She is a fertility expert who has transformed the way millions of Americans think about their bodies. Across a generation’s span, where science and technology has left remarkable, dazzling imprints on fertility, Toni Weschler’s impact has been profound.
Profiled now alongside the modern greats of reproductive communication, she gives an exclusive interview to Fertility Road magazine…
Sadly, a modern education still leaves women in the dark about their own bodies. We now have a generation of women in their 30s and 40s who were taught nothing whatsoever about their fertility and have not the slightest clue about how the female reproductive system works.
Essential facts every woman should know – for example that it’s possible to predict your next period if you know when you ovulated because the luteal (post-ovulation) phase has a consistent length in each woman, while the follicular (pre-ovulation) phase varies each cycle; or that cervical mucus with an ‘egg white’ appearance is a healthy sign of high fertility – were simply not included in our school ‘sex education’ lessons.
Women today have left conceiving much later, and when we finally stop taking the pill to get pregnant, we suddenly realise we know nothing about our natural cycles. Tragically, we usually only come to understand our own biology at a late stage – when often, the time pressures are starting to become unbearable.
In this era when women want to know as much as possible about their bodies, the new science of fertility awareness, made available with the advent of the digital thermometer in the 1970s, is more popular than ever. Our mothers are mystified to see our carefully plotted graphs. “It was so different in the 70s,” Suzanne, a 69-year-old writer, recalls. “We were vaguely aware the middle of the month was fertile, but getting pregnant just happened; we didn’t try.”
But women trying to conceive today are older than ever before, desperate for knowledge so we can understand our natural cycles and maximise our chances of conceiving, fast – which is why modern women are getting hooked on the fertility awareness movement, the bible of which is the super-selling book Taking Charge of Your Fertility by American Toni Weschler. Published in 1995, the book was the first to explain – in amazing detail – how to get pregnant by monitoring and recording on a chart the body’s daily fertility signs, including waking temperature, which rises after ovulation; cervical fluid (dry in infertile times of the month, increasingly creamy and then like egg white as you approach ovulation); and cervical position.
And although these facts are now all over the internet and other fertility books, the fact remains that TCOYF explains them in the most comprehensive and authoritative detail – it’s still the biggest and the best manual for understanding your fertility. The book is currently ranked at number three out of the nearly 19 million published books sold on Amazon.com when it comes to customer ratings (trumped only by two Harry Potter novels). But that’s not down to marketing or publicity – TCOYF remains an underground, word-of-mouth fertility phenomenon.
Usually what happens is that when a woman starts ‘trying’, a clued-up friend who’s been trying for a while shows her some fertility charts, and asks incredulously if she’s never heard of ‘Toni’. That’s Toni Weschler, she explains, a cult figure to women trying to conceive.
As an undergraduate studying Psychology, Weschler found herself running to the gynaecologist every month – like many women, she felt ashamed and concerned about the white discharge that returned again and again and wondered what was wrong with her. “It wasn’t until years later, in the mid- 1980s, when I was told this was a normal fertility sign that occurs before ovulation, that I had my light-bulb moment,” Weschler, now 54, recalls.
“Oh my God – all those years I thought I was dirty, when I was completely healthy and my body was doing exactly what it was meant to do and showing me signs telling me what was going on inside. And this made me so mad. I thought, it is unacceptable that in today’s times, women have no clue how their bodies work. I wanted to yell it out to every woman: there is a world of knowledge in your body.”
Weschler achieved a Master’s degree in Public Health and tried to raise awareness among doctors – but, she recalls, they wrongly equated fertility awareness with the entirely discredited rhythm method, with which it has nothing in common – “it was humiliating and made me even angrier”, Weschler says. With no other options, she set up fertility awareness seminars for couples in her living room in the late 1980s, then wrote TCOYF.
A tidal wave of responses came from thousands of women from all over the world, who flooded (and still flood) Weschler’s PO Box with letters – “I can’t even count how many”, she says, “all of them saying ‘This book has changed my life – why wasn’t I taught this stuff as a teenager, instead of whether to wear sanitary pads with wings or not?’’’.
Women who read the book felt cheated to discover that they had been taking the pill with all its side effects for years without knowing that, by charting, they could reasonably safely have sex at infertile times of the month. And that they had been trying to get pregnant without taking into account, for instance, that they had an abnormally short luteal phase which didn’t allow for implantation. Thus, that they weren’t producing enough fertile cervical mucus to allow semen to travel towards the egg. Or that they weren’t ovulating at all – facts which charting clearly shows.
Yet in both the UK and US, many doctors still don’t take fertility awareness seriously – or are even uneducated enough to believe that every woman ovulates on day 14 of her cycle. The official advice for conception from the NHS website, indeed, is to have sex throughout the month, with no need to time intercourse to ovulation (which, it says, ‘usually happens about 14 days after the first day of your last period’). Given that many women ovulate early or late, and know thanks to charting or ovulation tests when they are fertile, this advice seems dismissive and dumbed down.
“Doctors insult women who chart to get pregnant by rolling their eyes,” notes Weschler. “Yet no doctor can know a woman’s body better than she does.”
The charting pioneer, who lives in Seattle, believes that it’s still the case that not enough of us are fertility-aware, and this could well be at the root of struggles to conceive, ironically despite all the high-tech options now on offer. The low-tech, DIY methods of fertility charting are, Weschler feels, by contrast a simple and reliable knowledge base. “Of all of the fertility treatments developed in the past few decades, IVF has undoubtedly helped more couples than any other, which is extraordinary. But its appeal as the end-all, be-all, is also insidious,” she says.
“I have major concerns about women being put through this incredibly expensive and invasive procedure when they have not been taught the most fundamental information necessary to achieve pregnancy: the Fertility Awareness Method. By charting their cycles, they may be able to conceive on their own by simply learning how to identify their most fertile phase, or potential problems that can be easily rectified before moving onto something as invasive as IVF.”
So at what point should fertility charting take second place to medical treatment like IVF? “If a couple is officially diagnosed with a physical problem such as blocked tubes, then no amount of charting is going to help them to conceive,” says Weschler. “But in most other cases, charting works beautifully in conjunction with fertility treatments to help the couple take control of their medical management, rather than feeling like it is all being done to them.
“Ultimately, if a couple has actively timed intercourse perfectly for at least 4-6 cycles (for women 35 and over) or 6-8 cycles (for women younger than 35), then it is time to seek medical treatment. But the operative phrase here is ‘timed perfectly’. That means that they know her cycle so well that they know if she is ovulating altogether and they have consistently timed intercourse around ovulation.”
Some women can’t be bothered with charting (“It just makes me think ‘maths’’’, says Sophie, a 32-year-old photographer, in horror), and the average man would rather eat his own fist than check out his wife’s chart. But the practice appeals enormously to women who like to have a plan.
Still, taking your temperature can too easily become the focal point of each day. You irrationally find yourself looking at your chart every few hours in case it tells you you’re pregnant, or worrying over signs and symptoms.
Weschler stresses that charting should be about seeing “the big picture, not obsessing over one single temperature or letting your life get consumed by minutiae.” Still merrily ovulating, and charting on paper, she sees charting, when done right, as a worthy object of one’s attention and pride. “I’ve been charting 28 years and my charts are a thing of beauty – I love showing them to people! Seeing the patterns of what a woman’s body does is a fascinating privilege. Still, at a certain point, you do have to get on with everyday life.”
So if she could give one piece of advice to a couple wanting a baby, what would it be? “It would be to focus on her cervical fluid,” says Weschler. “She should try to have intercourse every day that she has wet, slippery cervical fluid at her vaginal opening – or every other day if the man’s sperm count is low.”
Of course, fertility awareness doesn’t end with pregnancy achievement. It is an invaluable tool for women dealing with troublesome or irregular periods, PMS or menopause, and can be used as a form of natural birth control. Weschler’s second book, Cycle Savvy, educates teenage girls about the female reproductive system.
Hopefully, with her influence, the next generation of women will grow up with a greater understanding of their bodies.