The Mother-Daughter Connection: Empowering Mothers and Daughters to Communicate About Health
By Mary Marcdante

Under what circumstances do mothers and daughters decide to come together and communicate as friends? For some it involves marriage or childbirth. For others, it is a physical or emotional crisis. For me, it was when my mother was diagnosed with ovarian cancer. From the moment I heard the word "cancer" until her death, I was filled with questions that led to answers and a new-found friendship I never expected - but that was shortened far too soon.

Why does it so often take a health crisis for us to understand the power and value of connecting with our mothers and daughters?

After my mother passed away, there were still so many things I needed or wanted to know. In pursuit of answers, I read books, spoke to other women, interviewed psychologists and revisited my own past. I learned that most women have questions they want to ask their mothers, but are afraid to broach certain subjects. Ironically, it was while I was researching this topic that I awoke from a dream in which my mother suggested I write a book about questions daughters should ask their mothers. I was stimulated by the idea, but unsure I could face what it would 'stir up,' so I pushed the thought back.

However, when I was diagnosed with early-stage cervical cancer, everything changed. I was shocked because my Pap smears had always been normal, except for some "slight changes that only needed to be watched," according to my doctor. I later discovered that cervical cancer is caused by the human papillomavirus (HPV), a sexually transmitted virus that almost 80% of sexually active women get at some point, regardless of whether you are single or in a monogamous relationship. All it takes is sexual contact with one person who carries the virus. I also learned that although the body usually fights off the virus before it causes any problems, women age 30 and older with HPV are most likely to have a persistent infection with a high-risk type of HPV - in other words, one that doesn't go away on its own. And, as in my case, the Pap doesn't always catch these women in time. That's why many doctors now recommend that women over 30 get an HPV test along with their Pap. But at the time, I didn't know all that, and I was scared, embarrassed and uneducated. The worst part was that I didn't have my mother to talk to. She had a hysterectomy herself when she was in her late 30s, and knowing more about that could have been helpful to me. It was then that I promised myself that if I survived this experience, I was going to dedicate my life to helping women communicate more effectively with others - especially their mothers - about their health and well-being.

After my treatment, I spent the next six years collecting thousands of questions and interviewing hundreds of mothers and daughters for my book My Mother, My Friend. I found that health was the most avoided topic that women wished they'd asked their mothers about - followed by money, aging and end-of-life issues.

Through these other women, I learned that whether your relationship with your mother is strong or you haven't spoken to her in years, the quality of both of your lives today and in the future is directly related to the quality of your conversations. Following are some tips to ensure you can have a meaningful conversation with your mother about HPV and cervical cancer, or about any other subject that may be difficult or embarrassing:

• Consider the best time and place to talk. Select circumstances that will be low in anxiety and allow you to feel in control (such as a coffee shop or a walk in the park).

• Determine what you want from your conversation. This will help you stay on track (for example: "I want my mother to be informed about HPV and its role in cervical cancer").

• Think of your questions in advance. For example: "Are we both doing everything we can to stay healthy?" or "Do you know all the tests that you need to have to prevent cancer or diagnose it early?"

• Prepare for possible responses. Think about what your mom might say in response to your questions, and how you'll react. This will help you remain patient if you're faced with resistance (Mom: "I've been with your dad for more years than you can count. I'm not at risk of a sexually transmitted virus." Besides, I already get a Pap test every year." Response: "Mom, you could have gotten the virus many years ago and it's just stayed dormant all this time. And as for the Pap, it isn't always accurate. If you get an HPV test too, you - and I - can be a lot more confident that you're not at risk. Do it for our peace of mind.").

• Visualize a positive response. Even if you know your mom may react negatively, keep a positive mindset, because your energy and attitude will set the stage for her responses.

• Establish a positive direction. When your mom says, "I don't want to talk about this," empathize. You can say: "Mom, I know this is uncomfortable, but it's really important. Women over 30 are at the highest risk for cervical cancer, but it's easily preventable if you get the most advanced tests."

• Stay calm. If she's really resistant, stay calm and remember you can always continue the dialogue later. If she is overly opposed to the subject, drop it and then send her a related article, with a note that says: "I love you and I know you'll make the best choice for your life and our future together."

For more information about Mary Marcdante, including her mother/daughter retreats, or to receive her free list of "20 critical health questions to ask your mother," visit www.marymarcdante.com.