your great life

Welcome (again) to July ICLW at Your Great Life

Hi there,

Thank you to those who commented this month for July's ICLW at Your Great Life. My Welcome letter is reprinted below as I am still working on the topics introduced there and want to keep them fresh. See you in August, though I very much hope you will pop in for a visit and a comment between now and then.

Lisa

...................

I'm feeling really great to have already received a good number of ICLW visits and comments today, despite not having posted a welcome until just now.  I seem to have struck a note with my series of blog posts on how single fathers can take on or improve their knowledge, communication and availability regarding body issues relating to their pre-teen and teenage daughters.  Quite a few of you have told me that your mothers weren't particularly open or instructive about personal hygiene, skin care, first bras, shaving or lightening of body hair. There is no reason that mothers can't benefit from these blog posts too, so if you know anyone who isn't coping well with this area of parenting, please send them the link. The next one in the series will be menstruation...awaiting the first period and learning the best way to manage periods.

Don't worry; I'm not moving away from the areas of infertility and conception. My mind is working laterally.  My primary purpose is to give women of all ages, and men too, a knowledge of, and respect for, their bodies and how they work SO THAT they can maximize good reproductive health and have the best chance of having families of choice, when they are ready to do so. Even my personal experiences, having the benefits of:

1. Sex education and Health classes at Junior High School and University;
2. communicative, instructive and supportive parents;
3. an annual (actually once or twice yearly) well-woman exam by a gynaecologist since the age of 17 (initially set up by my mother and continued by me);
4. the ability to talk to friends about our bodies (comparing notes is a very useful way to learn) and sex; and
5. a culture of preventive medicine that keeps me on top of changes in my body or its functions;

I was amazed to learn what I did not know about my body, fertility, pregnancy and childbirth when I ran into my own reproductive health problems in my 30s.  As a fertility advocate, I would like to help other people remedy that situation so they can take personal responsibility for their own health, the emotions and decision-making that appear in the context of fertility.

Awareness, education and communication are key to getting people the help they need to live healthy lives, conceive and eventually, parent. However, just as important is the ability to do this all while feeing good about yourself and how you are coping with life's challenges. If you know anyone who would benefit from fertility coaching, either individually via office or phone sessions, or on one of my group courses, please give them my contact details:

Email - lisa@yourgreatlife.co.uk

Phone (internationally) - 011 - 44 - 208 954 2897 London is on Greenwich Mean Time. Please check the time before dialling. (I can usually phone you for sessions.)

Phone (within the UK) - Landline 020 8954 2897 or Mobile 0777 909 1466

My office calendar can be arranged through Reception at the Stanmore Chiropractic Clinic, Stanmore, Middlesex, UK. Telephone - 020 8954 8311.

The Newsweek article that unleashed fury in the infertile community; my comments

An article published in Newsweek Magazine, Should IVF Be Affordable For All?, has caused an enormous reaction in the Infertile community, flooding Newsweek.com's own Comment section, as well as social media networks, with furious exchanges of opinion.

Discussion includes the price tag of $15,000 for IVF and the fact that not all American states mandate insurance coverage of fertility treatment.  Reading the many comments on Newsweek's website, I have no desire to engage in a verbal slinging match with people who are uneducated, yet very opinionated about infertility.  I do, however, want to set out my perspective on this topic, having been through an unsuccessful IVF cycle myself, without the financial means to repeat it. Anyone who wants to comment here is welcome to do so.

1.  According to a study by the European Society of Human Reproduction and Embryology, published in The Human Reproduction Update last month, direct costs of fertility treatment vary substantially between countries, but the U.S. stands out as notably more expensive than other countries.

This is direct evidence that the cost of IVF need not be as high as it is in the U.S. I know of plenty of women who are conceiving through IVF in other countries, including the UK where I live, where many women receive up to 3 IVF cycles on the National Health Service and private costs are about £8,000 (currently under $12,000).  The United States fertility "industry" considers itself to be where the sun rises and sets, and take financial advantage of their patients accordingly. Foreign clinics are proving this wrong, and American couples should seek better schemes, through the new clinic founded by Elan Simckes in St. Louis called Fertility Partnership or others like it, charging $7,500 for IVF, roughly half the cost for the same procedure at many clinics, or clinics abroad.

2.  A complicating factor, according to Dr. Sherman Silber, a reproductive specialist at St. Luke’s Hospital in St. Louis, is that up to 80 percent of infertility cases are caused simply by increasing maternal age. “It’s hard to call infertility a disease. It’s normal aging,” he says."

Dr. Silber's comment will play directly into the hands of those who argue that a) women are choosing to have children later, therefore their infertility is not a disease or medical condition that needs fixing but a lifestyle choice, and b) that the resulting need for IVF is self-imposed and shouldn't be covered by medical insurance.

In response to the first argument, there are many sociological/economic trends that have caused the average age of first attempts to conceive and first pregnancies to go up.

• Since the 1950's increasing percentages of women have gone on to higher education and/or employment because opportunities for both have increased.
• As a result, more women are leaving their parents' home as young adults and living independently for a time before meeting and marrying a man.
• Economic conditions now require that both parents need an income in order to pay for the rising costs of raising a family. Consequently, people are choosing to earn enough money ahead of time, before beginning to have their children.

These changes in conditions have necessitated a delay in timing of childbirth. Many infertile women have had no choice but to start later; therefore it can't really be seen as a lifestyle choice using free will.

It is also unfair to claim that infertility is self-imposed, therefore not deserving of insurance coverage. A commenter to the Newsweek article, NS says
"Having children via IVF is a cosmetic surgery. IVF is effective less than 15% of the time and this after multiple attempts. This should all come out of thier pockets and not mine." First of all, the word cosmetic refers to someone's or something's physical appearance, which is clearly not applicable to having medical treatment to overcome a reproductive obstacle, which refers to a function. Second, there are huge numbers of young women finding themselves infertile because of known health issues like PCOS, thyroid function, blood clotting, autoimmune dysfunction, irregular menstruation, etc... that are not self-imposed. Additionally, it is estimated that 40% - 50% of infertility in couples trying to conceive can be attributed to the man.

3.  "David Fleming, director of the Center for Health Ethics at the University of Missouri, says the main concern with making fertilization affordable for more people is the risk of “commoditization” of babies. “The more you have access, the more people will do it.”

I have never heard of anyone in the UK say "I can get IVF free on the NHS, so I may as well do it." IVF is not a picnic in the park. It requires forced abstention from sex, heavy doses of medication (which can be seriously mood-altering, from my experience) administered by self-injection, dozens of physical examinations which require exposure of one's genitals to various medical staff and uncomfortable internal probing, a scary procedure to harvest eggs from a woman's ovaries and another to implant fertilized eggs back in to a woman's womb, a mind and heart-crushing 2 week wait, the possibility of multiple pregnancy/birth and the more-frequent-than-not disappointment that follows, when you have not conceived.

Making IVF more widely available isn't like an advertised release of an IPhone, a 2 for 1 manicure/pedicure, the UK government rebate on purchases of new cars, or getting a tattoo. Children take up a lifetime of love, attention, energy and expense. Parenting isn't something entered into lightly. Not only that, but we are sentient beings, i.e. we have the power to think and make decisions. Just because a woman could conceive 10 children doesn't mean she would. Most people are happy with 2 or 3 children. It's not often a case of "I can, therefore I will." Basically, I think David Fleming's statement is pure nonsense.

4.  "Health insurers in the U.S. typically don’t think “wanting a child” is a medical necessity."

This argument assumes that we all either want or don't want to have children and that having children is not a right, likening it to breast augmentation, hair implants or surgically corrected vision: privileges if you can afford to pay for them. I disagree.

Our bodies were designed to reproduce in order to continue the survival of our species. Physically, the male and female of the human species is meant to function as two halves of a whole, each posessing organs which necessary to the conception, gestation and birth of offspring. The physical inability to do so is as much an integral flaw of our functionality as anything else that threatens our survival.

I believe that, in conjunction with our physical design, we are programmed mentally so as to support our need to procreate and, ultimately, to survive. Therefore, the ability to produce children is essential to our feelings of security, purpose and fulfillment. (Please don't misinterpret what I am saying as saying that everyone has to actually have children in order to feel secure, purposeful and fulfilled. I believe that most people do want to have children, but that some people don't, as with any rule and the exception to it.)

Conversely, it must be true that the inability to produce children creates a stress that threatens physical, mental and emotional wellbeing.  It makes what other people see as a desire to have children, into a bona fide feeling of need. It can cause feelings of low self-worth, lack of femininity or masculinity, a feeling of being "broken" and in need of being fixed, hopelessness for the future, not fitting into their society and being classed as useless, freakish or pitiful.

Surely, if medical science exists that can assist infertile people to conceive, it would be of benefit to all society that this knowledge and skill be made available to anyone who wants or needs them. While I have no medical training, it seems to me that more frequent usage of IVF should increase the level of that knowledge and skill, raising the percentages of success over time. More success should inspire more medical research and progress, that can then bring costs down and increase availability. 

Why aren't we (well, I am) all getting behind that?  Is it a case of haves and have-nots; the haves not wanting to foot the bill for the have-nots to succeed? If you feel that way, I have a theory I would like you to consider. Over a lifetime, what you do for others and what they do for you, indirectly, evens out. If not in numbers, then in our contribution to society or in karma. If you tried to work it out in dollars and cents or pounds and pence, it would take so much time and effort, you could be losing some of your valuable time on this earth and miss an opportunity to either give or receive. So, don't bother. Just trust in it and go forward.

Shaving, bleaching, waxing, threading...huh?

No. 4 in a series for single fathers, raising, caring for and talking to pre-teen daughters about their body.

Men, do you remember when you used to watch your father shave in the mirror every morning? It's entrancing; not least because hair on your smooth face was hard to contemplate. The concentration required meant he couldn't talk to you at the same time. Shaving made the bristly bits go smooth and he smelled nice afterwards.  You dreamed of the day when you could be a man and shave too.

Well, it's not exactly the same with girls and shaving. Most women shave in the shower, without an audience. It's hard to see what you are doing, but easier than contorting yourself like a Chinese acrobat to get one foot in the sink and keep the other firmly on the floor, while naked or in a nightie. If you don't have an older woman in the house, your daughter is going to need some help from you. Step up.

A lot of us women were raised with the message "no pain, no gain." In other words, you have to suffer to be beautiful. I suffered plenty; I used a disposable razor on my legs and invariably skinned my knee, shin or ankle every week.  Bloody disaster zone.  Of course, it's not universal that women must have shiny, hair-free legs, but in most Western countries you can take it for granted. However, you do not have to suffer too much for your beauty if you are smart about it.

One thing you have to keep in mind, (and this goes for hair, skin, teeth, breasts and fingernails) is that women, and even pre-teen, women-to-be, check each other out at every opportunity.  If a girl discovers that her classmate or camp bunkmate is shaving, she will want to do it too. The other motivating factor can be if she noticed that her legs or underarms have more hair than any other girl she knows. Take into account:

• her age;
• how noticeable her body hair is;
• her level of interest;
• peer pressure; and
• your ability to teach her what she needs to know.

When your daughter first mentions shaving her legs, mentally go through this list and casually ask her why it has come up. Obviously, a razor and shaving cream aren't cult items, but you may be surprised to find out that she knows a lot about them. Ads on TV and in girls' magazines make it sound very grown up and either exciting or terrifying. She doesn't need the razor.  What she really needs is a solution to a problem, as she sees it. That goes back to whether she is really hairy or whether she just wants to do what the other girls are doing.

Girls are coming to these milestones earlier these days. I think I started shaving my legs and underarms in 8th grade, age 12 or 13. It just seemed right at the time. My own child first asked me at age 9, which I thought way too young. She then wore knee socks with her school uniform, or trousers, until I gave in the following year. It intially bothered me, as a mother, that she was rushing into teen-hood when she wasn't even "double-digits" yet. However, if faced with an unhappy child, you have to ask yourself if the principle of a minimum age is a worthy one. I think not. The compromise could be that she doesn't shave, but can use a depilatory cream, such as Veet, that is spread on, left for 5 - 10 minutes and washes off in the shower. Very uncomplicated and blood-free, as it should be.

Moving on to other body hair: face, arms and tummy. I'm not talking about werewolf levels of hair. Your daughter may think she has a noticeably hairy upper lip, forearms or the vertical line from belly button to bikini line. If she is dark-haired, she may be right. If she never noticed before, but suddenly it bothers her, it is probably because aother child pointed it out to her. Do not let her shave these areas, or when it grows back it will be blunt-edged and bristly.

There are choices here; home-bleaching kits like Jolene Creme Bleach (a.k.a. Jolen) and Boots Expert Hair Lightener. Take it from someone who has had more than a few home-grooming disasters;

1. Do not let your 11-year old, or even 13 yearold do this for the first time by herself. That's why you are there;
2. Follow the directions, do the patch test it recommends and don't leave it on longer than you are meant to;
3. Beware: some people can have an allergic reaction to the ingredients, so do the suggested test patch first. Also, her hair may go blond, but it could also go strawberry blond, which is reddish.  Again, do the patch test first. 
4. Don't let her brothers, if there are any, see your daughter with bleach on her  upper lip. It leaves the door open for much teasing, and tears.

This is a very viable option and usually does the trick, however, if it doesn't work for her (too much hair, reddish hair, etc...), the alternative is waxing.

Waxing body hair has its pros and cons. The pros are that it leaves your skin smooth and hair-free, with no blunt edge as it grows back over the next month or so. You can wax pretty much anywhere (pro), as long as you she can stand the pain (con). If you are there, she will scream and cry louder (con) and you will wince with each strip of wax (con). I would always recommend you take her to a professional who is experienced in waxing, because they do it very quickly. Yes, it hurts, but it works (Big Pro). 

Threading is the new tweezing, though it isn't new at all. Eyebrows are funny things; on a young girl's face they are often quite thick and feathery,which looks fine with her soft features. However, women, who want to look more sophisticated, prefer a sharper line to their brow. Over the past 10 years or so, brows have been promoted by beauty therapists as the "frame" for our eyes, evidenced by the creation of "brow bars," where you can go for 1 or many methods of hair removal.

If a girl has heavy eyebrows, she will eventually want to shape them. In Western countries, this was traditionally done by plucking hairs out with tweezers.  A whole company, Tweezerman, was created to sell trendy, but excellent, tweezers. The concept includes limited edition colours and patterns decorating the arms of the tweezer; such as pink for a breast cancer campaign. While tweezing and waxing obviously work, threading has been taking the beauty world by storm. It comes from Asian and Arabic cultures like Iran. Practitioners use a pure, thin, twisted thread which is rolled over untidy hair on the face, plucking it at the follicle level. Threading can remove an entire row of hair, resulting in a straighter line. It's not for the squeamish, as many practitioners anchor the cotton thread between their teeth,which can be very off-putting.

Whatever the situation with your daughter, take it slowly. Either you will have to be observant, so as to notice that she needs some help,or you will have to be there to comfort her when she decides that it bothers her enough to do something about it.

• Ask her if a friend is already shaving, waxing, bleaching, tweezing or threading. Ask her if she minds you calling that friend's mother for a consultation.
• Ask her aunt, cousin or older friend to take her to the store to buy whatever she wants to try.
• Ask if she needs help, and even if she says no, stay outside the bathroom door in case of a crisis. 
• Keep it in perspective; it's just hair, not health, but if it matters to your daughter, it has to matter to you too.

One final warning: donot try to doit all at once. One small area from start to finish, at first; see how it goes, then take a successful remedy further. I wish you good luck on these bumps in the road.

Breasts, bras and boys - all to come for you and your preteen

No. 3 in a series: Single fathers raising, caring for and talking to pre-teen daughters about their body

Way before breasts begin to appear, like little soft hills on the flat landscape of a girl's flat chest, she will have an awareness that she is different from her brothers and male classmates. It might seem that awareness has always been present, from when 3-year old girls dressed up as fairy princesses and 3-year old boys showed a preference for any game that made a lot of noise.  That's a completely different thing, due in part to the way they were treated by adults and gifted with dolls or trucks. Physical awareness of gender is inseparable from the child herself. Most girls and boys know innately who they are and identify strongly with members of their own sex, without knowing anything about breasts, vaginas or penises.

The self-consciousness that comes with a girlish growth spurt, dictates that you mustn't run around topless with your boy-friends on a hot day because someday there will be breasts on your torso and not on theirs. Probably at about six or seven, a girl no longer wants to take a bath with her brother unless he is still a baby, but she'll still fall about in a fit of giggles after streaking naked through the house with a hat on. By eight years old, she will close her bedroom door to get dressed and will hide if you open it.  At nine, she is likely to want to wear a pretty half-undershirt that resembles a bikini top, regardless of the fact that there is nothing there to cover. But, by ten, she wants it so that she has another layer between her body and the boys' glances. 

If you are raising your pre-teen daughter without a woman in the house, you are also likely to be buying her clothing.  If you haven't noticed a change in your daughter's figure, you probably think you are safe for a little while longer; before undershirts give way to bras and shoes get heels.  That's a mistake:  At about ten years old, (Year 5 in the UK, th grade in the US) your daughter is observing other girls for clues as to what is expected of her.  She is trying to figure out how she can be similarly equipped without having to ask you outright.

Wake up Dad! This is the most confusing time for a girl and even more confusing for both of you if her mother is absent. Puberty brings moodiness; emotional swings and round-abouts. Girls sneak peeks at each other at school or swim practice, curious to discover their level of physical maturity, their place in the social hierarchy and their style, including:

• whose first hint of breasts shows through her top;
• who turns away from the others to undress for PE;
• who wears an actual bra;
• whose bikini underwear has come from the teen department rather than the Disney store; and
• who is wearing a coveted label (Thank G-d for school uniforms).

If you're open-minded about what you will find for her, and sensitive, there's no reason not to take her shopping yourself, but if you feel out of your element, why don't you ask her to nominate someone else to help her.

Your daughter needs a confident guide for this particular journey. It's not as simple as just buying your daughter the first training bra you find. If you lack confidence in relating to your girl about her body and/or her clothing, find someone who has it to spare. This is where my Single Father's Toolkit comes in handy again. The second tool on the list is "friendship with the Mom of at least one of her friends." Talk to the nicest Mom-friend you know and ask whether her daughter has brought up the subject, and what "grown-up" activities she is doing, i.e. shaving, wearing a bra, using deodorant, experiencing the odd pimple or getting greasy hair.  Ask her to keep you in the loop so that your daughter isn't left behind. She may not be the right person, though, to talk to your daughter or take her shopping.

Ask your daughter to which Mom it's easiest to talk, or whose style she admires. If you feel comfortable with her choice, ask her if she will take the girls shopping and help your daughter pick out what she needs or wants at the same time as her friend. There has to be a trust between them; that she will give it generous attention and help her find "the right things," right not necessarily having a literal definition.

This is still about breasts; visible and undeniable emblems of being female and of femininity. This can be very difficult for a father to accept. There is the sense, that she is yours to protect until you feel she is ready for a relationship with a young man. It's a shock to realize that her body will proceed with its development, with or without your approval. Likewise, you won't want her body to draw male attention, but it will. If you try to keep her in little girls' clothes or display any disapproval of her body, you are in danger of undermining her efforts to accept the changes she is experiencing. She needs to feel proud of herself, inside and out.

It's about acknowledging that she is growing up, while understanding that she will still act childish sometimes. It's about her feeling confident that she will always be loved no matter how she changes. It's about accepting why she has to have whatever the other girls have.  Peer pressure is a big influence to a young girl; she doesn't want to be the only girl with discernible breasts, but doesn't want to be the last girl to get them either. By all means, have those heart-to-hearts about anything she wants to discuss. Positively acknowledge the changes in the rest of her body: her face, waist, hips, legs, etc... so that she can see her breasts as part of the entire, nearly teenage package.  The goal is to help her stay positive, accepting, responsible and confident; actually that is your goal too. Tread carefully, and keep love in your voice.

Something went bump in the night - Pre-teens and Pimples

No.2 in a series: Single fathers raising, caring for and talking to pre-teen daughters about her body

As your daughter approaches puberty, changes are bubbling and brewing under her skin, waiting for a chance to erupt: pimples and breasts. OMG!!! That would be a typical reaction on her part..."I can't go to school. Daddy, please write me a medical absence note."  Hopefully, she isn't the first child in her class to get either of them. You may want to start praying now that she is neither the first, nor the last of the girls in her class for either type of new growth.  At lease, let someone else's child go first, pleeeease. Today I'm talking less about pimples, than about how you, as a single Dad, can help your daughter cope with some of the less welcome aspects of growing up.

If there aren't any women or older sisters in your daughter's life and it's all down to you to help her through this coming-of-age trauma, G-d bless you. Think back to your own pre-teen time and try to remember how you felt when your very first, red, shiny and possibly painful pimple took up residence on your face. I think it's fair to say that most of us approached the mirror with a mixture of curiosity and disgust and then checked every 5 minutes to see if it had gone yet.

She may try to deal with it on her own first. You may find "pimple" in the history of her Google searches. She may be whispering into the phone a lot.  I advise you to pretend ignorance before she brings up the subject herself, no matter how glaring the mini-mountain.  If she pretends that the pimple isn't there, you would be best to ignore it too. The positive message you are giving her is that if she's not bothered, you're not bothered.

But, what do you do if your daughter reacts as if Mt Vesuvius is erupting on her nose? Panic. Evacuate. The sky is falling. The way that you respond is crucial to this second test (first was hygiene) of your new relationship. "What new relationship; nothing's changed" you might ask. It surely has. Before, you were the father who picked her up from a fall, kissed the bruise and put a Band-Aid on it, reassuring her that everything would be fine.  That will not placate her now. Instead, you must be careful:

• Don't use more negative or exaggerated words than the ones she uses;
• Don't react emotionally. Do not say "you're growing up. You're not my little girl anymore," because that will confirm her worst fears (that comes in my next post about breasts). She wants you to help, protect and support her; or
• Don't laugh, say she is over-reacting or call her silly. Her face has been smooth, soft and unadorned all of her short life thus far. Now she has a Christmas tree bauble on it.

Equip yourself with both emotional and practical tools for parenting in this area, traditionally the domain of mothers.

In your Single Father's Toolkit, make sure you have:

• familiarity with a good search engine,
• friendship with the Mom of at least one of her friends,
• knowledge of which pharmacy and/or supermarket is open late,
• familiarity with trusted names in skincare,
• calm, patience and wisdom, confidence; and most of all
• time and attention to devote to your daughter. 

Back to that pimple now. If she is hysterical, or extremely low, comfort her. Look your daughter in the eyes and keep calm, speaking to her with a soothing voice. Be patient. Don't drop away. Eventually, she will calm down too. If she seems able to listen, tell her what causes a pimple. If you know what something is or how it works, explain. If you don't, it's not necessary to bluff. You will earn much more credibility by being honest, so look it up together, or ask if you can talk to her a little later.  Patiently, explain to her how to keep her face clean and not to scratch, pick or otherwise attack her pimple.

The most painful part of having pimples is the social aspect of it. She still has to go to school.  She will probably worry that she will be stared at, teased or called a name. Even if there's not a boy-crush to worry about, other kids can be insensitive or even cruel when they see a sign of vulnerability. It's not necessarily going to be bad, but you can't promise her that it won't happen. Remind her that she has friends there, who care about her feelings. Reassure her...if her classmates haven't had one yet, their time will come. She will have an opportunity to be kind toward them, adopting a stance of blemish-blindness; what you pretend you don't see becomes invisible.

Next up is my discussion of how to cope with your daughter's feelings about her breasts

Single fathers raising, caring for and talking to pre-teen daughters about her body

Personal hygiene: No. 1 in a series about girls growing up

If you are a single father, raising an adolescent or teenage daughter on your own, having a talk with her about her body can be really difficult.  It's hard to know when is the right time. Do you arrange a conversation the moment you notice a slight roundness developing where breasts will be soon? You both may be appalled to realize that you noticed. This is your little girl. You want her to be informed, responsible and savvy to the threat that is called "teenage boys." You want her to stay your little girl. How do you reconcile the two?

These days, the school curriculum includes sex education for children who are 9 to 10 years old. It seems so young, but if you have done the school run lately, you will notice that 10 year old boys look like someone has grabbed them by shoulders and feet and stretched them to an awkward height. Girls' legs are becoming shapely and they are noticing some hair on their legs.  Both the boys and the girls are whispering about crushes one minute and furiously playing dodgeball together the next.You may find some hearts with scribbled-out names inside her notebook. Do NOT panic.

Dad, I'll make it easy on you by listing the topics you may need (even if you don't want) to explain.  Do not assume what she knows, what her friends talk about in the playground, or how much of the sex ed class she heard while burying her flaming cheeks behind her fingers. There is no hard and fast rule that says you have to do all of the explaining yourself.  However, if you are chief cook, laundryman, shopper and source of comfort to your daughter, you are responsible for making sure she is informed, in the most positive way possible.

This is where you may need some help from a sister, aunt or close female friend.  Don't completely pass the buck, but

1. talk to one of the women in your daughter's life and ask if she is willing to be the touchstone for your daughter's questions.
2. Each time you introduce a subject, ask your daughter if she would prefer talking to you, or the woman you chose. 
3. Break it down into bits, because (cue the sirens and flashing red lights now) telling too much at once is too much information. If you attempt to give her the top to toe explanation too quickly or too much in depth, it's likely that she will say "T - M - I!" (too much information)  Stop, right there and then. The topic will come up again when she's ready.

That being said, there are practical reasons why you need to discuss personal subjects. First up is hygiene. You may feel shocked the first time you smell body odor while hugging your little angel or bringing her laundry down to the washer. Get over it quickly. Too much attention paid to this and you will have lost her before you start.

Calmly, bring up the subject of deodorant/anti-perspirant, for instance: "have any of your girlfriends started using deodorant?" If she is ready for this conversation, explain why underarms smell (Google it) and how washing is important. Take her to the shop and let her look at the bottles of deodorant for awhile and smell them until she finds one she likes. Remember to tell her that deodorant goes on after a shower, not instead of one.  Whatever you do, do not tease her.  She may seem either disgusted or relieved that she knows what to do, or both, and possibly even a little proud of having hit a milestone in her life.

Dad, listen closely. Do not think about killing 2 or 3 birds with 1 stone; there is no need to discuss pimples, vaginal cleanliness and feminine hygiene products all at the same time. One step at a time, or you will lose ground. Do not buy overly scented items, inappropriate for young girls and a possible source of skin irritation. People who clean themselves regularly should not need to use feminine body spray. Anyway, they usually smell like air freshener meant for the toilet. Just give her moisturizing soap of her own that you do not use for her body. Tip - young girls can be rendered hysterical by one stray, adult, pubic hair on a bar of soap.

Come back this week for my next post on single fathers and pre-teen/early teen daughters. Future topics will include:

• Breasts and bras;
• Shaving, bleaching and clipping;
• Moody blues (door-slamming);
• Periods;
• The talk about sex; and
• Privacy (no one in her knickers but her)

Oh, please leave a Comment below if there is anything else you want me to blog about in this series.

Is deserving fertility treatment a moral issue, a health issue or a financial issue?

Who deserves fertility treatment? In the UK, the State-run, taxpayer-funded National Health Service, doesn't answer that question, it merely says who will receive it and who won't. The government watches its bottom line like a hawk, so I'd venture a guess that deserving doesn't even come into the conversation; it's about statistics and where to put the money. In the United States issues arise based upon 1) insurance companies who don't want to fund fertility treatment and 2) States that have not enacted legislation that would require insurance companies to pay out on fertility claims.  Is deserving a moral issue, a health issue or a financial issue?  

The argument the NHS and the insurers use against treating an infertile person, is often that it's not necessary medical treatment for the health of the insured; it's a "lifestyle choice."  The health sector also makes these decisions based upon who is most likely to benefit from treatment; women 23 - 39 years old; of healthy weight, not indulging in unhealthy habits like drink, drugs or alcohol. I'm not really interested in going into bureaucrats' decisions based upon statistical analysis. I am more interested in examining the social aspect of it:

• is it right or wrong to expect your treatment to be funded by another entity?
• Is parenthood a right or a privilege?
• is it in the public interest to support the institution of the family?
• What do we do about reconciling the "haves" and the "have-nots" in terms of family, in society now and in the future?

Many people have confused these two separate issues: who deserves parenthood and who deserves medically assisted conception.  "Deserving" is such a subjective word in the context of procreation. Whether we deserve to have and parent a child, sounds like an edict passed down by Gd.  In this world, who is qualified to make a Gd-like judgment like that?  

It seems a fundamental right to follow one's human instinct to have children. However, we all voluntarily live within a social structure that regulates what we can or can't do, based upon our moral behaviour and our ability to care properly for children.  Someone who wants children and fulfills their desire without compromising the children's physical and emotional safety and their quality of life, should, all being well, be deserving of parenthood.  The more earthbound limitations come up when people want to have children, but find themselves unable to conceive.

In regard to deserving funded treatment, it's a different story.  It's no longer about who you are, what kind of parent you would make or continuing your family lineage. It can be about your unique reproductive challenges, the chance you have of conceiving with or without assisted conception techniques, how long you have been trying and crucially, how much money is available.  Medical treatment costs money. Who will pay for that medical treatment? 

• If the woman or couple want to pay out-of-pocket for IVF, they have many options for treatment, as there seem few corners of the world that aren't populated by a fertility clinic. If it's too expensive at home, you can take a 2-week vacation abroad and pay less. Older women or a woman with secondary infertility will fit this profile.

• Under the NHS system you could be wealthy or destitute and the eligibility, care and cost (nothing to the patient) would be the same. If found not to fulfill the criteria for funded fertility treatment, the couple would be back to the decision-making above. Is it fair that someone who neither qualifies for NHS treatment, nor has the thousands of pounds to pay for it, may not have a chance to have a baby?  *The concept of fairness is as subjective as who is deserving, which is unique to each person.

• Under a strictly private medical scheme in the U.S., the financial aspect of fertility treatment is like a game of dodge-ball. No one wants to hold on to the ball, so they keep throwing it back at each other. Those who can't afford health insurance are in a bind. Those who have health insurance, believe that paying their premiums are enough reason to have their treatment for the medical condition "Infertility" covered.

The lines are blurred. There is public opinion. It's a given that in democracies, the public always wants a vote.  The decision-makers are accountable to their constituency; the people who pay those taxes that sustain the NHS. If individuals have no need or desire to have fertility treatment, they question why and how much money should go to a non-essential treatment. The loudest naysayers may argue that they don't support any "free" treatment for people who are irresponsible with their health. For example, this would apply to obese people who won't take steps to lose weight through diet and exercise, but want funded gastric band surgery. 

It's the same group that would call parenting a lifestyle choice. Is it a lifestyle choice? If there is a person who wants to parent, has patience to spare, is physically capable of raising children and wants to spend 20 years without enough sleep, privacy or expendable income, it's not a lifestyle choice, it's a life choice. Some see it as a primal need. Others may just want to have a family around them, for love, support and more love. There is also some natural programming going on to carry on your bloodline and to re-populate the earth.

Its more of a lifestyle choice to decide that you don't want to have children. This is a conscious choice to break free of traditional expectations of family. It's a statement that says you aren't interested in permanent attachments, dependence, noise, toys, broken sleep, inconvenience, expense and responsibility for another person's life and welfare. If a high-gear career, late nights, financial freedom, restaurant food, relaxing adult-only vacations and/or dancing until dawn still seem attractive to you, having a baby will undoubtedly cramp your (life)style.

This is my personal message (plea?) to anyone who is interested; any law-maker, any insurance company, fertility clinic, individual doctor, educator, chemist and/or any philanthropist: Forget questions about who deserves what and do what you can to help build families. Defray the costs to the patient, and even to the NHS and insurers. One by one, you can make a difference to hundreds of thousands of infertile women and men who are dependent upon fertility treatment to conceive. I don't care whether you benefit from it in terms of your profits, your public profile, or self-satisfaction, as long as the infertile community does.

• If it's too costly for patients, do what you can to lower costs of treatment,  medication and other paraphernalia like ovulation and pregnancy kits. (See what Asda did).
• Start with the generation of girls whose fertility begins now, teaching and checking reproductive health earlier. (See my proposal "A Shot in the Dark")
• Introduce more inclusive criteria for funded treatment that gives leeway for case-by-case analysis.
• Raise awareness of issues around infertility so it's understood by the general public, loses any stigma still in play, and is seen as a worthwhile expense.
• Make more opportunities available for non-profit fertility treatment to those infertile couples who can't afford either health insurance or to pay for treatment themselves.
• Donate to charities that fund research into reproductive health, provide educational programs, public seminars and emotional support to people affected by infertility.
• Talk about infertility so that someone coping with it in silence will feel able to come out of hiding and get the support they need.

Taking positive and generous action in this way will fulfill dreams of many people who want the best opportunity to have a family of their own.

Your ovaries do not know that it's July/August: 8 Tips to get you through the summer

What is it about summer that makes everything slow down or grind to a halt? I have had quite a few people tell me that they want to put a new project "on hold," deal with a health issue later, change a date or sort out some problems.

I'm not the only one; several others have queried the same thing...canceled appointments, a laissez-faire attitude toward agendas, trying to get a hold of builders, decorators, doctors... The irony is that if you are self-employed, your clients drop out on you, but if you need someone who is self-employed, as above, you can't reach them. It seems everything can wait until September. Could it just be the unusually good weather we have been having so far this summer? Knock wood.

Who can't afford to procrastinate this summer?  Inevitably, it's those in the IF community. It's understandable that infertiles want or feel they need a break from trying to conceive. Time marches on, whatever the weather. It's understandable:

• If they have had a disappointing, difficult or grievous year, the summer represents relaxation; 
• If their marriage has seemed confusing, strained or argumentative, summer gives them opportunities to find each other again; and
• If they are not sure what to do about a procedure, their doctor's summer vacation plans can be the deciding factor.

There are two reasons why you (especially if you are 35 or older) might want to go ahead with the fertility treatment you need, on schedule.

1. Your ovaries do not know that it's July/August; and
2. You will have lost 2 cycles and could regret it in the fall, when life/work will be busier.

Here are eight tips that could make a difference in how you enjoy and employ summer to work for you, even while going through your fertility regimen:

• Nutrition and Weight - Summer is a great time for making positive changes in your food. Lighter meals can make use of the freshest fruit and vegetables, meats and fish can be cooked on the bbq to reduce fat and there are free, healthy, summer recipes available on give-away cards in the supermarkets. Choose refreshing treats that are low fat/low processed sugar, so you don't feel left out of the group at meals and parties: watermelon, fat-free frozen yogurt, homemade lemonade, brewed iced tea, etc..
• Exercise - If you like going to a gym, keep it up. At least they are air-conditioned.  If you would rather be outside, you and your partner can spend some quality time together and be supportive of each other on a pre-mapped walking route, going for a swim or playing tennis. Dancing counts as exercise too, so see if there is a salsa class nearby. It's quite sexy.
• Job stress - If you want to make the most of summer days, change your routine. Change your arrival and departure times at work to allow you to fit in your visits to the clinic and some down-time. Create a more relaxed environment in which to work.  Meetings can be held outside, or if that's not possible, lunch on the patio to relax and promote good working relationships before the meeting inside.
• Relationship - Everything looks better with a little sunshine on it. If the two of you have been starving your relationship of fun, enthusiasm, intimacy, laughter and the friendship you thrive on, take it outdoors. Find outdoor entertainment, meet up with friends at sidewalk cafes, visit weekend-morning garage sales or flea markets, re-introduce spontaneity and put some effort into it.
• Finances - If fertility treatment is bleeding you dry financially, you could feel depressed or resentful. You deserve some time away! Instead of the 1 or 2 weeks you would like, pick 2 separate nights that you can go away this summer. Use sites like lastminute.com to get the best deal at a location which requires little travel. Take off after work, check in and relax, then go out for dinner, a walk, a film, people-watching, etc... Even better, book a hotel that has a spa where you can have a couples massage. When you go home, your re-entry into home life is smoothed by the knowledge that you have another night coming soon. 
• Mental space - If your concern is how mentally tired you feel, consider how difficult it would be to sustain a self-imposed ban on thinking or talking about your fertility treatment during your summer off. Instead, plan a wordless day in the week and ask your friends and family to respect it. Other effective ways to clear your head without stripping your bank account: anything that requires focused attention, like painting, sewing, sport, gardening, sudoku, etc. Set a small goal and finish it within the time allotted. You won't be over-thinking your issues while you are concentrating on what you are doing.
• Friendships - It can be really painful to be with your friends who already have children, and children are always present during the summer. At the same time, you don't want to not be invited. Take the lead and tell your friends that for this period of time, you would like to be given the choice of going, or not. Ask them not to be offended if you choose to stay away...just a bad day. It's also a good idea, if you can handle it, to go ahead to a family day out, reserving the option of leaving early. It builds resilience; give yourself points for every minute that you stay. Watch the kids and think "I'm going to have that one day too."
• Motivation and self-confidence - Self-talk can be positive or negative. Whichever you use is what you will have. Negative self-talk will get you nowhere good and can be quite self-destructive if you begin to believe it. If you desperately need to take a break from fertility treatment this summer, talk to your doctor about how you feel and ask his opinion of whether it could set you back and how much.  If your need has more to do with that tempting summer feeling, consider doing a simple exercise: Write down your negative self-talk and then rewrite it so that it reads like a positive, but realistic, script of your summer. Then, when you have been sufficiently motivated, get out there and live it. Keep your eye on the goal and have your fun too.

Whether you decide to take that break from trying to conceive over the summer or not, these tips can help you get through the unexpected bumps in the road. It's all about keeping all the different aspects of your life balanced, your thoughts positive, your priorities true and your plans flexible.

Infertility: Invitations not required

In my last blog post; ‘Nothing is absolute in the world of Infertility’ I talked about the IF community being inclusive, not exclusive.  I wondered if you (individually) would include, under the Infertile umbrella, a woman who has:

1. Miscarried repeatedly, so is not technically infertile because she is able to conceive. She still doesn't have the ability to carry a baby to term; to life. In or out?
2. Had an abortion previously, but now can't get pregnant. In or out?
3. History of recurrent miscarriages, birth of first child, secondary infertility and unsuccessful IVF, but then had a 2nd child, like me. In or out?
4. Has had successful fertility treatment and is now pregnant... In or out?
5. Is now a mother, having been able to have a child (or children) through assisted conception. In or out?
6. Is the wife or girlfriend of an infertile man who is trying to conceive? In or out?

I also told you that I make a practice of referring to women with recurrent miscarriages as Infertile, even though they do not fit the scientific definition.  Why? Because:

• These women also lack what infertile women do; their own baby.
• They feel many of the same emotions as infertile women, including, but not limited to confusion, anger, low self-esteem, fear, guilt, or self-loathing. 
• They encounter the same type of ignorance about their condition, such as “whose fault is it?", "it wasn't meant to be," I'm sure you will be lucky this time.", "just relax" or "you can always adopt."
• They feel isolated and sometimes even freakish, especially when around other pregnant women or mothers.
• They experience the same type of marital and financial stress that infertile couples do.

I assume that I would be accepted by the IF community because of my fertility history, even though I am a mother now.  But, perhaps you don’t. I am no longer trying to conceive. Do you think "she's had 2 children...she’s not one of us anymore, she's not a true Infertile?" I can tell you that infertility is a significant part of who I am.

I talk openly about my experiences in order to advocate awareness in young people about their bodies and bodily functions, how to achieve optimum health for conception early on and how to decide which path to follow. I advocate acceptance of yourself and of others.  Infertility has certainly played a large part inmy  work as a specialist fertility coach. It helps me to understand how deep my clients' emotions and belief systems go, necessary changes of beliefs, attitudes and behaviour in order to conceive and how else I can help them with their family-building. I don't generally like to label people, because it takes attention away from their individual needs. However, sometimes a label is useful, as long as you realize that the other person may not agree with your opinion about it, i.e. are you in or out?

I would really like to see your comments on the section above that asks "In or out?"

Nothing is absolute in the world of Infertility

I was reading an article in the new Fertility Road magazine last night, discussing male infertility, which ended with a quote by psychologist Trudy Hill:

"Remember, much of infertility is not absolute..."

While Hill was referring to how infertile men can restore their sense of control and reduce their stress, her simple description jumped off the page. It was a distillation of everything I had been thinking, but couldn't put in words. It encompasses the constant progress of reproductive medicine, bringing new opportunities to conceive. It also covers the mysterious nature of the human body and its ability to confound even the most brilliant doctors. I think it is also applicable to the question, "who is infertile?"

Every once in a while, I see or hear women debating someone else's fertility status with an "Is she one of us?" edge to it. This usually follows a debate about something an offending party has posted in a blog comment. Very recently, one of these free-for-alls occurred on the Facebook page 999 Reasons to Laugh at Infertility by Infertile Naomi. I was glued to it, like a fan at Wimbledon watching with fascination as some little-known upstart battles a top-seeded, favoured tennis player.

I've written before about the IF sisterhood; the vast number of infertile women, most of whom have only "met" on the internet, but who know each other in the way they know the hidden parts of themselves. Their best qualities are the support they give each other and the welcome into the fold of newbies who pick up their special language, with nicknames, slang and acronyms. Their least attractive quality is how some of them react when others try to join the group without proving themselves, or who Gd-forbid, say the wrong thing.

RGMN  im really...found out im pregnant seems unreal after how long its taken the reason it happened was bcz i stopped thinkin about it

R M  It's obvious that RGMN is not truly infertile, and therefore cannot truly empathize with the painful journey that we, as women and couples, have had to endure.

M D  RGMN, maybe you should not be posting on infertility pages. Some of us have been trying for years and don't care what you say...

KMS  RGMN did u really say ur pregnant bc u stopped thinking about it. Wow that's the stupidest thing I have ever heard

RGMN thanku for the nasty comments i wasnt being spitefull i was just trying to give a glimmer of hope  id never be intentionally cruel to any1 so i dnt no why any1 wud treat me like this

*These, above, are only a few of the dozens of comments that followed RGMN's taboo statement. For anyone reading this, who doesn't understand this, it's a wrong assumption and condescending to say that infertile women will conceive if they "just relax" or have a vacation. That isn't exactly what RGMN was saying...just that she believed her pregnancy is due to not thinking about trying to conceive.  What shouted off the screen was not that; it was one woman to another, judging who is a True Infertile. 

Trust Kate of Busted Plumbing fame to weigh in with the voice of reason! Part of Kate's post is below.

Busted Kate  "Look, everyone handles these fertility challenges differently. There's really not much value in arguing who is a true Infertile... I took 5 years and many miscarriages to get where I am, but because I'm pregnant does that mean I'm no longer an Infertile?

This is a group I identify with. I'm intentional when I capitalize Infertile. Lowercase "infertile" = someone who has trouble conceiving for longer than a year. Thats the scientific definition.

Infertile, with a capital... there's no definition to that. If you think you belong, you do. If you struggle with your own fertility, you belong. Maybe you're not even trying, but you've had your uterus removed... but you feel like you belong with us Infertiles more than anyone else. I'm pregnant, and I still feel like I belong with the Infertiles. I'm never going to tell anyone they don't belong with me. Because I already feel isolated enough from the Fertile's world.
We need to stick together, defend one another, protect one another. Because no one understand our experience like each other.
All of us want the same thing, for ourselves and for each other. A child. And I love that people still wish that for each other, even at times of disagreement. Some might get there sooner rather than later, some might get there through adoption or surrogacy. But, in a very basic way, we're all in the same boat.The same hormonal, emotional, fertility medicated boat. God help us all. :-)"

Please note Kate's distinction between "Lowercase "infertile" = someone who has trouble conceiving for longer than a year, and Infertile, with a capital. It takes me back to that Trudy Hill quote ; "much of infertility is not absolute."   

I completely agree with Kate's statement; "If you think you belong, you do ." It is my experience that in order to attract the right kind of resources and support, you may have to identify with, and be recognized as part of, a group of people who have already figured out how to get that support. Whether in pain or jubilation, it's so much more comforting to be a part of a "we" than an "I." 

Everyone has a right to their opinion, and can use the internet (Blogs, Facebook, Twitter, etc. ) to state it. But, everyone will have a different opinion about that too; who gets to comment and how loud their comments can be before it turns into cyber-bullying.  By turning on someone who has said something you don't like and fanning the flames of an Us v. You exchange, you are effectively cutting that person off from support she may need from the blogging world. She is unlikely to visit that blog or comment again.

The commonalities between all of the people discussed here, including me, are:

1. they are all Infertile;
2. they are all on the internet;
3. they all want, or wanted, to have children; and
4. they are all looking to give or get information and support.

I am uncomfortable with the idea of closing ranks; being exclusive. I definitely don't like the thought of someone else deciding for me (without my vote) who is in or out. To my mind, there are no absolutes. Someone who identified as Infertile, with no hope of pregnancy, might one day benefit from the continuous progress of medicine science. It doesn’t mean they were never infertile.

Let's be more inclusive and less judgmental, less aggressive and more generous.  We can impart wisdom or experience to those who, like us, are unfortunately affected by infertility; and they can carry the hopeful message to others: "nothing is absolute."

*By the way, other women in the verbal fistfight above besides Kate commented in more measured and forgiving ways, some putting RGMN's statement into context of her excitement about getting pregnant or just not understanding the significance of her words, and asking us all to support each other.