• Mon, Jan 27 - 5:00 pm ET

Whoa, Whoa, Whoa. 41% Of Women Are Total Idiots About Their Own Reproductive Health

Female genital system Illustration

Whoa, whoa, whoa. A study funded by First Response and conducted by the Yale School of Medicine found that many women are seriously, seriously ignorant about the workings of their own bodies.

Using a sample of 1000 women between the ages of 18 and 40, the study published today in Fertility and Sterility looked at reproductive knowledge, encounters with healthcare professionals and other data to paint a powerful picture of where American women stand on understanding of fertility and reproduction.

The results were shocking to me, although I guess it shows my educational and class privilege that I am so freaking amazed that 41% of women believe that their ovaries continue to make new eggs as they age, that only 10% of women seemed to be aware that intercourse needs to occur before ovulation and that 50% have never discussed reproductive healthcare with their medical provider. About a third of women in the study admitted to visiting a reproductive health care provider less than once a year or never, and about one-fourth said they had no knowledge that obesity, smoking, STDs or irregular menstrual cycles can affect fertility.

The press release doesn’t clearly discuss factors that may have affected women’s knowledge about reproductive issues, like level of education, geographic area and socioeconomic status, although it does say:

“The sample is generally representative of the US population of women in the reproductive age group by racial and ethnic distributions, and regional representation matches the US census for this age group by design. The survey included questions to assess knowledge, attitudes, beliefs, and practices regarding conception, pregnancy and reproductive health.”

And even though I sounded decidedly shame-y in my headline and in my first paragraph, I want to say, clearly, that burden for this ignorance doesn’t lie on individual women.  So much of the information we receive about women’s health and women’s bodies revolves around shame, misinformation and fear, especially when we’re younger. I mean, I’m 28 years old and I just learned about a year ago that my cervical fluid is indicative of my fertility. WHAT? How did I not know that? I’m a feminist who considers reproductive health and reproductive rights as a personal interest, and only after deciding to practice the Fertility Awareness Method of birth control did I really and truly learn about my cycle. I feel like many women, even educated ones, don’t really learn the ins and outs of fertility and how it works until they’re actually trying to get pregnant.

I assume that most of the beginning information about health and reproduction starts in school, as most schools have at least some kind of health curriculum. And honestly, how much do you remember from middle school health class? Were you seriously paying attention to the weird movie about menstruation or trying not to blush bright red because holy hell, this is awkward and I have a body and boys are in the room? Ok, maybe that was just me. But still.

Also, our society is one where many women take hormonal birth control from an early age, sometimes starting as a teenager or even tween. While I am 100% in favor of hormonal birth control for any and every woman who wants it, I know that when I started taking the pill at age 18, I didn’t give a second thought to what hormones were doing what to suppress ovulation or anything like that. I definitely didn’t have a good knowledge base of what the pill actually did to my body to make sure I didn’t get pregnant. I just thought, “Ok, this makes me not get pregnant! Great!” That is, undoubtedly, on me. That said, I know I’m not the only woman who went into her sexually-active years with that mindset, with what I thought was enough knowledge of eggs popping out and blood once a month and the crossed-finger, squinty-eyed wish that everything would just be fine until I actually wanted to have a baby. I also think that care providers could certainly be more explicit when prescribing and discussing reproductive options, especially as to what is actually happening in the body both when you are using hormonal birth control and when you’re not.

Another issue I think could be at play in the results of this study is how incredibly overworked and over-scheduled doctors are, both primary care providers and women’s health specialists. I know I’m not the only one who has sat in my gynecologist’s waiting room for an hour with a list of well-thought out questions and then experienced a quick-as-lightning Pap smear, in-and-out in fifteen minutes, with most of my questions still unanswered. How are you supposed to get information or share about the most private areas of your body and your life when you’re made to feel like a number, like a cog, like an appointment to cross off the list? That’s not necessarily the fault of individual doctors, either, but an indication of how our healthcare system is just, for the most part, not working.

This study, more than anything, clearly highlights the ways in which our healthcare system is not serving women. The results might be surprising in some ways, but not in others, because ultimately, the percentages are indicative of a world where ignorance about women’s bodies (and the desires of some people to control the bodies they seemingly don’t understand) continues to run rampant. This study shows how that ignorance really and truly affects women.

Photo: UIG via Getty Images

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  • Kheldarson

    That’s one thing I do appreciate about learning Natural Family Planning, whatever anybody’s opinion on that is. It taught me a lot about my own fertility and cycle and what affects it.

    Now, if I could get my OB/GYN to stop being an ass about the fact that that’s my preferred method, I’d be all set.

    • CW

      Get an electronic fertility monitor, and suddenly NFP becomes a whole lot more acceptable to GYN’s and nurse-midwives. It’s the same method at the core, but the high-tech nature of it seems to make health practitioners realize it ain’t their grandma’s old calendar-based Rhythm.

  • Bria

    I agree. I didn’t realize how little I really knew about my own reproductive system until I started trying to get pregnant. I had always assumed that what I learned in my health class and “sex ed” was all I really needed to know. I was very surprised at how much effort and timing is really involved in getting pregnant because I had always been told that if you have unprotected sex ever that you will for sure get pregnant!

    • AP

      Sex educators and fertility educators have different agendas, though. Sex educators want students to think that getting pregnant is super easy, to encourage them to be careful and not take risks. Fertility educators want people to know that getting pregnant is difficult and requires work, so they can do the right thing.

      That’s the crux of a lot of this misinformation: A lot of people fear that giving people full information will lead them to make bad decisions, ex: if you tell women that birth control methods can have side effects, they’ll opt to not use them. It’s a trade-off: how many women would end up with an unwanted pregnancy vs. would suffer the side effects of a form of birth control?

      I personally think the decision should be mine and mine alone to make, but people across the ideological spectrum seem to think otherwise.

    • Kat

      This, exactly. It’s a strange switch to flip, to go from actively preventing to actively trying to conceive. It took us almost a year to conceive, which surprised me, given the fact that we were timing correctly, using ovulation predictors, etc.

      But I still don’t think it’s wise to present conception to a room full of teenagers as something that can be a challenge. Teens are inherently reckless and studies have shown they believe themselves to be invincible and will beat the odds. Telling them they have a 20% chance of conceiving each month, assuming both parties are healthy, means they will hear they have an 80% of not conceiving.

      Plus, it aggravates me that sexually active people often forgo condoms because “I’m/she’s on the pill.” What about STIs? I grew up at the tail end of the AIDS crisis and by god, you wrapped that shit up. From my casual viewing of 16 And Pregnant, it seems that getting pregnant is the only fear, and nobody is concerned with contracting a disease.

  • AlexMMR

    I’ll admit a little TMI. I’m almost 39 years old and only just found out that women get smegma and we need to be more hands on than I realized in the shower to ensure proper lady bits are properly cleansed.

    So, as my daughters get older, how do I teach them that they should learn sexual joy on their own before letting a boy give it a try, how to cleanse properly, and what lady bit does what without having CPS at my door because my 12 year old overshared with her friends?

    • jj

      I was never taught how to properly cleanse – I was older than I care to admit before I figured out how important it is to clean the entire area. My mom assumed that it was just getting clean by sitting in a bath? I dunno – but I will make sure my daughter knows!

    • CW

      My mom gave me a copy of “Our Bodies, Ourselves for Teens” when I hit puberty. I won’t be giving that to my own daughters because I disagree with the values in it, but if you’re okay with a liberal POV, it is very informative. I wish I could find a Christian version that just has the health info without all the sex stuff.

    • gothicgaelicgirl

      my mom would be frowned on a lot for her style of parenting. it’s very open, very loving. she would take me to the doc when she was getting a breast check done from when I was about 14, because, breast cancer runs in our family and she wanted to show me how important it is for ALL women to get checked regularly.
      She also allowed me to come with her when she was getting a smear done when I was 18 because I was terrified at the thought of someone I wasn’t sleeping with poking around.

      She would get odd looks from the nurses but the doc was always great, he’d say there’s no better way to prepare yourself or learn than by seeing first hand.

      My mom also showed me from a very young age how to properly clean down there from when I was quite young. The way she described it is, you wash your bum gently with soap and make sure you clean carefully and properly. Do the same with your “front bottom” but make sure you get really clean.

      No way to say this delicately, she said make a “V” Victory sign with your hand and hold it level.
      Clean up with your hands that way.

      Sorry if that was TMI but in fairness, everyone has their own way. I consider myself lucky I had a mother who wasn’t shy about whipping off her bra to show me how to check for lumps or who had no problem answering any questions I had about ANYTHING. Sure, to many this is inappropriate, but that’s how I was raised and as a result of that, I do feel better off as she is so open.

    • Reba

      Properly clean it? HUH? just soap up the outside like any part of your body and never soap inside. why would that need to be taught its the same as cleaning your armpit. Never ever clean inside your vag, it’s a self cleaning oven.

  • Imalia

    Yeah, I was also shocked to hear one of my friends (in her 40′s) declare to me that birth control was pointless, “none of it’s very effective from what I hear” or to read a study that about half of women don’t know what the menopause is, or believe it’s linked to poor health and not a natural occurance. I am always truly surprised at how many people (it’s not just women) don’t seem to even know the first thing about their body, or their health at all.

  • helloshannon

    when i tried to explain my fertility problems or treatments i was often amazed how little people actually understand about how babies are made.

    • ChickenKira

      Same. IVF in my 20′s here due to stage 4 endometriosis causing extensive damage to both my fallopian tubes. “What do fallopian tubes have to do with getting pregnant?” was a common question.

  • Aimee Beff

    When I was teaching biotechnology to high school seniors, one of them asked me seriously if she could get a yeast infection from eating too much bread. I was shocked but then I realized: where would they have learned it from? Most rural sex-ed classes involve listing out every STI that exists and shouting “ABSTINENCE!!!” as kids get shoved out the door. :(

    • CW

      It’s actually not as dumb a question as it appears on the surface. A high-carb (especially high starch & sugar) diet makes it more likely for yeast to overgrow. One of the recommendations for women with frequent yeast infections is to go on a low-carb diet.

    • gothicgaelicgirl

      You seem to be the one to ask- My nan used to tell me not to eat raw mushrooms (I LOVE ‘em!) because it gives girls yeast infections.
      Any truth in this or is she being odd?

    • Alexandra

      IDK if there’s any truth to this but I’d say I eat on average about 40 raw mushrooms per week and I’ve maybe had 2 yeast infections in my life. So…….maybe an old wives tale? When I was first preggo my diner waitress chastised me for ordering mushrooms in my omelet, I freaked out, but have never read or heard anything negative about mushrooms in ANY book or from any of my doctors, so maybe it’s an old school mushroom fear thing?

    • gothicgaelicgirl

      this is after putting my mind at ease lol.
      it must be some old wives tale as you say, now I can eat raw mushrooms to my heart’s content!
      I’m the kinda weirdo who’ll buy a box, wash em and eat em

    • Alexandra

      ME TOO – I’ll add them to everything from salads to Chinese food LOVE EM!

    • CW

      Vinegar is on the “no” list, don’t remember about mushrooms (it’s been a while).

    • gothicgaelicgirl

      Ireland by any chance?
      We had crap sex ed. It consisted of a woman coming in to us and basically doing the whole- “IF YOU HAVE SEX YOU WILL GET PREGNANT! YOUR LIFE WILL BE OVER! IF YOU ARE GAY AND HAVE SEX YOU WILL DIE!”

      Yeah, with an education like that, no wonder we had seven young mothers sitting the Leaving Cert in the same year!

    • Tanya Engesser

      actually, my sister DOES tend to get yeast infections when she eats too much bread. But that is more likely to be something particular to her unique body and not universal to all women.

    • Reba

      1. that question isn’t stupid, also I was taught by my mom that sprouts will give you a yeast infection
      2. I live in Atlanta which is NOT rural by any stretch of the imagination and we were taught “abstinence only sex ed”

  • SarahJesness

    My middle and high school didn’t teach shit about reproductive system. The “sex ed” part of our health class consisted of showing us pictures of diseased genitals and telling us that condoms don’t always work so we should wait until marriage to have sex. Being a pretty active reader, (plenty of teen chick magazines supplied me with reproductive health info) I managed to get the information from other sources… Alas, my classmates weren’t in the same boat. Many didn’t know the words for most of their lady parts. Many believed stupid sex myths like “you can’t get pregnant on your first time”, and I know at least a few of the pregnant/mother teens didn’t use birth control when they conceived because they believed that.

    In 10th grade one of my friends had just learned that you lose an egg every time you have your period, and lamented that at any month, she could lose one of her best ones. I lamented with her, like, what if you wait too long and all you have left are the serial killers? Ah well, good thing I don’t want kids. But I digress.

    • gothicgaelicgirl

      “What if you wait too long and all you have left are the serial killers?”

      This actually just made my morning!

    • SarahJesness

      Cool, I had a positive impact on someone’s life today!

    • gothicgaelicgirl

      well we always joke that any child we have will be born with a beard (him) and multiple piercings (me) lol

  • Ife

    More proof that Taking Charge of Your Fertility should be required reading for every teenaged girl.

    • Emil

      Unless, like me, they think they can use it as an effective form of birth control. I read this book and got all kinds of ideas that I could prevent pregnancy by using these techniques. Best mistake I ever made but glad I did it at 33 with a committed partner and not 16.

    • http://carrie-murphy.com/ Carrie Murphy

      You can use the methods in TCOYF to prevent pregnancy. I’ve used them to avoid getting pregnant for over a year.

    • Emil

      I know, I just wouldn’t recommend the pregnancy prevention methods to the average teenage girl unless it was combined with another form of birth control.

    • Kat

      I think what she’s saying is she did get pregnant, so this comment probably doesn’t mean much…

    • CW

      TCOYF is geared towards getting pregnant. Couples who wish to avoid pregnancy should take a Natural Family Planning class through the Couple-to-Couple League because that goes into a LOT more detail.

  • Katherine Handcock

    I’m going to insert a shameless plug for the website I work for, A Mighty Girl (www.amightygirl.com), which has a variety of really awesome resources for girls to teach them about sexual health. Our Health / Wellness section has books for all ages (up to age 16) about everything from hygiene to emotions to sexuality, and some of our most popular blog posts have been about body talk (http://www.amightygirl.com/blog?p=2006 for books for girls aged 3 – 8, http://www.amightygirl.com/blog?p=2229 for books for tweens and teens, and http://www.amightygirl.com/blog?p=3281 for books and resources to help prepare girls for menstruation and understanding their cycle.)

    I wasn’t exactly a poorly educated kid on these matters – my parents were very open and provided us with tons of resources – but I’m still amazed at how much I have learned researching these blogs.

  • MamatoOne

    I knew most of this, but am confused about the ‘sex before ovulation’. All I had read and discussed pointed to sex before or after because sperm ‘hang around’ for a bit before they die and sex at the time of ovulation should work too no?

    • steampunk

      The egg lasts 12 hours if that.If you don;t catch it in that window you are SOL. Plus I read that apparently one is more likely to miscarry if the only time they had intercourse was the day of ovulation. The best time is I think 2 days before. Can’t remember where I read this study off the top of my head now.

    • Alexandra

      Yes, steampunk, I think it’s the 4-5 days before you’re fertile and then the day of is iffy….basically, the egg leaves the ovary and travels down the fallopian tube, and this is when the sperm (almost always) must meet the egg. That way, when the egg finally reaches the uterus, it’s gotten the “signal” to stick to the uterine wall and burrow in for pregnancy. If you have sex when the egg is already almost in or in the uterus, there’s not enough time for it to be impregnated and also get the signal to burrow in, so the egg can be technically fertilized but will not stick to the uterine wall. That’s my understanding, please anyone correct me if I’m wrong?

  • ChickenKira

    I had a debate with a friend, a 27yr old female friend, recently who was adamant that women urinated out of their vagina, “but where else would it come out from? It’s not like we have another hole down there”

    • JAN

      That is just sad. It reminded me of a friend in high school who believed something similar because she thought she couldn’t pee if she was wearing a tampon. Essentially she said she really needed to pee but she didn’t have any more tampons with her so she’d have to wait until she got home….this led to an anatomy discussion!

    • Reba

      haha i just posted the same thing except my friend is THIRTY.

    • Whatwhatque

      Just the other day I explained my husband the difference…he was literally like “I don’t fuck your pee hole?” It was ridiculous.

    • canaduck

      Sweet Jesus

    • Reba

      My 30 year old friend (who is a girl mind you) asked me in private if it’s okay to leave the tampon in when she pees. and that she ALWAYS has taken it out and used a new one.

  • CW

    It is possible to get pregnant up to 48 hours after ovulation. That is why the Natural Family Planning rule is to wait a full 3 days after ovulation to resume intercourse.

    • Kara

      THIS!^ My husband and I tried for a year to get pregnant. We always did the deed a few days before ovulation and the day of the positive opk. The one time we did it the day after the positive opk (I know because the opk was clearly negative so the egg was out of my ovary at that point) we got pregnant! Crazy stuff right there.

  • Gangle

    I am not surprised by any of this. I went through years of infertility treatment before falling pregnant, and my RE told me that he even thought that most GPs had very little idea about fertility health (I can back that up with all the moronic ‘medical advice’ I got from doctors over the years). I am part of an online infertility support group, and the amount of misinformation being fed to some of these women is incredible. Not long ago one of the ladies asked if it was true that an internal female orgasm was necessary to fall pregnant (she was freaking out because she was unable to orgasm during penetrative sex, let alone synchronise it with her partner), and about half a dozen women immediately replied that yes, it was important and would greatly increase her chances, so she and/or her husband should work harder at it! OMFG!! I ended up having to say that while there are a couple of whacky studies out there by scientists trying to push this theory, it has all proved to be completely inconclusive and there is no real medical proof to this insane theory at all. She had been spending all this time being shamed and shaming herself (and possibly her husband) because she was orgasming wrong. I think that there needs to be adult sex/reproductive ed. Not just one contraceptives and sexual/reproductive health (important!) but on how sex actually ‘works’ and what normal sex is/can be.

    • Alexandra

      The flip side of this dangerous thinking is that rape can’t result in pregnancy because your body will recognize that and won’t “accept” the baby. I’m embarrassed to say I know ppl who believe this. SMH.

    • Gangle

      I have heard that too. And regurgitated by so many people (and often by people – mostly men – who consider themselves ‘sex experts’ who know more about my body and sexual experience than I do). It is a dangerous precedence, and one I have also heard in infertility groups, by women who probably know more about sexual reproduction than most. I think it indicates just how badly informed we must all be on sex in general. I am sick of hearing people telling each other what a female orgasm *should* be (usually through penetrative sex with a man, and at the same time he does – because that is the only and the best way, right?!). And for that matter, what a man is supposed to do in bed. And if you haven’t experienced all these specific things then something is lacking and you need to ‘fix’ it.

  • SusannahJoy

    I always make a list of questions on my phone, and I ALWAYS double check it before leaving. I’ve also found that I have to mention “migraine with aura” at least 5 times during any discussion about birth control, because I cannot take a lot of them (no pill for me) due to those, but docs never seem to remember that (although conversely, if I go to the doc for anything else I neglect to tell them about the migraines because then they’ll go through the whole diagnostic procedure for them, and that gets really, really old).

    • SusannahJoy

      My biggest pet peeve that it seems like most women don’t understand is about the pill though. I have sooo many friends who all insist that the pill is the best, most effective birth control, and use it as their only form, and think it’s ok to skip doses. That as long as you take it almost every day, it’ll work. Unsurprisingly (to me anyway, they’re always shocked), they get pregnant, and then announce that they are just one of those rare people that birth control doesn’t work for. *bangs head into wall*

    • gothicgaelicgirl

      I’m on the Implanon implant and I had this discussion with a friend who skipped two days of the Pill. Her thinking? “Sure it stays in your system doesn’t it, like your implant?”
      NO NO NO NO NO NO NO NO NO NO NOOOOOO A THOUSAND TIMES NOOOOOO

  • gothicgaelicgirl

    I only recently heard you can still get your period for a while when you’re pregnant!!!
    Ashamed it took me 23 years to realise this!

    • Guest

      Wait, what???

    • gothicgaelicgirl

      I KNOW!!!! it seems you can still get monthly light bleeding for the first month or two!

      http://voices.yahoo.com/3-ways-pregnant-still-10158965.html

    • Unwirklich

      Hello, as the author of this link I was just jumping in to update it. Yahoo stopped hosting a large portion of content in July, 2014, including this one. It has been republished at:

      http://www.lifewithgremlins.com/2014/09/period-while-pregnant-3-ways-you-can-be.html

    • Reba

      it’s not your period, if you’re bleeding during pregnancy it’s implantation bleeding which is nothing like a period for me at least, some other problem such as having tests done and them scraping your cervix or whatever, or miscarriage. not your period.

  • http://www.twitter.com/ohladyjayne allisonjayne

    I still know women my age who think that breastfeeding is a 100% birth control method. My oldest sisters are 10.5 months apart and would like to disagree with that one. When my mom took her oldest to the doctor for her 3 month check-up, she told the doctor that she was pregnant again. “That’s impossible! You’re breastfeeding!” was his response. He realized she was right at my sister’s 6 month check-up.

    • Alexandra

      LOL so funny – just goes to show there’s A LOT doctors don’t necessarily know! Irish twins rock though :) I’m hoping for that myself! :)

    • http://www.twitter.com/ohladyjayne allisonjayne

      Heh. My mom said it was really, really hard in a lot of ways, but easier in others (my older sister potty trained the younger, for example). She left when they were still pretty little though.

  • Alexandra

    So interesting, I recently tried to tell my BF that you had to have sex BEFORE ovulation (like all of the 5 days before if you want to be comprehensive LOL) but then once ovulation occurs, the egg basically starts dying if it hasn’t been met by sperm in the tubes by then. She did not believe me and said they just have sex 5 days before and 5 days after ovulation date. No harm in that, but I was like, well maybe I’m wrong? But it’s good to hear that that was a little-known fact! (plus now I know when I got pregnant LOL)

  • CanadaGirl

    A few months ago, I had to explain to a 27 year old female coworker what a cervix is…

  • Tinyfaeri

    I’d be interested to see how much men know about their reproductive systems in a comparable study. I’d bet it isn’t a lot more than women do.

  • Honestly I’m surprised that it’s only 41%. I met some of the dumbest people in my college biology classes. (and I was a bio major, so they were all people who were supposedly interested in science and had somehow made it to the 300 level classes…)
    My doctor acted a little surprised when I mentioned something about reading the little 4-5 page booklet she gave me about Mirena because apparently many other patients aren’t the least bit curious about the foreign object being inserted into their bodies to regulate their hormones.

  • Teleute

    I remember reading something on BabyCenter about a one-year-old baby girl who kept getting UTIs and horrific infections all over her genital area. The mother didn’t understand what was going on but insisted that when the baby was first born, the hospital nurses had instructed her that it was not necessary to clean the vagina during diaper changes.

    It quickly become apparent that this moron did not know the difference between the vagina and the vulva, so she had NEVER ONCE wiped her daughter up front during a diaper change, insisting she had been told that her daughter’s genitals were self-cleaning.

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  • Reba

    I live in Atlanta and our sex-ed and health classes didn’t teach us anything other than to never have sex or our gentials would turn into a pile of dog shit stds and fall off. I had no idea how period cycles worked other than “if you see blood, put a tampon it, it’ll be every month”, had no idea when or what role ovulation had, thought that you could get pregnant any day of the month even on your period, and yeah. .. I still have friends that don’t understand it. I had no idea how to chart my ovulation until I was actively trying to not get pregnant and didn’t want hormonal birth control and then just googled it. SAD.