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Talking to your doctor about Taharat Hamishpacha

When people find out about The Confident Kallah practice, one of the reasons they get excited about it is because they know that they don’t have to EXPLAIN anything to me about the religious stuff.

But I know not everyone who may want to make an appointment is able to.

So how do you talk to your own doctor about observing Taharat Hamichpacha and what that entails?

Straightforward. Direct.

For a cyclical schedule and bleeding concerns that can seem really complex, beating around the bush is NOT helpful. Just say it like it is so someone who may be hearing it for the first time, gets the general gist of it. As literal as it gets: “I am not able to have sex when I am bleeding and for 7 bleeding-free days after my period.”

Another thing to keep in mind is that breakthrough bleeding whether on a hormonal medication (birth control, IUD, etc), during your regular cycle, ovulatory spotting, here and there is NORMAL. This can be affected by so many things: stress, illness, etc.

So when spotting, staining, bleeding during the time when you want to be bleeding-free, it may not seem like a big deal at all to your doctor, because medically, it isn’t (most of the time). You may feel like they’re minimizing your concerns because they don’t understand how much it impacts your life.

The only way for them to understand that is to tell them.

I’ll also flip this around to say that if you ARE having frequent mid cycle spotting, staining, bleeding that ends up being halachically ok and it’s month after month, cycle after cycle- you SHOULD discuss this with your doctor as a diagnostic workup or change in medications may be warranted.

This also applies to labor. Be upfront with your nurses and doctor/midwife about what your husband is able to do/not do, see/not see. It’s possible they may be familiar with this situation or had some sort of cultural sensitivity awareness training. But don’t assume. Just say it. You’re there to have a baby, not feel bad or embarrassed for the way you live your life. Especially when it’s part of a religion you value.

Here are some scripted phrases to help you:

For breakthrough bleeding: “I know breakthrough bleeding can be normal when trying different birth controls, but due to my religious observance, it’s really important to me to not be bleeding during the month, except for my period. It affects the times I can be sexually active. What may work the best for me to avoid that?”

For midcycle spotting: "I know ovulatory spotting can be normal but due to my religious observance, it can affect the times I can be sexually active. Is there anything I can do to stop it?

For long periods: "Due to my religious observance, I have to have 7 bleeding free days after my period ends, before I can be sexually active. And I do not have sex during my periods. Since my periods are on the longer side, it really makes the time we can be together short. Is there anything we can do to help that?

For halachic infertility: "Due to my religious observance, I have to have 7 bleeding free days after my period ends, before I can be sexually active with my husband. Since my cycle length is short, I end up ovulating before we can have intercourse. This is causing difficulty getting pregnant. Is there anything that can be done medically to delay my ovulation?”

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