Common Questions about Breast/Chestfeeding & How to Support Each Other

Can I nurse after nipple piercings or breast surgery?

Nipple piercings: I’ve worked with many people who’ve had no problem breastfeeding post nipple piercings. However, it is possible piercings can affect breastfeeding, so here are a few things to keep in mind. Scar tissue from the piercing can block milk ducts, inhibiting milk flow and ultimately milk production. Milk may also come out of the holes created by the piercings, creating a faster flow for the baby (or babies). Be sure to remove any nipple jewelry before breastfeeding, in order to avoid a choking hazard.

Breast surgery: To what extent breastfeeding is affected by breast surgery depends on the type of surgery and its impact on the milk ducts and nipples. Many people have had breast biopsies or fibroadenoma removals with little to no impact on breastfeeding. While lumpectomy, breast augmentation, and reduction are risk factors for low milk production, it’s not possible to know how milk production is affected, if at all, before breastfeeding. In the case of a one-sided mastectomy, when one breast is removed, the other breast can make a substantial and even full milk supply. If someone has had a double mastectomy and cannot breastfeed, skin to skin is one important and special way to bond with the baby or babies.

Top surgery: While there is a high risk of low milk supply after top surgery, chestfeeding is still possible. Chestfeeding is about more than nutrition; it’s also about bonding. Infants can be supplemented with donor milk and/or formula while they’re chestfeeding. A supplemental nutrition system is a tube that’s attached to a bag or bottle on one end and to the chest, near the nipple, on the other, so that at the same time the infant is chestfeeding and transferring milk directly from the parent, they’re also getting supplementation they need. Read more about Trevor McDonald’s experience chestfeeding. Most recently on his blog, he wrote about trans women, inducing lactation, and breastfeeding.

In all of these situations, it’s ideal to talk with a lactation specialist. Many lactation specialists work at clinics, hospitals, WIC, and do home visits, which may be covered by insurance. Look for breastfeeding clinics and support groups, like La Leche League, as well.

What if I have small breasts?

Size doesn’t matter! Breast size is related to fatty tissue, not mammary glands, which produce milk.

How to support someone who decides to nurse

Breastfeeding isn’t really a choice unless we have support.

Following the recommendation to breastfeed exclusively for the first six months of a child’s life is not easy when you don’t have paid parent leave and need to return to work or school after six weeks (or less). Here are a few ways we can support each other.

In the US, breastfeeding in public, covered or uncovered, is a legal right. A video of a man verbally assaulting Jessie Maher for breastfeeding in public, and of the people who defended her, went viral a few years ago. If you see someone getting harassed for breastfeeding, and it feels safe for you to do so, intervene as a bystander. If you want to look up breastfeeding laws specific to your state, go here.

If you’re a brick and mortar business owner, create more private breastfeeding spaces and post signs like this in your windows. Or, as patrons, we can request storeowners do this. NYC has five nursing pods throughout the city.

Advocate for your breast pumping coworkers, especially if you’re a cis man who is less vulnerable to any pushback around the topic. Does your workplace have a private pumping room that’s not a bathroom? If not, and particularly if you work at a company with more than fifty employees, demand one, because it’s now federal law as part of the Affordable Care Act that people are given adequate work time to breast pump for up to three years. If your workplace is smaller, insist on a pumping space, and help your coworker out if they need to pump for fifteen to thirty minutes a few times throughout the day. Also, high five your colleague for simultaneously working really hard and making food for another human being with their own body!

What are the benefits of breast milk?

Breast milk is alive, meaning it’s responsive to its environment. (Side note: it also changes flavor based on what you’re eating!). When the breastfeeding parent is exposed to potentially harmful bacteria, they make antibodies, or bacteria-fighting cells. Antibodies get transferred to the baby through breast milk, providing the baby with immunity to infections. For infants, breastfeeding decreases risk of ear and respiratory infections and diarrhea. That means less sick days taken off from work or school, too. Plus, nursing can lower the risk of breast cancer and postpartum depression for the nursing parent.

Read more about the personal and public health, economic, and environmental benefits of breastfeeding here.

Touch your chest

Whether or not you can or want to breastfeed, love on your chest. Massaging your chest can increase circulation of blood and lymph fluid. Remember that breast tissue goes from the clavicle to the lower ribs and from under the armpit to the sternum, in the middle of your chest. Chest awareness is one way to get to know your normal, so that you’re better able to detect anything abnormal to tell a health care provider about. Plus, if you do nurse one day, you’ll already have a more comfortable relationship with your chest.


In November, our post on Instagram about gender inclusivity and lactation got a lot of support and a lot of violent pushback for using the term “chestfeeding.”

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In this blog post, we wanted to answer of your questions and provide more LGBTQI-affirming lactation resources.

Image from La Leche League, artist unknown

Image from La Leche League, artist unknown

“Chestfeeding” is generally considered a more gender inclusive term than “breastfeeding,” because everyone has a chest; however, it’s up to the individual to decide what term(s) feel best for them. La Leche League of USA and Canada made a joint statement on the use of the word, explaining “chestfeeding is a term used by many transmasculine and non-binary parents to describe how they feed and nurture their children from their bodies. Some prefer the term nursing instead, while others prefer breastfeeding. We use all of these words, and . . . warmly accept whatever term a family chooses for their own experiences.” Families can always be asked what term they prefer. The Department of Health in New York City has encouraged hospitals to use the term “chestfeeding” as well. The International Lactation Consultant Association also released style guidelines for written lactation resources that recognize gender diversity in lactation.

The acceptance of these terms by international lactation organizations does not justify the need to use this language. Organizations are often far behind in addressing people’s lived experiences. Frequently, these changes are the result of the hard work of LGBTQI people advocating for themselves.

LGBTQI lactation provider Alice Farrow published the article, “Lactation Support and the LGBTQI Community” in the Journal of Human Lactation in 2014. Alice begins to explain the importance of using gender-inclusive language in this interview:

“‘Misgendering people —for example referring to a birth father as “mum” or “mom” or referring to a female partner as “dad”—is erasing, hurtful, and disrespectful. A care provider is not doing a good job if their client or patient is uncomfortable, unable to listen to them, does not trust them, is afraid of them, is not intending to return for follow-up, is triggered, or is in any way damaged by the consultation or visit.

Transgender and gender nonconforming people have higher rates of suicide and mental illness and lower rates of health than the general population (not due to their gender, but due to society’s prejudice). This is a serious health equity issue. Knowledge of gender-inclusive language and a willingness to adopt gender-inclusive language will improve access to your care and improve the quality and appropriateness of the care you provide.’”

If you are looking for LGBTQI affirming lactation resources, here are a few we recommend. Please let us know if you have any resources you’d like to be added to this list.

Milk Junkies: Breastfeeding and Parenting From a Transgender Perspective is an amazing blog by Trevor McDonald. Trevor also started a Facebook support group, called “Birthing and Breast or Chestfeeding Trans People and Allies.” Trevor wrote a blog post, “Transgender parents and chest/breastfeeding” for Kelly Mom that goes into language and lactation information for transgender women and men.

Cis people, if you feel bothered by the term “chestfeeding,” we invite you to breathe, research experiences outside of your own, listen, and reflect on why you feel the way you do. We have a lot of work to do in dismantling white supremacy and the gender binary, and it’s a constant practice of learning and unlearning.

Conversations in Consent

Consent comes from the Latin consentire; con means together, and sentire means to feel. At its core, consent is to feel together. In the past 25 years, the cultural definition of consent has expanded, moving toward the essence of consent. While the legal definition of consent in the US, for the most part, is still limited to “no means no,” universities, feminists, and activists have pushed it further, toward affirmative consent and welcomeness.

In 1991, Antioche College implemented the first affirmative consent policy, the Sexual Offense Prevention Policy, on their campus. The policy defines consent as “verbally asking and verbally giving or denying consent for all levels of sexual behavior” and for the escalation of any sexual behavior. Two decades later, California and New York signed affirmative consent policies into law to hold colleges and universities to a higher standard for ensuring safety on campus. Also, affirmative consent education is required in California high schools by January, 2018. Affirmative consent is the standard on many campuses nationwide, but that doesn’t mean it’s the standard in many bedrooms yet.

Consent is

  1. Freely given: It’s not coerced or gotten through persistence or manipulation.

  2. Enthusiastic

  3. Specific

  4. Informed

  5. Reversible

  6. Active: The absence of a “no” does not mean “yes.” Silence and lack of resistance do not mean “yes.”

  7. Ongoing

  8. Clear: If you’re not sure, clarify with your partner(s). “Is ____ okay?”

Sex educator, Corinne Kai, describes what the above adjectives look like in-practice and offers phrases to use and listen for assure a mutually consensual interaction. Also, you can watch this soft-core consent porn

Zine by:  @corinne.kai  / artwork by:  @sydney.schav

Zine by: @corinne.kai / artwork by: @sydney.schav

Zine by:  @corinne.kai  / artwork by:  @sydney.schav

Zine by: @corinne.kai / artwork by: @sydney.schav

Currently, the difference between Antioche’s policy and that of many other universities is the inclusion of non-verbal consent. According to SUNY, for example, consent can be given through actions as long as the actions communicate clear willingness to engage in a sexual activity. Corinne also lists possible signs of non-verbal consent and no consent.

Zine by:  @corinne.kai  / artwork by:  @sydney.schav

Zine by: @corinne.kai / artwork by: @sydney.schav

It’s redundant but important to state: there is no such thing as implied consent. Certain societal expectations have been normalized. For example, “if you are hanging out naked with a man, it’s safe to assume he is going to try to have sex with you,” or if you go home with someone, there’s an assumption you’re going to hook up. Those societal norms do not equate to consent, and can often lead to victim blaming. “What did you expect? You should have known better.” Persistence has also been normalized as “game,” when it’s actually predatory. If someone says no or expresses doubt or disinterest non-verbally or verbally, sexual activity stops and only begins again if all parties express affirmative consent that is freely given, active, enthusiastic, clear, specific, and informed. Of course, consent is reversible and ongoing as well. These normalized behaviors and assumptions are worth naming, examining, and tearing down.

Welcomeness goes one step further than affirmative consent in its emphasis on mutuality and feelings. In practice, each person is simultaneously asking for and receiving consent. The idea of a “giver” and a “receiver” is questioned, and the idea that everyone involved is simultaneously giving and receiving in some way is raised up. Welcomeness also acknowledges how the encounter feels to everyone, emotionally and physically. In other words, Is this action welcomed, or do you welcome this action?  

Yes, it can feel vulnerable to be so honest with what you want, especially when you might already be feeling vulnerable. As Brene Brown says, the only way to address deep shame is through vulnerability. The only way we can make ourselves vulnerable is if we feel safe, and that means taking responsibility for unearned privilege. Unearned privilege--through whiteness, cis-maleness, financial wealth etc.--is associated with unearned safety. Those with greater privilege and safety have greater responsibility to address inequitable power dynamics, in and outside the bedroom.

As Emily wrote, “It takes bravery to be radically vulnerable. The reward is to be loved and love in the absence of power,” or to have equitable sex. (Of course, sometimes a power dynamic is part of sexual play, but it’s only consensual if the power dynamic is acknowledged.)

Just like the definition of consent has changed over time, so has the societal definition of assault. Lindy West writes, “sexual norms have changed . . . the line between seduction and coercion has shifted, and shifted quickly, over the past few years (the past few months, even).” This is why some people may read Grace’s reflection on her experience with Aziz as assault and dispute her claim. Sexual assault is sexual contact or behavior that occurs without explicit consent, and, culturally, the activities that fall beneath that definition are changing. We can recognize not all forms of sexual misconduct and violence are the same. We can and need to make room to discuss and address all actions that contribute to rape culture.

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Behind this changing definition of assault lies fear of broader criminalization. “The insidious attempt by some women to criminalize awkward, gross and entitled sex takes women back to the days of smelling salts and fainting couches,” wrote Bari Weiss in the New York Times. While I didn’t read Grace (or hear anyone else, for that matter) suggest Aziz’s actions be criminalized, we do need to hold individuals accountable. Accountability is not synonymous with criminalization, and that’s where Weiss likely got it wrong. We are so governed by a criminal justice system, we don’t even know how to work outside of that. The criminal system doesn’t lead to healing and this is where we need to step back and ask, “Do we want to be right or do we want to heal?”

At a recent talk with Patrisse Khan-Cullors, co-founder of Black Lives Matter, when speaking about prison abolition, she said, “There is another way of being in relationship to one another and there’s another way to deal with harm and conflict. We’re always going to have harm and conflict. How do we decide to deal with it? I feel always most inspired when I think about transformative and restorative justice and a world without policing and prison. . . Prison abolition isn’t about getting rid of something. It’s about imaging something else, and it’s not just about replacing. We want to build something new, sometimes something we’ve seen before and sometimes something we’ve never seen before.”

This is about centering the needs and stories of people who have experienced sexual violence and about building something new, together. One example of this is Corinne Kai’s and Olivia Ahn’s “An Accountability Structures Toolkit.” They created an alternative to the present situation, in which “individuals impacted by harm in their communities are left feeling isolated and overwhelmed to recover by themselves and pressured to seek justice in proscriptive ways.” The toolkit provides communities with a guide to supporting survivors and victims of harm, with the ultimate goal of interpersonal restoration and resilience. They provide guidance on how to choose allies for the person harmed and the person who did harm, how to set goals, how to safety plan, and how to track progress. Corinne and Olivia have generously provided their toolkit here. Incite also has created resources specifically for community accountability for women of color and their work can be found here.

When people are unable to get out of the idea of winners and losers, right and wrong, good and bad it tells me that the commitment to our current system is bigger than our commitment to change. These binaries, however you apply them are a commitment to white supremacy and to the patriarchy. No human is disposable, so how are we going to move forward with each other, in community and in the knowledge that each person has value but that behaviours must change and patterns and beliefs must be unlearned? Our conversation and hopes go way beyond consent. What we want to imagine together is:  what does sexual equity look like to you?

We will be hosting a consent workshop for heterosexual, cismen on February 18 in Brooklyn and a dating support group. More details to come.  


5VS News Roundup

We will regularly roundup current articles that have stayed on our minds to share with you all. If there are any articles, podcasts, videos, or content that you want to add to our next round-up, please email us at

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  • This is a critical time for many immigrants, and we MUST continue to put pressure on our representatives to pass a Clean Dream Act.
  • If you don't know about the Clean Dream Act, read more here: "The Dream Act of 2017 is bipartisan legislation that provides a path to citizenship for more than 2 million immigrant youth and young adults who came to the U.S. as kids. It would include the 800,000 DACA recipients who have been left in limbo after the program was rescinded on September 5, 2017. The legislation should be clean and avoid conditioning solutions for Dreamers on harsh and unnecessary policies that target other members of our immigrant communities. A clean Dream Act would not include: Funding for a border wall and increased border security that further militarizes border communities, funding for increased interior enforcement, which would involve more raids and deportations, funding for more immigration detention centers, or mandatory use of E-Verify, the federal government’s employment verification program."-ACLU
  • The most important thing: Listen to and follow undocumented folks. Follow these Instagram accounts for ways to support DREAMers and get information from those affected: @undocumedia @polibeats @undocuqueer @undocublack @undo_cu @unitedwedream @nysylc @askangy. Here's an interview with America's Voice communications director Juan Escalante:
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  • "Mr. McConnell reiterated a pledge he offered on Sunday night that he intended for the Senate to take up immigration legislation in February if the issue has not been resolved by then. A major question as senators seek to end the shutdown is what kind of commitment Mr. McConnell is willing to make regarding the consideration of legislation for the young immigrants, a central issue in the current impasse."
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When They Call You a Terrorist: Black Lives Matter Memoir came out this week!

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  • The notion of affirmative consent did not fall from space in October 2017 to confound well-meaning but bumbling men; it was built, loudly and painstakingly and in public, at great personal cost to its proponents, over decades. If you’re fretting about the perceived overreach of #MeToo, maybe start by examining the ways you’ve upheld the stigmatization of feminism.”

Eco Friendly Period Options: Here’s What you Need to Know

By Jackie Bolen

Let’s talk periods. I know that’s not a subject that’s brought up too often, but it’s an important one that should be discussed more.

Don’t make the same mistake I did.

I didn’t even know there were eco friendly period options until I was in my early 30’s. I used to just go to the store and pick up my favourite brands of disposable pads and tampons and not have a second thought about it. Maybe menstrual cups were on the shelves all those years that I did that? Maybe they weren’t.

In case you haven’t heard about the environmentally friendly, menstrual care awesome, I’m here to tell you about the three most popular options. But first, I’ll give some information about why pads and tampons don’t make the best choice.

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What’s in My Tampon?!

Here’s something you might not know...

Pads and tampons contain trace amounts of pesticides and chemicals from the cotton, as well as the manufacturing process (bleaching agents are particularly bad). Manufacturing companies aren’t required to disclose what’s in their products because they’re classified as “medical devices” by the FDA. We hope that they’ll just disclose what’s in them anyway, but that doesn’t seem likely to happen anytime soon.

Although there isn’t a lot of this stuff in pads or tampons, repeated exposure to it is thought to have some serious side effects, including possibly cancer.

Scary stuff. What’s even scarier is how unaware people are of this problem.

The Plastic Problem

People will use between 11,000 and 16,000 tampons over the course of a lifetime. And of course, you have to add pads and panty-liners on top of that. It’s a lot of waste that goes directly into the landfill because these products, by their nature, can’t really be recycled effectively.

Pads are in large part plastic. This doesn’t biodegrade and will be still be hanging around the landfill in hundreds of years from now. Even OB tampons, without an applicator, come wrapped in plastic.

The Wasting Money Thing

The final problem with disposable menstrual care products is how much they cost. Most people spend, at minimum, $5 per month. If you have a heavy and/or long period, this number can double, or even triple. I know that I get some serious sticker shock every single time I walk down that aisle in the drugstore.

Disposables can easily add up to thousands of dollars over a lifetime. Things get worse. Depending on where you live, there are taxes on menstrual care products, ranging from 3% to 10% This isn’t right. Thankfully, there are some alternative options.

Where a menstrual cup sits in the body

Where a menstrual cup sits in the body

Eco Consumer Option #1: Menstrual Cups

A menstrual cup is an eco friendly period option that can replace tampons. It’s a bell-shaped cylinder, usually made of medical grade silicone that’s inserted into the vaginal canal. The best part about menstrual cups is that they’re reusable, and with proper care and cleaning, can last for up to 10 years.

In terms of health, there are a lot of reasons why you might make the switch. There has only been one reported case of Toxic Shock Syndrome (TSS) being caused by a cup. There are thousands of cases associated with tampons.

The best cups (avoid the cheap ones from China) are made from top-quality materials that won’t leach chemicals into your bloodstream. It really is possible to have a chemical free period experience!

Although the up-front cost of menstrual cups is higher at around $30 USD, you’ll come out ahead in only a few months when compared to disposables. Every single time I put mine in, I feel good about NOT wasting money on pads and tampons.

Finally, menstrual cups are pretty amazing for the environment. Think about this. If a menstrual cup last for 10 years, that’s four of them over a lifetime of menstruating. Compare that to thousands of pads and tampons. It’s a game changer for our Earth. Imagine the possibilities if every menstruating person had one?

It’s not easy to choose your first menstrual cup because there are so many options. Check out Reusable Menstrual Cups for unbiased reviews of the most popular cups available today.

Check out the cute polka dot cloth menstrual pad!

Check out the cute polka dot cloth menstrual pad!

Eco Consumer Option #2: Cloth Menstrual Pads

The next eco consumer option to consider is cloth menstrual pads. They are pretty similar to their disposable counterparts, but are made mostly from natural materials including bamboo, charcoal and cotton. Although they’re slightly less absorbent than disposables, they still work quite well.

Best of all, cloth pads have the same money-saving potential as menstrual cups. They also are far less harmful for our Earth than disposable pads, which are mostly plastic. After washing them, it’s another way to have a chemical-free period experience.

Try them out for yourself, but a small word of caution. They do have a tendency to shift around a bit more than disposable pads. So keep a box of those in your cupboard for days you’re planning on hiking, or running a marathon while you have your period, okay? For the regular times? Cloth menstrual pads work just fine.

Eco Consumer Option #3: Organic Disposables

The last option to consider besides regular pads or tampons is the organic version of these same products, which usually contain no plastic. The reasons you might consider buying them is because they’re biodegradable and contain fewer chemicals. They don’t, however, reduce the amount of overall waste going to the landfill like menstrual cups or reusable cloth pads.

The biggest negative to organic pads or tampons is the price. They cost 20-50% more than the regular versions, depending on where you buy them. A quick tip: Don’t buy them at your local natural/health food store. Get them on Amazon for a far more reasonable price.

Ready to Make the Switch to an Eco Friendly Period Option?

Welcome to the club! Get ready to save yourself thousands of dollars, reduce your exposure to harmful chemicals, and cut down on waste significantly.

Sounds awesome, right? It is.

BioJackie Bolen is a tree-hugging, friend of the Earth that can often be found on top of a mountain, catching a wave, or drinking organic coffee around Vancouver, Canada. Her hope is that a reusable menstrual care  product will one day be found in the hands of every single menstruating person in the world.

5VS News Roundup

We will regularly roundup current articles that have stayed on our minds to share with you all. If there are any articles, podcasts, videos, or content that you want to add to our next round-up, please email us at CW: violence against LGBTQ and POC, maternal mortality

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  • "Six years ago, California became the first state to mandate that students be taught about the contributions of and trials faced by LGBT people in social studies classes. It remains the only state to have such a law on the books. Now, after many delays and much wrangling over the details — including a failed attempt to nix the law by conservative groups — state officials reached a milestone this November when they voted to approve the first revised K-8 textbooks to include the mandated material."
  • Read more here:
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  • "California is now the largest state in the nation to have legal and regulated recreational marijuana. . .  a lesser-known provision in the state’s new law, along with efforts in a few local jurisdictions, aims to repair some of the damage that the criminalization of marijuana has done to so many communities."
  • Proposition 64 "also authorized a new process for individuals in the state to get previous marijuana-related convictions retroactively reduced, reclassified as lesser offenses or dismissed altogether." "But relief is not automatic under the new law. Individuals who want their marijuana convictions reclassified or cleared must submit an application to a court. They may also need to hire an attorney to help them through the process."
  • "Oakland launched the nation’s first equity permit program earlier this year. It sets aside half of all medical and recreational marijuana business licenses for applications by individuals hit hardest by marijuana criminalization. . . .To qualify as an equity applicant, individuals must be an Oakland resident whose annual income is less than 80 percent of the average in the region and either have a previous marijuana conviction or have lived in over-policed areas of the city for 10 of the last 20 years. For those who qualify, the application fee is also waived. City councils in Los Angeles, San Francisco and Sacramento are also considering equity programs."
  • Read more here:
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  • "Celebrities wore all black to The Golden Globes last night to protest sexual assault and sexual harassment happening in the film/tv industry (and to a small extent, elsewhere). I was one of the few people unimpressed. It's great that celebrities donated money to Time's Up, a legal defense fund combating sexual harassment in the workplace, but the wearing of black $150,000 dresses is creating a visibility that is unrelatable, passive, and potentially more harmful than helpful."
  • Read more here:
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  • "When the school became concerned that some of the 150 students, aged 11 to 13, may not have a "dad" to join them for breakfast, Dove got an idea. She put up a notice on Facebook seeking volunteers. Her initial goal was 50. Overnight, however, she got hundreds of responses. In four days, she nearly reached 400 mentors interested in participating. Ultimately 600 men showed up to Billy Earl Dade Middle School."
  • Read more here:


5VS 2017 Highlights

2017 was an incredible year. Let’s take a look back at some #5VS highlights.

At the beginning of 2017, we continued our facilitator training we launched in November as a call to action. 50 amazing people joined us for the training, and on February 14, 2017, on the one year anniversary of #5VS, many facilitators taught 5VS classes in their respective communities, spreading vital information. Some continue to teach regularly! If you live in Austin, San Francisco, or Troy, NY, check out their 5VS facebook pages for events!

Inspired by the facilitator training, we launched Conversations in Community in August, 2017. 29 incredible people are participating (it’s still going on!). It’s a nine-month facilitator training to support people to create a reproductive health curriculum, centered in human rights, that’s specific to the needs of their communities. The program is designed to support informational learning and collective- and self-reflection around different aspects of reproductive health. Read more about why we started this program here, and look out for more online courses and trainings in April, 2018!  

In addition to creating Fifth Vital Sign programming, we had the opportunity to attend conferences and events this year! It’s so important to us to keep our knowledge current and to continue to learn and grow from others who have been doing this work before us. Let’s recap these adventures.

With Cass Bliss and @tonithetampon at the SMCR Conference

With Cass Bliss and @tonithetampon at the SMCR Conference

With Chelsea of #HappyPeriod and Rachel and Ruby of Sustainable Cycles at the SMCR Conference

With Chelsea of #HappyPeriod and Rachel and Ruby of Sustainable Cycles at the SMCR Conference

Society for Menstrual Cycle Research (SMCR) Conference in Atlanta: We really enjoyed being on a panel with some of our favorite period activists, like Chelsea VonChaz of #wearehappyperiod and Sustainable Cycles, who cycled 3,000 miles, teaching workshops along the way to be at the conference. Cass Clemmer made us all laugh with their wicked sense of humor and period positive ‘Toni the Tampon’ cartoons. We finally met Jennifer Weiss Wolf who wrote Periods Gone Public: Taking a Stand for Menstrual Equity, which we are mentioned in!

SisterSong’s Let’s Talk About Sex conference in New Orleans: This was five days of deep inspiration and magic. We had the incredible opportunity to be present for talks and workshops with Loretta Ross, Dr. Willie Parker, Charlene A. Carruthers, Jessica Byrd, M. Adams, Miski Noor, Raquel Willis, Dr. Tlaleng Mofokeng, and many, many more activists, changemakers, and teachers.

Woodhull’s Sexual Freedom Summit - Emily went to this with three amazing sex educators, (who you should all check out) Cameron Glover, Corinne Kai and Olivia Ahn. Corinne and Olivia gave a presentation called ‘Towards a New Love Ethic’ which was moving, cathartic and deeply relevant. If you see them offering it--go! Tracie Gilbert gave a presentation entitled ‘Beyond Tuskegee’ which Emily thinks about almost daily and learned a lot from.

Decolonize Birth Conference in Brooklyn: This conference felt like coming home, as the Fifth Vital Sign began in Brooklyn and among birthworkers. So many friends came together and everyone at Ancient Song Doula Services who organized and volunteered made it feel like home. We enjoyed and learned so much from talks given by Loretta Ross, Dorothy Roberts, founders of the Black Mamas Matter Alliance, Erica Hart, Fanm-Saj Boon, Farah Diaz-Tello, and Ynanna jehuty.

Michigan Network for Youth and Families (MNYF) Conference in Kalamazoo: This was our second year in a row to present “Knowledge is Power: Tools for Self Advocacy in a Reproductive Health Care Setting” at this conference. MNYF brings together people who work with runaway and homeless youth in Michigan. We met Jim, one of the program coordinators of Traverse Place, a transitional living program for young adults in Flint, when he invited us to teach there during our road trip.

Cycles and Sex with Nicole Jardim, Holly Grigg Spall, Dr. Eden Fromberg, and Tessa

Cycles and Sex with Nicole Jardim, Holly Grigg Spall, Dr. Eden Fromberg, and Tessa

Emily at Cycles and Sex's "Ugh, What are My Birth Control Options?" panel discussion

Emily at Cycles and Sex's "Ugh, What are My Birth Control Options?" panel discussion

Cycles and Sex in Brooklyn: We attended the first Cycles and Sex event in Brooklyn. Emily spoke on the “Ugh, What Are My Birth Control Options?” panel. Click here for to listen to the panel discussion!

We attended Aimee Brill’s workshop, Deconstructing Allyship and White Privilege in Birth Work. We cannot recommend this workshop enough as part of the ongoing, lived practice of addressing racism. The workshop is aimed at white people but open to all and you don’t even need to be working in birth to get a lot out of this.

Bonus: Naturopathic doctor, Lara Briden, published a second edition of one of our favorite books, Period Repair Manual, and we are mentioned in it!

Last year our tour was generously supported by the Langhart family, who lost their daughter  Erika to a double pulmonary embolism due to the Nuvaring. This year we met with four families who’ve all lost a child to hormonal birth control and had a work session in Scottsdale, Arizona. We continue to work towards ending preventable harm and death due to hormonal birth control. Be aware of the side effects of your birth control and the signs and symptoms of blood clots, as hormonal contraception containing estrogen and progestin increases risk of blood clotting. If you experience any symptoms, we invite you all to ask “could it be my birth control?” The weekend was emotional and extremely meaningful. We are grateful to know these families and to carry this message forth.

Emily’s highlight: Becoming an aunt to Nyah Soleil. Attending sistersong and decolonize birth and making new connections and friends.

Kelsey’s highlight: I am so humbled when reading all that we were able to do and be present for this year. I feel grateful for all of it. (Of course, the birth of Nyah Soleil is top of the list!)

In the spirit of moving into 2018 and setting intentions, we have chosen a word. This year our word is ‘conspiracy.’ This word literally means to breathe together. For this to be true, collective respiration, we must fight for each others right to breathe in a way that is continued, adaptive to situations and climate, and in fierce love, as if life depended on it, because it does.  

Where will we see you in 2018?

We are listing a few people to keep in your heart and to support either monetarily or by amplifying and sharing what they share in 2018. They are invaluable.

Efe Osaren

Ancient Song Doula Services

Village Birth International


Big thanks to:

Aimee Brill, Erica Bech, and Heather Mourer who provided ongoing professional support, counsel and guidance to us.


5VS Weekly News Roundup

We will regularly roundup articles that have stayed on our minds to share with you all. These are our must-read articles each week.  If there are any articles, podcasts, videos, or content that you want to add to next week's round-up, please email us at 

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  •  “According to the CDC, black mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health.”
  •  “A 2016 analysis of five years of data found that black college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women who never graduated from high school. . . It tells you that you can’t educate your way out of this problem. You can’t health-care-access your way out of this problem. There’s something inherently wrong with the system that’s not valuing the lives of black women equally to white women.”
  • “But now many social scientists and medical researchers agree, the problem isn’t race but racism.”
  • “In the more than 200 stories of African-American mothers that ProPublica and NPR have collected over the past year, the feeling of being devalued and disrespected by medical providers was a constant theme.”
  • “But it’s the discrimination that black women experience in the rest of their lives — the double-whammy of race and gender — that may ultimately be the most significant factor in poor maternal outcomes. An expanding field of research shows that the stress of being a black woman in American society can take a significant physical toll during pregnancy and childbirth.”
  • Read more here:
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We’ve been paying close attention to the discussion around net neutrality. This is important to us as internet users, as small business owners, as people who believe in social justice. This Thursday, December 14 the FCC will vote on whether or not to maintain net neutrality. Read more here:

The White House Wants to Exclusively Fund Fertility Awareness Programming?!

The White House Policy Wish List recently leaked by Crooked reveals a maniacal focus on fertility awareness methods (FAM) as the best, most tremendous sex ed strategy ever, according to Trump and his aides.  Our first reaction was to wonder how Trump knew of the scientific fertility awareness method, being as outwardly anti-science as he is. Our second was to ask, “Oh God, what does he THINK it means?”  

In March, 2016, we left on a three-month, 15,000 mile road trip across the US to teach over sixty free reproductive health classes on body literacy and how to make informed choices about contraception. We spent half an hour each class discussing fertility awareness, because it can be both birth control and an empowering tool with which to get to know your body. But you know what’s not empowering? Limited access to other forms of contraception and critical information about them. According to the Wish List, abroad "no other family planning programming for girls should be provided except fertility awareness methods." We can simultaneously claim fertility awareness for what it’s worth to each of us and reject Trump’s attack on informed choice.  

What is fertility awareness anyway? On our road trip, we met thousands of people, many of whom had never heard of it. Fertility awareness is an umbrella term for several types of methods. It’s not just another term for the rhythm method. Rhythm or calendar methods are focused on preventing or achieving pregnancy and assume most people ovulate around the same time. Modern methods acknowledge our human variation and value body literacy, in addition to fertility. While it’s unclear which type Trump’s wish list refers to, it’s highly likely, because of who’s at the table, that his version of FAM won’t include barrier methods during fertile times or a focus on knowing your body, but will include abstinence only.

In our classes, we teach the sympto-thermal method of fertility awareness. By charting basal body temperature and checking cervical fluid and positioning daily, it’s possible to identify the day of ovulation, a fertile window, anovulatory cycles, some vaginal infections or STIs, signs of hypothyroidism and polycystic ovarian syndrome, pregnancy, miscarriage, perimenopause, and more. It’s an invitation to listen to and connect with your body throughout your life. Don’t let Trump and the Christian right use a powerful tool for body literacy against us to control our bodies.

We would have loved to know about fertility awareness as adolescents. People with vaginas, when you reached puberty, how many of you knew what that fluid in your underwear was about? Did you think something was wrong? Did you wonder why it was there or where it came from? One class attendee told us about how learning to monitor her cervical fluid saved her life. When she recognized her cervical fluid was abnormal for her, she went to her OB-GYN and was diagnosed with stage 1 cervical cancer at age 25. Fortunately, It was caught early enough to be eradicated through a procedure. Through learning about fertility awareness, another attendee felt confident to transition off of a hormonal birth control method that was causing serious mental health side effects. These are examples of informed decisions that could only be made with access to information about multiple forms of contraception and knowledge of their own bodies.

So, fertility awareness can provide valuable body knowledge that is our right, and it can be used as a form of contraception that can be up to 99.6% effective at preventing pregnancy if used consistently and correctly and 74% effective if used inconsistently and incorrectly. Sweetening the Pill author Holly Grigg Spall says, "its an important precursor to informed consent on all reproductive health related decisions, including which form of contraception is best for you." But none of that is important if fertility awareness is the only option presented to adolescents, because no single contraceptive is a one-size-fits-all solution.

Informed choice is the only ethical alternative to a one-size-fits-all approach that dangerously insists all our bodies, needs, and desires are the same. This wish list not only blinds adolescents to all but one contraceptive method, it also denies them critical information about which and how to choose. To make an informed choice about birth control, we first need a comprehensive list of options. Then, it's important to know the risks and benefits of each option, their efficacy rates in preventing pregnancy and STI transmission, accessibility, affordability, and knowledge of how each method works, and our family history of blood clotting disorders. Next, we have to see if our choice physically and emotionally works for us. Many hormonal birth control options really work for people and many do not, and when they don’t, the side effects range from headaches to mood swings to death. So, do we think that championing only fertility awareness methods will fix this? No. It will further deny individuals the right to make the best decisions for their bodies. An attack on options creates an urgency to choose that can obliterate the process of an informed decision.  Our Facebook inbox is full of time-pressed questions regarding concern over continued contraception availability, and Planned Parenthood’s 900% reported increase in IUD insertion post-election is a testament to this.

We need more choices and information, not less. We know what it means for policies to impact our bodies. Don’t come for us, don’t come for our knowledge, don’t come for our choices, and don’t come for our bodies.



Your Best Fertility Ally: Fellow Fertility Warriors

By Elyse Ash

When my husband Brad and I first started our whole “Let’s Have a Baby!” project back in September 2014, I didn’t tell many people. I naively thought this would be a short-term secret and we’d reveal our pregnancy in a cute, totally viral-worthy way.

Ha. Ha. Hahahahahaha. Oh, so naive.

As this “project” began taking longer and longer, it started seeping into all the other parts of my life. Physically. Financially. Emotionally. I began turning to my friends for emotional support as the fear and anxiety surrounding my infertility started feeling way too heavy for me to carry alone. The support I got from my friends was a mixed bag. While many of them tried to be there for me, it was hard for them to truly empathize with my struggle. They had no idea what to say...

In the summer of 2016, I hit an emotional low after our first cycle of IVF failed. While the cycle yielded two blastocysts, after genetic testing we learned both were abnormal, leaving us no healthy embryos to transfer.

I was heartbroken. No one understood the unique flavor of pain and shame I felt. Well, not NO one...I learned that a select group of people did understand: other fertility warriors who had once been where I was, but were now safely on the other side. They were the only ones who could offer me the support, understanding and perspective I so desperately craved.

It was then I had the idea to create Fruitful, a free fertility mentorship program that connects individuals struggling through infertility with a mentor who has been through it firsthand and is now on the other side.

Brad and I got right to work. He’s a web developer and I’m a copywriter, so together we used our skills to make Fruitful Fertility. We proudly launched the site for National Infertility Awareness Week on April 23 and we could not be more excited about this new project and its potential to help others like us.

To sign up to receive a free mentor or to volunteer to become one, please visit Or if you just want to follow along, check out our Instagram account @Fruitful_Fertility.

Remember, you are NOT alone.

Elyse Ash is the founder and CEO of Fruitful Fertility. She and her husband Brad have been trying to conceive since September 2014 and live in Minneapolis with their cat Puck. Elyse loves poetry, hockey, social justice, Beyonce and pretending she’s into yoga.


Why We Created Conversations in Community


We feel it’s been some time since we last talked and updated you on our journey. Here’s a recap: Last year, we drove 15,000 miles across the US to offer over 60 free reproductive health classes in three months in order to address a systems-wide gap in accessibility to knowledge about our bodies. We named the project The Fifth Vital Sign, because the menstrual cycle is an essential health indicator, a vital sign, like blood pressure or heart rate.

Our mission has always been to use education as preventative care through body literacy and informed choices. Following the November election, we announced a call to action to invite people to resist and respond by sharing our curriculum in their respective locations. We trained more than 50 facilitators and had many conversations and exchanges; we learned a lot. Now, we would like to extend the invitation to converse in more depth with our newest offering: Conversations in Community.

This program is designed to support both informational learning and collective- and self-reflection around different aspects of reproductive health. It is a nine-month program, consisting of six months of bi-monthly, followed by three months of one-on-one mentorship. At the end of the program, each participant will have created a reproductive health curriculum based on their community’s needs. The goal is to present the curriculum in a way that feels most comfortable to them. This may be as a story, theater piece, Powerpoint, essay, podcast, meet up circle–anything you can imagine. Our role is to support you in realizing this goal and in building a logistical framework to bring it into the world.

Through online modules, we will learn  topics including anatomy, physiology, the menstrual cycle, fertility awareness, breast and chest health, contraception, informed choice, hormonal health, and radical consent, as well as ideas about how and why this information is important.

Reflection will play a large role in our learning process. If we don’t have the opportunity to engage with this information on a personal level--if we leave it abstract, just as words and pictures on a slide, without placing it in our own lives--then we are cutting out the heart of this work. We encourage heart-, head-, and hands-on learning, on a human-to-human level, to make social and political change. Integrative learning is vital. In addition to the online modules, we will facilitate reflection with physical, visual, and audio exercises and explore questions like, what is my relationship to my own body; how do I converse with my body; what was my sex education in school like, why was it presented to me that way, and what impact has it had on my life; if I could speak to my 12 year old self, what I tell them about their body?

We feel that continued community learning is key to combating national and worldwide issues that we face. Without telling and hearing our stories in an intimate setting, we risk labeling any experience that isn’t ours as “other;” and therefore move further and further away from humanizing issues and policies that do not cater to our personal needs.

So, why did we decide to do something like this? After our initial facilitator training, we reflected on how personal, even intimate, this information and work are to people. It reinforced our belief that you know your own body best, and you know your community--the body at large--best, too. It’s not possible to make a one-size-fits-all curriculum, just like it’s not possible to have a one-size-fits-all approach to reproductive health care and solutions. While we still would like to share our curriculum far and wide, we would also like to commune with people who are passionate about sharing this work and their own stories. We feel that learning together is key and that reproductive health information must be shared in a thousand different ways on a thousand different days until one day, someone will teach it in a way that is accessible to YOU.

We also feel the urgency to connect, to expand, and to struggle TOGETHER. Reproductive health is a realm that encompasses many different experiences, and by speaking about the provision of care at any of its stages, we will be speaking about and considering the intersections of race, income, gender, sexual orientation, etc. These conversations are not a one-time event, and, as such, we want to invite them in and to stay in them. This journey must be holistic and invite conversations about power structures, politics, social, and cultural constructs and encourage us to ask how the micro and the macro are linked, how they affect each other.

It is important to us to not feel confined to the ways in which we may currently be measuring success in “programs.” This is not an academic setting. For this reason we would like to be transparent about the fact that this learning space is fluid and it is designed to be able to match different learning styles. The “why” is so important that the “how” will go anywhere to get there.  

The way in which we envision and are learning to practice as an organization can be best described as ‘relationship-based.’ This means that no matter how the organization scales, no matter what happens, we will always return to the one-on-one and group relationships to inform this work. We are open to change and to will respond rather than react to systemic, social, political, and personal changes and transitions. If we are going to expand, we will do so together. We promise to strive for relationship-based rather than an exploitation-based business. Ask us about it!

You can sign up for the training here as well as scheduled information sessions. Please reach out to us with any questions – we would love to hear from you!



Consent is consent is consent. Period.

By Emily Varnam

Over the summer I wore the same red dress with yellow roses on it. It was the only thing that I felt comfortable in, and recently, since it’s been snowing, I’ve been packing away my summer clothes and came across it. I looked at it and recalled all the memories that were made in its cotton comfort. One memory stood out to me.

Weirdly, it was not running in the park, riding my bike around Brooklyn, or going to the beach. It was visiting my OB/GYN. You see, this dress was part of one of the most empowering experiences of my year. One hot day in June I went to my OB, battling through the crowds in Times Square, I arrived just on time. Once it was my turn to see the doctor, I was excited to ask my questions. I had removed my dress and was waiting to have a breast exam and pap. After three years of fertility awareness method charting, I had grown accustomed to looking for clues, and my charts were telling me that I had not been ovulating. I wanted to know more and was here to ask for more information. My doctor explained that I would not need to ovulate unless I was trying to conceive. Here is where we got into a disagreement, where I suddenly was able to get up-close-and-personal with the experience of a doctor offering opinions and not facts. There are important health benefits to ovulation and it is important to know why one may not be. My doctor began to raise his voice to me as I questioned him further. “You’re going to argue with a doctor?!” At this point I suddenly realized that I did not feel safe. So instead of letting someone who was shouting at me put their hand into my vagina to examine me, I calmly responded with: “You’re going to hand me my dress, and I am going to leave, because it is unacceptable for you to speak to me like that.”

Fast-forward six months and here I am at my local Planned Parenthood to get my STD screening done. I was seen by two midwives and was surprised at how gentle my pelvic exam was. I was asked for my consent to do it and was relaxed when it happened. The difference between this experience and the aforementioned one is disturbing. It took me having an experience of true consent to understand how noticeable and disturbing its absence is. What really brought this home to me was a Facebook conversation I was having while I was in this appointment. Noted below is a friend’s reaction to her obstetric treatment.

Emily. Apologies for the random PM, but I am just trying to process something that happened less than an hour ago. Something that felt really fucking horrible and like a violation, and I thought I'd like to check whether I'm overreacting with someone who is unlikely to judge me and an expert in the field.

I've just had my first cervical smear for years and I started to cry a little on the way home

Firstly, the nurse apparently didn't realise that's what I was there for. So I waited while she did some admin and complained to me about the new receptionist not informing her etc. No calming words/chit-chat/humour... I was already nervous as it's been a while and I can get a little awkward about my vag

So I got ready as told, and without warning or asking me to relax she jammed it in and I was squirming and said it was painful but she kept pushing I felt so fucking stupid but it really really felt horrendous

I know it's not a fun experience but I can't recall it ever hurting that much. Like, at least warn me? I rushed there after work and was probably already tense for more than this reason. Then she had a go at me for being too tense and that there was a lot of discharge, and I didn't make it easy for her to find my cervix. I stupidly said I forgot that being relaxed helps and tried to laugh it off. I even apologised. Yet she kept going on that I was too tense.

No reassurance at the end either, she just said how long it'll take to get results and went quiet while I got dressed. I hope this is just an overreaction and I'll forget it soon. Maybe it's just been too long. Am I being a little silly? I feel like I can trust your opinion.

Sorry about being so long-winded. Can't stop playing it in my head and just wish it didn't make me feel this shit.

So here’s the thing: It is never okay to touch someone without consent or in a situation where that person is made to feel intimated or unsafe, and I am tired of seeing it happen in a medical setting, whether that is as a patient or doula. There is a cultural norm of expecting and accepting lack of consent and its perpetuated by a culture of victim blaming. We do not protect people with the tools to combat it and need to call on providers to do no harm, to honor people’s boundaries. Coercive language is used in health care settings that create an environment in which it’s easy to forget that you are the authority on your body. It took me practicing as a doula to see that I would have to set my own boundaries with my health care provider. I could not just assume I was safe.

Cristen Pascucci writes, “It is so very hard sometimes to explain our maternity care system to expecting mothers. The challenges they face are so unbelievable, it sounds like a paranoid fantasy to tell the truth, which is: “It is not unlikely that you will be lied to or completely misinformed by the people you trust. It is not unlikely that the things you think are making you safer are actually making things worse for you. And, yes, I know you won’t believe me until you go through it and learn this all the hard way. I’m sorry for that.” This idea goes beyond maternity care.

In my profession as a doula, there are conflicting ideas about whether we are advocates are not. In some doula trainings the scope of practice would ask me to simply encourage my clients to frame their experiences in a positive way, rather than challenge them. The issue is in a situation where consent is violated or not explicitly gained, if I tell someone that what happened is okay or minimize what happened, then I’m going against their body, which recognizes trauma, creating more internal conflict for them and in some cases an inability to heal from something. If I witness abuse and do not speak up, I become complicit in it.

 We need to normalize the idea of people saying “No” and other people respecting it. No is a full sentence and idea; it doesn’t need to be justified, but in all cases needs to be respected.

-For more information on knowing your rights as a patient:

-You can bring this free pamphlet with you to your provider’s office to discuss what you are and are not okay with prior to any consult or procedure.

Recent cases of violation of consent in maternity care: and



How does our society hate women? Let me count the ways:

A is for Access to Abortion or lack thereof and Ageism

B is for Birth trauma, Body shaming and the Beauty industry

C is for Cis white male privilege and also for cervical fluid, the fundamental piece of a conversation about fertility, left out because of the collective disgust for the powerful things a women’s body can do

D is for Domestic violence reminding us that statistically the most dangerous thing to happen to a woman was a man

E is for Emotional labor, the free work that women do on behalf of the world in order for it to heal and the lack of recognition we get for it, and for the male Ego, lest it not be bruised in our fight toward Equality

F is the Female genital mutilation a practice that is alive and well that seeks to remove an organ whose sole purpose is pleasure, an organ whose full anatomy was not recognized by the medical community until 1998

G is for Gaslighting, Ghosting, and the Glass ceiling we have to smash through

H is for Hate crimes and Human rights=women’s rights

I is for Income Inequality and Infertility over diagnosed, under discussed, stigmatized, and for Identify, as in you are allowed to identify however you want

J is for Justice, a system that fails to protect us and often works against us. Asking us to bury our aborted fetuses, asking us to value a man’s ability over a woman’s right to feel safe in her body, asking us to prove that we are worth considering as human beings.

K is for Knowledge, access to which is limited based on the genitals you were born with, the biggest weapon and the humblest cure

L is for Locker room talk and Language, like hysteria, hormonal, incompetent cervix, even vagina, the etymology of which is scabbard or sheath, considered only in relation to the penis and not on its own terms, and something to enter violently with a sword

M is for Misogyny, Misgendering, Mansplaining, and Menstruation. Matriarchy now!

N is for #Notallmen rather than #yesallwomen

O is for Oppression and Obstetrical violence

P is for “grab them by the Pussy” - united states President elect but it is also for (Pantsuit Nation)

Q is for Queer, a way of defining yourself, you are allowed, and it is for Questioning the status Quo—Question everything

R is for Rape culture, the unreported crimes, the unopened kits, the idea that a man’s swimming career is more important than enforcing the correct definition of consent

S is for Street harassment and Sexual assault, Sterilization without consent, and Slut Shaming

T is for Transphobic and Tampon Tax

U is for Uterus – which is not necessary in the definition of what a woman is, which has power, meaning, and the ability to create life

V is for Victim blaming, for VULVA the word for the thing that most of us are still calling VAGINA because we don't bother to call women’s parts their correct names

W is for Witch Hunts, White supremacy, and, as Ta-Nehisi Coates Writes, the belief in being White, which has meant the belief in one’s power to dominate, exclude, and dehumanize. “Black women, we can and will do better for you”-Jesse Williams.

X is for Xenophobia

Y is for You, as in You, as in Your part in all of this

Z is for Zero—the tolerance we have for all of the above

A Call To Action

“Our mission is to use education as preventative care, encouraging individuals to make informed choices about their health. We strive to spread unbiased, free, reproductive health information so that we all feel more secure, safe, and alive in our bodies.”


The Fifth Vital Sign has always been about being safe in our bodies. When we sat down last year to discuss our mission we agreed that above all else, if we could communicate nothing further that our message was: your body has worth and you matter regardless of the body you were born into.  Today we feel the need to address the feeling of bodies being under threat. The etymology of consent is “feeling together,” and that’s what we are here to do. We both received messages from friends and family asking us ‘are you safe?’ and we want to have that conversation with you. We are here to listen. We are here to validate your feelings of rage, frustration, sadness and fear. We are not here to disprove your experience in your body but we do want to move forward, together.

As birth workers we have become accustomed to conspiring, to gathering together as one under the radar to help keep ourselves and our communities safe. How can we extend that? How can we grow our community? We are ready to love the shit out of you. We are ready to stand by your side. We are ready to unite.

When we are faced with adversity we are given an opportunity to show up authentically as ourselves. In this case we feel that we are asked to stand up and be counted and to offer the skills that we have. What does your community need that we can offer? Can we come and offer information or support where you are? Let this be a time in which we come together and stay together. In which we water each other and love each other into blossoming.

Let us be clear: we want to show up for you. We are ready to fight for what is true which is that all bodies have the right to be safe and protected. Let’s start with education. We want to offer training people in communities to fill the roles and needs and services that may be under threat, and we want to do this for free.  We want to undermine the idea that there is a price to pay for freedom in our bodies, a price on bodily autonomy and access to information with which to make decisions. The ability to be safe in our bodies is a human right.  If you would like to participate in training to facilitate our workshop email us: We are looking for representatives in every place. It is our goal to collaborate with at least one Fifth Vital Sign representative in each state, so that on February 14th (Valentine’s Day) there are at least fifty classes going on across the country: Love Trumps Hate 2017 5VS edition.

In addition, it is critical to us to grow an organization that is as inclusive as possible. We are two able-bodied, cis-women with white skin. In order to best represent more diverse opinions, lived experiences, and perspectives, we plan to elect a board that will guide The Fifth Vital Sign’s curriculum and future always toward further inclusivity, decolonization, social justice, and body positivity. We are stronger together. If this interests you, please email us.

This is only the beginning of what will be many action steps down a road we want to walk with you all. Let’s do this. ‘They tried to bury us, they didn’t know we were seeds.’  #stayhuman #lovetrumpshate #strongertogether #loveisacollaborativeart

In Love and Solidarity,

Emily and Kelsey


Theresa Marie Amanda Buccellato 7/7/94 - 8/16/10

The Fifth Vital Sign blog is a place for people to share stories about reproductive health. It's our belief and experience that stories are medicinal. However, these posts do not always reflect the goals, intentions, or perspectives of The Fifth Vital Sign.

This is Theresa's story, told by her mother, Laura Femia Buccellato.    

WHAT EVERY MOTHER AND TEENAGE GIRL NEED TO KNOW ABOUT HORMONAL BIRTH CONTROL: the hidden dangers and facts that the Doctors and Pharmaceutical Companies chose not to disclose

My only child, Theresa, came to me a month before her sixteenth birthday and told me she had sexual intercourse for the first time.  I was not happy about it, but I was very happy we were close enough that she knew she could come to me about it.  I spoke my mind about how I felt she was too young, but I also knew deep down my words would not prevent her from having sex again.  Theresa asked about going on the pill.  I had been on the pill in my 20's and had no side effects from it.  I told her I would make an appointment with my OBGYN that also delivered her, and we would discuss the options with her first.  

Theresa had an exam by the doctor and then I joined them in the doctor’s office to discuss birth control.  Our doctor mentioned the pill first.  My first reaction was to ask about other contraceptives but the doctor felt the pill would be the best for Theresa.  She said she would put her on one of the lowest doses of pills called Othro-Cept.  I was aware of some of the side effects of the pill like gaining weight, blood clots, and danger if you smoke (Theresa did not smoke). Our doctor did not go over any of the side effects with us or what to look for if something were to go wrong.  I trusted my OBGYN because I have been with her for most of my life and she had four children so I never felt she would put Theresa in any kind of harm.  She also was aware of my family medical history and that my mother had a stroke at 32 years old.

Theresa was on the pill for a month and a half and never complained to me about it.  On August 15th, 2010, Theresa and I spent the whole day at the mall putting the final touches on her Mardi Gras Sweet 16 party.  She was having her party in October instead of her birthday month in July because she wanted all her friends back from summer vacation so they could attend.  Theresa always dreamed about her sweet 16 party, it was the day she felt she would be a Princess and her start of becoming an adult.  That night after shopping we stayed up all night ordering the masks for her Mardi Gras party. When I went to bed that night I had no clue our lives would end the very next day.  That instead of watching my daughter’s dream party happen, it would be a memorial concert on her party date instead.

August 16th, 2010 started out as a normal day.  I woke up and got ready for work.  Theresa was still asleep so I did not wake her to say goodbye.  Around 1:00 in the afternoon she called me at work to ask if she could go out with two of her friends.  I said yes and that her dad or I would pick her up at 9:00 PM.  I told her I love you and we hung up.  Those were the last words ever spoken with her.

Her dad decided he would pick her up that night.  I remember just getting out of the shower when my phone rang.  It was her dad telling me Theresa was sick and he called an ambulance.  I did not even wait for details, I got in my car and headed to the pizzeria he told me they were at.  I was there within 10 minutes and saw a huge crowed outside the pizzeria along with an ambulance.  I rushed into the pizzeria and saw Theresa on the stretcher out cold.  I remember looking around the pizzeria and it being packed with people.  As soon as we got into the ambulance I saw the paramedics rip open Theresa's shirt and start CPR.  I was in a daze and in shock, I had no clue what was happening, but I knew I was losing my child.  When we got to the hospital the doctor on call continued CPR and made me and my ex husband leave the room.  A couple of minutes later the nurse came out to tell me to come in and hold her hand.  I already knew Theresa was gone.  The doctor then had me go out of the room and then told us Theresa was gone.  He said her pupils were not dilated, and their is no indication it was caused by any kind of substance.  That I already knew, Theresa hated drugs and did not do them.  I remember walking back in the room to be by my daughter.  She was lying on the table with her eyes wide opened.  I will never forget that picture.  Theresa had the most beautiful green eyes and she was so proud of them.  I remember blurting out I wanted to donate them.  Everything after that is a total blur.

My 16 year old daughter was dead and I had no clue why.  She was a very healthy, athletic, young girl.  I always thought we were blessed because if I took her to the doctor more than once a year for feeling ill, that was a lot.

I called our OBGYN the next day to tell her Theresa died.  I still had no thought in my head that the pill had anything to do with her death.  I actually thought she had an aneurysm because her friends said she complained about a headache an hour before she died.  Two days after her death our OBGYN called me that the autopsy results were already in.  She said Theresa died from a blood clot that burst in her leg and caused a pulmonary embolism.  I was then told Theresa had a blood clot disorder called Factor V Leiden.  Dr. Melgar told me that everyone in my immediate family and my ex-husband’s immediate family had to be tested for it because this disorder is genetic.  She told me a simple blood test would determine if anyone in the family carries this disorder. 

I immediately went and had blood work done and found out I have Factor V Leiden.  Theresa got it from me, and I never even knew this disorder existed.  My sister had her four children tested for it and two of her children turned out positive.  My nephew has it and one of my nieces has it from both her parents, which is very serious.  

I started doing research on this and that was when I found out the pill Theresa was put on was not the same kind of pills I was on in my 20's.  Hormonal contraceptives now have much more estrogen in them and are called Third Generation pill. I also learned if Theresa had a blood test the doctor would have known about her having a blood clot disorder and would have never been allowed on any kind of birth control.  After reading all this I drove straight to the doctor’s office to find out why the blood test was never mentioned.  Dr. Melgar explained to me that the blood clot disorder is rare and insurance companies will not pay for the blood work so doctors do not mention it to their patients. She did not even give us the option to pay for it out of pocket. The insurance companies feel it is not cost effective to run this test on people going on birth control.

A simple blood test (that I would have paid for) would have saved Theresa's life.  Instead, because she died from this, everyone in my family and my ex-husband‘s family had to be tested and insurance had to cover it. The insurance companies now had to pay for about 100 tests (we have a big family). 

Theresa's life to the medical industry did not matter.  She is now just a statistic to them.  For Theresa she lost her life, her future.  She was a promising young woman that wanted to either become a veterinarian or work as a social worker with Project Children.  She wanted to make a difference in this world. As for me and her father, we might be living, but we are both dead inside.  We lost the only important person in our life, our future.  We will not see our daughter graduate from college this year, get married, or ever have any grand children.  The medical industry stole everything from Theresa and us, just by not mentioning a simple blood test.

Since Theresa's death I have been trying to spread the word to others about this blood test.  I am not against birth control at all, but I am against the facts not being revealed.  I feel people need to know about this blood test.  In Theresa's memory I will tell people about this test over and over again.  Many people I have talked to have had this test done after hearing of Theresa's death.  So many people have turned out positive with Factor V Leiden.  I have come to find, this disorder is not as rare as the medical industry wants us to believe it is.  Actually talking to different doctors, I have found they are very ignorant to this disorder, and they have not been educated about it.  It is up to us to fight for this blood test and make it mandatory for all females to be tested for it.  Unfortunately a lot more people will probably die before it does become mandatory.

I am hoping by telling Theresa's story, this will bring awareness to others.  Please insist on the blood test if you or anyone you know is going on any kind of hormonal birth control.  You need to watch all signs in your body for complications.  Have you had many miscarriages? A swollen leg, that’s painful, red, and warm to the touch?  Trouble breathing? These are all signs that you might have this disorder (being a carrier is the same) or a danger sign about your birth control.  The number of people having strokes, PE, and dying have been increasing every year and it has all been caused from too much estrogen in birth control.  The medical industry no longer cares about saving lives.  They have teamed up with pharmaceutical companies to get as many profitable drugs on the market so they can benefit from it, instead of patience benefiting from it.  They need to be stopped and only we can do that with our voice being heard. I have written many, many times to Dr. Oz to do a show on this, but my emails have been ignored.  Finally I found Ricki Lake and The Fifth Vital Sign..............they care about woman and their choices.  They will hopefully make a huge difference with their voices being heard on behalf of all those that suffered complications and death from hormonal birth control.

In conclusion, if one person’s life is saved from sharing Theresa's story, then at least her death will not be in vain.  I miss my child every second of every day.  I lost my future, my best friend, my child and WHY? Because the medical industry felt she was not important.



Informed Choice

In our classes we always mention that we can’t and don’t tell people which form of contraception is best for them. Our opinions have no place there. What we do promote is informed decision making. We share reproductive health information that is as unbiased as possible and encourage people to ask specific questions of themselves and their providers. Knowledge, of oneself and one’s choices, is power.

Early on, we found someone who shared this mission, or, rather, she found us and became a strong supporter. Karen Langhart came to us out of the lovely blue and into our inboxes.


I’m at the Woman Up Summit – a think tank and project connected to the documentary [Sweetening the Pill]. It’s organized by Karen Langhart, who lost her daughter to a NuvaRing created blood clot. She has a foundation – Informed Choice for AmErika – and she and her foundation director are keen to talk to you about the birth control road trip and funding.

Shall I put you in touch?

--Holly Grigg-Spall”

I had read about Karen and her daughter in Vanity Fair a few years before. At the age of 24, on Thanksgiving Day, Erika Langhart died of a double pulmonary embolism as a direct result of the Nuvaring. A pulmonary embolism is usually a blood clot that’s formed in the leg, breaks off, and travels to the lung, blocking a major blood vessel there.

Erika Langhart

Erika Langhart

“In the ambulance Erika had two heart attacks, and she was semi-conscious by the time they reached Virginia Hospital Center. According to Karen, a doctor in the emergency room asked her over the phone: ‘Was your daughter using birth control?’ Karen said, ‘Yes, NuvaRing.’ He removed the device and said, ‘I thought so, because she’s having a pulmonary embolism.’”

Erika graduated from American University in Washington D.C., and it was important to Emily and I to have a class there, to share information about the risks of hormonal birth control, especially the increased risk of developing blood clots. 1 in 1,000 women per year who are taking combination birth control pills will develop a clot, and some studies have shown third generation, like the Nuvaring contains, and fourth generation progestins increase that risk even further.

Oorja Mehra, one of Emily’s dearest friends, helped us organize the AU class, which fell right in the middle of mid-term exams. Still, five students attended, impressively engaged, despite the late, studious nights. It was our first college class. This is an age group that is so critical to us to reach, and we were thrilled to be there. We feel so grateful to everyone who was able to attend. Plus, Oorja swiped us into the cafeteria afterward, making our post-grad dreams come true.

Emily and Oorja at Steak 'n Egg diner in DC

Emily and Oorja at Steak 'n Egg diner in DC

Tanisha Ferguson, the communications director for Informed Choice for AmErika and one of Erika’s best friends, returned to her alma mater to attend our class. She spoke about Erika and two other American University classmates who experienced pulmonary embolisms related to the Nuvaring. She used names, not numbers, to describe the risks of hormonal birth control. When pharmaceutical commercials list side effects in hyper-speed and lettering is miniscule, it’s easy to dismiss and downplay the risks. Tanisha’s presence was impactful for all of us, because these risks are real and life changing.

We had the opportunity to spend five nights at Tanisha’s. We basically moved in. She and her family were incredibly generous, sharing their space, food, time, washer and dryer. Over lunches and dinners, Emily and I listened to Tanisha describe Erika. How Erika didn’t want to miss out on a single thing, to the point she was nearly asleep at the end of Tanisha’s wedding night but, rather than give into tiredness, ran around the hotel several times to wake herself up, to be 100% present. She lived so much life in her twenty-four years. Tanisha found out she was pregnant right before Erika passed and imagines her son and Erika high-fiving each other as they crossed the earthly threshold, Erika passing her vivaciousness to Luke, Tanisha’s son. We feel like we know Erika, if only a little. Thank you, Tanisha and family, for having us; it was a gift to stay with you.

Karen’s favorite quote was: Love is stronger than fear, life stronger than death, hope stronger than despair. Since starting this project, we have heard and read more real stories about severe injuries and deaths caused by hormonal birth control related blood clots. We find hope through a task force of individuals and organizations that are questioning contraceptive choices and demanding informed consent. We find hope in education as prevention, and the task force is growing, one class and person at a time.

First class selfie-stick photo

First class selfie-stick photo

*In our classes, we always review the signs and symptoms of deep vein thrombosis (DVT) and pulmonary embolism (PE), because quick treatment can make a difference. We believe the more people who can recognize these signs and symptoms, the safer we will all be.*

What is DVT? It’s a blood clot that forms in the deep veins, usually in the legs, but sometimes in the arms.

Signs and symptoms of DVT

Contact your doctor immediately if you experience:

-Swelling, usually in one leg or arm

-Leg (or arm) pain or tenderness

-Reddish or bluish skin discoloration

-Leg (or arm) warm to the touch

What is a PE? Clots can break off from a DVT and travel to the lung, blocking a major blood vessel there.

Signs and Symptoms of Pulmonary Embolism

Call an ambulance or 911 for treatment in the ER if you experience these symptoms:

-Sudden shortness of breath

-Chest pain that’s sharp, stabbing, and may get worse with deep breaths

-Rapid heart rate

-Unexplained cough, sometimes with bloody mucous