Teaching Fertility Awareness Without Prior Charting Experience (Episode 564)

Full Transcript: Episode 564

Lisa Hendrickson-Jack:

This is the Fertility Friday Podcast, episode number 564. Today I’m sharing another brand new episode in my FAMM Practitioner Series. Today I’m interviewing Rhoda, and she is sharing with us her experience jumping into fertility awareness charting. Rhoda’s experience is a little bit unique because in her case she had no prior charting experience prior to joining our Fertility Awareness Mastery Mentorship Program. And so she shares her experience of jumping right into it in the midst of a very busy life. She is postpartum, she has a little one, and she’s working. And so she shares how she made it all work despite the obvious challenges in that situation.

So before we jump in, I’m going to share a little bit about Rhoda. Whether you’ve been struggling to conceive or you’re planning to get pregnant in the future, optimizing your fertility health can feel overwhelming. Rhoda Chee’s root-cause, personalized support helps encourage and empower you to take control of your fertility and achieve your goals with research and data-backed information. Rhoda is a registered dietitian nutritionist, ELNA Certified Fertility and Pregnancy Dietitian, and a FAMM Certified Practitioner in training. Her passion and purpose is working with women in the areas of women’s health, reproductive health, fertility, pregnancy, and exercise nutrition. So without further ado, let’s go ahead and jump into today’s episode with Rhoda.

And I’m really excited to be here today with Rhoda. Thank you so much for being on the show.

Rhoda Chee:

Thank you so much for this opportunity, Lisa. I’m excited.

Lisa:

Yeah, well, I really enjoy these episodes. After all these years of podcasting, I just love sharing genuine conversations where you get to share your experience. So I’d love to start just by asking you my favorite question, which is how old were you when you had your first menstrual period? And maybe just take us through what your experience was like, whether it’s related to menstruation or related to your experience on contraceptives — if you took those — and kind of what led you to this place where you’re at now, jumping into FAMM to add this aspect to your practice.

Rhoda:

Okay, so to start off, I believe I got my first menstrual period when I was about 12. I was one of the last of my group of friends to get my period. But I remember, I didn’t hear about your menstrual period or anything like that from my family or my parents. I just — it was just something I knew happened at some point. And so when I got it, I’m like, oh my gosh, what is this? What do I do? I had to kind of figure it out on my own. And then it didn’t seem like anything that phased me up until high school when I started participating in different sports. And that’s when I noticed my cycles start to be irregular. And because I wasn’t sexually active at that time, I didn’t think anything of it. I just thought, okay, I’m just going to do what I need to do. I didn’t look into it either, or didn’t go to a doctor or tell my doctor about it. So I just went through my regular periods during high school.

And then afterwards, once I did start getting sexually active after high school, then I had a little bit of a scare — I’m like, oh my gosh, am I pregnant? So that’s when I decided to get on a hormonal contraceptive, the pill. And it was for two reasons — obviously becoming sexually active, and then also with the irregular cycles, thinking like, okay, maybe this will help kill two birds with one stone. And then was on the pill for about — I think it was 13 years when I counted. So I was on the pill for a long period of time.

Once my now husband and I started talking about when we wanted to conceive, I decided, okay, maybe now I should start looking at getting off the pill. With the nutritional background that I had, I started looking at different research things — what to eat and how to prepare my body, especially with the line of work that I was working in at that time. And so decided to get off the pill, got labs done, tried to improve my nutrition a little bit more than it already was, took some supplements. And then I was also trying to time my pregnancy, because at the time I was doing an online master’s program. So I specifically remember calculating like, okay, this is when I’ll end my program. And so I don’t want to start conceiving until nine months before this, just so that I don’t have the baby — if she comes a little earlier — I’ll give myself a little wiggle room.

But once we were between that timeframe of when I got off the pill to when we started to actively start trying, there were so many other people that I had heard of that were having issues with getting pregnant. And with the annual checkups that I had, I ended up finding out that I had some abnormal tissues in the cervix and so had a surgery done. And so with the combination of those two things — thinking, am I going to have issues when we actually start trying? — I was really, really worried. And thankfully, when we actually did start trying, we didn’t have any issues. We conceived, I think, within a month of actively trying.

And it wasn’t actually until after I had my baby where they asked the question of, do you want to go back on the pill? When I had been doing my research trying to prepare for pregnancy, that’s when I had learned actually about all the side effects that I didn’t ask about or that I wasn’t told when I got on the pill. And I thought, oh my gosh, what — this is crazy. Why was I on the pill for so long? And I didn’t know and I didn’t ask and all this stuff. And so I knew that I didn’t want to get back on the pill, but at the time I actually didn’t learn about fertility awareness and tracking your cycle yet. And so I just told them no, that I was going to just abstain from sex or be very careful. And so for several months — I think almost a year — my husband and I were just like, no, we’re not going to do it that way, just very careful.

And then I finally — I think with my dietitian background and with me reading up on things from Lily Nichols — that’s how I heard about you and your work. And then I started listening to your podcast and bought the audiobook, listened to it like I think within a weekend or something, listened to the whole book. And that’s when I just went all in. I’m like, oh my gosh, I need to look this up and figure this out. And then I think that’s when we had the call for me to join your program, because I figured if I really want to use this as a form of birth control — because I don’t want to get pregnant yet again for the second baby — then I need to not only do it for myself, but maybe it’s something that I could incorporate into the work that I wanted to do with women.

Lisa:

Well, that is incredible. I love how that one question just takes us down anywhere from 10 to 20 years of your life in five minutes. Thank you so much for sharing. And you did allude a little bit to your background — do you want to share more specifically what your background is and what your practice is as well?

Rhoda:

Sure. So my professional background is registered dietitian. So for several years, I worked with my state WIC program, supporting women with their pregnancy and breastfeeding experiences. And so now I actually recently started — last summer — started my own private practice. It was originally intended to focus on nutrition during pregnancy and a little bit postpartum, but since now going through your work, I’ve incorporated the fertility awareness aspect to it and so hope to incorporate that more into my offerings for my business.

Lisa:

Well, I want to dig into some of your story. And what I find fascinating, just even given the FAMM program that I’ve created, is how many women’s health professionals have never heard of fertility awareness charting. This is one of the points that I always tend to make these days, which is that anyone who falls into this rabbit hole — if you’re listening right now to the podcast — after you’ve been immersed in this field for a while, you kind of forget that there was a whole period of your life where you had never heard of any of this stuff. And the majority of the people in your life still to this day still don’t really know any of this stuff.

What you shared is a story that’s similar to many that I’ve heard, where it’s just this natural thing — natural in air quotes — that we go on the pill, and you’re on it for a while. Given that you were on it for 13 years, I’d be interested to hear what your experience was like on it, because I know on this podcast I’ve highlighted many stories of women who had negative experiences, but obviously not all women necessarily have negative experiences, or for many women they may have had some symptoms but they never made the link.

But what you said really stood out to me, because you came off, you had some challenges with regards to the cervical cells and the surgery that you had to have, you were able to conceive when you were ready to — but because of your nutritional background, you kind of had the sense of, I should come off ahead, and then you spent all this time focusing on your nutrition during that time. We won’t know the answer, but I’m inclined to think that may have contributed — you were able to conceive when you wanted to, but you had already gone through a lot of that post-pill transition phase and done the things that you really needed to do.

But what you said was you came off, had your baby, and then of course at the six-week appointment they’re like, okay, so what are you going to do? And you’re kind of like, I don’t know — I know I don’t want to do that, so I’m not going to do that. But there was no plan because you hadn’t heard of it. That’s something that we want to change. We want more of our women’s health professionals and more women in general to be very much aware of this option for those of us for whom the pill doesn’t feel right anymore.

Rhoda:

Yeah, when I decided to get off the pill, I had no idea what I was going to do except try to be very careful when my husband and I would have intimacy. But yeah, I definitely knew that I didn’t want to get back on the pill. And so when I would have conversations with friends, if it came up about when are you thinking of having your next baby, I’m like, oh, not for a while. I definitely didn’t want to share too many details.

Lisa:

Basically, what stood out to me was that you knew that you didn’t want to go on the pill but you didn’t necessarily have a plan. And then it was when you actually discovered that there’s another alternative that you were able to fully jump on that. I’d be curious to hear how you felt when you actually discovered that there was an alternative — especially having been through your master’s program and all the other education that you took, and up to that point you had not ever heard of this thing.

Rhoda:

I think when — yeah, I was already about a year-ish postpartum, and that’s when I learned about your work. And I heard that you could track your menstrual cycle and use that as a form of birth control. And I thought, what? How? You don’t have to go on the pill to not get pregnant if you’re having intimacy? I was just so surprised. And learning all these things that you think everyone knows — every woman knows — but obviously like you said in your work, it’s not something that we’re taught in sex ed or even in high school or college. It’s not common for people to know about. And so when I learned about it, I decided I needed one-on-one support with this, because I don’t think even if I tried to Google it, I could figure it out myself.

Lisa:

And I love that. One of the questions that we do get from practitioners who are considering the program is because we get a variety of levels of experience with charting — in your case, no charting experience, but we also have practitioners who have literally taken a fertility awareness certification from a different program. So we do have everywhere in between. What I can say, Rhoda, is that I’ve been just so impressed with how you dove in. We know you have a little one and you’ve really been committed to the method. So it’s been just such a joy from our end working with you. But I’d love to hear what your experience was like.

Rhoda:

When I first started the program and started learning all these things about how to track your BBT and how to check your mucus — which was like, wait, what? I don’t think I ever noticed that before. But then when I started — the BBT thing took a little while, especially since my daughter still wakes through the night sometimes. And then in the mornings, I would put the thermometer in my mouth when she was nursing, and I knew that I wouldn’t be able to go back to sleep, and I’m trying to lay there with a thermometer in my mouth as still as I can. I’m like, okay, are 10 minutes up yet? Can I push the button?

And then with tracking my mucus — yeah, it took a while for me to get used to that, the wiping before and the wiping after. And then I printed my observational notation sheet and had one in each of my bathrooms, had a screenshot on my phone so that I could have it when I was out of the house. I think being the type-A person that I kind of am, I was like, okay, I have to do things almost perfectly. And then I had to get around that — my sleep isn’t going to be perfect, my mucus checking isn’t going to be perfect, but I have to just do what I can. And I think with my charting, you can see in my chart where I have so many different customized lines that I added on to track different things. Definitely went all in and I’m loving what I’m learning. I can definitely see the changes with the nights that I get better sleep, or when I control my stressors a bit more, and since I’ve been consistently eating liver on a weekly basis. Yeah, it’s so fun to see all the different changes. I think back on, wow, I wish I’d heard of this sooner and started sooner.

Lisa:

And you bring up so many important points. It’s no surprise that this modality attracts a lot of us fellow type-A people. One of the conversations that we often have with our practitioners is that the goal isn’t to have a perfect chart. The goal is to move towards whatever the broader goal is that you had. For you, Rhoda, obviously one of the issues was that you didn’t want to go back on the pill and you wanted to have an alternative type of birth control. Accurate charting is important to achieve that goal, but we do have specific considerations when you have a baby, when you’re in the postpartum period — and so will your clients. And that’s what we work through in our practicum: where do you find that sweet spot between all of the information that you know and the quote “correct way to do everything,” and how do you meet your client where they’re at and support them through whatever it is that they’re going through so that they still get the benefit of charting without needing it to be perfect?

Because I always say there’s no such thing as the perfect chart, because you’re a human being. If you were a robot, we might have everything looking the same every single day. As a person, you’re going to have nights where you don’t have as good sleep. And that brings us to what you said — if I have a better night of sleep, I notice that my cycle is different and my charts are different. That’s the point. The point isn’t to be perfect but to start getting into that conversation, that understanding of how your chart shifts with different things that you’re doing. That’s really how we get into using the menstrual cycle as a vital sign.

Now that you actually have this information, and you mentioned that you’ve started to think about ways to bring this into your practice — I’d love to hear what has shifted for you.

Rhoda:

The first part — I’m kind of glad that I went through my own experience of trying to be perfect with my tracking and charting, and knowing that if I don’t get enough sleep or if something’s not right that day, I just need to note it down. That way when I look back at my chart and see why something looks a little off, I can remember — because my memory isn’t that great right now — I can go back and see, okay, this could be the reason why it looks that way. And so it’s great that I’m having the experience myself, because with some of the clients that I’m seeing, I’m having to encourage them — even though you might not sleep very well, or even though your days might be very hectic, you do what you can and just note down what happened. Then you have more data to understand what might have gone on if you see something funky in your chart.

And then in terms of my charts, it’s just so crazy to see the different things — especially I’m taking the methylfolate and the vitamin A, and seeing how my mucus has changed over the course of a few months with doing that. It’s crazy just to see. And I think back on, wow, I wish I’d heard of this sooner and started sooner.

Lisa:

Yeah, that’s something interesting as well, because when you get into the nitty-gritty cervical details — if you’ve had a vaginal birth and a baby came out of your cervix, then you’ll never have a pre-birth cervix, right? So the best we can do is talk about it in the general way, which is it typically feels like the end of your nose. After a baby has come through there, you typically have more of an indent.

But I mean, absolutely to your point, it’s one of the things that can be hard. I remember when I first started this podcast, I would get emails from women in their 40s who would say, my goodness, I’m just discovering this now and I wish I would have known all this information in my 20s. I feel like I’m really missing out. And although there’s nothing we can do about that, we can’t go back — I encourage anybody who’s feeling that way. We’ve had clients of all ages take our programs, we’ve had clients after menopause take our various programs. No matter where you are in your reproductive years, when you discover this information, there’s still a benefit and a blessing for wherever you are.

And so perhaps if you discover it a little bit later, you can even have a greater appreciation for how important it is and relate to your clients in a different way. I know for me, there’s so much joy in sharing this information with younger clients — it’s one of my favorite things when I’m able to have early 20s, mid-20s ladies in the class, because you just know what potential this has to really affect the trajectory of their life in a positive way. But at the same time, you find women who discover this in their 40s and their mid-40s and it still can have a profound impact on how they experience those premenopausal years, and also a profound impact on what they can impart on their daughters or any females in their life.

Well, so one question I wanted to go back to — you did mention that you were on the pill for 13 years. So I would just like to hear about what your experience was — positive, negative, or neutral.

Rhoda:

When I first got on the pill, I was naive, and even though I was somewhat a young adult by then, I definitely didn’t ask the right questions when I asked to get on the pill. I wasn’t taking it at the same time every day — sometimes I wasn’t taking it every day. And so I think it wasn’t until a few years in where I was like, okay, I really need to set an alarm and put it on my phone. And so thankfully when I was consistent on being on the pill, I didn’t have any major horrible symptoms, at least physically that I could feel at that time. But once I got off the pill — and I don’t know, it could have been other things, other factors in my life — but I noticed there were times when I’d feel down about things, experiences going on in my life, and the insomnia and other things. And now I’m like, okay, was it the pill or was it this or that? You never really know.

Thankfully, I didn’t have any major horrible side effects, I think except for the cervical dysplasia-type stuff. That one, I definitely feel like the pill for sure.

I just know that if I knew better, if I could go back and tell my back-then self — ask these questions, look it up, do some research. With the clients that I have now, my ideal clients are the clients who are trying to conceive or preparing to get pregnant. But if I could, I would want to speak to younger women, especially once they start their periods, and tell them that they have options. They don’t need to go on the pill or hormonal contraceptives if they want to avoid pregnancy — there are other options. And this is something that will not only help with that but could help with their overall health too, with finding out other things like endometriosis or PCOS.

Lisa:

And I just wanted to ask a clarifying question, because you mentioned something about insomnia and depression — were you saying that you experienced some of those things while you were on the pill?

Rhoda:

Not — you know, it’s hard to say. I experienced them during the pill, but it was also during college. And so yeah, it’s kind of hard to say if it was one or the other or a combination. After I had my baby too, I don’t know if it was a little bit of postpartum depression or just coming off the pill again. Hard to say.

Lisa:

Yeah. It’s always hard in retrospect. The positive thing though is that in your case, it doesn’t seem like you had any really significant side effects. And I do think it’s important to highlight that as well, because everyone’s experience on the pill is so varied. I know on this show we’ve definitely highlighted a lot of negative experiences — I think that’s important. But it’s also important to put out that there are women like yourself who were basically fine. It’s really interesting how the same hormones can have different effects on different people.

There’s something else that I wanted to highlight with regards to your experience on birth control. For anyone who’s listening who isn’t as familiar with what the abnormal cervical cells / cervical dysplasia / pill connection could be — this is something I talked about in The Fifth Vital Sign and in Real Food for Fertility as well in the pill chapter. The pill is associated with a variety of nutrient deficiencies, and one of those is folate. Long-term use is associated with deficiency. It’s interesting when you read the research literature because there’s not necessarily a consensus. There are a lot of short-term studies that look at a three-month window that do not show a correlation. But I would argue that three months isn’t necessarily representative of the average duration that a woman is using birth control — and in your case, you mentioned you used it for 13 years. The longer-term studies do find a more pronounced association between long-term use and folate. And there does seem to be a very specific relationship between cervical health and folate. From that statistical standpoint, that is why women who’ve used the pill for a long period of time seem to have a higher rate of cervical cancer, as well as a couple of other cancers. But anyways, I just wanted to point that out for anybody who is curious about that.

So, a couple of questions as we start wrapping up. I would love for you to share about what your experience was in FAMM, especially coming from a nutrition background, and how you think that you may be able to start moving your clients through some of our protocols.

Rhoda:

I think even just before getting into the program, when we were having a conversation about whether or not it was the right time — just with me having my daughter and trying to start my business but also still working another full-time job and doing all these things — even though it felt like it wasn’t the right time, it was the perfect time. Especially me being postpartum and preparing again for my next pregnancy, it was the perfect time for me to learn how to track and chart my own cycles, and especially with being able to incorporate this now with my offering in my practice.

Yeah, I think going through the program — if there’s someone listening to this and they’re like, oh, I think I want to do it, but now is not the right time — it’s the right time. Take this as your sign. Like everything in life, it’s hard to choose when the right time is, but I think if it’s about learning to track and chart your cycles, the right time to start is now if you’re not already, because you’ll learn and gain so much from it.

And in terms of the program, I think being able to have the calls with you and the other ladies and listen to their experiences just makes me more aware of the different things that I’ve experienced that I maybe haven’t thought of, and experiences that other women have that I didn’t experience myself. Because we experience our menstrual cycles differently, and our daily lives are different. And so there are so many things that we can learn from each other.

Yeah, it’s been — I mean, we’re getting towards the last few months of the program and it’s crazy to think when I first started, I’m like, okay, this is going to take nine months, can I really do that in nine months? And it’s been challenging to get all my assignments done. I listen to the recordings and jump on the calls when I can, even if I’m trying to multitask to get my daughter to daycare or whatnot. But yeah, it’s been great. I’m glad I joined when I did and I didn’t use excuses not to join.

Lisa:

I do remember having the conversation. And at the end of the day, I’ve come to this kind of philosophy — because this is the stage of life for any woman who’s over the age of 20. This is the stage of life where we have a lot going on. We typically have a lot going on related to our careers or education or a combination of those things. We typically have family responsibilities. When things are important, we make the time for that. It’s just that there’s no good time. If you think about the last two years of your life — when would have been a good time? There’s no good time. The good time is now.

I’m glad that you shared that, because one of the things that we try to do is encourage our practitioners to jump in. Because when you feel that knowing — that this is something I really want to do, this is really important to me — the time will just pass, and years will go by, and nothing will have changed because you didn’t just jump in and do it.

Now that you’re on the other end of it after nine months — just based on what you’ve told us and shared with us today — you’re at a totally different level of understanding. You joined the program having not had any charting experience, and now we’re in the last couple of months and by the time you leave, it’s like a totally different world. Maybe share — if there were two takeaways — your two biggest takeaways so far.

Rhoda:

I’d say my one big takeaway would be to just dive in any chance that you get. Even if you have a million things going on — listen to the recordings in the shower, in the car when you’re driving. Listen to the books, read the books and the research. Just immerse yourself in the information whenever you can, because there’s so much to learn. And I think you’ve said it in our calls where even if you’ve listened to it once, listen to it again, because you might catch something that you didn’t catch the first time. So yeah, I’ve listened to the recordings and our sessions a few times over. That would be one thing — just immerse yourself and get in there.

And the second thing I would say is talk to your family, talk to your friends, talk to other people about what you’re doing. Because if they hear about what you’re doing, then maybe they can share the information with other people that might be interested in working with you or learning about this. And that could potentially help you if you’re wanting to serve a client or need a practicum client. That could be one way of getting that. So just share what you’re doing would be the second.

Lisa:

All right, I love those two. And so as we come to a close — I’d love for you to share a little bit about your practice and where you are for anyone who’s listening who wants to get in touch with you.

Rhoda:

Sure. Thank you. So I am specifically mainly on Instagram. My Instagram handle is @fertil.maven — that’s my business name as well. And so I focus on serving clients who are intending to get pregnant in the near future or have struggled to get pregnant. And so I work with women to help improve their fertility, not just focusing on nutrition but now incorporating this fertility awareness aspect of it, and that’s a major part that we focus on in the very beginning.

Lisa:

Amazing. Love it so much. Rhoda, this has been an absolute pleasure. Thank you so much for being a part of our FAMM Practitioner Series. It’s been so nice to hear. One of the things I love about these episodes as well is that even though we’ve been together for many, many months, I get to hear your story again in your own words, and I always learn a few things along the way. So I really appreciate you being here and sharing your story with us.

Rhoda:

Thank you so much, Lisa, for this opportunity. This was so fun. And yeah, I look forward to seeing you in our next calls.

Lisa:

Awesome. Thank you for listening. If you enjoyed today’s show, please share with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/564.

I hope that you enjoyed today’s episode with Rhoda. It was so fun to have an opportunity to dig into her experience. And also, a good reminder — I think one of the themes that has come up in our FAMM Research Series is that even with a wide array of women’s health training, the fertility awareness piece is still largely missing. The number of times I’ve had conversations with women’s health professionals who are highly skilled in their area of expertise but really had no idea about their menstrual cycle — this is just common. And I would say it’s kind of regardless of your training and background, because as women, it’s the general reality that we are not educated about our bodies. So it doesn’t matter if you’re a medical doctor or a nutritionist or totally not even in the field — in neither situation are we fully, properly educated in the area of fertility awareness, cycle charting, and of course the greater implication of tracking the menstrual cycle as a vital sign and learning about this deep connection between our cycle health and our overall health.

I think it’s a great reminder that especially for women’s health professionals who are in the field working with women — if this is not an area that you’ve specifically taken that additional effort to take a deep dive into, to the point that you can actually do an in-depth advanced cycle analysis with your clients — you are certainly missing out on an opportunity to be able to really support your clients in this way.

Of course, if you are wanting to take that next step and increase your fertility awareness education and confidence in your client work, registration is currently open for our Fertility Awareness Mastery Mentorship Program. So with that said, I hope you enjoy your week or weekend whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.