September 2013 – On ErikaRS' Mind

Review: Our Bodies, Ourselves: Pregnancy and Birth

Posted on September 29, 2013June 18, 2023 by ErikaRS

Our Bodies, Ourselves: Pregnancy and Birth was the first book about pregnancy I read so, of course, it is going to influence me more than books I read later. That said, it still stands out as a good book on the topic of pregnancy, labor, and the early postpartum period.

I appreciate the balance the authors of this book struck between being clear as to which choices they considered best but still discussing multiple options and the situations under which those alternatives might be best. One example prevalent throughout the book is the preference for vaginal, minimally medicated birth over more heavily medicated or cesarean births. The authors described both why they preferred less medicated vaginal births and discussed the situations under which other options were reasonable or necessary. With this background, I feel more confident in my ability to try to make the right decisions for myself without feeling guilty about not having the “perfect” birth experience.

Another aspect of this book that I liked was the clear focus on empowering and advocating for women. This book did not try to limit itself to just the birth process. The authors were not afraid to discuss policies they considered bad or advocate for change.

One aspect of this book that may be considered a weakness, depending on what you are looking for, is that it focused on breadth more than depth. The authors gave just enough detail to enable you to ask further questions. Thus, while it’s a great first book about pregnancy and birth, those who have read other books with similar scope will likely not encounter as much new material.

Primary Fertility Signs

Posted on September 23, 2013June 17, 2023 by ErikaRS

Most women are not going to be measuring their hormone levels daily, but fortunately, we don’t need to do so to be able to tell where in our menstrual cycle our body is. The hormonal changes that cause ovulation also cause other observable effects. Although everyone woman’s body has its own idiomatic ways of signaling ovulation or menstruation (mood, cramps, and breakouts are the classic examples), there are several signals which can be used by most women to understand their cycle.

Of course, these signals are not perfect, which is why in an earlier post I mentioned that they are incredibly valuable for a woman trying to achieve pregnancy and useful, but not as useful for women trying to avoid pregnancy. Depending on the regularity of your cycle, monitoring these signals may or may not be sufficient for avoiding pregnancy, and if you are in a situation where avoiding pregnancy is imperative, you should use other methods of birth control. That said, whether you are trying to achieve pregnancy, avoid it, or are not sexually active at all, tracking these signals can be a valuable way to learn what is and isn’t regular for your body. I personally wish that in my teenage years, when I had an incredibly irregular cycle, I had been educated about tracking and had spent some time understanding what my body was doing instead of being put straight on the pill to avoid the uncertainty of an irregular cycle. I expect I would have still chosen the pill eventually, but I would have had a much better idea of what to expect when I eventually wanted to achieve pregnancy.

Waking temperature

Back to the signals. The first signal is your waking temperature. After ovulation, a woman’s waking temperature shifts up by over half a degree. Given that the daily variation is generally within a few tenths of a degree, the shift is generally fairly easy to spot on a graph of temperatures. The temperature shift is due to the progesterone that is released after ovulation. Temperatures fall again when you start to bleed.

However, taking your temperature has a few weaknesses. The biggest is that your temperature shifts after you’ve ovulated. Thus, unless you have a regular cycle, this signal will not be useful for predicting when you are going to ovulate. Temperatures also can be effected by fever, alcohol the previous evening, shifting waking time (including adapting to changing time zones), and other shifts in your normal routine. Thus, waking temperature is most valuable as a confirmation that you have ovulated: once you see consistent elevated temperatures, you can conclude that you’ve ovulated, and may be able to pinpoint when, based on the quality of your data.

Cervical mucus

Cervical mucus, also called cervical fluid (because apparently some people think mucus sounds icky), is a more predictive but harder to interpret fertility signal. Rising estrogen levels eventually cause the release of the egg, and they also cause your cervix to release better quality mucus. Better, in this case, meaning a healthier environment for sperm. This is important, because after ovulation, the egg dies off rather quickly. Thick “egg white” cervical fluid allows sperm to live 3 – 5 days, so it can be ready and waiting when ovulation occurs.

Essentially, the gooier and more lubricative the fluid is, the better an environment it is. For most women, their mucus varies from nothing (dry or damp vagina), to dry and sticky, to creamy (like lotion), to egg white (which is often stretchy). The best days to have sex if you are trying to conceive are those when you have egg white mucus. If you’re trying to avoid pregnancy, you should avoid having unprotected sex when your mucus is creamy or egg white. And even if you aren’t having any sex, you should know that it’s normal for your vaginal discharge to change quite substantially.

Cervical mucus can be detected before you’ve ovulated, so in that sense, it’s more predictive than waking temperature. However, it has its own difficulties. It generally takes a few cycles to get a good sense of the different mucus qualities — the first time around, the difference between “creamy” and “sticky” is mostly guesswork, especially for women who have a small quantity of mucus.

The other difficulty is that your body can both over and under signal. One symptom of my irregular cycle was that I would have my mucus quality increase and then drop repeatedly without a temperature shift. Thus, while higher quality mucus was still a good signal of when it would be good to have sex to increase the odds of pregnancy, it was not a good sign of ovulation. On the other hand, while ovulation would always occur after my peak mucus quality, sometimes my peak was at creamy, not egg white.

Cervical position

In addition the releasing mucus, your cervix changes position in preparation for pregnancy. As you approach ovulation, your cervix goes from firm to soft, low in your vagina to high, closed to open, and non-wet to wet (because of mucus). If you can actually reach your cervix and tell from feel alone the difference between the two states, you can use this as another signal to correlate with cervical mucus. If you have ambiguous mucus, like me, this can be valuable, because there are only two states to distinguish. However, it also takes a lot of practice, and after several cycles, I did not feel like my observations were very reliable.

Conclusion

Tracking your primary fertility signals is incredibly valuable if you want to understand what your body is doing. It is also reassuring. When I would go for 50 – 100 days between periods, it helped to know whether or not I had ovulated yet, and once I finally did ovulate, to know when I would have my period. It’s also empowering to realize that your body is not just some random, unpredictable thing. You can understand it and its cycles.

Primary source: Taking Charge of Your Fertility by Toni Weschler

A room for two

Posted on September 15, 2013June 18, 2023 by ErikaRS

The great room is the heart of our home. Since we entertain frequently, it must serve two purposes — purposes which are sometimes at odds with each other. This is the place we spend time together and the place where we welcome others into our home. Today, we’ll focus on how we designed a perfect place to spend time together as a couple.

We wanted a space that would be comfortable, functional, and beautiful. We wanted a space where we would love to spend time. By honoring how we use space together and by using patterns from A Pattern Language, we were able to build a space that filled our needs.

The obvious pattern to start with is Common areas at the heart (129):

Problem: No social group — whether a family, a work group, or a school group — can survive without constant informal contact among its members.
Therefore: Create a single common area for every social group. Locate it at the center of gravity of all the spaces the group occupies, and in such a way that the paths which go in and out of the building lie tangent to it.

The heart of our house is the great room: a single large area consisting of the kitchen, dining room and living room. This open space allows easy interaction when Jeff and I are doing different activities and provides spaces for us to be together for cooking, eating, reading, crafting, or, well, whatever. Although we think of this space as a kitchen, living room, and dining room, the layout and the fact that over half the space is dedicated to the kitchen and dining room makes it essentially a Farmhouse Kitchen (139):

Problem: The isolated kitchen, separate from the family and considered as an efficient, but unpleasant factory for food is a hangover from the days of servants; and from the more recent days when women willingly took over the servants’ role.
Therefore: Make the kitchen bigger than usual, big enough to include the “family room” space, and place it near the center of the commons, not so far back in the house as an ordinary kitchen. Make it large enough to hold a good big table and chairs, some soft and some hard, with counters and stove and sink around the edge of the room; and make it a bright and comfortable room.

Even though the great room is a single large space, it allows for intimacy. The L-shape allows each function to have its own well defined space. Such functional differentiation also lends itself to the generation of a Sequence of Sitting Spaces (142):

Problem: Every corner of a building is a potential sitting space. But each sitting space has different needs for comfort and enclosure according to its position in the intimacy gradient.
Therefore: Put in a sequence of graded sitting spaces throughout the building, varying according to their degree of enclosure. Enclose the most formal ones entirely, in rooms by themselves; put the least formal ones in corners of other rooms, without any kid of screen around them; and place the intermediate one with partial enclosure round them to keep them connected to some larger space, but also partly separate.

Each area has its own level of intimacy. The seating in the living room, which looks out over the whole space and is visible from the entry, is the most social and public but even with in that space, some seats — the one facing toward the outdoors, the end of the couch half hidden behind the fireplace — feel more private. These are the seats we gravitate to when it’s just the two of us. The dining table is a bit more intimate; people sitting there are, by the arrangements of the seats around the table, more closely connected to each other than the rest of the space. Although we don’t use them when it’s just the two of us, sections of the bench around the fireplace are most intimate. These are the places you go to have a 1:1 conversation or to get some time alone.

We can’t ignore the functional aspects in a space like this. Of course, we made sure that spaces like the kitchen are highly functional. We also included a fair amount of storage for our games and books and the projects we are working on. With laptops and phones and tablets, a office is not necessary as often as it use to be, but when it is, we have a space that is near enough to still feel connected to the life of the home. For when we do need a little more isolation, we built a Half-Private Office (152):

Problem: What is the right balance between privacy and connection in office work?
Therefore: Avoid closed off, separate, or private offices. Make every workroom, whether it is for a group of two or three people or for one person, half-open to the other workgroups and the world immediately beyond it. At the front, just inside the door, make a comfortable sitting space, with the actual workspace(s) away from the door, and further back.

Our office does not (yet!) have comfy seating, but it is connected to the rest of the home when we use it, by virtue of a large opening and a sliding glass door. For those times when we need a bit more privacy, it is a Solid Door With Glass (237):

Problem: An opaque door makes sense in a vast house or palace, where every room is large enough to be a world unto itself; but in a small building, with small rooms, the opaque door is only very rarely useful.
Therefore: As often as possible, build doors with glazing in them, so that the upper half at least, allows you to see through them. At the same time, build the doors solid enough, so that they give acoustic isolation and make a comfortable “thunk” when they are closed.

The space also works well because it connects us to the outdoors. This is helped by windows with Low Sills (222):

Problem: One of a window’s most important functions is to put you in touch with the outdoors. If the sill is too high, it cuts you off.
Therefore: When determining exact location of windows also decide which windows should have low sills. On the first floor, make the sills of the windows which you plan to sit by between 12 and 14 inches high. On upper stories, make them higher, around 20 inches.

Although our window sills are not as low as Alexander recommends, they are low enough that the sill is just above the seat of our couch. This means that whenever we glance aside, we are connected to the outdoors.

Of course, some of these are Windows Which Open Wide (236):

Problem: Many buildings nowadays have no opening windows at all; and many of the opening windows that people do build, don’t do the job that opening windows ought to do.
Therefore: Decide which of the windows will be opening windows. Pick those which are easy to get to, and choose the ones which open onto flowers you want to smell, paths where you might want to talk, and natural breezes. Then put in side-hung casements that open outward. Here and there, go all the way and build full French windows.

The connection to the outdoors is even more direct when we use our deck as an Outdoor Room (163):

Problem: A garden is the place for lying in the grass, swinging, croquet, growing flowers, throwing a ball for the dog. But there is another way of being outdoors: and its needs are not met by the garden at all.
Therefore: Build a place outdoors which has so much enclosure round it, that it takes on the feeling of a room, even though it is open to the sky. To do this, define it at the corners with columns, perhaps roof it partially with a trellis or a sliding canvas roof, and create ‘walls” around it, with fences, sitting walls, screens, hedges, or the exterior walls of the building itself.

Our deck is just such an outdoor room. Enclosed by the building and a rail, it is a pleasant place for sitting and relaxing, reading, or cooking and eating a meal. Of course, it wouldn’t work so well if the details weren’t right, so we made sure to have a Six-foot Balcony (167):

Problem: Balconies and porches which are less than six feed deep are hardly ever used.
Therefore: Whenever you build a balcony, a porch, a gallery, or a terrace always make it at least six feet deep. If possible, recess at least a part of it into the building so that it is not cantilevered out and separated from the building by a simple line, and enclose it partially.

At 10′ x 12′, our deck is about the same size as our living room, and we have just enough furniture to make it really work as an outdoor space.

All of this together leads to a space where Jeff and I can do things together or do things separately while still being together. We have privacy when we need it and companionship when that is what we want. By being sensitive to how we use our space and by taking advice from A Pattern Language we were able to design a space that works well for two people. As the next post will show, it works just as well for ten or twenty.

The menstrual cycle

Posted on September 15, 2013June 17, 2023 by ErikaRS

If I’ve learned nothing else in my various debates about abortion, it’s that many people have absolutely no idea where babies come from, beyond the sperm plus egg basics. At the extremes are people who say that birth control pills work by causing abortions, but many who are not spreading misinformation — whether pro-choice or pro-life — seem to have at best a shaky understanding of fertility.

So, since it’s important to anyone wanting to achieve pregnancy and interesting to anyone who cares about reproduction at all, I want to give a bit more background on a woman’s reproductive cycle.

The menstrual cycle can be divided into two parts: the part before ovulation and the part after. Pregnancy can only be achieved for in the 3 to 5 days preceding and including the day of ovulation (more on that later). Once ovulation has occurred without the egg being fertilized, pregnancy cannot occur.

But that’s jumping ahead of ourselves. First, a hormone called Follicle Stimulating Hormone (FSH) causes some eggs to mature in each ovary. Eggs are encased on follicles, hence the name of the hormone. Once one follicle is large enough, your estrogen levels trigger the release of Luteinizing Hormone (LH), which causes the winning egg to be released. The rest disintegrate.

The egg that makes it moves into the fallopian tubes, which connect the ovaries to the uterus[1]. The follicle which formerly held the egg collapses and starts to release another hormone, progesterone. Progesterone prevents other eggs from being released and prepares the uterus for pregnancy (although sometimes more than one egg is released, which, if fertilized, results in fraternal twins). The 12 – 16 after ovulation are called the luteal phase after the corpus luteum, the name for the collapsed follicle.

If fertilization does not occur, the egg dies, and eventually the uterus disintegrates, resulting in your period. However, if it is fertilized, after about a week, it will implant in the uterus. Although numbers are hard to get, ultrasound studies indicate that 50% (or more) of fertilized eggs fail to implant[2]. However, if the fertilized egg, now a multi-cell embryo, does implant, it will cause Human Chorionic Gonadotropin (HCG) to be released. This is the hormone that home pregnancy tests detect, hence why are not not effective until 10 days or more after ovulation — about a week for implantation plus several more details for hormone levels to build up enough to be detectable in your urine.

That’s what’s going on behind the scenes. In a later post, I’ll explore the observable changes caused by all these hormones, which are valuable for a woman trying to achieve (and to a significant but lesser degree, avoid) pregnancy.

Primary source: Taking Charge of Your Fertility by Toni Weschler

[1] Interesting factoid: There is actually a gap between the ovaries and their respective fallopian tubes. This gap serves no purpose — in fact, if a fertilized egg falls into that gap, it can be fatal for the woman. This gap is taken as a bit of evidence in favor of evolution since it’s useless but can be cleanly explained by looking at the fallopian tubes as an addition to a reproductive system that laid eggs directly in the water. From Why Evolution is True by Jerry Coyne.

[2] Libby Anne over at Love, Joy, Feminism has a post that discusses what this statistic means for those who think the pill is bad because it causes abortions: How I Lost Faith in the Pro-Life Movement

Review: Taking Charge of Your Fertility

Posted on September 8, 2013June 18, 2023 by ErikaRS

Before trying to get pregnant, it seemed appropriate to learn more about how female fertility works. For that, I chose to read Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health by Toni Weschler.

The first, and perhaps most important, thing to know about this book is that it is a book every woman should read. Whether you want to get pregnant or avoid pregnancy, whether you’re taking birth control pills or attempting more manual methods of contraception, if you’re a woman who cares about how her body actually works, you should read this book. (Note: I use “you” and “your” throughout this review because it’s more conversational. I acknowledge that this may a bit awkward for any men reading this. Consider it an exercise in what it’s like being in a situation whose “you” is not, in fact, you.)

It amazed me, when I started reading this book, how little I knew about my own fertility. While I think that birth control pills were the right contraceptive option for me during the years I wanted to avoid pregnancy — my ovulation cycle has always been much too irregular to depend on my physical signals — I am, in retrospect, sad that I spent a over a decade taking a drug without understanding the system it was regulating. Now that I am trying to become pregnant and having a hard time, I regret accepting the explanation from my doctor that the pill would “fix” my extremely irregular cycles. Yes, it suppressed the symptoms, but now that I actually want to get pregnant, I still have the same issues and no more knowledge of them than I did as a teen. (By the way, Weschler also wrote a book targeted at teens, which I haven’t read.)

Now to the book itself. This book is centered around the Fertility Awareness Method. This can be seen as a natural birth control method or a technique for helping achieve pregnancy. I see it as a way to understand how your own body works. Part one discusses these different perspectives and encourages women to take charge of their own fertility. Part two contains background on a women’s reproductive anatomy, menstrual cycle, primary fertility signs, and various types of irregular cycles. Parts three and four apply knowledge of the primary fertility signals to, respectively, birth control and pregnancy achievement. Part five discusses other practical benefits of charting your cycle, even if you don’t care about the other two.

In subsequent posts, I’ll cover some of the most important background for understanding the menstrual cycle.

As a final note, if avoiding pregnancy is absolutely vital for you, I cannot recommend the Fertility Awareness Method as a standalone method of birth control. Even if you’re extremely regular normally, stress, sickness, alcohol, and other life factors can make your signals less reliable. But I still recommend reading the book.

Introduction

Posted on September 1, 2013June 17, 2023 by ErikaRS

Welcome! Pregnancy is discussed in many blogs, forums, articles, books, and just about every other media type. So what makes this blog different? Mostly that it’s mine =)

I wanted a place where I could talk about pregnancy as a emotional, physiological, and social issue. I am not going to be hesitant about expressing my opinions. So if you expect “this week, baby is the size of an orange!”, you’ll get some of that, but you’ll also get discussions of pregnancy and privilege.

The name of the blog is loosely based on neko koneko from the anime Azumanga Daioh and the it’s-too-late-to-think game my friends and I call “I have a thing”.

One last note, the early posts in this blog are all backdated to approximately when I wrote them. For obvious reasons, I didn’t want to start publishing the blog before we announced the pregnancy.