Correction to This Article
A March 20 Health article incorrectly identified the brother with whom health educator Toni Weschler collaborates on her books. It is law librarian Raymond Weschler, not New Yorker writer Lawrence Weschler.
Girls' Fertility Chartbook Stirs Debate

By Maia Szalavitz
Special to The Washington Post
Tuesday, March 20, 2007

Should teenage girls be taught to recognize the physical signs that indicate when they are most likely to become pregnant? Health educator Toni Weschler -- author of the 1995 bestseller "Taking Charge of Your Fertility" -- thinks so, rallied by hundreds of letters from women who read her book later in life and wished they had had such information earlier.

Consequently, Weschler has published a version for teens. Titled "Cycle Savvy: The Smart Teen's Guide to the Mysteries of Her Body" (HarperCollins), the more recent work has sparked controversy -- and not just among supporters of abstinence-only education. Some comprehensive sex education advocates are asking: Is this too much information, too soon?

"You can't imagine how challenging it was to do in a way that respected the intelligence of teens," Weschler says. "All I can say is, I will never be a politician."

In fact, Weschler -- who collaborates on her books with her brother, New Yorker writer Lawrence Weschler -- argued fiercely with him over just how much information to include.

He wanted to feature the specific rules that show how women can chart their waking temperatures, cervical fluid and cervical position to avoid or achieve pregnancy. But she argued that teenagers weren't yet responsible enough to follow those rules.

Ultimately, over her brother's objections, the book wound up detailing how teens can determine their most fertile days -- but not telling them when sex carries little pregnancy risk. It does note that there's a way to use charting for birth control but says that this should only be done by adults and stresses that adolescents should never have unprotected sex.

Unlike the notoriously failure-prone rhythm method, which does not take a woman's individual cycles and fertility signs into account, fertility charting is highly effective. Research published online last month by the journal Human Reproduction finds that for women who faithfully follow fertility-awareness rules, it is only slightly less effective than the pill. So how do mothers, teenage girls and those concerned with sex education feel about "Cycle Savvy"? Lisa VanDercar, 43, director of development at a charter school in Boise, Idaho, has two daughters, Mallory, 15, and Aubree, 13. She shared the book with them while reviewing it for her parenting blog.

"By giving them knowledge, you are treating them in a more adult way, and I think that helps them make more adult decisions," says Lisa. Aubree says she found the book "useful" and "easy to understand."

Mallory agrees, saying, "I think it would make it a lot easier to know how to avoid pregnancy. It tells you so much about how to protect yourself that it would make more sense that it would help you avoid that."

But Susan Ito, 47, a writer from Oakland, Calif., who also has two adolescent daughters, feels differently. The older of her daughters came into the world as a result of Ito's failed attempt at using charting for birth control.

She supports sex education and shared the book with her girls. But, she says, adolescents "tend to be scattershot, and I fear that some teens will skim the book, pick up something and say, 'I can do this a few times and know when I'm likely to get pregnant or not.' A little information is a dangerous thing. I think the issue in my case was that I was not as vigilant as you have to be. I feel like if I as an adult woman couldn't be that vigilant, what will a teenager do?"

As 16-year-old Molly Ito says, "Girls probably won't be studying it closely," adding that she doesn't know anyone who would make the effort to try charting. "I think it would be better for women in their 20s."

Expert reactions to the book tend to track political views on comprehensive sex education vs. the abstinence-only approach. Vanessa Cullins, vice president for medical affairs at the Planned Parenthood Federation of America, takes the line that better-informed teenagers make better decisions: "Time and again," she says, "research has shown that giving information to adolescents about reproduction and sexuality will not lead to promiscuity and will only arm teens with information that they need whenever they decide to become sexually active."

But Janice Crouse, senior fellow at Concerned Women for America's Beverly LaHaye Institute, disagrees. "I think it is inappropriate. Instead, I think that we need high ideals for our teenagers, to teach them the value of self-control because those are disciplines that you need for your whole life. Providing this type of information says that teenagers are hostages to their hormones."

Carrie Lukas of the Independent Women's Forum, author of "The Politically Incorrect Guide to Women, Sex and Feminism" (Regnery), read "Taking Charge of Your Fertility" when trying to conceive her own children. Like Weschler's many correspondents, she thought, "How did I not know this earlier?"

"Any time you give young people information, there is the potential for them to misapply that knowledge," Lukas says, "but that is not a reason to warn people away from this book."

"I think we need a totally frank and honest discussion about all aspects of fertility, whether making sure young women know the role that menstruation plays in reproductive biology or making sure that 20-somethings know the relationship between age and fertility," Lukas says, noting that many young women are unaware of just how sharply fertility declines with age and how expensive, ineffective and emotionally draining infertility treatment can be. "Cycle Savvy," she believes, could be the perfect opener for this conversation. ยท

Maia Szalavitz, a senior fellow of Stats.org, is the co-author of "The Boy Who Was Raised as a Dog and Other Stories From a Child Psychiatrist's Notebook" (Basic). Comments:health@washpost.com.

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