This is a post about my uterus*. It is not a love letter.
This post is not for the squeamish, but I hope you read it anyway. This post won’t apply to some of you, but I hope you read it anyway. You may think this post is TMI — too much information. I disagree, and I hope you read it anyway. This post may have some of you thinking, “Why the hell is she writing a post about reproduction and birth control on a blog about women in academia?” Read on.
My reproductive system and I have always had a love-hate relationship. It started with that first period that left me debilitated on my 12th birthday (the messy, painful reality was so much less romantic than the readings I’d devoured. Becoming a “woman” was not what the rose-colored pamphlets promised, in addition to being biologically essentialist). For the first year, I spent a lot of time wearing jackets tied around my waist when yet another overnight-sized maxi-pad let me down. By high school, I’d settled into a comfortable routine of regular-ish, heavy periods. By the time I was 18, I was on hormonal birth control (Ortho Tri-Cyclen Lo). The few times I’d go off The Pill (more often related to access than choice), it would take months for me to have a natural period, and the cramps would be so debilitating that I’d miss work or school for a couple days. The Pill kept everything under check: regular, light, predictable, seemingly no side effects except fantastic skin. Perfect!
During one of those off-times, a catastrophic condom failure led to what was a very bad abortion experience (again related to access rather than choice). The clinic was fantastic, but the runaround with insurance, state officials who lied to my face about Medicaid access for an abortion, and a deliberately obtuse nurse who pretended she didn’t know why I was getting the ultrasound (“it’s a girl! And she looks perfectly healthy!”) meant that I never wanted to go through that again if I could help it. I was in an emotionally abusive relationship, and I didn’t want a baby. I was still in college. I knew that for me, having a child meant not being able to pursue my dreams. I was a first-generation college student from a working class background, and I couldn’t go to my family for help. I had the abortion, in Canada, in my 2nd trimester. I don’t regret having it, though I am still angry about the how and the why.
I went back on The Pill as soon as I could. When I hit my late twenties, however, my love affair with oral contraceptives hit a rut. I found myself irritable, lacking physical affection for my then-boyfriend, dizzy with hunger by 5 pm, and getting migraines more and more often. When another access-related snafu hit during grad school, I ended up going off birth control for a few months. The transformation was incredible– I felt like my old self again; less anxious, less irritable, physically affectionate. I knew right away that I couldn’t go back on The Pill, but I absolutely did not want another abortion if I could help it. My gynecologist was sympathetic, but wanted me to stay on some form of hormones because of concerns that my not ovulating regularly put me at a higher risk of ovarian and uterine cancer. So I tried the NuvaRing. I didn’t react well to it physically — too much discharge. I tried the Mirena, and expelled it within days (ouch!). At a loss, I tried a mono-phasic birth control pill and some B vitamins, hoping that not having swings in hormones would reduce the moodiness and migraines. I found that I felt even worse, and more troubling, I kept forgetting to take the damn things (despite having had no previous issues with remembering).
I finished grad school, and moved away from my then-boyfriend-now-husband. I went off birth control entirely for a year, relying on condoms for the few times we were together. I felt great, except when I had a period, which was so heavy I became anemic. Still concerned about cancer, my new gynecologist prescribed monthly progsterone pills to trigger a period. After one pill turned me into The Incredible Hulk for 24 hours, I swore to myself that I would never take another. I remember sitting at my desk, actually shaking with anger in overreaction to some small thing, my heart racing. When a small voice said, “this isn’t normal,” I googled “progesterone angry.” To my relief, it wasn’t just me.
And now, here I am, just starting a faculty position. My husband and I are still a part-time long-distance couple, at least for two more years. We’re still relying on condoms. We want to start trying to get pregnant in a couple years. We know we might get pregnant sooner than that, or that hormones might delay that start date even further. We’re also aware that I’m reaching an age (early thirties) where it may be more difficult to get pregnant at all. In the meantime, I live in perpetual dread of having a period, where between the debilitating cramps and losing an ounce of blood every four hours (I have a Diva Cup**; I checked) means a full stop to productivity or travel of any kind. I also dread not having them, and take regular pregnancy tests. I feel, in a word, hijacked.
And that’s why this matters to me as a woman and an academic:
It matters because lack of access to birth control and reproductive healthcare nearly kept me out of graduate school. I know it’s possible to have a kid as a college or graduate student, but it wouldn’t have worked out for me at the time.
It matters because my periods can completely destroy my productivity: I can’t work, I can’t attend talks at a conference, I can’t go into the field. I only have a period every 3-4 months; I know women that are having periods like that on a monthly basis.
It matters because I already feel like the tenure clock and my biological clock are having a Royal Rumble in my uterus. If we do get pregnant now, living apart, the timing would be terrible for us. But what if it’s our only shot? Would my husband have to quit his program?
It matters because I don’t want to get cancer. I kind of like being here to do science.
It matters because I feel like this has been the single most tangible expression of work-life-balance in my life. When I was on The Pill, I was miserable at home. Just before I got off of it, my then-boyfriend and I were having discussions about whether we were working out. As soon as I got off it, it was like a completely different relationship. I don’t blame this entirely on The Pill, but I think it made a real difference.
It matters because women are constantly judged as inferior because of our biology. We’re written off as emotional, irrational, bitchy, or “on the rag” for asserting ourselves, or even just for existing. The fact that I attribute strong emotional side effects to my contraceptives is deeply troubling to me as a feminist, because it feels like I’m buying into that culture that dismisses women’s emotions because of our biology.
If we want to help women at home and in the workplace, we need to think about access to reproductive healthcare options. We need to validate women who express dissatisfaction with a given method– I once changed gynecologists three times in a row because of dismissive, condescending attitudes about my physiological responses! We need to provide safe alternatives to hormonal birth control. New options for male birth control need to be on the table. We need to rethink a tenure clock system that is out of sync with our reproductive biology (male and female!) and provide flexible plans, childcare, and parent-friendly workplaces.
I don’t have answers for managing my own uterus right now, let alone the collective uteri of women in academia (and beyond!). I do hope we have these conversations, because I don’t think they’re TMI. If anything, we have TMS — Too Much Silence about women’s health, and not enough information. Not by a long shot.
So, folks, here’s your TMI-safe spot to kvetch. Share your frustrations, experiences, advice, and questions in the comments. Leave the sexism and evo-psych bull honky at the door, please. Comments will be monitored heavily.
*I am a cis-gendered woman. I have a uterus. Not all women do. Throughout this post, my intention is not to suggest that this is a problem that only women deal with (some folks who identify as men have uteruses), or that women automatically deal with, or that you have to have a uterus to be a woman.
** I highly recommend menstrual cups. I wish someone had given me one when I was 12; I’d never have needed those jackets around my waist. Bonus points for being reusable (no waste!), non-irritating, high-volume, and graduated, so you can see how heavy your periods are if you’re a nerd like me. I recommend getting two to swap out at work, with a little dry bag like the ones they use for cloth diapers (check Etsy). On heavy days, I use PUL-lined cloth pads as a backup, which I love.