The Conception Question

By Laura Newsome

For most of human history, sexual relationships were infused with a stark element of chance. A fleeting liaison could result in an unwanted pregnancy that would forever change the lives of its creators. Then, in the 1950s, as scientists were predicting a cataclysmic population boom, the pill arrived to save the day. A high-dose cocktail of hormones, the pill gave women a taste of sexual freedom and families a notion of self-determination, but the pill’s physical and emotional side effects took an exacting toll on its female clientele. 

Sixty years after women gained control over their reproductive systems, modern women are still trying to strike a balance between their long-term health and effective family planning. Faced with the choice of when and how to conceive, women today arrive at a personalized solution based on family goals and dreams, health concerns, religious faith, age, physical well-being and their financial outlook. Far beyond the simple prevention or permission of a sperm meeting an egg, a growing number of families acknowledge that birth control and fertility are vitalistic decisions that should take the emotional well-being of women into account.

Modern Birth Control Options and Their Consequences

While celibacy is the only fool-proof method of birth control, after years of testing and molecular tweaking, modern science is helping sexually active women prevent pregnancy at every turn. Besides vasectomies and female sterilization, the most effective means of birth control are rod implants and intrauterine devices (IUDs) like Mirena and ParaGard, which are effective for five to 12 years, respectively. Though IUDs carry a risk of pelvic inflammatory disease and don’t protect against sexually transmitted diseases, they are popular with many monogamous women who have had children. “I’m seeing more and more women who are using IUDs because they’re very effective. You don’t have to think about them,” says Hilary Schlinger, CNM, of Sage Femme Midwifery, which provides well-women care, contraception and family planning services.

On the next tier of effectiveness, resulting in two to nine pregnancies per 100 users, is Lactational Amenorrhea Method (LAM) breastfeeding after pregnancy and hormonal birth controls such as the Depo-Provera shot, the NuvaRing, the patch and the infamous pill. “In the ’50s, birth control pills contained high amounts of estrogen—50 micrograms compared to today’s 15 to 20 micrograms,” says Schlinger. “As a result, the population of women reaching sexual maturity today [is less concerned about] hormones. When it comes to an easy option that gives women control over when they have their periods, hormonal birth control can be a good choice.”

While the pros of the pill are well-known, ingesting artificial estrogen and progestin is a concern for many women trying to lead natural lifestyles. While there is some evidence that the combination pill helps prevent acne, endometrial and ovarian cancers, bone thinning, cyst development and eases premenstrual symptoms, there is also evidence that links the pill to an altered sex drive, as well as higher instances of stroke, heart attack and blood clots, particularly in women who are older, overweight or smokers. “With hormones, you’re fooling your body into believing it’s pregnant, and anytime you fool the body into a false pregnancy for years and years, you’re going to increase the possibility of side effects,” says Dr. Jeanne Ohm, a chiropractor and mother of six home-birthed children, who supports natural birthing practices and chiropractic care during pregnancy.

Popular pills such as YAZ and YAZMIN have been linked to higher occurrences of blood clots, and some recent evidence links artificial hormone use, such as estrogen replacement therapy in menopausal women, with bone thinning and an increased breast cancer risk. “I always like to remind people that the risk of using the pill pales in comparison to the risks of pregnancy, which carries a much higher risk of blood clots and high blood pressure,” adds Schlinger.

In lieu of permanent birth control, IUDs and hormonal methods, many women opt for barrier methods, which result in 15 to 24 pregnancies per 100 users. Barrier methods include the sponge, the cervical cap, the diaphragm, the female condom, withdrawal and the male condom. While the male condom is the only method that prevents sexually transmitted diseases, and one of the few methods that involves male agency, it also inhibits sexual pleasure. Barrier methods in general must be initiated before intercourse, which can interfere with sexual desire and result in operator error in the heat of the moment. “What I tell women when it comes to these less-effective methods is, ‘What would happen if you got pregnant? How sure are you that you don’t want to get pregnant?’”says Schlinger.

For women in stable, committed relationships—who can afford to get pregnant if the situation arose—the most natural birth control method is fertility awareness, which involves charting the release of the egg through ovulation and avoiding intercourse on the days a woman is most fertile. Once called the rhythm method, this family planning practice has been popular for generations with couples that adhere to religious strictures on birth control. “The ovulation method looks at taking charge of your fertility and determining the safe periods for sex,” says Schlinger, who notes that the ovulation method is 97 percent effective with perfect use and 75 percent effective with normal use.

Since an egg lives for about a day after ovulation, and sperm can live inside a woman’s body for six days, a woman has a seven-day window every month when she can become pregnant. The most effective natural family planning method is the symptothermal method, which involves charting cycles, taking morning temperatures and checking cervical mucus every day at the beginning of a cycle. While these methods can be time-consuming, prone to error and challenging because they hinder both male and female desire, for women who are determined to live a natural, hormone and device-free life, they are the only way to go.

The Conception Question

“I’m a big advocate of conscious conception,” Ohm says. “I had six kids, and they were all consciously conceived. A woman who is in touch with her ovulation is always conscious of her reproductive capabilities and knows what it means to bring a new being, a whole new soul into the world. It’s vitalistic to consciously conceive. Your emotional state throughout pregnancy is very important to the developing fetus and its nervous system, and you don’t want to be stressed about carrying an unplanned child.”

When a woman is ready to conceive, she can rely on the mechanism behind natural family planning to determine her most fertile days and plan sexual intercourse during that week. For Schlinger, who also counsels women struggling to conceive, their natural cycle is a great place to start. “I find out what they do and don’t know about fertility and tracking ovulation,” she says. “A lot of women don’t have a basic understanding of when an egg is developing, when the egg is released and when they are fertile.” If a woman’s partner has a low sperm count, Schlinger recommends they avoid hot tubs, tight underwear and bike riding, and abstain from sex [for the] three days leading up to ovulation in order to increase their sperm count. For women, she often prescribes herbal remedies like red clover, licorice and peony.

“For some women, weight loss results in conception, so eating a whole-grain, low glycemic diet and reducing sugar consumption is important,” Schlinger says. “Anything that improves health is going to increase fertility. If there isn’t a sperm count issue and a woman has made all the necessary lifestyle changes and she still can’t conceive, then she can undergo hysterosalpingography, which sometimes pushes debris out of the fallopian tubes and helps a woman conceive. If that doesn’t work, then it’s my job to inform patients about options like in vitro fertilization (IVF). Certainly with that option there is a higher risk of multiple births, which can increase the risks of birth defects and pregnancy complications.”

Many women who are dedicated to living natural lives find that moving away from the medical means of conception often aids in pregnancy. “I think you first need to exhaust natural planning options,” Ohm says. “If you can’t conceive, chiropractic care and getting adjusted can balance out the whole nervous system.” Ohm also recommends seeing a naturopath who can help clear toxins out of the body. “There are numerous cases where a woman can’t conceive until she adopts a baby,” Ohm says. “It happens because she gets over her stress and that opens the door to conception. If you have a fast-paced lifestyle and you’re working all the time, there’s a good chance you may not conceive because your body doesn’t think it’s the right time. The innate intelligence of the body wants to conceive, and it knows when conditions are ideal.” For Ohm, procedures like IVF may produce a baby, but they do little to address the underlying physical, chemical and emotional factors that prevent pregnancy in the first place.

For women who conceive through fertility awareness, the practice is often a gateway to natural pregnancies, natural births and natural child rearing. “I believe there is a universal intelligence present in all matter,” Ohm says. “That intelligence knows how to develop a fetus the same way it knows how to conduct every other life function. If you connect to that vitalistic principle, then you can deduce every other decision and trust you are doing the right thing.” Though natural birthing and child rearing practices were not popular when she gave birth to her now 32-year-old son, Ohm believes her trust in the innate intelligence led her to practice natural birthing, on-demand breast feeding, co-sleeping and baby wearing.

While nearly every week a new book about pregnancy, conception and child rearing soars to the top of the bestseller list, few can doubt the innate intelligence of the maternal instinct when it comes to rearing happy, healthy and successful children. “When women are healthy and happy, their families are healthy and happy,” Schlinger says. “In countries where women have control over their health and their fertility decisions, we see much lower maternal and infant mortality rates. I’m a strong advocate for wanted pregnancies and chosen children.”