Online Support for Women Trying to Conceive
A woman of childbearing age who is trying to conceive can typically assume that she will become pregnant. If pregnancy does not happen after a period of time, she might look on the Internet for guidance. Here she will likely find a community of women with the same goal of trying to conceive, collaborating and supporting each other through the process, which exists within a system of genres related to fertility and health care. As Amy Devitt notes, “Communities thus are better defined by their common goals, values, or identities, than by their common discourse or genres” (39). Women who are trying to conceive (“TTC” as it’s known in online forums) share the common goal of pregnancy and the common value of motherhood. These online TTC forums, available on websites and within certain mobile applications, function as a genre for this discourse community that depends on user-driven data collection, community support, and the wider genre of informational online articles that help women understand their fertility.
In this essay, I will describe common features of the TTC discussion board genre, discuss how this genre functions within an activity system of genres for women trying to conceive, and discuss how women using these genres can enact or subvert ideologies and social institutions via their performance of and participation in these genres.
Because of the personal nature of the topic, I have only linked to discussion board pages where users are not publicly identifiable. While the features I discuss exist across numerous online TTC communities, I am citing conversations primarily in Glow because users’ names are more hidden on this platform.
Features of TTC Discussion Boards
The discussion boards that TTC community members use share similarities across the various websites that host them. Women can create accounts on platforms such as Glow, Fertility Friend, Baby Center, Countdown to Pregnancy, or others in order to participate in and become part of this discourse community. While there are some forum posts that are not concerned with TTC (e.g., posts seeking general relationship advice), the majority of content relates to women’s menstrual cycles and fertility, which is the primary reason women visit these online spaces.
The discourse in TTC discussion boards relies on heavy use of acronyms and jargon. For example, TTC discussion boards use the following abbreviations more often than not: DPO: days past ovulation; CD: cycle day; BBT: basal body temperature; CM: cervical mucus; 2WW: two week wait; BD: baby dance (intercourse); SO: significant other; POAS: pee on a stick; FMU: first morning urine; AF: “Aunt Flo”; BFN: big fat negative (on pregnancy test); BFP: big fat positive (confirmed pregnancy). This heavy acronym usage suggests a frantic intensity--a speed and efficiency needed for maximum productivity, as well as a sense of being in an in-group.
Women using TTC discussion boards may also compare professional medical guidance related to conditions such as endometriosis or polycystic ovarian syndrome, or procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI). One woman turned to the Glow community after her experience with doctors was unsuccessful, writing, “After many treas [sic] and MANY not so nice words he finally gave me a prescription for metformin. In on [sic] month 2 of taking it. I'm an emotional wreck. Has anyone out there had any luck concieveing [sic] being over weight with PCOS?” (“PCOS and unhelpful doctors,” n. pag). This woman, like others, has turned to a community of peers after disappointment with medical experts. The discourse community of women trying to conceive has specialized knowledge--not the level of expertise a doctor would have--but insights from shared experiences.
In addition to using jargon and comparing medical advice from professionals, women also utilize collaborative analysis to interpret each others’ cycle data and answer each other’s questions. A typical thread might share one’s cycle timeline and ask about symptoms at that stage. For example, one user in a post titled simply “10 dpo” writes only: “Slight cramps & thick white creamy discharge?” (n. pag). Other users who replied to this post understood that this is implicitly a question about the likelihood of pregnancy, and respond that this is a pregnancy symptom (“10 dpo,” n. pag). Women may try to answer these questions using knowledge from credible health organizations, but the timing leaves answers indeterminate, and leaves women to guess the odds. Navigating this uncertainty, women can work with prior information they have gathered to identify patterns in their own cycles, or learn from similar experiences other women share. Some women post images of their basal body temperature charts, cervical mucus, and pregnancy or ovulation tests, to help confirm pregnancy or key dates in the menstrual cycle. For example, one user on Glow wrote, “Can someone help me figure out when I ovulated and why it’s all over the place?” (“BBT chart confusion,” n. pag). Women chime in to help.
Contributions to these discussion boards often display intense emotion and focus, as women return to cope with continuous waves of hope and disappointment as months cycle on, needing contact and acknowledgment amid the difficulty of waiting, or the greater difficulties of miscarriage, risky medical conditions, and the looming prospect of infertility. Some platforms such as Glow include a separate space for announcements of confirmed pregnancies, as women who are still trying may have difficulty hearing about so many positive results when they get negative results month after month (“Glow Announcements” n. pag). Some women leave the discourse community because the process can be too exhausting; better to relax and forget about it for a while rather than obsess over a recurring disappointment (“Leaving,” n. pag). Other women may spend hours continually guessing, analyzing, discussing, and interpreting information that could be confirmed by waiting several more days. The intensity of the space may welcome obsession and compulsions; a google search for “addicted to poas” (“peeing on a stick,” taking a pregnancy test) returns thousands of results, many of which are TTC discussion board pages.
Jargon, medical advice, and intensity are key themes of the genre of online TTC forums, but the primary feature is emotional support, the bedrock of its exigence. Women in these forums may share disappointment that their menstrual periods have begun and they have to wait at least one more cycle to achieve pregnancy, and discussing the pain with other women in similar situations can provide comfort. Stephanie Jackson shares her experience of this difficulty in her YouTube video series, Does This Baby Make Me Look Fat?, especially in her video, “The Two Week Wait” (n. pag). Given the emotional strain of vacillating between hope and disappointment, some women stick together online as “cycle-buddies,” as they enact the genres of this activity system on matching timelines. One Glow user wrote, “Just looking for some people who are around the same cycle as me to exchange some friendly support and comfort during the dreaded 2 week wait. I always feel like it goes a lot quicker when there's someone to talk to and share experiences with.😊” (“Anyone in 2 week wait” n. pag). A number of users responded, some sharing wishes of good luck, or their own cycle timelines, before a successful pregnancy was announced (n. pag). Overall, despite the intensity, the tone of these discussion forums is generally positive, hopeful, and supportive of women and their family plans. One of the most common phrases in TTC posts is the idea of sending someone “baby dust,” meaning “good luck” (“Leaving”).
Another reason TTC forums attract women seeking support is because of the taboo nature of the topic. Women may not want to discuss their fertility with people in their lives, so an online community is a safer space. In a TED talk on pregnancy taboos by Rufus Griscom and Alisa Volkman, the couple describes their painful experience with miscarriage and with the silence that surrounds the experience (n. pag). Bringing these taboo topics to light and facilitating conversations about them has a role in helping women with difficulties bearing children to heal and continue working toward their family goals.
Rhetorical Construction in the TTC Community
While the TTC discussion board genre can be characterized by its specialized language and its functions of data analysis and social support, the construction of the genre is deeper in terms of how it arose in relation to a wider activity system of genres, and how these genres enact social values.
The TTC discussion forums are a subgenre of the wider internet genre of discussion forums, which exist on seemingly infinite topics. Also known as “message boards,” these online spaces have been around for several decades, derived from the antecedent genres of physical bulletin boards and in-person group conversations at a peer-to-peer level. Users in these forums can and do share literature recommendations or links to outside sources when providing information to each other. For example, several users recommend the book Taking Charge of Your Fertility by Toni Weschler (“EVERY WOMAN,” n. pag). Weschler explains how to gather and interpret personal health data, particularly basal body temperature, cervical fluid, and cervical position, to gain fertility awareness and understand a pattern of signs (52-68). Because women can fact-check each others’ advice with their own research, and often provide corrections or clarifications to each other, the community knowledge base relies on genres of print literature such as Weschler’s book and informational online articles.
While the online forums are a collaborative space to share information, online articles and print resources tend to be more directive. These articles may include basic information such as understanding ovulation or early pregnancy symptoms. A typical informational article on pregnancy symptoms uses a list format, with notes on each potential symptom (BabyCenter). Women may also be drawing on resources from print literature. Marika Seigel has raised concerns about the level of information women may receive in typical pregnancy manuals, writing in The Rhetoric of Pregnancy that "unfortunately, most (but not all) pregnancy manuals provide users nothing more than functional access--that is, the knowledge necessary to engage with the prenatal care system, but not to engage with it systematically, let alone critically” (Seigel 14).
Writing at this level of “functional access” also exists in literature on becoming pregnant. The first chapter of Heidi Murkoff and Sharon Mazel’s bestselling pregnancy book, What to Expect When You’re Expecting, is titled “Before You Conceive,” and reads as a to-do list, including about ten pages of “Preconception Prep for Moms” and less than two pages of tasks for potential fathers. Using sentences written in the imperative, Murkoff and Mazel’s advice includes “Check your family tree,” “Get tests” (followed by a list of ten tests), “Get chronic illnesses under control,” “Improve your diet,” “Avoid environmental hazards,” and finally, “Relax” (2-11).
As Seigel notes, this list-like guidance common in pregnancy manuals typically does not give women enough information to think critically about their own decisions regarding what may be necessary to their health and the health of their future children, and which tests may not be necessary (14). This can have “material effects on their physical and mental well-being” (Seigel 14). The amount of work suggested by Murkoff and Mazel constructs the activity of becoming pregnant as an intensive process, and may contribute to the frustrations and concerns of women in TTC forums, who may find the process overwhelming.
The directive nature of informational articles can be helpful, but can also work to construct a woman who needs assistance understanding her body. The medicalization of women's’ bodies undermines their agency in testifying to their own experience and enacting their ability to comprehend their health needs. Judy Segal writes that this medicalization has been a larger trend over the past hundred years or so: “By the end of the nineteenth century, however, medical competence was in the hands of licensed practitioners in a proprietary frame of mind, and self-help books notwithstanding, physicians sought more explicitly to deprive their patients of, rather than equip themselves with the sense that they could look after themselves” (Segal 33). Segal’s commentary on how doctors became experts rather than part of a community of patients whose knowledge contributed to doctors’ knowledge has implications for the role of online communities today, which might help women be seen more as individuals than as rhetorically constructed patients.
The metaphor of women as containers for future children is ideological. Michel Foucault also writes of the medicalization of women’s bodies, noting that the “politics of sex” involved discipline and regulation of women: “the hysterization of women, which involved a thorough medicalization of their bodies and their sex, was carried out in the name of the responsibility they owed to the health of their children, the solidity of the family institution, and the safeguarding of society” (146-147). This discipline of women, based on their responsibility to future children, uses a woman-as-container metaphor to rhetorically construct women as a means to an end: reproduction. It is perhaps too obvious to say that reproduction has social value and that many women's identities may be framed by the social values of motherhood and submission to authority. However, this rhetorical and social construction of women as passive participants in their health undermines the individuality and voice of each woman as she makes family planning decisions.
Women have long produced social knowledge among each other. Today, women can use online spaces--as well as the expertise of doctors--for empowerment in making life choices. By seeking out each others' knowledge and collaborating with each other, women can share and validate each others’ experiences to better understand and value their own bodies.
Although this democratization of knowledge can help women subvert the ideological mistrust of women's voices, some women may continue to enact social values that undermine her personal choices, using language of oppression. Alicia Silverstone, in her book, The Kind Mama, discusses how healthy food and lifestyle choices will increase a woman's chances of pregnancy (6-63). Silverstone consistently refers to a woman's body as a "baby house" or "baby-making machine" and uses these metaphors to show how women's choices with respect to their body may help or harm future children (6; 11). While I agree that the concept of clean and healthy living to support a healthy baby should be front-of-mind for pregnant women, out of compassion for each child and for the welfare of society, I would argue that these metaphors should be used carefully so they do not eclipse the importance of each woman herself (in fact, I have argued this in my essay, "The Body as Machine Metaphor and 'Error" in Pregnancy").
Because online TTC forums focus on each women's individual experience and work through the power of listening to and working with each other, this genre does not rely on the machine and container metaphors that can be found in much informational literature about trying to conceive. The focus is on women's whole cycles, with little attention paid to men and their role in reproduction beyond the acknowledgment that intercourse happened at some point in the timeline.
The difference between the genres of discussion boards and informational literature, with respect to the social institution of motherhood and family life they act to support, demonstrates Anis Bawarshi's concept of genre function (337). Informational literature about women's fertility often enacts social values that do not give full voice to women; TTC discussion boards often subvert this ideological dismissal of women's knowledge. Anthony Pare writes that genres are ideological in that they embody attitudes and get taken for granted as "the way things are done" (59). Pare suggests examining genres' relation to ideology by seeing them as sites of resistance for different communities, whose attitudes become more apparent in relation to an expected genre (61). Online discussion boards for women trying to conceive can be seen as sites of resistance to ideology, as women empower and support each other, and develop social knowledge. With the guidance of their doctors and a community of support, women who are trying to conceive may have increased agency as they perform and enact genres to help achieve pregnancy.
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