CW: this article contains mention of infertility and pregnancy loss

When it comes to reproductive health—especially the reproductive health of people with uteruses—there’s a lot of misinformation, stigma, and shame. Few people with a uterus ever learn how their bodies work, beyond what a period is and maybe how to prevent pregnancy and STIs. Add on to that layers of oppression for people in marginalized bodies. Add on to that jokes about PMS and being hormonal. And, onto that, societal expectations around when, how, where, and with whom one is supposed to get pregnant—and you’ve got yourself a shit storm. To put it bluntly.

So what’s a human to do when they decide to get pregnant and start trying to conceive (TTC)? You have options! And also, it depends on your journey and where you are in it. We’ve compiled a list of TTC dos and don’t to help guide your way.

DO practice discernment

Before you start TTC, consider all the factors involved in pregnancy and parenting. This pretest offers a great framework for considering parenting and the various ways it will impact your life.  Consider the questions on your own as well as with your partner(s) or coparent(s), if you have them.

DON’T get tricked into thinking it’s all in your control

Much of the information that exists around menstrual health, periods, pregnancy, and conceiving takes a hyper-individualistic approach. It says, “If you just do x, y, and z, you’ll be pregnant!” Not only can add more stress to those TTC, but this approach ignores that individual behaviors are only one of many determinants of health—and its impact is only a small part of what actually impacts your health and health goals, of which pregnancy is one. 

Furthermore, such an approach ignores the experiences of people who aren’t cisgender, heterosexual, and able-bodied. The fact is: people of all identities, relationship statuses and lived experience may want to conceive. And while there’s a lot you can do (keep reading!) there’s a lot that’s outside your control—especially if you find yourself using a turkey baster, donor sperm, a surrogate, IVF, or any of the many amazing options that exist for bringing a family into the world.

DO recognize the agency you have 

Depending on your gender, sexuality, relationship status, physical ability, where you are on your conception journey, and your preferences, some of these suggestions won’t apply to you. Others might feel like a burden. Others, simply boring or undesirable. If so, ignore them! While stress doesn’t cause infertility (more on that below), it also doesn’t help you have fun in the bedroom. Consider these suggestions rather than rules. Start with whichever ones apply and pique your interest or sound fun. You can always revisit the other ones if you feel they’d be supportive.

DO learn how your body works

The menstrual cycle has four separate phases. Typically, menstruating humans can only get pregnant during the ovulatory phase—aka when the ovary releases an egg—IF viable sperm happens to be nearby. The ovulatory phase is the shortest part of the cycle, lasting only a few days out of an average 24 to 38 days. This means there are only a few days every month in which you can get pregnant. 

Read that again. 

If this comes as a surprise, you aren’t alone. Given the conservative, patriarchal, racist roots of most sex education—and the continued silencing of comprehensive programs—its not uncommon for people with uteruses to think they can get pregnant at any time. Learning about your body can provide a sense of empowerment and pride. 

Assuming it’s an option, you DON’T need to have intercourse every other day, all month long 

Need help figuring out when you’re fertile and when you aren’t? A variety of fertility awareness methods (FAMs), apps, and tools exist to help with that.  This means you have options beyond the standard advice to have sperm in the vagina—typically through penis in vagina (PIV) sex but not always—every two days. This is typically recommended by healthcare providers as an alternative to tracking your cycle and timing sex for ovulation. With a regular timed sex schedule like this, you’re bound to have sex at least once during your fertile window, without tracking.

Of course, if such a schedule sounds like an adventure—go for it! If it sounds stressful instead of fun, know that you have other options. Regardless, if you’re otherwise sexually active, continue enjoying all forms of physical intimacy—including but not limited to PIV—with yourself and your partner(s), if you have one. You just don’t need to do it all month long. 

DO go in for a checkup

A preconception checkup includes such things as checking to make sure your vaccinations are up to date, screening for sexually transmitted diseases (STDs), reviewing your medical history and medications, and discussing potential lifestyle recommendations that may support a future pregnancy. 

DON’T stress (but not for the reason you think)

Let’s get this straight: stress does not cause infertility or miscarriages for that matter. People get pregnant in all sorts of scenarios and situations, including in highly stressful and traumatic ones (e.g. 2020). To this day, half of all the pregnancies in the U.S. are unplanned. It’s safe to assume that some of those people are under tremendous amounts of stress.

What does stress do, then? It decreases libido, desire, and creativity. It makes it harder to sleep, connect, and give and receive support. It even limits the ways you move! Guess what helps you have an intimate, exciting, and fulfilling sex life? All of those things.

Managing stress can make having all forms of sex easier and more fun—which is exactly what you want and need when TTC. For ideas on managing your stress that also boost your libido, check out these sensual self care practices.

DO give yourself time

On average, it takes six months to one year to get pregnant. If it’s not happening right away, don’t freak out immediately! And, maybe refer back to the section on stress above.

Coming off hormonal birth control? It typically takes 1 to 3 months for ovulation to return depending on which method you used.  All this is to say: don’t get discouraged if you don’t get pregnant like that despite what society says.

DO keep playing and experimenting. 

For many people, exploration and trying new things are key parts of having a satisfying sex life. That need doesn’t change because you suddenly also are having timed PIV!  Continue to play with new positions and toys, explore kink, and generally mix up however you typically get it on.

DON’T limit your sexual intimacy to PIV—or whatever your go-to sex act is

One of the most common sexual ruts that any couple gets into is only having one kind of sex and having the majority, if not all, of their physical intimacy be part of that. Keep being physically and sexually intimate—cuddle, hug it out, give each other massages, self-pleasure, masturbate together, makeout, etc.—throughout the month as you’re TTC. This supports the health of your sex life and relationship, if you’re in one.

DO work on your mindset

If you’ve spent a portion of your life actively trying to avoid pregnancy (TTA) just having PIV without protection can feel unsafe! That, in turn, can stress you out, make you less likely to want to get it on, make it harder to be present during sex, and make the sex you have feel less enjoyable—all of which, in turn, can make you want to have sex less. And the circle continues.

There’s no switch that gets flipped  in your brain-body once you decide to TTC. It can take a minute to bring it on board! If you feel frustration between what you know you want—a baby—and your body’s reaction, know that this is totally normal. Rather than push it, go at the pace of the body. Use mindfulness tools in the moment and in your day-to-day life to help shift these feelings and let your body know it’s safe and you’re happy here. It’ll make all types of sex easier, more satisfying, and more fun. 

DON’T pressure yourself

If you aren’t on a timeline, or you’re in a position of not actively trying but also not actively not trying, don’t worry about timing PIV with your fertile window—just do it. Let your body learn it’s ok to enjoy PIV without birth control measures.

If you are on a timeline, be more precise with timed intercourse—aka having PIV around ovulation. Again, try not to let that be the only time you’re physically intimate but rather the cherry on top if you will. 

DO seek support—mental, physical, emotional, and communal

In other words: don’t go on this journey alone. Have someone—ideally multiple someones—you can talk about it with. If that’s a loved one, great. There are also tons of support groups on the various social media platforms and elsewhere. 

Working with a mental health provider—for individual, couples, and/or sex therapiy— can also support you in navigating whatever comes up during this period. And, let’s be real—it’s never a bad time to support your mental health! 

Lastly, if after a year of trying you have not conceived or if you have experienced pregnancy loss, it’s time to seek out the support of a healthcare provider. There are many different ways you can go about this, including but not limited to: functional dieticians who specialize in hormones, your  OB-GYN, and reproductive endocrinologists. If you do find yourself on an infertility journey, know that you aren’t alone and there is an amazing community of infertility warriors on Instagram and other social medial platforms as well as at infertility centers. 

DON’T beat yourself up

There is so much about conception and pregnancy that we still don’t know. Even the research is limited in quality and scope—there’s a lot of testing, trying, and hoping. Instead of focusing on the things that frustrate or upset you, ask yourself how you can make this journey as pleasure-filled as possible.

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