KateC Says...

Compromise

Hi Kate,

 

I'm hoping you can offer some advice.  Your blog recently discussed how to handle a long-distance relationship, and from reading this I know that you and your husband were long-distance for quite a while before he moved to the US.  I'm wondering how to handle the fact that my boyfriend just accepted a job offer in another state.  We're both in the same career field, one that lacks flexibility; jobs are scarce and regionally-based.  Essentially, we both have to move to our jobs, instead of finding jobs where we'd like to be.  To be blunt, I have no desire to move to that state where I am unlikely to find a job myself.  I have recently finished grad school, and I am crestfallen to have to have to make the decision: do I move with my boyfriend, or do I continue with my career path (which will probably take me elsewhere) and force us into a long-distance relationship?  Following him means (at least temporarily) abandoning my hard work to get to where I am in my own career.  In addition, I've had my heart set on moving back to be closer to my family, and moving with him will not bring me any closer to them.  Did your husband have any difficulty in deciding to leave his friends and family, to come to you in a brand new country?  I feel like I'm being ridiculously selfish.  I should be thrilled my boyfriend got offered this fabulous job- his dream job, really.  Instead I'm wallowing in self-pity that I can't have my cake and eat it too.    

Poster, I'm sorry that you're facing a tough decision.  Sometimes life throws us a little curve and forces us to compromise.  I don't blame you for feeling down about this!

To answer your question, I am certain that my husband felt it difficult to leave his family and friends to come live with me, but by the time he did it, I'm also certain that the decision was an easy one.  We faced our hardest decision when we entered our relationship knowing full-well that it would stretch on for a long time as a long-distance relationship so that we could both finish our educations.  When we stood where you are now, we chose to buckle down for the sake of our careers.  A few years later, the priorities shifted for us and it was time to put our relationship first. 

I can't tell you which choice is right for you right now.  I will tell you this, though: I think that long-distance relationships are most likely to work when there is an end in sight.  If you decide to move back home to be near your family and endure the distance for a while, you and your boyfriend should devise an end to that scenario -- maybe he moves to be with you after a while, or maybe you stick it out for one year, and if he still can't find work near you, you move to be with him.  It's important to have something to look forward to like that. 

On the other hand, if you do move to live with him in this new and undesirable local, outline a plan of escape for the two of you together, so that you needn't feel trapped there forever.

Talk it out with your boyfriend.  Figure out where your priorities lie, both as a couple, and also as a pair of individuals.  Talk plans and scenarios, and find something that you can both live with.  Think broadly, and cover some extreme possibilities (What if one of you were not to work for a time?  Switch professions?  Work together or at the same company?  What if you stayed apart for a few months?  A few years?)  Be aware that this conversation might be painful for both of you -- your not wanting to follow him to his new job might hurt his feelings.  Be ready to explain why you're feeling the way you're feeling about wanting to move back home, and be sure to help him to feel your love and commitment despite your hesitation to follow him to the ends of the earth. 

I'm sorry that I have no easy answer.  These things are so very personal, so specific to your relationship and your situation.  Whatever you choose, make the most of your compromise and work to improve your situation over the coming months and years.  Good luck to you and to your boyfriend at his new job!

Long-Term Long-Distance

Hey Kate! I occasionally read your other blog and remember reading about your relationship with your husband (such a cute story by the way!). I am currently in a long distance relationship and have been for almost a year and a half. I go to college in Texas and my boyfriend is out of state in Missouri. We get to see each other about once a month, usually for a weekend. Occasionally we do for longer periods of time such as winter break, and my favorite by far was the 3.5 months last summer! The only problem is that we are looking at being long distance for the next 3 or 4 years, depending on if he graduates on time. Unfortunately one of us transferring doesn't seem to be a possibility financially, plus we would be judged pretty heavily by both our families because we are both young. I love him and definitely want to stay together, so I guess the advice I am looking for is how to get through the next few years with the least amount of hard, depressing days as possible. What can I do to motivate myself to not dwell on the fact we aren't together when it gets hard? Thank you so much for any words of wisdom you can share :)

Thank you, R

R, perhaps the best motivator is to know that long distance really can work out if you're in love and committed!  I know there's a lot of negativity out there, especially in college, but just because distance is tough, and not for everybody, does not mean that your relationship is doomed.  You're right that my husband and I had a long distance relationship (New England to New Zealand) for about a year and a half.  That has worked out beautifully in the end. I have other friends, too, who have survived space and time and gone on to have beautiful happy marriages.  California to Guatemala, Washington to a ship in the Pacific, Germany to Massachusetts, and half a dozen China to Boston.  Some of these are still going strong, and others have ended very happily with both parties happily married and living under one roof.

I have a few general tips for you.  Stay close in spirit even if you can't be close in person by using all avenues of communication available to you.  Email every morning.  Call every week.  Skype when you get the privacy.  Text little thoughts when you can.  Send love letters the old-fashioned way.  Discuss important and weighty matters as well as trivial little whims.  Let him know that you're thinking of him, and help him show you the same.  Keep planning your weekends and vacations together.

If it ever comes to the point where you want to transfer or move or seek a job near your mate, then talk to your family in a way that helps them to see that this is a reasonable move.  They want things to work out well for you.  At some point in your life, it becomes healthy and productive to change your life's course for the sake of love.  That doesn't mean that you should give up your dreams and education, it just means that sometimes dreams change to include someone else.  Show your family that you are making sound choice, and that happiness is sometimes worth a bit of an investment of energy and planning.

I don't know when you'll get to that point, but if the relationship continues to be a strong one, it is only a matter of time.  Long distance relationships without any hope of an end to the distance don't stand much of a chance.  Whether that end is one year off or four years off, realize that it will come.  It is not foolish to plan for it. 

Entering into my long-distance relationship felt rash at the time.  So did moving my boyfriend around the world to be with me, moving in together immediately, and marrying within a few months of this change.  Looking back now, these were easily a few of the best and most natural choices I ever made.  I don't regret any of this.  At the time, it felt like the only choices I made with my heart instead of my mind, but now I see that I was choosing with both, and that's why things worked out so well.

If you and your boyfriend both prefer being with one another at a distance to independence or the company of anyone else close at hand, then the relationship will work.  You don't stay in long distance relationships because they're hard, you stay because the relationship makes you happy despite its challenges.  Keep coming back to that, and you'll always have something to feel good about. 

I wish you both the best of luck!  May the next few years fly by.

Unexpected Pregnancy

I'm not reprinting the entire story, but this question comes from a woman who got pregnant unexpectedly, while on birth control.  She and her boyfriend had been planning to marry in the future and did want children someday, but not right now.  They decided, together, that abortion is the best choice at this time.  If you are very affected by discussion of abortion, then you might want to skip this entry, because I support this choice in every way, and that may upset some readers.

From everything that I've read, medical abortion is still an option (mifepristone and misoprostol). This gives me some measure of comfort, but still scares me. I have no idea what to expect other than the small amount of information I've read, and I have no idea how bad the miscarriage is going to be. I have no idea how I'm going to feel afterward. I know that I cannot have a baby now, and yet I still feel like I'm doing the wrong thing somehow.

My boyfriend has been nothing but supportive, and I know that he and I ultimately agree on our choice even though it isn't easy for either of us. It's just hard for me to have a tiny glimpse of something that I know I want eventually, but to have to give it away because the timing is wrong. I read online that I'll have to have an ultrasound to confirm that I am less than eight weeks pregnant before I can be approved for medical abortion. I just went back and looked at your ultrasound picture from when you were first pregnant (about six weeks). I imagine that this is going to be heart-wrenching.

I'm sorry about the long note. I've been trying to put everything I'm feeling into words for a few days now, and I fail miserably each time. I never thought that I'd be having an abortion. Never. I'm just worried about the emotional effect it's going to have, what it might do to my relationship, how much it might hurt, all of the normal stuff, I guess. Things I never thought I'd have to worry about. I have the support of my boyfriend and best friend, but no one else knows.

I've always been very pro-choice, and always said that if I got pregnant before I was ready to have kids that I would have an abortion without hesitation. I still feel that way, but I didn't expect it to be nearly this hard.

Thanks for reading -

I'm so sorry that you had this particular surprise at a time when you are not ready for a child.  It's always so hard to know that you were being responsible by using birth control, and despite that planning, you were not able to protect yourself entirely from an unexpected pregnancy.  These things happen, and it isn't anyone's fault, just the way the statistics hash out.  I'm sorry you're on the wrong side of the math on this one. 

Due to the time-sensitive nature of this topic, and my inability to access my anonymous box for so long, I wouldn't be surprised if my words come too late to really help you, but I want to answer anyway.

I'm glad that you have come to a decision that works for you and your boyfriend and your plans for an eventual family.  I understand that it doesn't feel great, but I trust that you are looking at this in depth, from all angles, and making a sound choice with the help of both your emotions and your rational mind.  If I were in your shoes, I probably would make the same exact choice, for a very early, medicated abortion.  The physical consequence of medicated abortion is induced miscarriage, as you know.  I have never miscarried, so I welcome responses from women who have for more specific experience, but I would expect that you cramp severely and for a long time.  You will be having uterine contractions, and they hurt like bad menstrual cramps.  You may vomit.  There may be sharper pain if you're passing any clots of endometrium (uterine lining -- what you normally pass during your period). It won't feel good, but it also won't last forever.

I like the medicated abortion because it is the induction of an otherwise natural process.  Miscarriages happen spontaneously in nature, and the vast majority of the time, they do not harm the woman who has them.  Also, women have been inducing miscarriages through herbs and traditional medicine for thousands and thousands of years.  This is in no way new, we just benefit from the precision that modern medicine offers us.  We have finer control over this process than our ancestors, and we benefit from very sound medicine to support us if anything goes wrong.

Some women, however, might actually prefer a traditional abortion.  In a traditional abortion, you won't avoid all pain or cramping, but you will be able to treat it as a medical procedure, and that might feel better to you.  You won't have to do it at your home.  There is no risk of the abortion not working.  Also, if you are further along in your pregnancy, this method still works. 

At this point, before 8 weeks, the embryo is tiny and not far developed.  That ultrasound that you saw on my pregnancy blog was taken at 6 weeks.  It was 3 mm long and had a heartbeat, but nothing else to speak of.  No telling head end from tail end in the ultrasound, no fingers, no toes, no brain -- just the cells that would differentiate and divide to become all of those things with lots of time and lots of support from your body.  How you feel about seeing an ultrasound like this is going to be very personal.  For me, it was exciting.  I was having the ultrasound because I wanted to be pregnant and feared I was miscarrying, so for me and my husband, it was exciting and happy -- but I will tell you straight, I did not see a baby when I saw that embryo, and it does not hurt me to think that some other woman in some other circumstance might decide to end her pregnancy at that point. 

I can't tell you how you will feel after ending a pregnancy.  I completely understand your anguish over wanting something so badly... just not yet.  Timing is important.  Situation is important.  When you make a choice like this, you have to do what is best for your future family and for yourself, because if you put yourself in a situation of great hardship, you will not be able to be the best mother you can be.  I believe that abortion is sometimes the best choice for all involved. 

I don't know if you'll feel relief or regret -- I just know that complicated emotions are normal and healthy.  I know that just because you feel conflicted about a choice does not mean that it is the wrong choice.  I know that sometimes, the very best thing you can do in a tough situation is enormously difficult and painful. 

Maybe it will be hard for you, and maybe it will be a simple relief, but most likely you will feel mixed emotions.  There is no wrong response to something like this, you just have to let yourself feel what you need to feel, then work towards moving on so that you can build your future, your education and career, your life, and your family.  

I don't think anyone ever thinks she'll have to have an abortion.  I don't think anyone ever wants to have to make this choice and face an unexpected pregnancy.  I fully support you in this.  No matter how hard it is in the short term, you might find that choosing not to have this child brings you other children, well in the future, whom you won't be able to imagine living without.  Someday you will have your family and be the best mother that you can be.  It's okay if now is not that time.

Best wishes for good health and strength and resilience.

Greetinger

I announced technical difficulties accessing my anonymous greetinger box a few weeks back.  I tried again today and was able to access these notes.  I'll address the questions in the box as soon as I can, but I wanted to leave this note to apologize for the long delay and to remind everyone that you can email me at KateCSays@gmail.com and use anonymous email service (just search for one on google or a similar search engine) if you're not comfortable sharing your email information.

Sorry for any long delays!

Permanent Birth Control

Hi Kate!

My partner and I have been considering getting some type of permanent birth control as tubal ligation or vasectomy for a while. We had discussed it plenty of times but never had the determination to do it until now. I had an abortion last month and it revived the discussion. First, I want to make clear that this decision is based on our lack of desire to have children. It's not a result of us freaking out due to the abortion. No. We've talked about it in depth and we're sure it's the right choice for us.

Now there's the decision. Tubal ligation or vasectomy? We've reading about both of them and it seems that him getting a vasectomy would be easier. While I'm thin and don't suffer from any disease that could make it not recommended for me, I'm still young (24) and I've never had a baby. I've heard/read a lot about young women being refused a tubal ligation due to these reasons. Truth is I've never asked my gyno about it and I suppose it would depend on the doctor.

We've made the decision but there's no rush. He has an appointment next month and I shall talk to my gyno soon. But being the impatient and avid for information person I am, your input would be much appreciated.

Thanks for writing in and following up!  I infer that everything went well after your last question, and I'm so glad that you and your partner are on the same page about your future together.  That makes life much easier!

I, too, have heard that doctors are reluctant to grant sterilization procedures to young people who do not have children.  It's likely based upon the relatively common instance of changing life goals, colloquially known as "the ticking biological clock."  I'm sure that many a person who, at 24, thought she never wanted a baby, comes to want one later in life.  I'm also sure that many a person who knows, at 24, that she never wants a child, continues never to want a child and leads a full and wonderful life without ever procreating.  I support whatever decision you make at this point and I hope that your doctor does too.  The more you can think on this, and the more thoroughly you know yourself (and your partner, himself), the better this decision is likely to be, so take your time and do your soul-searching, and then look for a doctor who supports your right to control your fertility -- absolutely.

The short answer to your question: I hear that vasectomy is a much easier, safer, cheaper, and less invasive procedure than tubal ligation with fewer instances of serious side effects.  Do your research.  Ask your OB/GYN, and have your partner talk to a urologist.  Read up on vasectomies and tubal ligation, but everything I've heard points to vasectomies being the easier procedure.

The long answer: you should talk with your boyfriend about what happens if one of you dies.  Seriously.  I know it's morbid, but consider the possibility that you may not always have each other.  What if tragedy strikes?  What if you are forced to move on?  What if the next person you fall for wants kids?  How will that affect the way you feel about procreating?

If one of you feels that, with another partner, you just might want to be able to reproduce, than the other person should get the surgery.  Sure, vasectomies and tubal ligations are sometimes reversible, but not always.  The person who is most sure about not wanting biological children -- under any circumstance -- is the one who should have the procedure.

Also consider both of your health in this decision.  Anything that might put you or your partner at risk for complications (obesity, diabetes, severe allergies, etc.) should be considered before elective surgery. 

Any reluctance at all from either one of you should be cause to shift the procedure to the other or postpone it to some later date when things seem more certain and the choice is easier.

Whatever you and your partner decide, good luck with it!  If you go with tubal ligation, opt for laproscopic surgery.  In fact, any time you're considering abdominal surgery, get laproscopy if you can!  The healing time is much quicker and there are fewer scar-tissue-related complications.  Local anesthesia is always easier to recover from than general, and the smaller the incision into your abdomen, the better for you in the long run!

Follow whatever directions the surgeon gives you, abstaining from sex, heavy lifting, blood-thinning pain meds, and rigorous activity for as long as you are asked.  Rest well and heal thoroughly.

If you can't find anyone to give you sterilization, consider using a long-term effective method of birth control like an IUD in the interim.  No, it's not quite as effective as surgical sterilization, but it's not easy to forget like a pill, it delivers extremely low dose of hormones or nothing at all, and it lasts for years.  It's general policy not to give an IUD to a childless woman, but I know many young women who use one with the support of their doctors.

Best wishes for the surgery, whoever decides to get it!  Congratulations on being responsible in your sexual activity.

Blogging

Hi KateC,

I hope all is well with you.
I'm writing to you because I'm going to as a volunteer to a far-away destination. I want to document and share my experiences in this place, and I thought the best way to do that would be to start a blog!
I'm asking you this question because one day I clicked on your blog links, and I think you're a terrific writer. You write about personal experiences without giving out important personal information, and that's what I would like to do.

So, from a beginner-blogger to an experienced-blogger I'd like to ask for your perspective on safe blogging and your experience with blogging overall. I'd be very thankful if you could share a few tips on staying safe while on the web.

Thanks so much for the compliments, poster! I'm so glad that you like what I write!  Apologies for the delay in my response.  I am sluggish in my blogging responsibilities these days!

I have two blogs, and one is more personal than the other.  In case you're wondering, I consider this one to be the less personal one, though it does include some very personal details about me mixed into my responses.  I treat the two blogs differently because I share some of your concerns about privacy and safety on the very public and free-reeling world of the internet.  Here are some things to consider when you set up your blog.  It's best to make decisions about these factors up front and then stick to them throughout the duration of your blog.  If, as you write, you become more comfortable and want to share more, then you can always open up and do so, but you can't ever count on going backwards, so keep that in mind.

Names:  Are you going to use your own name, some variation of it, or a pseudonym?  There's no right or wrong answer here.  Do what you're comfortable with.  Kate is my real name.  It's a very common name, so I'm comfortable using it, but you might feel differently and want to go with a fake name or a title. 

Consider, too, how the people in your life might feel about being included in your public stories.  Try to be respectful of them by protecting their anonymity to a reasonable extent.  I'm sure there are people who read this who know exactly who my husband is and what his name is, but I take the conservative route and refer to him as only "Hub" in all of my internet dealings. 

Readers: Who is your audience?  Are you writing this for yourself?  Do you want strangers to read it?  Do you want friends and family to read it?  You may well find that you want people to read your blog, but not people that you know.  There is a lot of safety in anonymity, and there is a lot of freedom in it.  If you don't want friends and family reading your blog, don't give out the address.  Don't tell them that you're writing it.  Use a pseudonym and don't post pictures of yourself on your blog.

If you want your friends and family to be able to keep track of you and your adventures (it will save you a lot of email correspondence), then do share your address!  Post it on your facebook or myspace.  Send it out in a mass email.  Then just realize that whatever you will write has got to be grandmother, younger sibling, professional colleague, and nosy-neighbor appropriate.  It could be a lovely way to stay close to friends and family, but it will require a lot more self-check when you're writing.  If you want to share this with your loved ones, absolutely no ranting about anyone who could be recognized by any of your potential readers.  That's a pretty good rule to follow anyway, as everything you put on the internet is public.

If you really want to restrict readership, then put a password on your blog.  Make it private.  This isn't a guarantee that nobody else will read it, but it's your best bet at controlling readers.

I do share this blog broadly on my facebook, because it is intended for everyone -- the world at large.  A lot of my friends and my parents' friends read it through that link.  Some of my former students and teachers do, too.  My colleagues have access to it.  It's a fine line, because a lot of the questions I answer here are sexual in nature, but I strive to answer all questions in a mature and dignified manner, so I share.

On my more personal blog, I have shared the URL with some friends who I think might be particularly interested, but most of my readers are not people I know in real life, and I do not advertise that link on facebook or anywhere else. 

Safety: I admit it; I'm totally irrationally afraid of some psycho from the internet trying to track me down.  I think it's good policy to withhold the kind of information that makes it extremely easy to find you.  Linking to your blog from your facebook allows people you know to read your blog.  Linking your facebook from your blog allows people you don't know to find you.  I advise against it.  Don't post your address or your phone number.  Use your discretion about sharing with people who ask for it. Most people mean well and just want to get to know you, but don't feel pressured into anything you're uncomfortable with.

You've probably noticed that I have an email account set up specifically for this blog.  It makes me a little bit harder to pin down. 

I also plaster my blog with warnings that I am not a medical professional.  This is important because, even though I have opinions and advice on living healthily, someone may read this who needs more than what I can give or something different than what I say.  It's important that they have all the best information available to make their own best decisions about seeking professional support.  They must know that I am not an expert.  Asking me should count as calling your mom or asking a friend, not as visiting a specialist.  It feels sadly litigious, but it's important. 

I enjoy my experience blogging.  I like to write.  I like to read what people have to say about what I write.  I like to be a part of this internet culture.  It's fun!  The vast majority of feedback I get is pleasant and constructive.  My questions and answers provide conversation topics among family friends.  Some of my trials and tribulations evoke help and support that I wouldn't otherwise know to ask for. 

There have been a few problems.  There's the spam.  Someone asks me about hair removal, and I get a comment about this laser-center.  That's annoying.  I don't want to be an ad.  Keep your eyes out for that.  I also get the occasional hate mail.  It's generally always along the lines of, "What right do you have to give advice ... ON THE INTERNET?!"   It's a silly complaint.  It's the internet.  I know that.  If my blog is so annoying to people, why the heck do they keep reading it just to send in hate mail?  But despite it all, it still bothers me. 

You can avoid hate mail in two main ways: first, don't become popular.  The haters just HATE it when lots of people love you.  Second, don't provide any anonymous response option.  If they have to say it to your face, most haters won't say it at all. 

One last note: keep in mind that everything you write on the internet is public.  It could all be found by the person you least want to read it.  Protect yourself against this in every way you can, but still realize that it could happen and write accordingly.

Best of luck in your travels and blogging!  Send along your URL if you want me to read it.  I'd love to see what you're up to.

Rhythm Method

Do you think rhythm or calendar-method birth control methods are ever
worth considering for someone who does NOT want to get pregnant? I
know the mainstream word on the issue is that these methods are
generally ineffective, but their legitimacy and popularity seems to be
growing in more alternative circles in the last few years. Is this
something that the world of conventional medicine has rejected out of
a fear of the unknown, or should cycle-based methods absolutely be
avoided if you’re not willing to chance pregnancy? Do any other
effective non-hormonal birth control methods exist?

[I have edited out a couple of paragraphs of personal information on the poster.  The pertinent details: she is in a monogamous, committed relationship and is using condoms but has had some trouble with their reliability.  She used the depot shot in the past with no bad side effects, but would prefer not to be on hormones.  She is allergic to nickel.]

I apologize for the long wait on this response!  As luck would have it, I actually happened upon an expert opinion on the matter today!  The nurse and lactation consultant I see at my mothers' group used to coach people in natural family planning.  Just by chance, she brought it up today so I got to pick her brain about it.

There are different ways to use natural family planning.  You use the term Rhythm, and this is technically just the calendar method of birth control where you chart your periods, count out the days from your last period to estimate your ovulation date, and remain celibate around this time of your cycle to prevent pregnancy.  There are various ways of counting and various tools for reminding you what day you're on.  You have to be celibate for up to 14 days out of your cycle, which is a long time, and perfect use gives annual failure of about 5-10% (according to Wikipedia and that oft' quoted table that is printed on all birth control pill pamphlets).  This method relies on a cycle like clockwork and   Regular use gives up to 25% failure rates (according to the same table and the Mayo website).  That isn't great -- worse than condoms and much worse than hormonal methods of birth control.  It's even worse than the pull-out method.  It is decidedly better than nothing (85% of women using no birth control get pregnant in a year), however I think it is not a suitable method of birth control to be used if you really want to protect yourself well from pregnancy.

There are ways to improve your results without introducing synthetic hormones, IUDs, or condoms.  The Sympto-Thermal method of birth control is more accurate, less reliant on a regular cycle, allows for more days of sex, and gives much better results than the calendar method alone.  This is very similar to the calendar method of BC, but instead of just counting days and poking your finger at a likely ovulation date, you develop a very acute awareness of your body, reading it for clues about your exact day of ovulation and abstaining from sex (or using a condom ) on these days. 

Clues include:

• Basal Body Temperature:  Buy a basal thermometer (it has an extra decimal, measuring to the hundredths) and take your temperature every morning, very first thing, before you even get out of bed.  Chart your temperature on graph paper, and when you see it jump about 0.4F (~0.2C) then you know that you ovulated.  Tough luck if you've had sex in the last three days!  Sperm can live that long inside of you.  Temperature alone does not warn you of impending ovulation, but it can help you get to know your cycle better, and that is a good deal more helpful than counting days on the calendar. 

• Cervical Mucous: Inspect your vaginal discharge every day.  Keep an eye out for the changes.  When it seems to get slippery or mucousy, stop having sex or use a condom.  When it appears like egg whites, forming goey strands between your finger and thumb as you stretch it apart, then that's your ovulation.  Abstain for a few more days.  This will likely add up to about a week of condoms or abstention. 

If you choose to practice this method of birth control, I HIGHLY recommend that you get a coach or attend a class to help you learn how to do it well.  When done correctly, this method is about as effective at preventing pregnancy as condoms, but without help, you might end up staring at your discharge every day not quite knowing what to make of it and getting pregnant for lack of support.  There are educational seminars on this method almost anywhere there is a Catholic church.  Seek one out and drop in, no matter what your religion. The church certainly has its dogmatic motives to push this method of birth control.  They have funded most of the research that has gone into it and they run most of the education that there is about it.  My gut reaction to that fact was suspicion of the results, but then I thought about it further and realized that lots of stats on the pill are presented by drug companies, and stats on condoms are presented by durex, so the church probably isn't that different.  If this is a method you want to use, then I recommend using their resources.

Now, none of this is as effective at preventing pregnancy as hormonal methods or IUDs.  Condoms and sympto-thermal method have ~3% failure rate per year (perfect use).  The pill and IUDs have ~0.1% failure rate per year (perfect use).  If you really, really want to cover your bases, you want to prevent ovulation or implantation, and that means hormones and IUDs.  Being allergic to nickel, I agree that metal is out as a method of BC.  You'd have to go for an IUD that is made of plastic, and these contain very low levels of hormones.  Consider that you were once on the shot, which is the biggest wallop of hormone on the market.  It's a huge dose, delivered in one go every few months.  It is a method of birth control that has many side effects for many people because of this dose and drug delivery method.  If you didn't get side effects from that, you would very likely be absolutely fine on a low-dose pill (less hormone) or on a hormonal IUD (minuscule amounts of hormone).  These would be the best at preventing pregnancy, but if you don't want the hormone, then you don't want the hormone.

Hormonal contraceptives are a very effective method of birth control.  IUDs are also very effective and are dummy-proof.  Condoms are a good method of birth control and the only one that protects against STI transmission.  Sympto-thermal is also, in my opinion, a good method of birth control, but one that takes a lot more planning and self-control than simply taking a pill every day or keeping the cupboard stocked with condoms.  Calendar method?  It's definitely better than nothing, but I wouldn't rely on it.

I believe that the sympto-thermal method of birth control is a really, really good thing to practice for any ovulating woman, but that it's even better if you're not using it exclusively.  More knowledge about your cycle can only help you.  So go ahead and learn about it!  Track that temperature.  Inspect that cervical mucous.  Learn as much as you can about your fertility.  On top of it all, I recommend to keep using those condoms.  Two methods are better than one!  And if your condom fails you?  At least you'll have a good idea of your risks and will know whether or not to run out for the Plan B.

Good luck with it!  I hope that it works out well for you.

Additional Reading:

I talked to three women today who used the sympto-thermal method of birth control, two to avoid pregnancy, and all three to get pregnant when they felt ready.  The all recommend a book: Taking Charge of Your Fertility. 

Technical Difficulties

Apparently my anonymous message box, the "greetinger" is not working.  I don't know how long it has been down, but there may be some questions in there that I can't gain access to.  Ever time I try to read them it gives me an error message.  If you are worried that one of your questions got lost in this tech gap, re-send it.

For now, please send questions by email to: KateCSays@gmail.com

I promise that I don't give out any of your email addresses, nor do I make any effort to track down who you are based on your email, and I never write a name up on the blog with a question unless you tell me what to call you in the post.  I occasionally respond to emails, if I am delayed in responding to a question just to say, "I got a lot of questions this week, so your answer won't be up until Friday, but it's coming!"  And after that, I leave you alone.

If you're still uncomfortable sending questions through email, do a websearch for "anonymous email" and find a server who will let you send your question without attaching your email address to it.  Just be aware that such questions may be at higher risk for being weeded out as spam.

Coming Down Off Summer Love

I'm editing this to make it shorter and draw out the main points.  I did read the whole thing, though, poster!

Hi Kate,

 

My boyfriend and I met in August in Myrtle Beach. We never intended to end up dating. I was leaving the beach soon and had ties to someone else, he was still living with his his ex-girlfriend and her family. When we met the attraction was almost immediate. We couldn't deny it and we couldn't fight it. We fell hard and fast and we were a couple only a few days later. I had to leave from the beach and he promised to visit whenever he could. That turned out to be once over the next two months. Eventually after many false starts and much trepidation he moved in with me. Things have gone down hill from there.

[Summarizing:

The sex life fizzled.

There are still feelings for the ex-girlfriend (who was also a fiance).

He is flirts with other girls online in a way he doesn't flirt with you.

He wants you to initiate sex, but that is not your natural style, and when you do work up the assertiveness to initiate, he does not reciprocate.

He barely even kisses you and never cuddles.

You've talked about your sex issues, and he has blamed it on money issues, but now he puts the blame on you instead.

You feel that you have a lot of baggage that you're bringing to the relationship, and he claims that he wants to get you help, but you don't feel that's a possibility right now (at least not professional help), and you don't know what to do.]

Most recently all of our fights have been about the issues I have, he claims to be really concerned for my emotional and mental well being. He says that the issues I have frighten him that I'm going to end up doing something self destructive or dangerous and that basically if I weren't so crazy things would be better. He doesn't use the word crazy but I know thats what he's thinking and I'm not sure how to handle that.

I guess my question comes down to really, how do I undo all of the years of stuff thats pent up inside me that is ruining my relationship. I feel so helpless, so hopeless to fix myself or my relationship.

To be honest, it doesn't sound like a very healthy relationship.  I'm not sure that it is a relationship worth fixing, either.  Look at what you've written.  You fell in love fast and hard and moved in together without really getting to know each other and all of your issues first.  He has baggage left over from his last relationship.  You have baggage from your life.  Neither of you really knew about the other's issues before you got together.

Now consider the issue of trust.  He is flirting with other women online and not giving you what you need in the way of affection.  That's a pretty big deal. You're snooping around on his computer to find this evidence.  That's a pretty big deal too.

As far as equality goes, there isn't much in this relationship.  I know that you mention being sexually submissive, but being submissive shouldn't mean that you are treated without respect in your relationship.  He's not reciprocating emotionally or sexually.  He's blaming you for all the troubles when, really, it's a two-way street.  He's hiding his online dealings with other women from you. 

It's not healthy.  It doesn't sound as though he respects you or values you in the way he should.  I believe him when he says he's worried about you, but I'm not sure I believe him if he's telling you he loves you.  The way he is treating you, it doesn't sound like love to me. 

Most relationships start out strong and passionate and in a whirlwind of giddy emotion.  Most relationships then have to survive the tempering of that emotion, for that giddy high is not sustainable over the long term.  Love may start out wild, but a healthy love calms as it matures.  Some relationships grow stronger through this transition.  Others don't survive it.  I want you to think really hard about whether or not yours ought to survive it.  If you are willing to put in the work on your side, perhaps by seeking ways to better manage this past that you elude to (therapy, lifestyle change, philosophical shift), then that is only half the battle.  He has to be willing to put in his work on the other side.  It doesn't sound as though he even realizes that this is something he ought to be doing, and for the relationship to survive, you're both going to have to embrace the effort.

I'm so sorry to be such a downer.  I know that you want to make this work and that you're trying.  Don't put yourself down so.  I'm difficult in a lot of ways too, but we're worthy of love and worthy of a healthy, gratifying relationship. 

My advice to you is to throw yourself fully into trying to gain stability in your own mental health, independent of this boyfriend.  Seek the support of friends and family and build yourself a strong network so that you don't rely on him as your only source of love and comfort and guidance.  If, for whatever reason, you can't seek professional help in the way of therapy or drug treatment, consider alternative sources of self-betterment like exercise for the endorphins, eliminating stimulants from your life for the stability, and maybe taking up something like yoga or religion that combines introspective meditation with a life philosophy shift.  These are ways in which you can chip away at your own issues.  As for the relationship, I hate to say it, but I think that you would do better if you moved out and put some distance between yourself and this man who is so thoroughly undermining your confidence.  I'm not saying he's a bad person, but it's pretty clear from your story that he isn't a constructive or uplifting force in your life right now, and that he isn't likely to be any time soon.
 

I'm so sorry.  I imagine that isn't at all what you want to hear, but it just sounds so thoroughly unhealthy that I wouldn't feel right encouraging you to pour your all into it.

Baby Time

Whenever you get a chance..

Hi Kate! I am a single mom of a 6 month old baby. He is healthy, happy, and generally a wonderful kid. The problem that I am running into is absolutely my fault, but I can't figure out how to fix it. His sleeping hours are backwards (He sleeps from 5 am to 2 pm at night, then takes a nap at 4-6, and another one at 10-12.) and his 'schedule' is just simply one that he's created himself. I never set my own schedule, just moved around whatever I had to do, and I find myself at a complete loss at how to get this under control. I'm concerned that I'm messing up his internal clock, and that such an unstructured life in the beginning is going to be a detriment to his development.

I've tried waking him up early, but he has a bad night, and then I end up sleeping in with him, and it's all screwy again. I don't have a job, just being a mom, and I don't have anything that I do every day. We've also done so much traveling in the first few months (6 trips to different places... aye it's been hard!) that I'm pretty sure he's living on a different country's time schedule.

So, how do I create my own schedule, and more importantly, how do I create one for him? We can't live like this anymore.

I know what they say about babies: "Don't try to put your baby on a schedule."  I've read it several places and understand what they're getting at.  They're saying that rigidity doesn't work with an infant.  That is all well and good, but I totally disagree about the scheduling.  I think schedules are great, even for babies.  Maybe you can't schedule your baby down to the minute, but I believe that you ought to work towards some form of schedule for the sake of your own health, happiness, and simple sanity!

I know that this advice is too late for you, but if anyone else is reading with the same issues a little earlier, I recommend starting to work at shifting a baby's sleeping hours in the first few months. Say, as soon as the sleep deprivation starts to get to you.  For most moms, that will be within a matter of weeks or days, and though enforcing any sort of order so early may not work right away, it never hurts to start pushing sleeping hours towards the night from the get-go. 

We get this question a lot at my breastfeeding mothers' group.  Janice, the nurse who runs the group, gives the following spiel every time.  Keep in mind that this is generally directed at younger babies, so you may have to modify it in ways that seem sensible to work with your older baby. 

Janice always starts by saying that babies are born without a clock, but what patterns they do have tend to be nocturnal.  Remember when you were pregnant?  The little guy was probably really active at night when you lay down to rest.  That means that if he's born with any body-clock at all, it's all jet-lagged from day one. 

Did letting your baby indulge in his nocturnal habits impede his development?  Certainly not!  I'm quite sure he's just fine.  But it does make things tough on you, who have to exist functionally during daylight hours. It's time to get back to it now.  It may take a few days or even a couple of weeks, but kids are incredibly adaptable and resilient.  I have the utmost confidence that, two weeks from now, you and your baby boy will be sleeping much better at night and enjoying much more alert days. 

For a small baby, say, three months and under, there's really very little emphasis on keeping a baby awake during the day.  These tiny new babies need a lot of sleep, up to 20 hours a day, and keeping them up may just make them overtired and frustrated, actually hindering night sleep.  Instead, Janice recommends trying to encourage night sleep by instituting a daytime feeding schedule that breaks up the daytime sleep.  You, with a 6 month old, may need to encourage wakefulness during the day as well, but I think that modifying the feeding schedule is a good place to start.

Your goal is to feed your baby mostly during the day, finishing the day with an intensive group of feedings called "cluster feeding."  Most babies sleep for at least one long stretch in a 24 hour period.  Right now, your baby is doing that from the early morning to the afternoon.  Your goal is to shift this block so that it starts at, say, 10:00 pm.  

Start by breaking up the day (when you want to be awake) into feedings.  Maybe your baby eats every 3 hours or so when he is awake.  If so, start watching him at 2.5 hours.  You're looking for light sleep, when you see the REM, his eyelids flutter and he moves around a little bit.  Rouse him now, before he plummets back into deep sleep again.  You can wake him up by moving his little limbs, playing with him, or undressing him until he is cold and cranky.  Change his diaper.  Do whatever you need to do to get him annoyed and awake.  Then feed him.

Babies are usually alert after a feeding, so take advantage of this and play with him.  Keep him active and awake for a while.  Eventually he may want to nap again, and you can set the timer and repeat the process as the next appointed feeding time approaches.

At the end of the day, after your dinner time, start pushing a couple of feedings closer together.  You want to fill up the baby's tank so that he's prepared to sleep for his long stretch, starting when you're ready to go to bed.

During the night, when he wakes and wants to play, it's all business time.  If he needs a feeding at night, that's fine, but don't play with him.  Just respond to his cries for food, feed him, burp him, change him, sooth him, and put him right back down again.  I place a hot water bottle in my baby's crib when I pick her up at night to keep it warm for her while she feeds.  When I put her down, it's not as great a shock as the cold sheets would have been.  Tricks like this can help ease the transition, especially if you're trying to avoid ending up with the baby in your bed.

After a few days of the new and improved feeding schedule, he may be completely well adjusted on his own, or he may still be pushing for attention at night.  At night, if you know that he's all set (fed, clean, burped), but you put him down calm and he works himself into a fit, you can let him cry and see if he will settle himself.  You know your baby best, and you have to make the call about when it's really time to go in and sooth again, but at six months, I'd say he's ready to learn self soothing.  Call his pediatrician to ask about how long is reasonable to wait if he's crying and you're trying to get him to learn how to sleep through the night.  The pedi should be able to give you an appropriate time frame for this exercise.  Remember, if he is safe and sound in his crib, this stage is generally harder on the mom than on the baby.  My parents say that it took three torturous nights to teach me how to sooth myself, but I learned and everybody slept better from then on.  My parents did this at six months, but I know some mothers in my group did it as early as three months.

Rest assured that you've done nothing wrong for your baby's development.  Babies need food, shelter, hygiene, and, above all, love.  It doesn't matter if they're getting it at night or during the day.  You're not setting your baby back by traveling or allowing him to keep his own schedule or cuddling him when he asks for it.  There's nothing bad about co-sleeping for a child's development*, in fact, it's supposedly really good for them, but it may be keeping you up and making you exhausted and miserable.  What's good for the mom is good for the baby.  When you are happy and healthy and alert, you will be the best mom that you can be.  Don't feel guilty for being flexible with your baby to this point, but also don't feel like some sort of terrible task master for enforcing a schedule.  Babies are so resilient and adaptable!  The transition will probably be much harder on you than it is on your son, though there may be a few tears shed on each side.  I'm confident that you both can make the change and that you'll be feeling much better soon!

Good luck, momma! 

* If you do cosleeping, they recommend using an insert for your bed so that you won't roll over onto the baby, so that he won't fall out, so that blankets won't get in his face, and so that he can sleep on his back as recommended by the current medical studies.  I feel that I must pass this along in good conscience even though people have been sleeping with their babies in their beds for thousands upon thousands of years.  To me, the very most important part of cosleeping isn't any of these things, it's making sure that you don't go to bed under the influence of drugs or alcohol.  Many cosleeping tragedies involve drugs or alcohol of some sort.  If you want to sleep with your baby, just make sure that you're always doing so sober so that you won't be sleeping too soundly to respond to his needs or to notice his presence in the bed, and keep his airways free from pillows and blankets and your own clothing and body-parts.