#SXSW: Fertility Insights, Part 2

Artwork from SXSW panel “Handmaid’s Tale IRL, What if Roe Were to Go?”

As #SXSW closes, here is — as promised in Part 1! - a more down-to-earth set of fertility-related insights from the conference. Let’s jump right in!

I truly enjoyed a session on “Handmaid’s Tale IRL, What If Roe were to go?”. By now, many of you must have enjoyed at least the recent TV series, if not the original book by Margaret Atwood (which I highly recommend!). I often feel that the social discourse on women’s reproductive health is fragmented — people advocate for choice, specific conditions (hey, #endometriosis awareness month!), access to care, infertility, etc. But I think what is missing is the realization that all of these issues are inextricably linked, and that we might get further with improving reproductive healthcare if we made bridges between these activist communities.

To wit: one of my favorite parts of this panel was hearing from Judith Arcana, a former JANE who helped women secure safe pregnancy terminations prior to Roe, talking about how they helped women. She talked about referring women to doctors who were safe and practiced good medicine, who — to use the terminology of the day — wouldn’t “harangue” them, and how they utilized providers who weren’t always MDs. All of these characteristics hold true for fertility as well. In general, women trying to conceive want physicians who will follow scientific evidence and take care of them emotionally, who won’t make them feel guilty for their life choices or medical diagnoses, and who are willing to work within a team of providers (acupuncturist, nutritionist, nurses, embryologists, and more!).

Basically, when we go to a gynecologist to talk about the most intimate parts of our body and lives, these requests are all common denominators. And the fact that we’re not reliably getting them raises 3 points, all of which were made in this panel:

• Self-management: reproductive knowledge ahead of time can make things cheaper and easier. In this panel, this theme related to medical pregnancy termination, and knowing your options in the face of an accidental pregnancy. Trying to research what to do when you’re already finding yourself in a physically and emotionally difficult spot is way harder. This phenomenon is totally true in fertility also! Much of my research relates to low levels of fertility knowledge in the general population (and it holds across countries, educational levels and even within healthcare!). We would be much better prepared to ward off preventable cases of infertility, and seek care when something seems awry if we could just access comprehensive and scientific information about reproduction as young women — how to avoid undesired pregnancies and conceive healthy wanted ones.
• Stigma: unfortunately, frank conversations around reproduction are not common (though that may be changing a bit now!). As a result, women often feel stigmatized when they: face infertility, recognize an undesired pregnancy, suffer sexual assault, endure a miscarriage… and the list goes on and on. And yes, these are all common things! Around 12% of women in the U.S. have difficulty conceiving, about half of pregnancies are surprises, 1 in 6 women survive an attempted or completed sexual assault, and 20% of all pregnancies end in miscarriage. None of these reproductive outcomes should generate shame.
• Storytelling: part of combating the shame is brave women sharing their experiences. It is not always easy to come out of the woodwork and share your story, but the pain we endure from unwanted reproductive outcomes can at least go toward helping others. I am ever so grateful to celebrities like Chrissy Teigen and Hilarie Burton, who have recently opened up about their struggles with infertility, alongside so many others sharing their stories via social media, blogs, forums and so on. Sharing an abortion story, like super-inspiring panelist Candice Russell, is rife with more risk, but can debunk so many common myths! There is so much value to communicating our struggles.

And this bears reiterating — myths about female reproduction are unbelievably common. At the Wellness Expo, I attended a very fun session with Cycles + Sex co-creator Ashley Spivak called “Turns Out, Periods are Dope”. It’s important for all of us in reproductive medicine to sometimes just sit with other folks and listen as common misconceptions were called out, and people asked questions and got answers they were shocked to hear (yes, birth control pills prevent you from having a true “period”; it’s more of a withdrawal bleed that doesn’t tell you as much about your own reproductive health!). This type of health activism and promotion is so important because it’s accessible, fun, honest and approachable!

One last post-script. As I said last time, I was mostly there to have fun, and indeed I did! I attended a bunch of film screenings, including A Vigilante, an Olivia Wilde-starring feature that depicted with stunning visuals and a novel screenplay the impact of domestic violence. I promised myself I would do my part to raise some awareness on how prevalent it is (estimates suggest 12 million people a year are affected by rape, physical violence or stalking by an intimate partner!). It bears noting that pregnancy is a high-risk time for women to experience violence, and everyone can do their part to help those who may need help. If you can, spare another 5 minutes to read through this website and be prepared to help.

So yes, I left the conference last week armed with some new and reworked ideas about fertility. There were many more events I would have loved to attend, but alas! Did you see anything great and relevant?