Blog of the Society for Menstrual Cycle Research

Choice, Fertility, and Menstrual Cycle Awareness

April 2nd, 2014 by Laura Wershler

Guest Post by Lisa Leger

Photos courtesy Lisa Leger

Posing while pregnant in my pro-choice T-shirt in 1993 was a political statement, one I made with a huge sassy grin on my face. When I recreated the pose recently on my daughter’s 21st birthday, I found it easy to reprise the grin. First take, in fact. My choice tee is well worn; it’s a house/jammy shirt that my daughter has seen me in her whole life. Little does she know that she’s had her nose wiped by a piece of Canadian history.

I bought the choice tee at a fundraiser in Toronto when the Ontario Coalition for Abortion Clinics was helping Canadian abortion rights crusader Dr. Henry Morgentaler with legal expenses when he was forced to defend in court his practice of providing safe abortions in a free-standing clinic. At the time, abortion was legal in Canada, but only if approved by a Therapeutic Abortion Committee and performed in a hospital. I was 27 years old, fresh from university, and a legal abortion had allowed me to finish my degree unburdened by an unplanned pregnancy, but I supported fewer restrictions to access.

Like most twenty-somethings, I had a long history of contraceptive use. I’d tried the pill, an IUD, and even the rhythm method, a fuzzy grasp of which I probably had picked up in a public school health class. I had a rotten attitude about my fertility, saw it as a huge hassle, and had no interest whatsoever in becoming a mother. My social and political opinions about the right to reproductive choice were fully formed when I bought this T-shirt for the cause I so ardently supported.

I was 32 years old when I posed in it while pregnant. By then I’d been charting my menstrual cycles for enough years to have improved my attitude about fertility dramatically. I’d met Geraldine Matus in the late 80s and learned to use the Justisse Method for Fertility Awareness that she developed. It changed my life forever; not only did I gain body literacy, develop a healthy relationship with my cycling body, and break free from contraceptive drugs and devices forever, I also gained a cherished mentor in Geraldine, and a career path as a Justisse fertility awareness educator that has sustained and gratified me for the past 25 years.

I took that picture in my choice T-shirt in 1993 because, for me, it says “I’m choosing to be pregnant.” I grinned because it was my choice to have Clair; I wasn’t scared or forced or coerced into that pregnancy. It was entirely my free will to lend my body to the great task of having a child and I made that choice because of the healing that had gone on over the years of charting, coming into relationship with my body, and learning to appreciate the awesomeness of my pro-creative power. Now that my daughter is 21 years old, I think about the freedom and choices she has as a Canadian woman in 2014, and feel sadness for those who don’t have that choice. I reflect on what a shame it is that these battles over reproductive choice, human rights, access to birth control, stigma, and power seem never to be put to rest. On Clair’s birthday, I posed in my choice T-shirt for my family archives and for those who still do not have choice.

Lisa Leger is a Holistic Reproductive Health Practitioner (HRHP) and women’s health activist on Vancouver Island. She serves on the board of the Society for Menstrual Cycle Research.

A Letter to My Mom: I am Sorry I Was A Brat

February 17th, 2014 by Chris Bobel

Photo courtesy someecards.com

Dear Mom,

I owe you an apology.

Remember when you were perimenopausal (or as we called it, “going through menopause”)? Remember when you experienced hot flashes? And remember when you did, how we, your loving family, either 1) ignored 2) trivialized or 3) mocked you? Your hot flashes were a constant source of humor around our house and I recall you joining the fun.

But I am betting that while you were yukking it up, you felt lonely and misunderstood. I think you were just ‘being a good sport’ because what choice did you have?

You deserved better.

I admit that until recently, until I began hotflashing myself, I forgot about your transition and how we responded to it. But now that I am living with my own body thermostat on the fritz, I get it.

Now that I am consumed by cycles of heat and chill with no warning, I am having a major A HA ! moment. Now that I find myself waking in the night, my pillow wet, my face wetter, my sleep disrupted, I am time traveling to our sunny kitchen on 2nd Street—you: flapping your blouse, face flushed. Me: rolling my eyes.

I feel badly that I did not appreciate that this process is HARD. I feel badly that I made fun of you, thinking you just a silly old woman whining about something meaningless.

In short, I was a total brat.

Sure. I did not have models for compassionate support. It seems that the discourse of peri/menopausel has two nodes 1) joking  2) patholgizing—another distorted binary that fails to capture the complexity of human experience.

I know that today, struggling through my own perimenopause, I need some simple understanding. I am normal. This is normal. AND this normal reproductive transition can suck to high heaven.

While, we don’t need to stop the clocks or call the midwife, I would like some acknowledgement (minus the sexist aging jokes, please) that doesn’t make me  (or my body) the butt of a joke.

You deserved better when it was your time, Mom, and I am so sorry you didn’t get it.

Love, Chrisi

Making Room for Menstrual Shame

January 20th, 2014 by Chris Bobel

This fall, our family TV indulgence was Master Chef Junior. My 10 year old, a master of scrambled eggs, pancakes and experimental smoothies, was into it, her enthusiasm contagious. So once a week, we sat on the couch– Mom, Dad, and Kid—and watched a dwindling number of freakishly talented miniature chefs slice, dice and sauté their way into our hearts.

Photo credit: Stuart Miles
FreeDigitalPhotos.net

I enjoyed this respite and low-output family time,  but, there was a price.

The commercials. Oh! Damn those commercials. Because we watched the show online (we don’t have TV), the commercial breaks typically repeated a small set of ads. Over and over again.

In a single episode, we screened some combination of ads for these products a dozen times. According to my crude math, by the time the Master Chef Junior (Alexander, in case you are a fan) was handed his trophy, we watched around 100 different glossy messages that pointed out just how inadequate we are, or would be, soon enough.

I began calling our ritual of watching Master Chef Junior “Self-Consciousness Hour.”

Here is a short list of what’s wrong with me:

My eyelashes are stumpy, thus, my eyes are ugly. 

My teeth are yellow. Yellow teeth are gross. Why bother to dress nice when my teeth are so unsightly? 

My skin is flawed and if I fix it, I will have more friends and a happier life. 

My deodorant is embarrassing me. I might have my disgusting animal smell under control but white powder under my arms can make me the laughing stock of the nightclub. 

Obviously these messages unnerved me (I am not immune to feeling inadequate in spite of my fierce feminism, let’s be honest).

But I really worried about was my daughter. I watched her watch those commercials, her brain processing how she measured up to the standards.

Of course we offered our own critical voice overs at every turn (e.g., You know, human teeth naturally yellow with age. Teeth are not supposed to be pearly white.). We mocked the commercials, trying to expose their absurdity. We initiated more serious discussions of the industry and its nefarious methods, and she engaged these critiques, to some degree. We did what we could (excepting refusing to watch the show, which we could have done, I know). But in spite of our efforts, we doubted our power to counter the power of marketing to manufacture “problems” and sweep in with “lifesaving solutions” all in one (minty fresh) breath.

When all was said and done, between lessons on how to perfectly boil an egg or debone a chicken, my impressionable kid was fed heaping spoonfuls of body shame.

And here’s the menstrual link.

This body shame is the context for her menstrual experiences-to-be. The menstrual taboo, the Grandmother of Body Shame, will slink into her life soon enough, directing her to hide, deny, and likely, detest a natural (and healthy body process). And thanks to  noisy, flashy persistent messages like these, the door is swung open, the lights on, and the pillows fluffed. Come on in, Menstrual Shame! We have been waiting for You! Puleeeze…make yourself at home! Have you met ‘Fat Shame’ sitting here with a throw pillow in her lap? 

I know it is impossible to censor everything my kid sees, hears, reads. I have some experience with this. She is our 3rd kid; we’ve been down this road before and we’ve learned. We tried to do somethings differently this time. Namely, we send her to a crunchy school with an explicit low tech policy (which we observe, on good days). But then the other day, I overheard one of her classmates look down at her feet and exclaim, with horror: “Ewww…My feet look fat in these shoes!” I remind you; she is 10.

Recognizing the ubiquitousness of media messages, our  aim is to teach our kid to responsibly consume what surrounds her. If we equip her with good media literacy skills, she can see commercials through a critical lens. And maybe when her friend complains her feet are fat, she will not take the bait. This is the best we can do, I think.

KHORAI: Women’s Reproductive & Maternal Mental Health & Well-being at the Public Library

November 12th, 2013 by Saniya Lee Ghanoui

Image courtesy of KHORAI

Guest Post by Marie Hansen

November 23rd will mark the third session of KHORAI: a scientific & scholarly reading & discussion group about women’s maternal & reproductive mental health.

I decided to take this opportunity to write a blog post to let you all about what we have been doing at KHORAI and how you can start your own KHORAI group at your local library (or other public space).

What is KHORAI?

KHORAI is a new initiative started by the Maternal Psychology Laboratory at Teachers College, Columbia University in partnership with the New York Public Library. The idea is to translate scientific and scholarly articles about women’s health & psychology to the general public. It works pretty much like your typical book discussion group; only instead of books we read & discuss journal articles. Each session is led by a member of the Maternal Psychology Laboratory using a journal article of their choice. The purpose of the groups are to take our knowledge of women’s health research out from behind university walls and into the greater community as well as  foster conversations about topics that might not be otherwise talked about — including menstruation & gender. Our goal is body literacy and, importantly, since most of us come from a clinical psychology background, we are interested in promoting psychological literacy and exploring the ways in which women’s experiences of their bodies and reproductive life impact their inner life.

So far we have discussed:

It’s not all bad: Women’s construction and lived experience of positive premenstrual change by Marlee King and Jane Ussher

The Pervasiveness and Persistence of the Feminine Beauty Ideal in Children’s Fairy Tales by Lori Baker-Sperry and Liz Grauerholz

Our next article is:

Motherhood as Opportunity to Learn Spiritual Values: Experiences and Insights of New Mothers by Aurélie Athan and Lisa Miller

The groups so far have been a really wonderful experience. People from all walks of life have attended, from fashion designers to schools teachers to new mothers! Tasha Muresan, the lab member who ran the session on fairy tales, wrote up a great little piece about our last discussion.

Why the public library?

Public libraries have long been known as “the People’s University”—their purpose is to enhance public education, literacy, and community—basically, the perfect place to introduce women’s reproductive & maternal mental health! As free & open public spaces, they make for great locations to host discussion groups. Plus, most libraries have access to databases where you can retrieve the scholarly articles to use for discussions.

How do I start a KHORAI group?

Starting a KHORAI group is really simple. Just contact your local librarian and ask him/her if they would be interested in hosting a KHORAI group. If you live close to a university, you can ask other students or professors in psychology, sociology, or women’s studies departments if they would be interested in leading a group discussion (or if you are feeling brave, try leading one yourself). You canalso ask women’s health professionals such as nurses, midwives, or doulas. Plan a day for your group, make a flyer, & put it up in coffee shops, hair salons, & bookstores—any place you think people will find them. Give out the journal article through e-mail (or hard-copy at the library) at least a week in advance to give people time to read it.

If you are running the discussion yourself, take notes while you read the article and highlight the parts that you find interesting. What did you think of the methodology used? What ideas or thoughts did you have while reading the article? Do you see any limitations to the study? Why is the research important for women’s health?

The day of the discussion, relax! We have found that people are excited to talk about women’s reproductive health & psychology, and it generally feels like having a great conversation with friends. If there seems to be a lull in the conversation, you can always bring up something that you noted while you were reading the article to get things going again. We also discovered thatcapping the audience to 10-13 people has been really helpful to keep thingscoherent & flowing.

Ethics in Wonderland: The SUPPORT Study

June 24th, 2013 by Paula Derry

Arthur Caplan is a well-known ethicist, the head of the Division of Medical Ethics at New York University’s Langone Medical Center. On June 11, 2013, Caplan posted an article called “Get real: No need to overdo risk disclosure” on the medical website Medscape. According to basic ethical standards, subjects in research projects are supposed to give written informed consent, which means among other things that they are informed of possible risks that a decision to participate in the study might cause. The Office of Human Research Protections (OHRP) of the U.S. Department of Health and Human Services criticized researchers in a large project called SUPPORT for failing to clearly disclose the study’s risks. In his Medscape article, Caplan disagreed with OHRP and argued that strict, inappropriate requirements for consent discourage important research. His sentiments were echoed in a recent editorial in the New England Journal of Medicine, a major respected journal. In contrast, SUPPORT is criticized in a New York Times editorial entitled “An Ethical Breakdown” and by watchdog organizations like the Alliance for Human Research Protection and Public Citizen (many of the critical documents are on the Alliance for Human Research Protection website).

Here’s some background: SUPPORT was a large study of how best to treat very premature babies. These babies often need to be given oxygen to help them breathe. However, if too little oxygen is given, there is a risk of death or brain damage; if there is too much, the babies may develop an eye problem called ROP or blindness. Enter SUPPORT. According to the researchers, their goal was to determine the best oxygen level to get lowest risk of blindness without increased risk of death. This amount had already been narrowed to 85% to 92% oxygen saturation (a measure of the oxygenation of blood) in medical practice; the researchers wanted to find out where within this range is best. Infants in the research were randomly assigned to experimental conditions; in one condition, babies were given enough oxygen to bring the oxygen saturation measure to the lower end of the range (averaging 85%); in the other condition, the higher end (averaging 92%). The researchers found that infants receiving less oxygen did, indeed, have fewer eye problems than did infants given the higher amount, but more of them died.

The critical letter from OHRP stated that the consent forms that the mothers of the babies signed should have clearly stated, but did not, that an increased risk of blindness (for babies in the higher oxygen condition) or death (for babies in the lower oxygen condition) was possible. The ethicist Caplan objected to this. He argued that the researchers were comparing two standard medical practices, since 85% to 92% is the standard range used by doctors. In his view, the current way that doctors decide how much oxygen to use within that range is “a coin flip”; randomly assigning babies to the experimental groups was simply comparing two treatment approaches currently in use to see which one is best and involved no increased risk than the babies would otherwise face. He distinguished this from studies that introduce a new treatment, where informed consent about risks is a different matter. Caplan stated: “I believe that this research is highly ethical” and expressed concern that overly strict rules will hinder needed research. The New England Journal of Medicine editorial also objects to the OHRP letter. The editorial states that the OHRP’s finding that subjects should have been informed of an increased risk of death was based on hindsight. The editorial quotes the researchers, who state that “there was no evidence to suggest an increased risk of death” for infants receiving the lower levels of oxygen before their study was done. The editorial states that OHRP has “cast a pall over the conduct of clinical research” and “strongly disagree[s]” with their letter. SUPPORT, in the editorial’s view is “a model of how to make medical progress.”

What is the controversy? First, with regard to the idea that what was being compared were two versions of standard care, although Caplan does not state this in his article, the OHRP letter specifically addressed this point. In real clinical practice, a range of 85% to 95% exists, but in this study only the extremes were used. As the letter states:

Working Mothers

April 29th, 2013 by Paula Derry

“Working Mother and Son” Photo by Russell Chopping // Creative Commons 2.0
http://www.flickr.com/photos/russellchopping/3501039851/

Research is often reported as though it is news, as though the most recent article is the best and research that was not published this year is somehow not as interesting or is out-of-date. I recently dug out some articles I wrote about the psychology of working mothers that were based on a study I did in the mid-1980s. I interviewed psychotherapists about how being a mother had affected their professional lives. This study was qualitative research. I offer the results as interesting ideas, not as definitive conclusions.  Some points I think are still interesting:

  1. Overall, about 64% of the 25 mothers I interviewed opted for part-time work; when children were preschoolers, this was about 78%. Psychotherapists, unlike many other women, have the option of working part-time:  part-time jobs, especially for therapists who see clients in private practice, are the same jobs that a full-time worker would have.
  2. I compared the mothers with another group of 19 therapists who did not have children. The non-mothers tended to work full time (about 90%).  However, both groups of women were deeply and apparently equally committed to their jobs.
  3. Many of the mothers (about 60%) felt that work was not as important to them as it would be if they were childless. However, this did not mean that work was unimportant. For most women, it only meant that they now had two strong priorities instead of one.
  4. Almost all of the mothers (88%) felt that having children affected their work as psychotherapists by deepening their empathy, understanding, or emotional knowledge about parents and parenting. This was not simply intellectual, that they knew more facts, although this was also true. It was experiential understanding, a different experience of what facts mean. This was so even though their profession involves helping clients understand their parents or their parenting, and was reported whether they had a child while in graduate school or after they had worked for many years.
  5. One aspect of this increased knowledge was an experience of how passionate an experience mothering is. Another aspect was a less idealized view of both parents and children, and greater tendency to see the experiences of parents and children from their own perspectives. For example, in addition to seeing parents in terms of how their children felt (e.g., that the parent was mean or rejecting), the therapists might perceive more clearly where parents were coming from or that children might misunderstand or be unreasonable.
  6. This greater ability to see the position of both parents and children more clearly is what a psychologist might call psychological individuation. That is, the stereotype is that mothers are or should be all-giving, selfless, thinking only about their children. However, these mothers seemed to grow more realistic, clear about and accepting of who children as well as parents are. As I said in one paper:  “Interconnectedness, or intimacy, requires a sense of oneself and the other as separate but related. (If children really do lack a sense of this separation, that is no reason why their parents, who are adults, should identify with their perspective.)”

References

Derry, P.S. (1994) Motherhood and the importance of professional identity to psychotherapists. Women & Therapy, 15, 149-163.
Derry, P.S. (1992) Motherhood and the clinician/mother’s view of parent and child. In  J. Chrisler & D. Howard (Eds.), New directions in feminist psychology:  Scholarship/Practice/Research. New York: Springer.

Motherhood

January 7th, 2013 by Paula Derry

I recently had the opportunity to present a talk at something called Ignite Baltimore. Scheduled a few times a year, Ignite has proven to be extremely popular. I discovered that not only had the event sold out, but people arrived early for a pre-event reception in a sprawling lobby filled with animated people conversing.

The format is this: Sixteen speakers each give a five-minute talk. During each talk, twenty slides are each shown for 15 seconds, and the talk has to be built around this constraint. During my Ignite event, the topic of talks ranged from musings about what magic is, to how to revitalize Baltimore, to mine on motherhood. For me, giving a presentation was an opportunity to experiment with using a different kind of language than I use in more academic presentations, and to experiment with a mixture of words and visual imagery.

Here’s the YouTube video of my talk about what it means to be a mother. It’s also about the idea that we exist as whole, integrated people, not isolated bits of hormone, brain chemicals, stereotyped behaviors, stimulus-response connections to the environment. The imagery is unfortunately blurred, but I hope you can make out enough, and I hope that what I say is of interest.

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.