Natural Family Planning awareness week is almost a week over so clearly it is the perfect time to submit a few thoughts, being all fashionably late and hip like I am. I'm like the swanky, sunglass-donning party guest who glides in an hour or two late because she clearly had Very Important Things she was doing instead. If by important things you mean fending off an all out nervous breakdown while Brian was away for four days and exhaustedly comforting myself with old Downton Abbey episodes, wine, and knitting, then yes, very important things indeed.
Anyway.
One of the best reasons I love Natural Family Planning as a woman is how empowering it is. (I know. I said the word 'empowering.' I apologize. Don't click away.) I love that a woman can understand how her body works. Even if it's not the "perfect" chart and even if she needs to figure out why her charts have some anomalies, she can know and understand what her body is doing...or that her body is "off" somehow and work to heal it. Natural Family Planning works under the assumption that women (and men!) aren't idiots. It assumes that our bodies are inherently GOOD. It works using an understanding that sees the the amazing design of God's plan for fertility and assumes that God clearly meant for us to know how it works. If not and fertility and baby-making decisions were to always be completely out of our hands and discernment, then the Creator would have done things differently.
One of the most unappreciated (and unintended) side effects of NFP or at the very least a woman having some sort of fertility awareness, is that when conception does occur the husband and wife usually have a good idea of when it happened, at least within a day or two. Nowadays, and within our current model of maternity care in our culture, that is actually really really important. Very often women in our maternity care system are given an "expiration date" or a date which she is not "allowed" to pass under threat of induction or unnecessary cesarean. If that date is based off of the standard conception calculator, then she may be pressured into that induction or cesarean based off a due date that isn't even accurate.
Can we all just take a moment and realize that the very same obstetrician who laughs off natural family planning as the "rhythm method" is the same obstetrician who USES THE RHYTHM METHOD TO DETERMINE THE DUE DATE?
I know. It just hit me the other day, too.
It's an intellectual hypocrisy that ends up hurting mothers and babies in the long run.
"When was the first day of your last period?"
That's the question most women have to answer when they come in for their first prenatal appointment. The nurse or doctor then uses a little fertility wheel (or computer program based off that wheel) that ASSUMES she ovulated and conceived on day 14 and gives her her due date. But how many women do you know that have the "official" 28 day cycle? Say a woman knows she ovulated on day 20 (quite common) and therefore her baby was conceived on that day or within a day after. Her due date based on the standard "first day of period" conception calculation will actually have her due date 7 days earlier than it needs to be. That is a big deal come birth time. A week means a lot at the end. (Just ask any woman in her third trimester ;) Her baby may very well be right on time but he is now considered "late" according to the 28 day cycle due date and she is pressured (or willingly goes) into an induction which presents a whole new host of risks to mother and baby. Or she is ushered in for an unnecessary c-section, also greatly increasing possible complications and discomfort for mother and baby and influencing future family size decisions. And all this time, the baby and her body were not even really ready.
An accurate due date can be the difference between an induction and a natural onset of labor.
An accurate due date can be the difference between a natural labor and a cesarean section.
An accurate due date can be the difference between a healthy baby and a baby making an agonizing trip to the NICU.
An accurate due date can be the difference between having more babies or regretfully limiting family size.
A KNOWLEDGE OF FERTILITY MATTERS TO YOUR BIRTH AND FUTURE FAMILY.
When I meet with doula clients I make sure to go over whether they believe their due date is accurate. Often they don't know but if they DO know the date the baby was conceived, that becomes the date we try to work with. (Getting a doctor to agree to that can be another story.) Otherwise, we have a doctor who may be overanxious to get the baby out when the baby and her body are not even ready. Let's not overlook mom herself, too, who gets that date into her head and the "I'm going to pregnant FOREVER" chant in her head begins even earlier than it would have. The frustration and restlessness increases and she ends up feeling like her body is broken or that she "just doesn't go into labor," as I've heard some women say. All based off of poor science and an inaccurate due date.
If we had a maternal care system that was relaxed about due dates and recognized that every baby and mother are different, this wouldn't be as important. But we (here in the States at least) don't. The due date becomes the expiration date when really it is meant to be the MIDPOINT of when a woman could potentially go into a healthy spontaneous labor. Two weeks before, two weeks after. And the date is not often even correct anyway. It makes me sad to think of how many babies and mothers have been put through so much simply because of a faulty date and an erroneous idea of what a "due date" really is.
So, to increase your chances of having the birth that you want for you and your baby, learn some sort of fertility awareness. Know your cycle and the signs of ovulation. Even if you don't have full-blown natural family planning charts or want to "use" NFP to achieve or avoid pregnancy, jot down when conception likely occurred and use that date to determine your due date. If your doctor doesn't respect that, think twice about whether that is the right provider for you. The fact that the majority of modern obstetricians do not truly understand how a woman's cycle works and that most women practicing NFP know more about the female cycle than their doctor is...troubling, to say the least.
Natural Family Planning or just plain 'ole fertility awareness is information. That's it. But it is powerful God-designed information and it is information that can have long term (eternal!) consequences for you and your family. That information can help you make conception decisions, yes, but it can also be a powerful tool for making birth decisions, decisions that are important for you, your baby, and future babies. Use it well, be empowered ;)
Well I'm with you, I think it is indeed empowering! and yes I see it as fertility awareness, knowledge all couples should have. Oh yes very ironic that little wheel, having fertility awareness;) I always know when I've conceived and give the doctors MY date (have been known to give them a different period date to line up with my date;)
ReplyDeleteI've known people to fudge their LMP dates, too, in order to get a correct due date...honestly, I can't discourage it because I think it's that important!
DeleteHm. I may have to print this out and take it to my next appointment with my provider. The due date they gave me is only four days earlier than the one I have charted, which I didn't really contest because I went a week early with both of my previous pregnancies, so I'm not real concerned about being pushed toward an induction because I am "past due." That said, I may have to request that they change it, just on principle. ;) For that matter, my midwife was amazed when I mentioned "cervix position" in the list of things I charted to monitor my fertility (BBT was out, with how often I was up with my toddler). Apparently the idea that everyday women know where their cervix is, let alone are willing to check it themselves, was astounding. :p
ReplyDeleteThis is so great :) One appointment at a time maybe they'll realize that women can understand their fertility! I love that my current midwife is all about teaching you what your body is doing and encourages women to test their own urine and understand what is going on. It's certainly not the norm!
DeleteTotally true! With my current pregnancy, we conceived on day 40 of my cycle O.o Talk about inaccurate by LMP! I am blessed to have an OB who fully supports NFP, so no issues there.
ReplyDeleteWow!! So glad they trusted you because that is a BIG difference!
DeleteI totally agree with you on the importance of knowing an accurate due date and how NFP can be wonderful for that. . However, aren't a lot of OB's moving away from using the calender to determine due date and instead doing a "dating ultrasound" in the first trimester? That seems to be more and more common from what I've seen anyway. Although a lot of midwife practices don't routinely do them, it seems to becoming more and more common among OB's.
ReplyDeleteYou're right, some practices are starting to do that, if they have an u/s machine. But I have my misgivings about how accurate they are and I've heard stories from moms who were told from those early ultrasounds that their pregnancy was "unviable" when really it was dating it wrong based on their charting. (A mom I know thank GOD did not get the d&c they recommended because her charts WERE right and baby was actually younger than they thought and completely okay and healthy.) I would definitely trust my conception date over an ultrasound dating. But I do think an u/s can be more accurate probably than the old wheel based on the last menstrual period.
DeleteThat is just outrageous that they would recommend a d&c!!!
DeleteI've had ultrasound datings too, and my NFP chart dating was always more accurate. My last pregnancy was a prime example, my chart dating was a week later than the ultrasound dating and about two weeks later than my LMP date. We have a NFP doctor, so he decided to use the ultrasound dating and keep the chart date in mind. I've never made it to my due date yet (one was 4 weeks early), and he was my 5th birth. Hindsight, I should have went with what I was thinking and insisted we use the chart date. Once the ultrasound due date got closer my doctor started doing more appointments and there was talk about "induction" and being "overdue"...even though I actually wasn't. My blood pressure started going up (which had never happened in a previous pregnancy) which I attribute to the additional pressure the wrong due date was placing on me. They set an induction date for my chart due date and considered me a week overdue. I went into labor on my own the day before, and he was born perfectly healthy, not too big and had no signs of being overdue. In other words, he was right on time and proved that my chart date was indeed more accurate than the ultrasound dating! Sorry for the long comment, it's important to trust your chart. I thought a week difference would be "no big deal" but it set up a chain reaction of interventions, extra appointments and worry I could have avoided.
ReplyDeleteThank you so much for sharing this, Amy. It is true that even some doctors who claim to respect NFP don't always follow that through or trust their patients all the time. I'm sorry you went through that but so glad he came on his own and you avoided any further unnecessary interventions or risks. Maybe your story can help prevent it happening to someone else!
DeleteYou would think they could at least ask about your historical cycle length before using the little wheel thingy. My cycles have always been 27-28 days so that isn't likely to make a difference for me. But my last 2 babies have been conceived prior to any postpartum menstrual cycle. For those babies, having an accurate chart has been really helpful for dating.
ReplyDeleteI am a former military wife. I know at least one woman who knew her EDD was off, since according to the doctor's dates conception would have occurred while her husband was still on an aircraft carrier. Another woman had a wedding night baby and, for her, the doctor's proposed date of conception of 10 days prior to her wedding was not possible. These are such easy things to ask about. A simple, "Does this DOC sound right to you?" would often suffice.
Great examples! I'm curious if the doctor's switched it for either of them! I agree, I think even a simple question like that would build up a level of trust that is really important for such an intimate relationship.
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