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As a teen and young adult the only part of fertility I had heard about was 'don't get pregnant, or a disease!' I wasn't given much information on even that, having attended a Catholic school. I had no idea my period not starting until age 16 and my irregular lengthy cycle was an issue at all.
Even as a student-nurse fertility and infertility were too specialist to be taught except generally.
Fortuitously, whilst still training, a notice about a clinical trial found its way into my hands. The notice was requesting a 'control group': someone not on hormonal contraception willing to wander around for a couple of days wearing a blood pressure cuff. It was investigating any links between high blood pressure and something I hadn't heard of: PCOS (Polycystic Ovarian Syndrome). I thought I may as well do my bit and, as part of the trial included an abdominal ultrasound, I was excited to have an opportunity to know my insides looked healthy!
All signed up I clocked up the hours with the blood pressure cuff in situ monitoring my ridiculously low blood pressure (a family trait), had a couple of blood tests and then the ultrasound. Expecting this to be the end of it I was surprised to receive a call from the Consultant asking me to pop in for a chat. Low and behold, my blood tests and scan showed exactly the opposite to what I was supposed to be part of the control group for: I had PCOS! It was apparent my ovaries weren't releasing an 'egg' - not that month anyway - and that my irregular and long cycle was classic of PCOS which could affect my chances of having a baby amongst a host of other medical issues. At the end of this 'chat' I was reminded if I wanted a family to 'get on with it sooner rather than later'!
I felt alarmed, however I also felt grateful I had this information with time enough to act on the advice.
Up until this point I hadn't given any thought to fertility being on a time line!
I went on to experience my own infertility journey deciding to try and get pregnant not long after. I went through surgery, medication trials and then 'unexplained infertility' when, even though I had begun ovulating (releasing an 'egg'), I still didn’t get pregnant. A really scary and challenging time.
During this period of medical intervention I was introduced to a nurse who taught me 'natural fertility methods'. I learnt about the anatomy and physiology and the signs the body tells you when it's fertile. I learnt about my own menstrual cycle and mine and my partner's 'combined fertility'. Again I wondered why this information was not taught at school. I found it empowering and my partner was also fascinated. It was a significant part of my feeling more in control of a part of my life that was feeling further and further away from my life plan.
Fortunately in my case, after about three years of 'trying' we were pregnant! We had a healthy baby boy and a healthy baby girl followed about two years later.
Having these experiences most definitely contributed to my specialising in womens' health care and ultimately, fertility nursing.
In addition, as my children started school I was interested to see what sexuality education was now offered. I was disappointed to find not much had changed from my day with very little time spent on the subject in younger years and the only focus in older years being avoidance of pregnancy and diseases. Also I noted this education was often in the form of 'fear tactics'.
Additionally, at this time I was given an amazing opportunity to train with the charity 'Natural Fertility NZ' as an Educator. Working with women and couples, some who were trying to conceive and others to avoid conception the feedback was always the same: "why weren't we taught this at school?!" Often times couples had no idea about age and its relation to fertility, male factor infertility, lifestyle choices and fertility and general understanding of when a woman is fertile and what the body lets you know naturally which may indicate a problem with fertility. Many women had left it far later in life to attempt to conceive than they would otherwise have done had they been aware of this information. Others expressed they thought IVF and other assisted reproductive technologies would solve any problems without realising this isn't always the case.
In response to these issues and comments I decided to spend some time researching and finally put together a programme 'Positive Puberty Plus' designed for Yr 5/6 with a follow on programme aimed at Yr 7/8. It is a holistic programme covering physiological, psychological, science and sociological age appropriate learning. It is a programme to ensure every child feels comfortable about their body and their place in the world, knowing the 'normal' ranges whilst not comparing themselves to others, understanding body functions and developing critical thinking skills and great communication. It is a programme meant to empower these students. Fertility is covered simplistically within this programme in a way they can understand and make sense of. With one school running the programme at the end of 2009 there are now 102 programmes running throughout Auckland and Northland, soon to expand to Waikato and Tauranga. Every single school who's run the programme has rebooked!
The next step was to create a programme aimed at high school level students. 'Teen Talks: Fertility Awareness and Responsibility' for Yr 10 was launched, along with a shorter class, 'Sensitive Subjects' which allows schools to pick and choice a specific topic for facilitated discussion, designed for older students (Yr 12/13). Again these programmes are holistic in nature and delivered at an age appropriate level.
The timeless topics of avoiding pregnancy and infections are vey much included (with a focus on avoiding but also on what to do if it happens without shame or blame) whilst also acknowledging the importance of everything from: really understanding 'consent', the risks of pornography, social media, what a healthy relationship is, body image and fertility wonder. Fertility wonder talks of a finite number of ova (eggs) in a women, sperm issues, how to influence quality of fertility, assisted reproductive technologies available and age versus fertility. It in no way encourages teen pregnancies. Research repeatedly suggests giving teens information is reflected in positive outcomes (less sexual contact, safer sexual contact, less infections, less teen pregnancies).
Now, as a Trainer for Natural Fertility NZ's new Educators I have an answer to their ongoing question "Do young people learn this at school?". "It's possible!"
I firmly believe a form of fertility awareness delivered through school (and University) programmes is an extremely useful tool. Infertility affects men and women, up to one in four of us. Perhaps with a little information, delivered early enough, treatment could be sought sooner reducing these statistics substantially.
In my opinion it is a subject that needs teaching age appropriately and starts with younger children receiving good sexuality education at home and at school so by the time they reach high school they already have a good relationship with their body and their place in the world with solid skills in communication and decision making.