the centuries old sense of the word, meaning a gathering, an event, a place to be entertained and to learn (to quote Wikipedia) "under the roof of an inspiring host." My friend Alexandra is the very definition of an inspiring host, and she has recently revived her Sunday afternoon salon series, which is part of her larger "vagina verité" project. (She does not like to use capital letters in that phrase, but I forgive her.) If you are in the New York area, I highly recommend that you treat yourself in the coming year to some great conversation, and some provocative art, and go. Here are the details, from Alexandra's content-rich website.

The topic of the December salon will also be the topic of the January salon, "v-anatomy 101." It wasn't a lecture on anatomy & physiology, however. Yes, we looked at some videos and books about the anatomy & physiology of the vulvovaginal area, but mostly we talked about stuff:  sex (of course), vulvovaginal health, first experience with tampons, where we go for information, how much information we want, and at what age - that sort of thing. We also looked at the "v-portraits," which are now one step closer to being in book format, and one happy participant colored in Tee Corinne's famous coloring book. 

If you're not in NY, well, you can still sign up for Alexandra's mailing list, and why don't you think about starting up your own salon series? I co-facilitated one for nearly two years and it was a blast. Be the antidote to Facebook in your community. Stop communicating in 140 characters or fewer.

I want to wish everyone a very happy and healthy new year. Take care of yourselves, and make the world a better place.

Sunday, December 12, 2010

Yet Another Disappointing Media Experience

FAM just cannot get a media break. About 6 weeks ago, I posted a call for interviewees for an article being written for New York Magazine. I had been interviewed and had spent a fair amount of time talking to and emailing the author (who was gracious and professional with me - no complaints there). Alas, the article came out, and I found it be tremendously disappointing, particularly in light of the fact that it was a very long article, the cover story of New York Magazine, which could have had some impact, had it been focused differently. If you missed the article, you can read it here: 

The article does present a reasonably accurate description of how Fertility Awareness works. So what's my problem? 
-The premise is thin and faintly ridiculous, not to mention alarmist: that the Pill "creates" a type of infertility, by causing women to postpone having children, as if women are unaware that having children at an older age is more difficult.
-It completely trivializes the health risks and side effects of hormonal contraception. (It's as safe as taking a vitamin!)
-The author refers to Fertility Awareness as a more sophisticated version of the Rhythm Method. Which is sort of like saying that a car is a more sophisticated version of a bicycle. 
-The contextualization of Fertility Awareness is completely off-base. The article doesn't discuss FA for contraception, and only a bit as a tool for health, but primarily as the largest factor in a "cult market" [which] has cropped up catering to women in the process of rediscovering their bodies when they go off the Pill." 
-One final choice quote: "You're not going to find anyone, male or female, who isn't a little grossed out by the words egg-white cervical fluid, but it's just basic biology." 

Women, are you "grossed out" by the normal, healthy functioning of your body? Does talking about the evidence of your juicy fertility, which may be accompanied by feelings of sexiness, not to mention a little awe at the power you hold within you, disgust you? If you have a male partner, does he run and hide if you tell him about the clear, slippery fluid at your labia? I didn't think so. 

Monday, November 29, 2010

World AIDS Day - December 1st, 2010 - Universal Access

December 1, 2010 is the 13th annual commemoration of World AIDS Day. This year, for a change, there is actually some good news! A drug in use for treatment of HIV/AIDS since 2004, Truvada, has been shown to significantly reduce the risk of contracting HIV when taking preventatively. We're talking VERY significantly. When taken daily, it was more than 90% effective. Now of course the study only included gay men, but scientists are hopeful that it will prove equally effective in other populations at risk, such as women, intravenous drug users, etc. (And the company hasn't even announced if they will apply for approval from the FDA - at this point this is just very promising research.)

This discovery comes on the heels of another advance, this past summer, when a vaginal microbicide, long sought after as a realistic way for women to protect themselves against heterosexual transmission of HIV, finally proved effective, after many years of failure with other drugs. (The vaginal microbicide was 54% effective amongst women who used it regularly, and the testing process is proceeding slowly due to funding issues.)

So it would seem that we are making some real advances, at least on the pharmaceutical front. But drugs for prevention and treatment are absolutely useless if they do not reach the people who need them. Most of the people who get HIV/AIDS these days are not people of means, people with access to health care, people who are empowered around their sexuality. They are poor people, especially poor women, living in poor countries. They are children, who are not born in settings where mother to child transmission can be prevented. They are prisoners, and drug users who cannot get the means they need to protect themselves (condoms, clean needles). Which is why the theme of this year's World AIDS Day is Universal Access.

The key to ending the global health crisis of AIDS is access to prevention, treatment, and care. (I would include in this concept access to education and decent birthing conditions.) Only about 5 million of the 33 million people with AIDS actually receive anti-retrovirals. Every year 3 million children contract HIV, and another 330,000 children die from it. AIDS isn't the problem here. Lack of access is the problem. Just as malaria isn't really a problem - lack of bed nets and medication is the problem. And how many American or Canadian children do you know who die of diarrhea? The solutions are in our grasp.

Here is an interesting article from the NY Times about why exactly it took so long for researchers to figure out that this drug (actually a combination of drugs), which has been around for years, would be effective in a preventative way, and not just as a treatment.

For you science-loving people, here is the original study about the Truvada trial, from the New England Journal of Medicine.

And for World AIDS Day, here's a nice little video from the folks at the great UK AIDS/HIV organization Avert.

Sunday, November 14, 2010

Long-term Hormone Replacement Therapy Doubles Risk of Dying from Breast Cancer

From the top:

-Back in the day (from sometime in the '30's, up until about 2002), many women used what is called Hormone Replacement Therapy (HRT). HRT has consisted of either estrogen alone, or estrogen in combination with progestin. Although they entail different health risks, for the purposes of this brief background I will consider them together. HRT was primarily used to alleviate discomfort during and after menopause (hot flashes, insomnia, vaginal dryness, etc). However, thanks to aggressive and deceptive marketing by the pharmaceutical industry, it was also widely thought to prevent heart disease, osteoporosis, dementia, and in general to be an elixir of youth. Many, many women took it, often for many, many years.

-In 2002, the results of a very large (16,000 women) long term (5 year) study, known as the Women's Health Initiative (WHI), were released. The results were so dramatic, the study was halted before completion, and the women in the study taking HRT were told to stop, because their health was at risk. The study had found that the women were actually at increased risk of breast cancer, blood clot, stroke, and, later analysis showed, dementia.

-Use of HRT fell off dramatically. Although so far it is only an epidemiological link, breast cancer rates have also dropped significantly during the same period.

-Data from WHI are still being studied. The point of today's post is to draw your attention to a new study, just published in JAMA, which shows that not only does long-term use of HRT increase the risk of getting breast cancer, the women who get it are actually twice as likely to die from it, due to poorer detection by mammography, more positive lymph nodes, and larger tumors. A previous study had showed a similar increased mortality rate from lung cancer.

-I don't think the pharmaceutical industry will ever be held accountable for the damage they've done with HRT, for the lives that have been lost. Of course the American public bought into it, by accepting menopause as a pathology. Hopefully we have learned some important lessons, which cannot bring back our loved ones, or help those now dealing with the consequences, but which we can use going forward. Menopause is not a disease. But as long as we (in the US) have a for-profit medical industry, with the pharmaceutical industry consistently ranking as the most profitable industry in the nation, and a political system in which legislation can essentially be bought and sold, the HRT incident will not be the last of its kind. It certainly wasn't the first: didn't we learn anything from thalidomide, or DES, and isn't baby formula still being sold and aggressively marketed to women in the developing world, as well as here in the US?

-Standing for women, against the forces of big pharma and medical device manufacturers, is the National Women's Health Network. Since 1975, they've not only advocated for us in Washington, they also get information out to the public in readily available, understandable form. Subscribe to their newsletter, and, if you can, send them some financial love.

For some additional reading about HRT and WHI, check out these links.

Long-term HRT doubles risk of dying from breast cancer

History of HRT and how WHI broke the truth

HRT and dementia

Oh, by the way, the estrogen in the most popular forms of HRT (Prempro, Premarin) comes from the urine of pregnant horses. Get it? Pregnant Mare Urine. Here's a little video about it, narrated by Mary Tyler Moore:

Monday, November 1, 2010

Are You Using FAM To Try To Conceive?

A reporter from New York Magazine is seeking interview subjects for an upcoming article. She would like to speak with women who are using Fertility Awareness to achieve pregnancy. Your comments can be anonymous, if you prefer. Click on her name to send her an email:

Vanessa Grigoriadis

I will let you know when the article eventually appears, and of course what I think of it!

Sunday, October 17, 2010

Love Your Body Day is 10/20/10: How Are You Going to Celebrate?

I know, my last post was about Adoption Awareness Month. And I promise, not every post from now on is going to be about a particular month or day. But I couldn't let Love Your Body Day go without notice. It was launched by the National Organization for Women in 1997. And I would love to tell you that things have changed since then. That women of all different shapes, sizes, colors, and ages now grace the covers of our magazines and find roles in theater and film. That breast implants and labiaplasties were no longer being done. That eating disorders were a thing of the past. That dark women were no longer using dangerous chemicals to lighten their skin. That women with "bad" hair were not straightening it. That baby girls born with big clitorises were not having them surgically "corrected." That women were not shaving, waxing, and otherwise depilating their vulvas so that they more resemble prepubescent girls than adult women. That advertising did not use women's bodies to sell anything and everything, often in demeaning and objectifying ways. That younger and younger girls were not being sexualized in the entertainment and fashion industries. And that media was not constantly presenting completely fake and unattainable images of thinness and beauty with a zeal reminiscent of China's (past) fondness for tiny feet.

Well, maybe next year. In the meantime, are you going to celebrate on Wednesday? How? Here are some ideas to get you started:

-NOW's Love Your Body Day website has some info and ideas, including ways to use social media to spread the word. There is a downloadable slide show there which is perfect for teens. And there's a wonderful selection of posters which you can send as e-cards.

-Have you seen the section of my website entitled "Loving Your Body?" Now might be a good time to check it out!

-Watch a movie, preferably with a friend or two. Here are some good ones:
America The Beautiful 
Beauty Mark
Naked on the Inside

-Practice social media activism. Some sex educators in New Mexico made a good video called "You Don't Need Labiaplasty.*" They posted it to their webpage on Facebook. The video contains photos of actual women's vulvas (courtesy of Betty Dodson), to illustrate the beautiful, natural variety of women's genitalia. Facebook decided that it wasn't appropriate, and took their page down. Go ahead - try to post the video to your FB page. Or create a new profile, and post it there, if you don't want to risk your own page. Or link to it. Or link to the article about the censorship of this page. Or create a group on Facebook called,  I don't know, how about "Normal healthy genitalia is not porn"or "The real outrage is labiaplasty." Make some noise!

-Send a kid a positive message. I don't envy parents these days, who have to combat a non-stop barrage of twisted media messaging. Here's a great blog post about the difficulty of that conversation, and the importance of having it, again and again.

-Turn someone on to Fertility Awareness. One place to start might be a radio interview I did with Barbara Glickstein a week before Love Your Body Day back in 2008, on Healthstyles (WBAI). This is an hour long interview/discussion that would be a good intro for anyone not familiar with Fertility Awareness. And at the top of the show is a list of 10 ways to celebrate Love Your Body Day.

Now make your own list. And please share it here. I'd love to hear your ideas for how we can love our own bodies, teach our children to love theirs, and fight the incessant stream of hatred & lies that comes from the media.

*I love everything about this video except that all the vulvas shown are in some way denuded of hair, either entirely or partially. Kind of undercuts the message, don'tcha think?

A Dove ad that I love
2008 Love Your Body Poster by Shanti Rittgers

Saturday, October 2, 2010

Adoption and Identity

November is Adoption Awareness Month, and although we're barely into October, I want to draw your attention to some wonderful films, that you can watch online, for free, for a limited time. (Of course you can also perform the radical, art-supporting act of actually buying them, on the website where they are now streaming.)

POV (Point of View) is an amazing documentary series that airs every year on PBS. Their online presence has grown increasingly strong in recent years, and now they offer many of the documentaries they've aired on TV, in their entirety, as well as lots of supplemental material such as background info on the issues and extra video footage. Currently they are featuring what they call "Adoption Stories." The centerpiece consists of three films. All the films feature trans-racial adoptions, i.e. adoptions in which the race/ethnic background of the child differs from that of the parent(s). Thus the question of identity is central to each of these films.

In the Matter of Cha Jung Hee will be available until 10/15. It tells the story of a woman who was adopted as an 8 year old child from Korea, by American parents, and whose identity was switched, at the time of her adoption, with that of another girl.

Wo An Ni (I Love You) Mommy will be available until 11/30. Its subjects are Fang Sui Yong, an 8 year old from China, and the Sadowskys, her Jewish American adoptive family.

Off and Running will be available until 12/7. It concerns a black teenage girl named Avery, who has grown up in a family with two Jewish lesbian moms, an older black/Puerto Rican brother, and a younger, Korean brother. She is coming of age and struggling with her identity. The film captures a particularly poignant and difficult phase in her life, and briefly but succinctly captures the perspectives of her adoptive family members.

In addition to the films themselves, there is a wealth of material on the POV website, which can be found on the left side of the page that each film is on, under "Explore." Poke around the website a bit more and you will find additional features such as the "Tell Us About Your Family" video contest, Facts About Adoption, and the blog section where you can read some (moderated) viewer responses to the films.

I also want to tell you about a couple of adoption-related blogs I've run across recently, both of which seem to emanate from the same person, a gifted, thoughtful writer. One is called "This Woman's Work," and encompasses a number of topics, including open, transracial adoption. (Click on categories on right side of the blog to find posts re adoption, parenting, infertility, etc.) The other is "Open Adoption Support" which is actually a community blog with membership (any one can read, but you must be a member to post).

I hope you'll be able to find some time to watch at least one of these interesting films. Feel free to post your thoughts here. I watched "Off and Running" recently and I thought it was fascinating, and moving, and raised all kinds of interesting questions about identity and race. At one point Avery tells her birth mother that she's not sure who she is. And her birth mother responds, "You are the person your (adoptive) parents raised you to be." The questions that Avery, and perhaps every adopted child seeks to answer, are along these lines: "Am I more than that? Is there some part of my identity that is intrinsic to me, that I have inherited, that is distinct from this family in which I now live?" If the child has been cross-culturally/trans-racially adopted, those questions loom even larger.
Avery and her family

Sunday, September 19, 2010

Getting Started with Fertility Awareness - East Coast & West Coast Events

I'm happy to share with you two upcoming events that are for people who are not already practicing Fertility Awareness. One of the events, in NYC, is an introduction (vs. a complete workshop), so that people can learn more about Fertility Awareness and decide if it is something that they would like to pursue in more depth. The other event, in San Francisco, is a complete workshop. If you have friends or family members who have expressed interest in Fertility Awareness, these events are great opportunities to get them started.

New York City:
The Traditional Nutrition Guild Parents' Group presents "Fertility Awareness for Natural Birth Control: An Introduction and Panel Discussion." Of course the discussion will touch on all aspects of Fertility Awareness, not just birth control. Attendees should be aware that the presenting organization is affiliated with the Weston A. Price Foundation, which strongly supports Fertility Awareness, but which is a separate practice. Discounted copies of The Garden Of Fertility will be available for purchase. Please try to purchase tickets in advance!
9/26/10, Kula Yoga (28 Warren Street, 4th floor), Tribeca Parenting (46 Warren Street),
2:00PM -5:00PM, $30-$60 ticket range.
Tickets and full information, including contact info, here:

San Francisco:
My West Coast colleague Sarah Bly is planning to teach a workshop in SF, with the help of local organizer Vanessa Alabarces. The 6 hour workshop will provide all the basic instruction necessary to get started with practicing Fertility Awareness. A followup session, which is critical for effective practice of the method, is included in the cost of instruction. 
10/23 & 10/24, 9AM to 1PM
Individual $110, Couple $130
For more info & to sign up:
541.821.2522 (Sarah, PST)
415.483.6202 (Vanessa, PST)

I'm always thrilled to get feedback about these events, so please let me know if you or a friend attends one.

Tuesday, September 7, 2010

Good Article On Miscarriage

This sensitively written piece from the British paper The Guardian touches on a lot of important points, including how miscarriage is extremely common, but hardly ever discussed, and the important differences between "sporadic" and "recurrent" miscarriages.  I tell my students that miscarriage happens all the time in perfectly healthy, fertile women - perhaps in up to 50% of all conceptions - and that they, as charters, will be more likely to notice early miscarriages than people who aren't as aware of their cycles. Most importantly, I tell them that miscarriages, while horribly difficult to bear, usually mean nothing in terms of a woman's overall fertility. Only a very small percentage of women will have repeated miscarriages. If you have had a miscarriage, or more than one, I encourage you to talk about it and to get support if you want it. Your friends, your family, perhaps even your partner may not understand your feelings, and may be uncomfortable with the topic, but the more we talk about it, the less taboo this topic will become.

Miscarriage: A Mother's Last Taboo

Sunday, August 22, 2010

"So For God's Sake, Please Breastfeed"

That quote comes to us courtesy of one of three (male) researchers at the University of California, whose research on breastmilk has recently led to a fascinating discovery. Up to 21% of breastmilk consists of complex sugars which cannot be digested by babies. Scientists had no idea what these sugars were doing in there. As anyone who as ever assembled a piece of Ikea furniture knows, just because you can't figure out where it goes, doesn't mean it doesn't have a purpose. It turns out that these sugars are not meant for the baby, at least not directly. Rather, they are for helpful bacteria (which I'll shorthand as bifido), which take up residence in the baby's gut, and protect it from harmful bacteria. The sugars both feed the bifido bacteria, and also serve as "decoys" for harmful bacteria and viruses. In short, the indigestible component of breastmilk turns out to be vitally important to the infant's immune system. Hence the hortatory exclamation from the researcher, which, you must admit, is rather uncharacteristic of a scientist.

NY Times article re immune function of indigestible sugars in breastmilk

Now, it's all well and good to urge women to breastfeed, but to mandate it by law, that's another matter. That's apparently what the government in Indonesia is trying to do. Under a law passed in 2009, which is set to go into effect in October of this year, mothers who fail to provide 6 months of exclusive breastmilk for their infants face up to 1 year in prison, or a $15,000 fine (unless medical conditions which preclude breastfeeding are shown to exist). Other people, such as employers who prevent breastfeeding, will also be subject to punishment. I wonder if next year they'll tell people how many children they can have. 

bifidum longum

Saturday, August 14, 2010

Ilene Now Teaching At Om Wellness

OmWellness is a new-ish facility on the west side of Manhattan offering a variety of health and wellness services. Foremost amongst these services is an intensive Holistic Nutrition Training Program. The directors, Tatiana Forera Puerta and Adam Elenbaas, are multi-talented, smart, enthusiastic people with whom I have been happy to work since the beginning of this year.  

As per their website, the training program is ideal for individuals who are interested in deepening their connection to food and nutrition while simultaneously studying a variety of holistic health modalities. Classes are held at their facility and include lectures, workshops, hands-on experiments, group and individual work. The primary topic is food theory and practice, including Ayurveda, macrobiotics, raw foods, veganism, whole foods, and food politics. And of course they consider the role of diet and lifestyle in sickness and disease prevention/treatment. Students enjoy small class sizes, lively discussions, unlimited yoga for the duration of the program, one-on-one health counseling, informative seminars, meditation, and hands-on work with doctors, chefs, and alternative health practitioners. Both weeknight and weekend programs are available. Graduates receive certification from both OmWellness as well as the American Association for Drugless Practitioners. 

Tatiana is passionate about Fertility Awareness, and wanted to make sure that her students were exposed to it as part of their training. Thus I was invited to teach there. I'm very grateful for the opportunity to reach future health care providers, and to provide the link to fertility & reproductive health that is so often missed when people embark on a more "natural" lifestyle.

If you are interested in participating in a training program at OmWellness, note that the next programs are coming up soon (at the end of August). Although it's not on their website, I believe that you can get a $250 discount if you sign up by 8/20/10. Of course they also offer a variety of other services, including yoga, nutrition counseling, cooking lessons, etc, so check it out, especially if you live in NYC:

Sunday, August 1, 2010

Study Shows E. Coli in Urinary Tract Infections Comes From Meat

We already knew that the majority of urinary tract infections (UTI's) come from E. coli. A common scenario is this: you have E. coli in your digestive tract, it comes out via your anus, you have sex (or you wipe from back to front), and the E. coli gets into your urethra, where it causes problems. Now a researcher has shown that the strains of E. coli which are causing the infections are precisely those that are found in the local meat supply (and more specifically tied to chicken). Reaction to the study has been pretty uniform. As the lead researcher of the team, Amee Manges, puts it, we should "follow hygienic practices in the kitchen, prevent cross-contamination between raw meat and other foods, and cook meat thoroughly." Good advice, but I have a better idea. How about we stop raising animals in factory farms, where they end up being coated in feces, eating feces, eating the bodies of other animals, and being slaughtered in conditions which are impossible to keep free of pathogens?

Study re E. Coli in meat and UTI's

Factory Farmed Chickens

PS: You may have noticed that we have a new look for the blog. I was trying to figure out how to get the Sheri Winston video, in my last post, to fit properly, and along the way I decided to try a new format. It matches our website more closely, and gives the blog entries a bit more room to stretch out. I also added the "share this" feature, which I personally love and use a lot. I wasn't able to fix the video problem, but I hope you like the new format. Now share some blog posts!

Monday, July 19, 2010

Sheri Winston and the Three Breath Orgasm

I've known about holistic sexuality educator Sheri Winston for many years, but I'd never actually visited her website. Until recently, when I was working on links for my own website. I like that she contextualizes her work as sexuality *education.* Fertility Awareness and sexuality education go hand in hand. It's all about empowerment, baby. People have told me how much they enjoyed studying with Sheri Winston. I can see why. Her approach is contagiously positive, and while she's spiritual, she's also down to earth. And she's a fabulous example of how a big woman can be really, really sexy.
Intimate Arts Center

Here's a great video from her site.

(Note to blog subscribers: If this video is not appearing in your email, please click on either of the headlines above this text, and you'll be taken to this blog entry, or go to Sheri's website and look on right for "Look Ma, No Hands!")

Monday, July 5, 2010

Couple of Item re Herpes

Herpes has been in the news recently, as a new CDC study was published in March that caused a bit of a media stir. Two main findings emerged from this study:

-One is that approximately 1 in 6 Americans is "infected" with HSV2. "Infection" simply means that someone has been exposed to the virus. Many people with antibodies to either herpes virus (HSV1 or HSV2) do not have outbreaks and don't know that they are infected, although they can still transmit the virus to others.

-The second finding is that there is a major discrepancy in prevalence when one looks at gender and race. Women are twice as likely to be infected as men, and black women are three times as likely to be infected as white women.

As is so often the case, I wonder where the other races are in these findings.

Other things to note:
-This CDC study did not address HSV1 at all. HSV1 is the type of herpes that prefers to reside in the area of the mouth. It causes what we call cold sores. It is also very happy taking up residence around the genital area, although outbreaks in that area tend to be less severe, less frequent, and the virus is less likely to be shed from that area.
-These findings are largely the same as those from the last such study, from approximately 5 years ago.

Here is the original press release from the CDC:
CDC Study Re Herpes (HSV2)

The discrepancy in prevalence based on race was of course the part that caused some controversy, especially in the African-American press. Here is a piece in The Root which questions the statistical sampling, as well as the meaning of the findings:
Reply in the Root to CDC Study

In related news, the New York Times "Consults" blog has been running a series about herpes in recent months. Here is a link to the post about transmission, with links to related posts below the main piece:
"Giving Your Partner Herpes" in the NY Times

And here is the NY Times main guide to herpes:
Times Guide to Herpes

Herpes is as prevalent as it is because (a) it's a quiet virus - many carriers don't know they have it and (b) people don't know much about it, or how it's spread. Much of the ignorance is due to the stigma that is attached to herpes. This is stupid. With up to half of some American populations, and approximately 16% of the general population, infected with HSV2, it's beyond time to grow up and treat this virus as we do any other virus. The more you know about herpes, the better your chance of avoiding it, or of giving it to someone else.

Saturday, June 19, 2010

My Talk at American College of Nurse Midwives Annual Meeting

I'm recently back from a few humid days in DC, where I gave a presentation at the 55th American College of Nurse Midwives Annual Meeting. It was a very impressive gathering. About 1500 were expected to attend. There were 5 days packed with talks, workshops, exhibitions, lobbying, parties, etc. I was pleased to see that there was a special focus on international midwifery, and the role that midwives can play in improving maternal health in the developing world.

On Tuesday, 6/15, I gave a one hour educational presentation entitled "Introduction to Fertility Awareness: How a Proven Method of Natural Fertility Management Works and How it Can Benefit Your Patients." I didn't think many people would attend, because my session took place during Lobby Day, when the midwives took to Capitol Hill to meet with legislators about issues relating to the practice of midwifery both here and abroad. However, I was pleasantly surprised as the room became completely full, with about 100 people in attendance. This was the largest audience I've ever addressed, and my nervousness was increased by the fact that they were all midwives, and that I might not be telling them anything they didn't already know. But what I found was that, although almost all of them had some familiarity with Fertility Awareness, only one of them was actually teaching it, and most were only really familiar with FA for pregnancy achievement. They were very interested in the presentation and had a lot of practical questions at the end.

There was only one other presentation related to natural fertility management, and it was on The Creighton Method a.k.a. NaProTechnology, which is a type of Natural Family Planning (NFP). As you probably know, NFP has religious underpinnings. The presenters completely de-emphasized this, and spoke mostly in medical terms. It was there if you were looking for it, but I have a feeling that most in the audience really didn't understand the distinction (unless they had been at my talk the day before). Their stats on resolution of fertility issues were compelling, but they spoke only in positive terms and did not mention a single drawback to their methodology, or a reason why a woman or a couple might not want to use it. It seemed more like a sales pitch than a medical presentation. In my presentation I spoke specifically of the pros and cons that a woman contemplating Fertility Awareness should consider. No method is right for everyone, and good reproductive health care always seeks to expand the range of choices available to women, not dictate to them what they should or should not be doing.

Wednesday, June 9, 2010

Saturday, May 29, 2010

Female Genital Mutilation Performed by US Doctors?

On 4/26/10, the American Academy of Pediatrics (AAP) released a statement which sent shockwaves around the world. A portion of the policy statement essentially sanctioned Type IV FGM, by suggesting that doctors be allowed to make a ritual pinprick or nick on a girl's clitoris, if it would prevent the girl's family from sending her to their home country where a more severe and dangerous type of FGM would be performed. This statement completely reversed the organization's 1998 statement, in which it condemned all forms of FGM and urged its members not to perform it, noting "its cultural implications for the status of women."

I understand that the intentions of the AAP were good. Dr. Friedman Ross, a member of the committee which drafted the statement explained their thinking this way: “If we just told parents, ‘No, this is wrong,’ our concern is they may take their daughters back to their home countries, where the procedure may be more extensive cutting and may even be done without anesthesia, with unsterilized knives or even glass,” she said. “A just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good.” Dr. Ross said that the committee does “oppose all types of female genital cutting that impose risks or physical or psychological harm,” and consider the ritual nick “a last resort,” but that the nick is “supposed to be as benign as getting a girl’s ears pierced. It’s taking a pin and creating a drop of blood.”

But international reaction was strong and swift in opposition to the measure. It was viewed as a major concession, and the top of a very slippery slope. You can read an excellent piece by Equality Now's director, Taina Bien-Ami, here:
Huff Post: Do No Harm

A month after it issued the statement, the AAP had been persuaded to retract it, after hearing from the UN, the World Health Organization, Unicef, V-Day (Eve Ensler's organization), Equality Now, among many, many others.  There are ways to fight FGM, in this country and abroad, but concession is not the way to go about it. Lawmakers are currently drafting more effective legislation, such as HR 5137, which would make it illegal to transport a minor girl living in the U.S. out of the country for the purpose of FGM. According to Equality Now, "the bill will hopefully also call for the launch of culturally sensitive outreach programs in FGM-practicing immigrant communities in the U.S. to educate parents about the lifelong harms of FGM."

The new AAP statement opposing all forms of FGM can be read here:
AAP Anti-FGM Statement

"Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." - Margaret Mead

Tuesday, May 11, 2010

Reflections on the 50th Anniversary of the Pill

There are lots of pieces like this in the media right now, so I'm not going to post a ton of links - just do a search if you're interested. But I sent one link to blog subscribers, and someone asked me to post it on the blog proper. So here is that one plus a couple more:

First, a link to a CNN feature in which various people (writers, commentators, politicians, etc) talk about the significance of the Pill. Note stupid, uninformed comment about Fertility Awareness by Sara Benincasa:   CNN on Pill

Similar piece in Time Magazine:   Time on Pill

Rather different piece on Alternet re Pill's effect on population and water supply: Alternet on Pill and water
And if you missed the piece that "Need to Know" did end up airing, which was exclusively about the Pill, you can either watch it during the "full episode" video, on this page, and/or you can watch an extended interview with Erica Jong ("The Pill, Then and Now"), only part of which aired during the show, also on this page. If you're watching the whole episode, the Pill segment starts just before 43 minutes: "Need to Know" on Pill

Enough about the damn Pill! Next post will definitely be about something else. 

Saturday, May 8, 2010

Nada. Zip. Zero.

That's how much time "Need to Know" spent on Fertility Awareness in their premiere (see post directly below). Terrific. The media blackout continues. Happy 50th birthday, birth control pill.

Sunday, May 2, 2010

They're Actually Going to Be Talking About Fertility Awareness on TV

It's a very, very rare day when Fertility Awareness is discussed on national television. The last instance I can think of was in 2002, when Toni Weschler was on "The Today Show." But on Friday, May 7th, viewers will (I believe) be treated to a discussion of Fertility Awareness running approximately 8 minutes. It will take place during the premiere of a PBS show called "Need To Know." The subject of the show (or at least a chunk of it) will be the 50th anniversary of the birth control pill.

A while back I was contacted by a producer for the show who was looking for footage, and people to interview. I hooked her up with an interviewee, who as far as I know will be on the show, but alas they apparently decided not to use footage of me teaching. Oh well. I'm still extremely interested to see what they are going to say, not just about FA but about the history & consequences of the Pill.

The debut of "Need to Know" will doubtless be watched by a huge audience, as it is replacing the extremely popular, long-running "Bill Moyers Journal," and there are concerns that PBS is going soft, and less controversial, with the new show (and with the cancellation of "Now," which followed the "Journal"). There's been a fair amount of media buzz about the format and the choice of Jon Meacham as one of the hosts. So FA stands to get some major exposure with this broadcast. I only hope that the treatment is well-informed. It seems like every piece about FA contains gross inaccuracies or conflates FA with Natural Family Planning, which is typically steeped in Catholic values and should not be confused with secular Fertility Awareness. My sense from the producer was that she had a pretty good understanding of FA, and planned positive coverage, but often the best intentions are undercut (literally) by ignorant editing. Stay tuned.

You can see "Need to Know" on Friday, May 7th, at 8:30PM EST (check local PBS listings if you're not in NY area). The good news for people like me who don't have television is that it will also be available all week, after airing, on their website:

If you watch the show, I hope you'll post your thoughts here.

Sunday, April 25, 2010

The Canary Died 20 Minutes Ago

Do you know the expression "canary in a coal mine?" Miners used to use canaries to warn them when dangerous gases were building up in the mines. Canaries are sensitive to methane and carbon monoxide, and will die at lower levels than it would take to kill a human. If the canary stopped singing (i.e. if it died), it was time to get out of the coal mine, a.s.a.p.

Scientists have been saying for years that certain animals are starting to exhibit "intersex characteristics" in far greater numbers than should be found naturally. Intersex means that the animals exhibit characteristics of both male and female genders. In a common example, a male fish will be found with immature eggs in their testes. Intersex is thought to be caused by endocrine disruptors, chemicals which interfere with the hormonal system. Some species seem to be more vulnerable than others, and some locales seem to be more affected than others. A well-known problem area is the Potomac River, near Washington DC, where a recent survey found 80% of fish exhibiting intersex characteristics. 80%, people. In another study, all the fish, whether intersex or not, were found to be contaminated with at least one endocrine disruptor, of the type typically found in personal care products such as antimicrobial products and artificial fragrances.

Studies have been published, articles have been written, yet the flow of chemicals into our waterways (and our bodies) continues unabated. The Potomac Conservancy is trying to get people to pay attention. They've launched a campaign called FishMystery. You can sign a petition calling for more attention to and investment in this problem. You can read about ways to minimize your exposure to endocrine disruption. You can read studies and press releases. But they really shouldn't call it a mystery. It's incredibly obvious where the chemicals are coming from, and what the implications are going to be if we don't get the hell out of the mine.

FishMystery website

Article in The Guardian re intersex fish

A related post I wrote a year ago

Saturday, April 10, 2010

New Group (NYC): Genital Herpes Is Not My Identity

My friend/colleague Melissa King is starting up a new meetup group for women with HSV (Herpes Simplex Virus). Women whose partners have herpes are also welcome to participate. Info from the website:

"This is not just a process group for women in the New York City area to work through the challenges presented by genital herpes infection, it is also a space for women affected by herpes to get their mind off of the infection and connect with other women on the everyday issues that we all deal with - dating, relationships, dreams about the future, health, and career... In this group I am combining the work I do in my single women's groups with the work I do with women who have herpes. We will sort through the facts about herpes and you will have an opportunity to get updated and accurate information about herpes. We will discuss body image, relationships, social stigmas and how all of these things uniquely affect you.

But we won't stop there. Genital herpes is only one part of your life. I have been hosting women's groups for a number of years and all women deal with challenges to their self-esteem, frustrations and disappointments in the dating world, questions about their career path, and joy in their achievements. This group will offer a structured environment with weekly topics that will provide you an opportunity to discuss these issues, process and solve the problems related, and find inspiration and motivation to move forward. Most importantly, you will be able to connect and share with other women in a safe space where you can also discuss your concerns about genital herpes."

Melissa is a fabulous facilitator and a certified holistic health counselor who has many years of experience helping women discover what is important to them, what makes them happy, and how to create positive change in their lives.

The first meeting will take place this Wed, 4/14. Women who are interested in participating but cannot attend this meeting should contact Melissa so they can have some say in when the group will meet in future. Monthly participation fee will be $75, and your first meeting is free, regardless of whether it's this Wed or at a future date.  Read all about it here:

Saturday, March 27, 2010

US Has Waaaaaay Too Many Caesarian Births

One in three births in the US is currently a caesarian section (C-section).   The World Health Organization suggests that the normal percentage of C-sections should be about half what we currently have, i.e. about 15%. (I should note that other countries have even higher rates. In Puerto Rico and China, nearly 50% of all births are by caesarian.) Here is an article from the New York Times about the US C-section rate and its implications:
US C-Section Rate Hits All Time High

Some C-sections are for primary deliveries (first birth), while others are C-sections following an earlier C-section. Fewer than 10% of women who have had a C-section in the US will go on to have a subsequent vaginal birth, or VBAC. VBAC, is considered risky, but so is a caesarian. The National Institute of Health recently held a conference devoted specifically to VBAC. You can read about the NIH conference here (with links to lots of data, reports, etc):
NIH VBAC Conference

The issues of primary caesarian and VBAC are separate, but of course related. They reflect an overall state of extremely poor maternal health care in the US. Amnesty International recently released a report with some shocking statistics about birth in the US:

"The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries. For example, the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain. African-American women are nearly four times more likely to die of pregnancy-related complications than white women. These rates and disparities have not improved in more than 20 years."

Here is a link to Amnesty International's report, along with suggestions for action you can take:
Amnesty Campaign for Maternal Health

Interestingly, although Native Americans generally lag behind other Americans in nearly every aspect of prosperity and health care, in terms of labor and delivery, their very lack of access to what is considered state-of-the-art medical care may be working in their favor. A recent NY Times article looked at births in Tuba City, Arizona, where most patients are Native Americans, and most births are attended by midwives. A number of factors contribute to the low C-section rate here (about 13.5%) and the high VBAC rate (about 32%). One is just patience; vaginal births take a lot longer, on average, than C-sections. Midwives don't mind waiting. Another is compensation: "Doctors and midwives here earn salaries and are not paid by the procedure, so they have no financial incentive to perform surgery." Native American cultural traditions also play a part. Make sure to check out the beautiful narrated slide show that accompanies this article:
Lessons at Tuba City Hospital, Run by Navajos, About Births

Saturday, March 13, 2010

Black Women Breastfeeding: A Multi-Generational Story

As in most measures of American healthcare, black women lag behind white women in breastfeeding. The reasons are of course complex, but are rooted in socio-economic disparity, lack of education, and lack of equal access to healthcare. This video explores the issue of breastfeeding in several generations of an African-American family (ok so it's a celebrity family - Carol Jenkins was a long-time TV news anchor and correspondent and her daughter is a writer). The video isn't edited particularly tightly and has the feel of a home movie, but perhaps it will inspire other women to have a conversation with their mothers, or daughters. And dig that chubby little baby!

Saturday, March 6, 2010

Upcoming Events!

I always feel a bit funny writing about events in NY, because I know that many of you don't live anywhere near here, but hopefully the associated links and websites will be of interest to my long-distance readers.

First, an event for the pregnant people in the audience, and those who hope to join them. Each month, Choices in Childbirth presents an evening of birth stories. From their website: "The evening features inspiring - not necessarily easy! - stories from three to four new parent storytellers and expert commentary from mother-friendly birth professionals. The stories tell of a range of births (stunningly short, impressively long, unexpectedly challenging, remarkably straightforward, twisty-turney, painless, orgasmic, painful, cesarean. VBAC, twins, etc.) and reflect a range of choices (home, birth center, hospital, midwife, Obstetrician, family practitioner, doula, family support, etc.)."

The next Birth Stories Evening is this coming Wednesday March 10, but the event is held monthly at various NYC locations. Here is the link for more info:
Birth Stories

If you're not in NY, check out the other resources on Choices in Childbirth's website, including their free guides to a healthy birth.

And on a completely different note, artist/musician/writer/activist Vanessa Boyd is launching a new website called To kick things off, she's teamed up with artist/activist Alexandra Jacoby, of vagina verite fame, to host an erotica writing salon on Sunday, April 25th, at 3PM. Here's how they're pitching it:

"A little food, a little wine, some heady Mid-town air... ladies only, come to an erotica writing workshop salon. Progressive Erotica is about challenging ourselves to create erotica that is based on equality and mutual respect, and still gets us off! All comfort and (non)experience levels welcome, pressure-free ~ participate at the level you want, whatever that is. This is part of a larger effort to create an online portal for erotic content and community discussion about our sexuality and our sensual journeys. will showcase erotica that looks beyond domination, submission and use of power and authority over another person for personal gratification."

If you want to attend, send an email to Alexandra at leavethecastle dot com. No charge for admission, and I suspect that you'll be able to see some of the V-portraits while you're there. If you don't know what V-portraits are, go to vagina verite right now!

Monday, February 22, 2010

Couple of Items re Overlooked Infertility Issues

Here are a couple of unrelated items about infertility issues that are often overlooked.

First, we have an article about a relatively common cause of infertility in women that many doctors don't recognize or test for. CAH, Congenital Adrenal Hyperplasia, resembles the much more well-known condition known as PCOS (Polycystic Ovarian Syndrome). In both cases, the girl (or woman) has an excess of androgens (male hormones) which can cause a variety of symptoms that may range from mild to severe. The disease is easily treated, in both girls and women, once it is correctly diagnosed:
CAH, a Hormonal Culprit in Infertility, is Often Overlooked

And here is an older piece which I've been meaning to share with you for ages. In 2008, a French study was published in Reproductive BioMedicine Online which indicated that the role of the male's age may be more important than previously thought for both pregnancy achievement and healthy outcome. Here is a summary & analysis of that article from Time Magazine:
A Biological Clock for Dads, Too

Sunday, January 31, 2010

Hospital Births May Finally Get It - You Needn't Starve and Be Thirsty During Labor

The medical community may be reversing itself on a practice that came about after the rise of hospital births but which has long been unnecessary. Women who give birth in hospital are routinely denied food and water when in labor, and only allowed to suck on ice chips.  The justification for this policy is that a woman might need to have an emergency c-section (perhaps 1-2% of current births) in which there wouldn't be time for regional anaesthesia, requiring the use of general anaesthesia, and in such cases there can be a rare but potentially fatal complication (which is why you have to fast before you have any surgery). But recent studies are showing no difference in outcome, which may lead to a reversal of this long standing policy that is based on birth and anaesthesia procedures dating back nearly 70 years. Some hospitals are (gasp) now permitting clear fluids for women in labor. The midwife/home birth community has long known that this restriction is ridiculous, and unnecessarily adds to a woman's discomfort and stress. Maybe in another year or so the world of hospital births will catch up and allow women to eat, and drink, or not, as they desire, during labor.

Saturday, January 23, 2010

Haiti's Women, After the Quake

I've been trying to think about what to write here regarding Haiti. It's been so much on my mind, and probably on yours, but this is a blog about Fertility Awareness and related issues, and there didn't seem to be much link. But then today I was reading today about three Haitian leaders who died as a result of the earthquake, and I want to draw your attention to them. I do so because these women did so much for the women of Haiti, and also because (as you may know) I believe that Fertility Awareness should encompass women's issues that result from our biological status as women, such as rape, domestic violence, and female genital mutilation. And I suspect that many of you don't know about how women suffer in the wake of a disaster, in a different and more acute way than men often do.

The names of the women who died were Magalie Marcelin, Myriam Merlet, and Anne Marie Coriolan.

Haiti's troubles were innumerable even before the earthquake, and in countries (and societies) where poverty is as endemic as it is in Haiti, women often suffer the extra burden of violence and sexual exploitation. A recent study by Kay Fanm, a women's rights organizations founded by Magalie Marcelin, found that 72% of women surveyed had been raped, and at least 40% had suffered domestic abuse. Spousal rape is not recognized as a crime in Haiti. Sexual harassment is not specifically outlawed. There are 523 maternal deaths per 100,000 births (vs. 12 in the US). This situation is only likely to worsen as a result of the quake. It's well known that women are at greater risk after major disasters. Rape and domestic violence become more common, women may not be able to gain access to emergency food aid, human/sexual trafficking may increase, and women's maternal health care needs go unmet.

This piece in the Huffington post by Taina Bien-Aime, the director of Equality Now, discusses both the remarkable women who died, as well as the precarious situation of women following this disaster:
"Haiti's Women in the Aftermath of Disaster"

You can read more about these women in this piece by Jessica Ravitz, for CNN:
"Women's Movement Mourns Death of 3 Haitian Leaders"

Here is an elegy to Myriam Merlet on the V-Day website. Myriam approached Eve Ensler in 2001, as she wanted to bring V-Day to Haiti. Together, they established a safe house for women in Port-au-Prince.
V-Day Mourns Myriam Merlet

The Haitian recovery will be going on for years. Even if you have already donated, I hope that you will consider donating, either now or in the future, to some of the organizations that will continue to fight for the rights and safety of Haitian women. Some of them are listed below. There is a Haitian saying, "When the women dish out the food, everyone eats." Help fill the pots of Haitian women so that all Haitians can be fed.

Dwa Fanm

Kay Fanm

V-Day Haiti Sorority Safe House


Madre (Madre also has a piece about how women are uniquely vulnerable after disasters, and how their model of relief puts women front & center, which you can read HERE, and there is also a nice piece about the midwives and maternal health care practitioners they helped send to Haiti, to assist the 37,000 pregnant women estimated to be among the survivors of the quake. You can read that HERE.)

Tuesday, January 12, 2010

More re Kenya Experience

As I indicated in my last post, the work I signed up to do in Kenya and the work I ended up doing turned out to be rather different. The title of the project was, and I quote, "Impact of harmful cultural practices - Female Genital Mutilation (FGM) and Early Marriages for the Girl Child." So you can imagine my surprise and disappointment when I got to the project site and learned that the project actually had nothing to do with that topic, and that the primary activity would be making bricks out of mud. Now mind you, brick-making is very important in Kenya. Nothing gets built until the bricks are made. The community group with which we were working, the Mowankwe Women Group, has a long-term goal of building a health clinic, as there is none nearby and most people go without any type of medical care except for major emergencies (and even then it's not always possible). Many women birth at home, unattended, and while I'm all in favor of home birth here, in rural Africa it often leads to very unfortunate outcomes, including mother to child transmission of HIV.

So brick making is an important activity, but not what I had signed up for, and definitely not one for which I'm particularly well-suited. (The fact that I had recently had surgery for a broken and dislocated thumb did not help matters.) But as several friends with development experience had told me before I left, when attempting to do any kind of development work in Africa, it is very important not to have fixed expectations, and to go where the flow takes you. That advice served me well. They wanted bricks; we would make bricks. We managed to make a few thousand of them, despite the daily rain. (It was the rainy season, arguably not the best time to make bricks out of mud.) It was unclear when we left whether the bricks would be sold, to raise income for the community, or whether they would be used to expand the one room building that currently serves as church, school, and community meeting place.

Mudmaking photos lifted from my friend Malcomb's Facebook page. Here you can see mudpit at rear, and Hitomi and Oska transferring bricks from mold onto ground.

In this photo I'm on the left. Mineshi (center) and I are trying to mix the mud that Oska is making, with
our legs. Way harder than a Stairmaster.

But I had done a ton of preparation regarding FGM, and here I was in Kuria, an area with an extremely high prevalence rate of FGM, so the Mowankwe group and I decided that I would give a presentation, during the last of our 3 weeks there. Mind you, this community has no electricity and no running water, so although I had been told that I would be able to show a dvd (Africa Rising), I was truly astonished when I saw that they had in fact procured a generator, a dvd player, and a tv. They even had a chalkboard and chalk. So with the help of 2 translators, I was able to give a presentation about FGM.

When one is a white person talking about FGM in Africa, one needs to be very cognizant of the complexity of the issue, including the history of it. Attempts to eradicate FGM have largely come from outside Africa, and from outside the cultures which practice it. A lot of resistance to change centers on this fact. I structured my talk in such a way that I left room for arguments in support of the practice. My intention was to have a discussion, not to give a lecture. I used the term Female Circumcision, rather than Female Genital Mutilation, so as to leave open as fully as possible the doors to dialogue. I was fully expecting to encounter the Cultural Imperialism argument. In the end, I encountered no resistance whatsoever. The women (and men) who attended my presentation expressed a pretty uniform opposition to FGM. I think this is because these women are activists within their community, working together to improve their own lives and those of their families. They are poor and in many cases of limited education, but they are engaged. Although most of them had themselves been circumcised, they seemed committed to not inflicting the same damage on their daughters. They lamented the lack of sexual desire/pleasure and were aware of the health risks. I realize that the people continuing the practice were not at the presentation, but it was heartening to see that the tide is in fact turning in Kenya, and to know that these women who are working to bring about change in their community are set against FGM. I hope that they will spread the message to their fellow villagers and lend them, especially the girls, the support they need to resist the tradition.

Btw, the video Africa Rising had been donated to me by the makers of the film, and I left it with the Mowankwe group. Thanks to EQUALITY NOW for the support.

Me, teaching.

Carol and Oska translating for me. They are laughing, despite the serious subject matter, because they are NOT used to saying these words out loud! And that of course made me laugh.

Watching the video Africa Rising.