Postpartum Fertility Awareness Charting (Episode 342)

Full Transcript: Episode 342

Lisa: This is the Fertility Friday Podcast, episode number 342. Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery charting journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with us today.

Today I’m sharing a new episode in my Fertility Awareness Reality series. I’m sharing my on-air client call with my client Liana, who was a member of my recent Postpartum Live series. So with this episode you’re getting a unique window into the postpartum period, and of course there’s a lot of different scenarios that can take place postpartum, and one of the biggest factors that’s going to determine how soon you get your period back, how soon you start ovulating and menstruating again, is whether or not you’re breastfeeding and how that goes. But of course that is only one of several factors that can determine it. So some women get their periods back pretty quickly — I think some women are really surprised at how quickly their periods return, especially if they’re not breastfeeding, or if they’ve had to limit or restrict the amount of breastfeeding they’re able to do. And for other women, they’re still waiting for their period to come back even a year or more postpartum. And especially when you get into the phase of recovering postpartum but also planning to have another baby, it can become a challenge, especially if you are impatiently waiting for your cycling to return. So we get into those topics and many more in today’s episode, and without further ado, let’s jump into my conversation with Liana.

To be here today with Liana — Liana is a current member of my Postpartum Fertility Awareness Mastery Live program. We are about halfway through the program, so it’s a great time to have this session. Either way, welcome to the show, Liana.

Liana: Thank you.

Lisa: I’m really glad to have you here, and I’d love to just jump in and give the listeners a sense of where you’re at with your fertility awareness journey. So I’d love to hear when you had your first period, how you managed your fertility, and what brought you to take the postpartum class in particular at this point.

Liana: Sure, so the craziest thing is that I started to think about these types of questions — when did I get my first period, when did I go on the pill — and I cannot even pinpoint it, which I think says a lot as part of my story. I think I got my first period probably in about seventh grade, around 12 years old, and I don’t have much recollection except that my friend had also gotten her period before me. It wasn’t traumatic in any way, but I do specifically remember not understanding how to use a tampon and my friends trying to teach me and leaving the applicator in. Besides that, I think that’s how my period started — not super memorable.

In terms of how I got to this course, it’s an interesting story. When I was in college I was dealing with a lot of acne, and I believe it was right after I graduated college where I wanted to figure out what to do about it. I didn’t have a specific OB/GYN, so I went to my regular doctor, and she recommended the pill to deal with the acne, and I just went on it. I didn’t even really do much research, which is crazy to me because in college I had gotten really into holistic health and took a course on holistic healing. I got really into learning about acupuncture and homeopathy, but I never made the connection that there could be detriments to taking birth control. I just did it, because my friends were all on it, and I didn’t realize there was even a need to look into possible side effects. I stayed on it — I remember hearing you could gain or lose weight, but I never really pinpointed if that happened. I do think it helped the acne a bit. So I was on it until a couple of years ago, well over 12 years, taking it every day. My period while I was on it always came around the same time, about four days, nothing too painful, though I have back issues and always had a lot of low back ache with it.

When my husband and I got married, we wanted to have a baby about two years after, and I knew I would be going off the pill at that point. I try to be super proactive about things, and in the last few years, even before I decided to try to conceive, I really dove into non-toxic everything — skincare, cleaning products, basically everything in my home being as free of toxins as possible. But I still didn’t really think about the birth control itself. When I was trying to be proactive about pregnancy, I went to speak to a midwife to ask when I should get off the pill, and she said just right before, immediately before. A friend told me she’d heard you should get off six months before, and my regular doctor also said about six months before to regulate and then try. By that point, though, we were already at the point where we were going to try, so it was August 2018 when I stopped taking the pill, and starting in September I wasn’t taking it anymore. That’s when we started to try, and I ended up getting pregnant in October. It happened pretty quickly, and I’m really happy and lucky to have had a wonderful pregnancy and an amazing natural birth that went very well.

When I was pregnant, I started listening to a lot of podcasts and heard about the book “Beyond the Pill.” I listened to it and thought, this is not good, so I decided that after I had my daughter, I would not go back on the pill — I would figure out what I was going to do, but I was not going back on it. After I had my daughter, I joined a lot of new-mommy groups, and one of the women facilitating a group is a doula who brought up birth control in conversation. I said I didn’t want to go on the pill, and she alluded to something like charting, but I still didn’t have the actual name “fertility awareness.” I made a note to look into it. Where I really started to hear about it was when I was looking for a doula for myself for a second pregnancy — one of the doulas I researched mentioned something called the Arvigo method, and I made a note to try Arvigo massage postpartum. About four months after I gave birth, I contacted a certified practitioner, an acupuncturist, and went to see her. She asked if I’d had my period, and I said no, and that I didn’t want to go on the pill. She asked if I’d heard of the fertility awareness method — I hadn’t by name, but I put together that it was the charting she meant. She recommended I speak to someone, so I went back to my doula friend, and she confirmed that fertility awareness method was what she’d meant, and that I should listen to Fertility Friday, because she also has a podcast. So that’s how she sent me to you. I started learning and realized this was a method I wanted to try, and when I signed up for your class, I had never charted before ever, so I’ve just been learning so much in the last month.

Lisa: Oh, that’s amazing. I really appreciate you taking us through that. I love it — I think this is my favorite part of the reality series episodes, because you take us through many years of your life in a short time. And there are a couple of really interesting parts of your story. This is something I talk about all the time, and it’s so many women’s experience: we’re living in a time where everyone is getting more health-conscious and trying to reduce their consumption, and there’s something that happens when you get pregnant and are preparing for the baby — we know we shouldn’t have tons of scented, chemically laden things for the baby. I think it’s ironic that we do that for the baby, but we don’t do it for ourselves.

Liana: Totally, yeah, yeah, yeah.

Lisa: But it’s so interesting — we don’t think of the birth control pill or hormonal contraceptives as endocrine disruptors. I refer to them as the atomic bomb of endocrine disruptors, because if you put lotion on your arm, it might contain estrogenic chemicals, but it wasn’t designed to stop you from ovulating. Hormonal birth control is the most potent endocrine-disrupting chemical, because it’s literally designed to disrupt the endocrine system — that is how and why it works, because it suppresses all of that. So I just want you to know you’re not alone, you’re in good company.

Liana: Yeah, it really opened my eyes when I started to actually look into it, which is important. I just wish I would have before.

Lisa: One of the things — it’s a fine line we walk, because part of this education around birth control is to provide the opportunity for informed consent and try to steer the odds in your favor. In your case, you did great, and it’s important to recognize some risk factors: if your cycles were pretty regular and had the opportunity to develop before you went on hormonal contraceptives, you’re actually in the category of an ideal candidate to resume normal cycling once you come off. If you had a couple years of robust cycling prior, it’s similar to how it takes a couple years for breasts to fully develop from breast buds — your cycle is similar. So for some women, coming off the pill does take a bit of time, and you just don’t know which category you’ll fall into.

Liana: Right, yeah. I was using the apps and the ovulation sticks from the drugstore, and it worked for me, but I’m sure I would have been way more knowledgeable if I’d been able to do the charting, so I’m excited to get more into it now.

Lisa: It’s also interesting, and it speaks volumes, because I’m sure some women listening are surprised that you were actively looking for this and didn’t even know it was a thing. This speaks to one of the biggest challenges: even though we talk about fertility awareness all the time here on the podcast, and there’s a huge group of women familiar with it, it’s kind of a little world unto itself, because the average woman doesn’t know it exists. And one last thing — you mentioned that you asked your midwife if you should come off birth control, and she said to wait until right before. I think it’s important to recognize that in any profession there are people who are more and less knowledgeable about different topics. Midwives are classically trained professionals and more likely to know about fertility awareness, but that doesn’t mean every practitioner is well versed in it. With medical professionals, there’s often a hesitancy to share information about these methods, partly because they haven’t been trained in them, and partly because that training would involve having a place to refer people.

Liana: Right, and I did not choose that midwife to actually use when I was pregnant, for a few reasons. But yeah, I tried to do all the research, but there’s only so much you can do.

Lisa: Of course. Well, I think you did great, and I’m glad you found your way to the method. So as we shift into the session part, let me know what’s kind of at the top of your mind and what you want to talk about.

Liana: I think the main thing is the whole fact that I have not had my period come back — it’s been almost two years, because my last period before I got pregnant was October 2018. I am still breastfeeding but have cut back, so I’m breastfeeding just morning and night. My daughter is 13, 13 and a half months old, and I still haven’t had it. I went to my acupuncturist this week and mentioned it, and she was saying that in her philosophy, breastfeeding is an expression of blood and chi, and you typically either produce milk or have your period, not both. So she was saying maybe not to try to get it back so proactively, but of course I do want it back because I’m in the course and want to learn. So I’m struggling with whether it’s still healthy, or what it might say about what’s going on in my body that I haven’t had it back, and if there’s anything on my chart that could give us some information.

Lisa: Yeah, I mean, we’ve spoken about it a bit in class — that’s an interesting assessment regarding breastfeeding and menstruating, because where does the milk come from? It has something to do with the blood, which is a topic for another day. Ultimately, it’s not the same for every woman. Some women get their cycles back quite soon even while breastfeeding — four, six, or eight months postpartum — and there are certainly women who don’t get their periods back until maybe the year mark. What I usually say is that if you hit the 15-to-18-month mark postpartum and still haven’t had your period back, there’s a point where you can no longer say this is definitely postpartum — you want to check in about what else it could be. For example, women who had PCOS or struggled with hypothalamic amenorrhea before their pregnancy should make sure they’re not just blaming a different condition on the postpartum period, even when they’re still breastfeeding past 15 months.

With breastfeeding, what’s interesting is that the number one factor suppressing ovulation is frequent suckling.

Liana: Exactly, yeah, and it’s not that frequent right now.

Lisa: Right. Particularly within those first several months postpartum, if you wanted to encourage the suppression of ovulation, the strategy would be — because of course the biggest factor in the return of your period postpartum is breastfeeding — you would breastfeed on demand, day and night, without limiting feedings, without a pacifier, essentially always being available. This is not a judgment, this is literally the tenets of ecological breastfeeding: not using a pacifier, not supplementing with formula, and lots of skin-to-skin contact. Night feeding is important too, because it’s about frequency of suckling — during a night feed, the baby sucks throughout the night, which is a significant frequency and duration. So looking at the other side, the things that bring the period back sooner are not being able to breastfeed, having to supplement, going back to work and being separated from baby (since pumping doesn’t have the same effect as suckling), introducing solid foods, and babies sleeping through the night. So there are plenty of women who continue breastfeeding for months or years who are also cycling.

Liana: Yeah, and all those things — I went back to work, I pumped, she started sleeping through the night, so it’s interesting for me that I still don’t have it, but I guess it’s just my body.

Lisa: Yeah, you’ve had quite a bit of blood work done, and I think it’s appropriate at this point to do exactly what you did — get testing done. It’s helpful to check your thyroid function and make sure you’re covering the basics, which we’ve done in class: how you’re sleeping, eating, and moving. There’s also some degree of bio-individuality at play, and it could be right around the corner — I think you posted in our Facebook group that you saw some mucus, and it actually could be around the corner, since you recently made a shift in your breastfeeding pattern.

Liana: Yes, I cut out a couple of feedings, so it’s just twice a day now. That was my main question — I saw mucus, definitely the type you could pick up and analyze, but didn’t see it again. What is that?

Lisa: Okay, so you’ve been in the class together for about a month, and this is the first time you’ve seen anything?

Liana: Yeah.

Lisa: Okay, so to give you an answer — it would be lovely if going into your fertile window was a perfect movie moment, going from dry to a gradual buildup of mucus like an orchestra, and then a peak. That’s not typically how it works. What can happen is that as your hormones start doing their thing — as you pull back on feeding, your body adjusts — the degree of suppression of ovulation can shift, and what many women see happening is a couple of days of mucus, then back to dry. That’s not uncommon. In our postpartum class, we’ve talked about dividing the postpartum phase into two main phases — phase one is from birth to the first time you ovulate, the everlasting pre-ovulatory phase, and phase two starts once you actually ovulate and begin cycling again. That makes it easier to strategize around each phase. When you’re still in phase one, it’s important to know all the things I mentioned — sleeping habits, frequency of feeding, introduction of solid foods — because as those change, they can impact the degree of suppression of ovulation, so it’s helpful to watch for shifts. I can’t predict the future, but the fact that you saw mucus and then it went away — what I’d note on your chart is that was a peak sign, so you’d do a count of three after that sign, because it was lubricative and shiny.

Liana: Yeah, and you marked it mucusy, and mentioned you could pick it up — that’s actually a peak sign, and then you do your count of three.

Lisa: Right, so basically it could simply be that your body is gearing up toward ovulation, and at some point you’ll see that shift, but it’s a good sign that you hadn’t seen mucus and then you did.

Liana: So what’s a little confusing is I think it was only day 10 where I could actually pick it up — the other day I marked it as very shiny, but I couldn’t pick it up, so I’m not sure if I did the code right. I’ve definitely been noticing just the moistness, and I did get nervous, because I know you’ve said that could not be a great sign, so I was a little confused about that. More often than not I’m seeing a bit of dampness — sometimes where I marked it shiny, but a lot of times it’s just damp.

Lisa: Okay, and on day 10 you marked it as lubricative?

Liana: Yes, when I wiped it was actually — that’s the day I picked it up. And day 15 was lubricative and I could totally feel the sensation, but I could not pick it off.

Lisa: Okay, well I think it’s helpful to remember that peak-type mucus can show up in three main ways — clear, stretchy, or lubricative and shiny. There are times when it’s super lubricative and obvious, but you can’t pick anything up off the toilet paper when wiping, and that still qualifies as a peak sign even if you can’t pick it up. For that purpose it’s helpful to remember that, and here on day 10 you did mark it as lubricative, so lubricative by itself is that peak sign — you could also do your count of three from there. As a reminder, depending on the resource — Taking Charge of Your Fertility uses Peak Plus 4, or the Justisse Method uses count of three — the reason you do that buffer period is because you want to see whether you did ovulate, and if so, let the vagina go back to its original acidic, non-fertile state.

In terms of differentiating between the dampness you’re experiencing and the peak-type signs — let me just look at the beginning of this chart. It’s interesting because on the first couple of days you marked it as dry with nothing, and then you started noting the dampness.

Liana: I think I wasn’t checking correctly because I’d never done it before, so I didn’t really get the full feeling or do the full check. I definitely learned — on day seven I realized I hadn’t been totally checking correctly, and I think that’s why that happened.

Lisa: Well, in terms of the dampness — it’s something I talk about a lot because it comes up a lot. I’d say anywhere from 15 to 20% of my clients notice a pretty regular damp observation, meaning when you wipe with toilet paper before you pee, the paper itself is damp. In that situation, when it’s very consistent, it can be a sign of cervical dysplasia — ideally you’d be seeing either nothing or shiny when wiping. So it’s nothing to be incredibly alarmed about, since it’s quite common, but certainly the next time you see your doctor you could ask about a pap if you haven’t had one lately, just to double check. There is a way to manage that — I talk a lot about folate and vitamin A and the role they play in supporting healthy cervical cells if that’s what’s causing it, and either way that strategy tends to dry up the dampness, and once the dampness goes away, the mucus patterns tend to improve for my clients who are cycling normally.

Liana: Yeah, that’s really interesting, I definitely want to look more into that. I also stopped taking my allergy medication, because I was wondering if it would show me anything differently, since I’d heard it could affect some things on the chart. I do think my temperature has gotten a bit higher, but it’s such a small shift — like 97.3 to 97.4 or 97.5. I marked the day, day 16, that I stopped taking the allergy medication, but I’m suffering a little from the allergies, so I’m trying to figure out if it’s worth being off it. I was also wondering how much of a shift I should be seeing with the temperature.

Lisa: Those are good questions — I did notice a little bit of a temperature rise, so I wanted to ask if you’d done anything different.

Liana: Yeah, and today it was the highest it had been, 97.6 this morning.

Lisa: In terms of how much higher — with the method I teach, there’s no specific rule that it has to be a certain amount higher. What you’re looking for are three temperatures that are higher than the previous six, so you’re typically seeing a group of lower temperatures and a group of higher temperatures, and if you draw a line between the two, you can see a clear difference. What I always say is it should be clear and obvious. The obvious question is whether it’s possible you ovulated and this slight increase is related to that — I’m not really convinced, because you’re noting your cervical position as basically the same every day, and we talked about the four main things to watch for: firmness, height, tilt, and openness. If you had ovulated, you’d likely have more than one day of mucus, and you’d likely see the cervix opening and in a different position.

Liana: Since I’d never checked my cervix before, I think I’m just used to feeling that it’s firm and closed. I imagine it would be a fairly obvious change if it were different, since I’ve never felt the change — I also wonder, did I just not notice it?

Lisa: No, it would be pretty different. You’ve had a baby — did you have a C-section?

Liana: No, I had a vaginal delivery.

Lisa: So your cervix will likely never be fully closed — you’d probably feel something like a dimple. I’ve had two babies as well, so my cervix has never been fully closed since. But yes, the difference is discernible — it’s typically softer, the opening is more pronounced, and the height and position are different, though it depends on the woman and the sign. For a lot of women, the most obvious difference is the tilt — outside the fertile window the cervix often faces back, and in the fertile window it faces down.

Liana: Got it, okay. I think I’ve gotten into a good rhythm of filling out my chart before I go to sleep, which means I’m always checking the cervical position at the same time, which I think is good. The first few days I was forgetting because it was so new, but now my body remembers to check, and I’ve been feeling that more lately.

Lisa: Something really good to think about even so far is that when you’re in phase one, it’s important to take some time to establish your basic infertile pattern, as we’ve talked about, to establish what’s normal — what does it look like most of the time. So when you had that one day of mucus, and then that lubricative sensation even though you couldn’t pick it up, you were on it.

Liana: Oh yeah, I told everybody — I told my friends, my husband. I thought that meant my period was coming back. I don’t think I realized that seeing it doesn’t necessarily mean the period is coming back.

Lisa: Yeah, and I love that you shouted it out to everyone. This is helpful, and it’s actually one of the things that can be frustrating about postpartum charting — if you notice you start to see mucus as you’re approaching that point, as your hormones are doing their thing, it can be frustrating that you might see mucus and then it goes away, and see a little more and it goes away. It’s helpful to recognize that as part of the process, and that it’s not going to be like this forever, but it certainly can be a bit challenging. What I always say is that when you do go into the fertile window, the shift is typically clear and obvious. I have a question about your allergy medication — is it an antihistamine?

Liana: Yeah, it was Zyrtec, for my seasonal allergies. So yes, an antihistamine.

Lisa: That’s something to be aware of, because antihistamines can actually dry your mucus, and that can mean it masks that sign. I’ve had clients who are on antihistamines and ovulate with no mucus, and then when they come off, they ovulate and have mucus — and pregnancy is possible in any cycle with ovulation, so that’s something to be really aware of if you’re taking it daily, since it could be masking your mucus sign.

Liana: I had been wanting to get off Zyrtec for a few years, so I actually did a technique called the Allergy Release Technique, which is a homeopathic-type technique to help get rid of allergies, and it worked very well. It’s just that this was prime time for tree pollen, so I’d usually take it during that week or two. Now I’ve decided I’m not going to take it and will just try the natural method and hopefully feel relief that way.

Lisa: Yeah, because you don’t want to get confused by that. You’ll figure out what makes the most sense — I’m not saying don’t take it or take it, but it’s important to know how it can affect your charting. It’s a little easier to do these kinds of experiments once you’re cycling naturally, because when your ovulation returns and you have your first period and start cycling again, it’s easier to chart through a cycle with the antihistamine during peak pollen season and then chart a cycle without it, to really see how it’s affecting your body. Some of my clients may still have some mucus but less, others may have none, and it’s really helpful to see for yourself how it’s affecting you.

Liana: That’s interesting. I’m definitely still learning the method and trying to figure it out, and since we talked about vaginal steaming in class, I’ve been learning more and listening to more of your episodes about that, so I am going to try it and see how that goes for me.

Lisa: We had a really great presentation on that, and it was so informative, specific to postpartum. It’s interesting to think about — in the episode I released with Keli Garza and Kimberly Ann Johnson about the results of their fourth trimester vaginal steam study, there were a lot of unexpected benefits you wouldn’t necessarily think to look at, in terms of speeding up the recovery process and making it a little less challenging. Any new mom wants anything that can help make the postpartum phase easier to manage, and it’s a low-invasiveness type of procedure that can have quite a bit of benefit, and it’s really relaxing too — having that time for yourself.

Liana: I remember after giving birth, all I wanted to do was lie in a warm bathtub — that feeling of warmth really helped with the recovery down there. So for sure, if I have another child, I would do steaming, and I’m already telling pregnant friends to look into it because the results were pretty incredible.

Lisa: Yeah, that study — I also did an interview with Jana Zubrod, who’s an Arvigo practitioner, and she did a study as well about vaginal steaming, and one of the things she looked at was cervical mucus production, and she found it resulted in an increase in mucus. That wasn’t something I would have necessarily thought it would impact, but that’s why research is necessary — it’s really helpful to do studies like that so you can see and quantify the results.

Liana: I’m curious, because I’ve dealt with some pelvic floor issues postpartum — I’ve had a bit of mild prolapse, and I’m curious if steaming might play a role, and also the Arvigo work. I think I’ll go back to do another session and probably should be doing the self-care on a regular basis with the Arvigo. All of those things in combination I think are great, and I’ve learned more from being in the class. So far in our class, it’s really opened my eyes to a lot more about my health than just what I thought it would be, in terms of tracking my fertility, so that’s been really great.

Lisa: Oh, I’m glad to hear that. It’s all kind of connected — it’s really about taking care of the whole woman, helping her track the practical aspects, so we spend a lot of time going through the details of charting, but when you’re paying attention to those details, you can start to look at what’s going on at a deeper level — you probably wouldn’t have thought we’d be looking at your cervical fluid so intently, and potentially your cervical health indirectly as a result. There’s a lot of implications for self-care and an opportunity to really take care of yourself in a different way. Well, we’ll be hoping your period comes back — whoever thought I’d say I want my period.

Liana: It’s interesting, because both times I had my sons, I was kind of waiting — when my period finally came back, when I ovulated, both times it was like, well, here it comes. I was very aware of the mucus changes.

Lisa: Right, wow, haven’t seen you in a while. One of the things I talk about too is paying attention to secondary signs like libido, because it’s helpful to have the heads-up if you experienced an increase in libido in your cycle before pregnancy, when you were cycling normally — because if you’re not paying attention to it, depending on your intentions, it’s helpful context. My point, going on a tangent, was more that I felt a relief when I had it, because I’m used to cycling, so it was nice to go back to that — having your period is kind of like a release, a reset emotionally.

Liana: Yeah, and I want to learn how to, and so far it’s a little tricky without having my period back.

Lisa: Well, I always point out — I’ve supported clients in different phases and parts, so what I’d say is it doesn’t feel like it, but when you’re postpartum charting in phase one, meaning lots of dry days and really looking for that point of change, it’s actually great practice for regular cycling, because what are you doing in the pre-ovulatory phase but identifying the change from dry to mucus patterns and feeling comfortable and confident in that. It doesn’t feel like it now, but you’re getting some really great practice. And once you get the mucus, you’ll have questions about the different kinds and how to interpret it, but with that said, it’ll be a lot easier for you because you’re already ready to see this mucus.

Liana: For sure, yeah, exciting.

Lisa: Well, Liana, this has been a lot of fun. A question for you — I usually end with a couple of questions. What would you say to the woman who is pregnant or postpartum and in a similar situation to where you were, where she doesn’t really want to go back on hormones but isn’t really sure what the options are — what would you say to that woman who’s considering fertility awareness?

Liana: I would definitely say educate yourself about what women are experiencing on both ends — women who’ve had a baby and gone back on the pill, what that’s felt like for them, but also women who have tried this. If you don’t know anyone, listening to the podcast and educating yourself about this method is the best thing. I’m always one to say, talk to your friends and talk to people, because it’s so informative — try not to be shy about it, and be assertive about your health and your cycles.

Lisa: Love that. And then a last question — for a woman who’s on the pill, in that contemplation phase but understandably terrified of coming off the pill and switching to a non-hormonal method, what would you want her to know?

Liana: I would say, first, I felt a bit of guilt when I learned there could be detriments to taking it, but it’s not healthy to make yourself feel bad — so don’t be too hard on yourself if you feel like you didn’t know this. I would just look into it more and see what feels right for you in the end. For me it was not adding something synthetic into my body, and that just felt right — it was a gut feeling.

Lisa: Yeah, it’s an interesting line we walk when talking about these issues, because it’s not about — I always say we all do the best we can with the knowledge we have today, and when you gain new knowledge, all you can do is pivot, because you can’t turn back time. It’s natural for us to beat ourselves up, unfortunately, but it’s not productive, and it doesn’t change anything. And I think it’s helpful to know there are women like you and others who’ve been doing this for years and have been able to effectively manage whether they wanted to get pregnant or not, and that it can work — that’s really nice to see too.

Liana: Oh, I love that, because that’s really what it is — it either works or it doesn’t, and the fact that there are women who exist, hundreds of thousands, who use this method successfully, that can be some encouragement. And the last thing — I felt a little overwhelmed when I heard it was such an everyday thing, like you’re always doing something, but then I heard you say, well, you brush your teeth every day, and I thought, this is my health, why not make this a thing I do every day. That helped me get over feeling like it was going to be so much work — it’s just part of the routine now.

Lisa: Ah, yes, I love that you said that, because as someone who does it, it certainly seems like it would be a lot, but you wipe yourself when you go to the bathroom anyway — you’re just adding an additional wipe. But I always say it’s a self-selected method — no one’s forcing anyone who uses fertility awareness into it. I truly believe women who use this method are called to it — we feel like this is what feels good for us, this is resonating, and so it’s not a chore, it’s like, am I going to see mucus today, this is kind of cool.

Liana: Yeah, definitely.

Lisa: All right, Liana, well thank you so much for being on the show. This was so much fun, and I’m excited to share our conversation, and I’ll see you soon.

Liana: Thank you.

Lisa: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/342. I hope that you enjoyed today’s conversation with Liana — we really went deep into some of the challenges you can experience postpartum, and I feel this episode really paints a picture of what this looks like for a lot of women, because every woman is absolutely not the same. Some women will get their periods back within 3, 6, or 8 months, others a year out, and even longer are still waiting for their cycling to return. I do think it’s helpful to keep in mind that there’s a point at which we can no longer blame the baby, so to speak — a point at which we do have to start looking at what other factors could be contributing to the delay in the return of normal cycling, particularly once you get into the year-and-a-half to two-years-postpartum range. By that point it does depend on the amount you’re breastfeeding, since babies that age are certainly eating a good amount of solid food in addition to any breast milk, but they’re still getting some. So it’s a helpful reminder that the menstrual cycle is a vital sign — a sign of health — and the absence of cycling when you’re supposed to be cycling is something we should be paying attention to and that warrants further investigation. That’s something to think about throughout your reproductive life, and as we learn this important information about the cycle and how it relates to our overall health, it’s up to us to demand that care and think about our cycles differently — and ignore the hype or the messaging that it doesn’t matter unless we’re actively trying to have babies. So with that said, I hope you have a wonderful week, and as always, until next time, be well and happy charting.