 | One summer morning I took a short trip which changed my life. I had little time. Trying to plan a wedding in a handful of months, I figured a 45 minute train ride to London was squeezable, between doubts about heel heights and emails about chair sashes. From Kings Cross I hopped over to Camden. The pavements shimmered in the heat of June. Everything slows down in London under the sun’s gaze. The fruit stands waft scent as though each item is waking from a slumber. Strangers find their smiles, become casually conversational. I went to see Sarah in London because of a chat at a clinic in Cambridge. |
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 One of the first things you’ll be asked if you're choosing contraception is whether you’d like to have periods.
Many methods of contraception have "no periods"* as a selling point - even the pill can be taken more or less continuously, with just a few pill free days every so often to stop irregular bleeding. If you’re using fertility awareness as contraception there isn't a "no periods"  If you want to get pregnant, the NICE Fertility guidance recommends that you have vaginal sexual intercourse every 2 to 3 days.
For many this is great news. At last – freedom from contraception! Woo Hoo! Others will find that their hearts sink. Maybe you don’t have sex that often (which is fine - you're not alone*), or your patience is limited, or you have a slightly more varied approach to sex (which is fine as well - just so long as everyone is happy). If that any of that sounds like you, then you might benefit from having some
 I love those brave people who dare to ask the questions that others don't.
“Do you need a speculum?” I was asked recently, when talking about about how to check vaginal fluid. “Nope", I said, "there's no need for a big performance with a speculum and mirror*. It usually just means you notice it when you go wipe after going to the loo.” [Yeah, OK, you’re allowed one Eww] A friend once said she knew “Tonight’s the night” when she noticed strings of stretchy stuff like raw egg white coming out of her. Sure enough, 9 months later her first child was born. Egg white fluid is released into your vagina by the cervix (the entrance to your womb). It is like the “sperm motorway” and can  Checking cervical fluid is one of the things that can put people right off using fertility awareness as contraception.
Of course we shouldn't hate our bodies and what comes out of them. Cervical fluid is very cool stuff. And yet it can seem like a bit of a hassle. Do you have to use a scoring system for stretch, colour and texture? Do you have to buy a speculum kit from the lovely people at the Beautiful Cervix Project?
This article originally appeared in the Spring 2014 edition of the Association of Breastfeeding Mothers magazine.  Going through childbirth can seem like the ultimate contraceptive – who would ever want to have sex again??
The amazing thing is that our bodies, and our libidos, generally recover and sex can still be a fun part of a loving relationship. The main thing is to be prepared, an unplanned pregnancy is probably the last thing you need and you never know when  "I was on the pill for 3 years for contraceptive reasons. During this time I developed digestive problems, and would experience nausea and vomiting around twice a week.
I thought maybe I had a weak stomach, and got on with life. My sister went on the pill and six months later had to come home from university due to depression and anxiety. This led me to research the undiscussed side effects the pill can have.
This article was published in the Journal of Family Planning and Reproductive Health Care in April 2013. It was written by myself (Sarah Panzetta) and Dr Jill Shawe. Log in here if you have Athens access to the journal.
Background and Guidance The Lactational Amenorrhea Method of contraception (LAM) was formalised over 20 years ago[i] and the Faculty of Sexual & Reproductive Healthcare (FSRH) guidance on postnatal sexual and reproductive health [ii] is clear: “Women may be advised that if they are<6 months postpartum, amenorrhoeic and fully breastfeeding, the lactational amenorrhoea method (LAM) is over 98% effective in preventing pregnancy. Women using LAM should be advised that the risk of pregnancy is increased if the frequency of breastfeeding decreases (stopping night feeds, supplementary feeding, use of pacifiers), when menstruation returns or when >6 months postpartum” Yet a recent survey[iii] found “particular inconsistencies” in the advice given to breastfeeding women in the UK
Are you a Catholic?" is something I'm often asked. I'm not, but I do have a Catholic hero.
Catholics, and non-Catholics, often have extreme views about both natural family planning, and fertility awareness for contraception. It is either hailed as a panacea, the only contraception anyone will ever need, or dismissed out of hand. My hero promoted a more balanced view. His name was Professor John Marshall and he's my hero for the work he did in his spare time as a natural family planning (NFP)* teacher for 40 years from 1959 to the 1990s, and for the book he wrote about this work. [He also did amazing work on stroke in his day job as a neurologist, but that's another story.] Strictly speaking, natural family planning is the Catholic cousin (or grandmother?) of fertility awareness based Research shows that 90 per cent of the UK population think that the contraceptive effects of breastfeeding are a myth. Equally unhelpful, is the belief that breastfeeding alone can work as reliable contraception. A Mumsnet/BPAS survey linked this belief to a rise in abortion rates among women with babies and young children in the UK.
The truth is that breastfeeding and following the simple but strict lactational amenorrhoea method (LAM) rules is over 98% effective as contraception - as good as condoms. The LAM rules are that your baby Contraception is a straightforward business for most women and couples in the UK. They buy condoms, or they visit the doctor or family planning nurse, and they get on with their lives. Nothing wrong with that. Having a range of contraceptive options is one of the blessings of the modern world. The side effects can be a blessing as well. Hormonal contraception can help with irregular, heavy or painful periods and with acne and other health concerns.
But not all side effects are helpful. It is very rare for side effects to be life-threatening, but they can have a big impact on our quality of life. Many women will go back to their doctor time and time again due to concerns about side-effects like irregular (or constant) bleeding, weight gain, headaches, nausea, or |
