Women’s reproductive health is a hot topic and claims about it are made freely. Given that, it’s worth pausing to reflect about the nature of the woman at the heart of these rights, and the type of health care that can best serve her and her needs.
Women’s health begins with respect for women. Caring for her reproductive health should not be a political agenda, manipulated to serve ideologies or ends. It should not be an agenda driven by profit, in order to sell women pills and commodities. It should not mask contempt for women, in an attempt to encourage her to give in to the urges or demands of men who do not care for her or treat her as a subject with dignity and rights. Authentic women’s healthcare recognizes that women have a right to know and understand their own bodies, and to receive the knowledge they need to be partners in the management and choices they make for their long-term health. Such knowledge enables women – and men – to work together to achieve the physical and emotional health that women need and deserve.
The recognition of women as subjects of rights requires understanding women as subjects. Subjects act; they self-determine. Interestingly, subjects come to know themselves as subjects only in relation to other subjects. The greater our experience and knowledge of ourselves as subjects, the greater our capacity to self-determine. Since subjects act and self-determine, it stands to reason that only subjects are able to make free choices. And subjects long for deep and lasting intimacy with other subjects, which they achieve in varying ways; through friendship, collaboration, within their families, and, most deeply, in the intimacy of couples.
It is because of this inter-subjective intimacy at the heart of women’s reproductive health that so many debates persist. Women want health care that recognizes this inter-subjective reality, and that supports their desire for intimacy while respecting the self-determining nature of the woman as a subject. Appropriate women’s healthcare responses address this, by treating women as self-determining subjects, and providing them with information that allows them to make free choices in the management of their health and fertility. As women expand their knowledge, their capability to make free decisions increases. Only an action taken with an understanding of the consequences and obligations of the act can be considered free. This is why knowledge and informed consent are so closely tied to the full ability to realize human rights, and why human persons, who have the capacity to both reason and choose, are the subjects of rights.
It is obvious, but worth stating, that men are also persons – subjects with rights – who experience themselves as subjects in relation to other subjects, and who act and self-determine. Further, as with women, men also long for intimacy with another person. Because of this deep longing and capacity to give fully to another, men want to enter into the reality and knowledge of the other person to whom he longs to give himself fully. Thus, men, too, are key partners in the understanding and management of women’s health.
This ability to interact in a way that respects each person as a subject, and which enables being in relation with another person while respecting his or her freedom, is necessary for authentically personal, or human interactions to take place.
FEMM is an approach to women’s health that is being developed to provide women optimal healthcare while respecting and enabling free and self-determining choices to men and women. The FEMM acronym represents its two components; Fertility Education and Medical Management. This structure to FEMM responds to the current science and data; namely, that understanding a woman’s fertility gives us the clues and information necessary to also manage a woman’s overall health. When women are informed partners in the management of their health and fertility they enable medical professionals to provide them superior healthcare, while operating in a way that also enables the exercise of their own freedom and self-determination.
Women’s health and wellbeing also involve her emotional health and FEMM supports the healthy management of this aspect of a woman’s life as well. Hormonal fluctuations in a woman’s body correlate with emotional changes, and knowing this information allows a woman to understand the relationships between her hormones, her emotions, and the underlying physical experiences that she experiences at various times. This can help a woman to differentiate between emotions that arise in her from external sources, and emotional sources that arise from her physiology and hormones. For women young and old, such information can come as a revelation. Understanding changing emotional patterns is the first step towards correcting patterns which might be wildly out of balance, pointing to underlying hormonal or other abnormalities. Or, it might simply provide a woman with another tool to understand more clearly her emotional compass for any given day, and to appreciate the response that this enables her to give to the world around her more clearly.
Finally, women’s health involves the support required for women to achieve healthy and long-term intimacy, particularly when relating to the opposite sex. I noted at the outset that FEMM is a system that enables men’s involvement, especially among couples. Men need to understand the complex physiological reality of the women they love, both to support women in achieving healthy long-term outcomes, as well as work together to achieve family goals in deciding when to have children. FEMM enables the conditions for a deeper intimacy between men and women by providing them with an understanding of her body and reproductive health, in order to facilitate the important conversations and intellectual and emotional support necessary to develop and deepen the intimacy and decision making of the couple. Greater understanding provides the framework and requirements for better communication. This, in turn, leads men and women to express fully their thoughts, fears, desires, emotions and needs, in order to choose together how to live out their intimacy.
FEMM is currently being piloted with the Ministry of Health in St. Lucia, in the Caribbean. Other countries in Latin America and Africa are now looking at the model. It offers a new paradigm for the care and provision of women’s health, and a way for countries to meet international human rights obligations while respecting the health and dignity of women, men, families, and their social and ethical values. FEMM is also being introduced into the United States, working with women, doctors, and health providers to find ways to offer this knowledge and service to a wide a range of women and men.