Birth-control pills, condoms, diaphragms, IUDs -- forget what you've read about their varying rates of effectiveness, says Byllye Y. Avery. The only thing that makes contraception work is the mind.
"You could pile up a table with birth control and, if my mind tells me don't use it, it won't help me," Avery says. "Birth control is a function of the mind."
Avery, who will be in Baltimore tomorrow to speak at the seventh annual state conference on Teen-age Pregnancy and Parenting, is the founder and director of the National Black Women's Health Project.
The network of self-help organizations started in Atlanta in 1983 and now is in 23 states, including Maryland. Its premise is simple: Black women must first address their psychological well-being in order to have physical well-being. Toward that end, women in the project meet every month in local support groups.
That message applies, Avery says, whether the subject is teen-age pregnancy, infant mortality or breast cancer. "Black women live in psychological distress. That distress has affected how we see ourselves and how others see us."
Given that most birth-control use requires some conscious action, how does Avery's theory about the mind's role fit in with the soon-to-be-approved Norplant implant? With this device, synthetic hormones like those in oral contraceptives are released by six tiny implants in the arm, protecting a woman for up to five years.
Some public-policy experts have said in published reports that the implant offers foolproof contraception after it is inserted by a doctor, making it an ideal contraception for teen-agers. But Avery is not convinced.
"No type of birth control will substitute the neediness of young girls who want to have a baby," Avery says.
Originally from Florida, Avery, 53, became interested in health-care issues when her husband died of a heart attack in 1970. At first, her efforts were directed toward things such as birthing centers.
But she became interested in the issue of black women and self-esteem in 1979, when she saw the results of a comprehensive study on health. According to that survey, Avery said, black women ages 15-25 rated their mental health lower than white women with diagnosed mental illnesses.
"I knew we were not crazy," Avery says. "So I wanted to find out what we were up against."
Avery now believes self-esteem -- she calls it people's "need to feel good about themselves" -- is the key. Through her networks, she says, women learn empowerment, which helps them aggressively seek help for health problems.
The conference on teen-age pregnancy runs from 8 a.m. to 3:30 p.m. at Marriott Hunt Valley Inn. Avery is to speak at the luncheon session.