When we released our documentary “The Business of Being Born” in 2008, it would have blown us away to know that eight years later we would be taking a tour of the maternity ward at Henrico Doctor’s Hospital in Richmond, VA with an amazing midwife named Amber Price. In response to the growing trend of women seeking more personalized birth options, the hospital had shrewdly recruited Price to restructure their entire approach to labor and delivery. As we toured the ward, one gushing new mother told us how she had only met Price in the final stages of labor, after her doctor was called away to an emergency cesarean.  Having been told that she would definitely require an episiotomy, she gave the midwife permission to perform the procedure but Price merely smiled and said, “Oh no, we don’t cut women here,” before calmly coaching her through the delivery. The young mother felt so respected and empowered by her care, it was clear she would be sharing her positive birth story far and wide.  Not too long ago it was unthinkable that midwives could actually be as good for business as they are for normal birth, yet there we were in Richmond witnessing a movement come to fruition.   

“The Business of Being Born” was originally inspired by Ricki’s simple desire to create the film that she wished she had seen before giving birth for the first time. Knowledge is power, but when it comes to vaginas, uteruses and ovaries we often find that knowledge can become buried under layers of fear, oppression, shame and the agendas of those institutions who stand to profit from women remaining “illiterate” about their bodies and their fertility. In these days of “body positive” and “sex positive” activism, we noticed that when it came to women’s reproductive health issues the evolution of ideas seemed slower. With our latest project, “Sweetening the Pill,” we turn our attention from birth to birth control, from the care of women during pregnancy and birth, to the care women receive during the larger part of their lives, when they’re trying to avoid pregnancy. Again we find ourselves inspired by the personal stories of women who wish they knew more about their bodies and their choices before making important reproductive health decisions with lasting effects. This project is riding the wave of the pro-period movement that is encouraging body literacy.

In the final month of last year, NPR declared 2015 “the year of the period” pointing to social media campaigns like #PeriodsAreNotAnInsult and the viral celebration of musician Kiran Ghandi’s choice to “free bleed” while running the London Marathon as indicators that the once taboo topic had entered the mainstream. Although this might have appeared hyperbolic to some, it’s hard to deny that the intersection of key menstruation moments has brought about this burgeoning pro-period movement. Long overdue and with much still to be done, this movement appears to have no intention of stopping its flow from small trickle to flooding the cultural landscape.

If in 2015 the focus was on bringing periods out into the open, allowing women to show their blood like poet Rupi Kaur on Instagram and share their stories with Tracy Clayton’s #livetweetyourperiod hashtag, 2016 will be the year that this new honesty shines a light on where our culture holds anti-period practices – that fear, shame, oppression and agenda, again – and how this affects women’s health and healthcare. Clayton asked for “communal commiseration” and now it seems that women are asking if it’s acceptable that many of us experience periods as something to commiserate over – as painful, difficult and life-stopping. High-profile and highly discussed – Lena Dunham publicly announced her need for a break from work as the result of endometriosis. The movement has not only brought periods out into the open, it has revealed the issue of period problems.

In this Women’s History Month, we see this growing new women’s health movement as a reflection of the original, spearheaded by Barbara Seaman in the ‘60s and ‘70s. It’s a movement formed by consciousness-raising groups (now hosted online instead of in homes), feminist organizations, patient advocacy groups, independent researchers, naturopaths, health coaches, and, as a new addition – technology start-ups. The origins of that original women’s health movement can be found in Seaman’s suspicion of the over-medicalization of women’s bodies –  the medications and medical treatments she believed were developed to deal with the perceived “disease of being female,” the medical establishment’s one-size-fits-all approach, and the lack of informed consent for all stages of well women’s lives – from menstruation to pregnancy to birth to menopause. About the then newly released birth control pill, Seaman wrote her first book, “The Doctor’s Case Against the Pill,” which became the instigator for an investigation into the safety and side effects, and then the reason for the Nelson Pill Hearings in 1970.

Today, women are once again questioning the prescription of the birth control pill for any and all so-called “women’s problems” as well as the lack of research into women’s reproductive health that has held back the development of effective solutions beyond the Pill. Taking on the grassroots methodology of feminist pioneers like Gloria Steinem, The Fifth Vital Sign project, headed up by New York-based doula Emily Varnam and nurse Kelsey Knight, kicks off a 3 month-long tour of the US this week, with the aim to provide free classes in contraceptive options, menstrual cycle awareness and charting, and menstrual hygiene products to anyone who needs this knowledge. Varnam and Knight hope these classes will allow women to “feel more secure, safe, and connected to their bodies.”

For some years, menstruation activists have argued for the medical necessity of seeing our periods as “the fifth vital sign” to be monitored alongside blood pressure and heart rate. If this were standard practice amongst young women and their healthcare providers, as it was prior to blanket prescription of oral contraceptives from teen years onwards, not only would we know more about reproductive health issues, but also have the possibility of early and successful treatment.

This view of the menstrual cycle has found its own terminology in the movement as “fertility awareness” and “body literacy.” Just as women in the pro-period movement are choosing Thinx pants, cloth pads, organic cotton tampons and menstrual cups over commercially mainstream femcare products with questionable safety and side effects, they are also thinking critically about their birth control choices. The birth control pill suppresses the menstrual cycle, replacing it with a stream of synthetic hormones and producing “withdrawal bleeds” as opposed to periods. These synthetic hormones also block our body’s own hormone production, as a consequence impacting our metabolic, endocrine and immune systems. Research has shown this disruption has an affect that is vast and varied – including changing your choice of partner, your psychological state, your brain development and your overall physical health. Our relationship to our periods, to our bodies, is inextricably linked to the birth control pill.

The popularity of the Pill developed in conjunction with the proliferation of anti-period messaging. The creation of the monthly bleed break to simulate the menstrual cycle gradually evolved into a propagated belief that women don’t “need” real periods, even in the face of the health recommendations of the American Congress of Obstetricians and Gynecologists.

Women are now seeking alternative to hormonal birth control for treating reproductive health issues like PCOS, endometriosis, cramps and heavy bleeding long term and finding solutions in the holistic health training of naturopaths, online video courses and Skype consultations, private Facebook support groups and in using new technologies like cycle-tracking apps and devices.

The technology industry has stepped up where the pharmaceutical industry has failed to offer anything more than variations in delivery of the same synthetic hormone-based treatments. Apps such as Kindara and Clue provide the opportunity for women to monitor their periods, their symptoms, and their sex lives. Women can share this detailed information with their healthcare provider to assist with diagnosis and treatment. They are also utilizing their data, basal body temperature and cervical fluid changes, to practice the Fertility Awareness Method for planning or preventing pregnancy. Medically-certified fertility computers like Lady-Comp, and the company’s latest upgrade Daysy, are helping women to take control of their health and also get their fertility status at a glance (green light: infertile day, red light: fertile day), with a hassle-free efficiency and simplicity that rivals popping the Pill.

With a body literacy sourced in menstrual cycle awareness, women can better make fully informed decisions about their choice of birth control and their reproductive health as a whole. The more they know about their cycles through fertility awareness, the better equipped they are to avoid unplanned pregnancies and plan wanted pregnancies, a skill that becomes more essential with every new closure of a women’s health clinic. As the home-diagnostics industry gains momentum, fertility monitoring technology is providing women who have experienced misdiagnosis and misdirection at the hands of their healthcare providers. As research shows, establishment healthcare providers are prone to put women’s physical pain down to psychological distress and class their symptoms as psychosomatic. Plus, all the pooled data from fertility tracking apps and devices may provide answers to reproductive health issues, like endometriosis, that are still considered to have no known cause or cure.

And it doesn’t stop there – in the years since the release of “Sweetening the Pill” (the book that originally inspired our documentary) when author Holly Grigg-Spall discussed the growing interest in the menstrual cycle as a life coaching tool, the concept has taken hold in the mainstream with Dr. Julie Holland’s book “Moody Bitches” arguing for an acceptance of women’s inherent changeability in the workplace and Thinx CEO Miki Agrawal advocating for mapping our work and personal lives around to our menstrual cycle phases (the ovulation phase is the best time for giving a presentation, the luteal phase is the best time for doing your taxes, the follicular phase is the best time to learn a new skill – as outlined in Alisa Vitti’s “WomanCode” and Gabrielle Lichterman’s “Hormonology”). Women are starting to see their menstrual cycle as having the potential to better their lives – both personal and professional, rather than as an obstacle to their success. They are re-examining their assumptions about their cyclical nature through the lens of new awareness of the anti-period culture.  In fact, this month sees the launch of Zahra Haji’s social media campaign #NotPsychoPeriod which aims to challenge the view of women as “hormonal” and cultural beliefs around PMS.

Just as “The Business of Being Born” inspired many women to investigate their choices, take control of their birth experience, and even become doulas and midwives themselves, “Sweetening the Pill”  seeks to inspire women to seize power over their periods through body literacy. Finding initial funding via a successful grassroots Kickstarter campaign last year, this documentary is coming in with the tide of period positivity, towards its 2017 release. This new project is already inspiring some to meet the growing need for more options, more self-knowledge, and more agency. We’ve already seen the development of a whole new category of doula – a birth control doula. We can only imagine where, over the coming years, this movement might take us.

 

ABOUT THE AUTHORS:

Ricki Lake

Emmy Award-winning television host Ricki Lake is a pop culture icon who has built a career on her graciously candid sensibility and her authentic, relatable nature. At the age of 24, Lake became one of the youngest daily talk show hosts in history with the debut of “The Ricki Lake Show.” After 11 successful seasons, “The Ricki Lake Show” wrapped in 2005 but returned in 2012, garnering Lake the Emmy for Outstanding Talk Show Host. In recent years, she has channeled her nurturing spirit and drive for social change into passion projects that are altering the way society views birth, breastfeeding, childhood obesity and birth control. Lake’s legacy and perhaps her greatest love is her role as independent filmmaker, launched with her 2008 documentary, “The Business of Being Born” and 2011 follow-up series “More Business of Being Born.”  Under their joint venture BOBB Films, Lake and partner Abby Epstein served as Executive Producers of the 2014 documentary “Breastmilk” and the upcoming, “The Mama Sherpas.” BOBB Films is also in production on two new feature documentaries: “Weed the People” and “Sweetening the Pill.”

Abby Epstein

Abby Epstein produced and directed the celebrated documentary “The Business of Being Born,” with her longtime producing partner, Ricki Lake. The success of the film inspired Abby and Ricki’s book “Your Best Birth,” and their follow-up DVD series “More Business of Being Born” was released in 2011. Abby made her film directing debut at the 2004 Sundance Film Festival with the documentary, “Until the Violence Stops” which premiered on Lifetime Television and received an Emmy and a Gracie Allen Award. Under their joint venture BOBB Films, Abby and Ricki served as Executive Producers of the 2014 documentary “Breastmilk,” the upcoming “The Mama Sherpas,” and are in production on two new films: “Weed the People” and “Sweetening the Pill.” Prior to her film work Abby directed theater, helming National Tours and international premieres of RENT and “The Vagina Monologues.”

Holly Grigg-Spall

Holly Grigg-Spall is the author of “Sweetening the Pill: Or How We Got Hooked On Hormonal Birth Control” (Zero Books, 2013). Her work on women’s health issues has featured in Marie Claire, Elle, Cosmopolitan, New York magazine, the Sunday Times, the Guardian, the Independent, the Washington Post and on BBC and CBC radio, amongst others. She also writes weekly for LadyClever.com. Holly is currently working on her next book.