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Graphic Medicine

The Facts of Life

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In the 1970s, best friends Polly and April collect hazy knowledge about the “facts of life”―sex, reproduction, and gender norms―through the gossip of older girls, magazines and books, and the everyday behavior of their families and teachers. What they learn reinforces their assumption that they will grow up to become mothers. As the years pass, they each choose paths that they believe will enable them to “have it all.” April’s dreams of motherhood come true before too long, but as Polly enthusiastically builds a career, her desire and hope to start a family become less firmly ingrained. Her struggles with chronic illness also have an effect on her choices and relationships, and she wonders whether motherhood will be in the cards for her at all. Soon she meets Jack, and together they start a fraught journey, first debating whether parenthood is right for them and then facing the heartbreak of repeated miscarriages and the effects of illness on their ability to have a child. Through it all, Polly is forced to reexamine what family can mean in a society that so often associates family―and womanhood―with children. Beautifully drawn and poignantly honest, The Facts of Life is a funny, sometimes painful graphic memoir that explores what it takes to be a woman, a partner, and a mother . . . or not.

240 pages, Paperback

Published March 15, 2017

4 people are currently reading
347 people want to read

About the author

Paula Knight

35 books35 followers
Paula is an author, illustrator and comics creator. She has illustrated numerous books for children and written three children's picture books as author. She's been a professional freelance illustrator since 1992.

Her first graphic memoir, The Facts of Life, (for adults) is published by Myriad Editions (UK) and Penn State University Press (N America). It's about the pressures on women to have children and what happens when life doesn't go to plan. An extract of it was shortlisted in Myriad's inaugural First Graphic Novel Competition in 2012. Judges included Ian Rankin, Bryan Talbot, Hannah Berry and Steve Bell.

"Intensely moving… honest and personal. It is a story told in pictures with sparse words about fertility, about loss, about growth. Of expectations - both personal and those from friends, family and society. It is about grief and pain and love. I wish I could think of a less trite way of saying this, but it makes you feel less alone."
Victoria MacDonald, Health and Social Care Correspondent, Channel 4 News

"Funny, poignant and philosophical, this elegant graphic novel challenges cultural pronatalism and examines the experience of living with a chronic, yet poorly understood, illness. I learnt a lot from this visually sophisticated and tremendously informative work, which is a must-read for anyone interested in reproductive politics." -Ian Williams, co-founder, Graphic Medicine

Paula's interests include wildlife, especially of the feathered variety. She pleads with them to prefer her garden, but local felines have other ideas. Her love of nature often inspires her writing, especially her own tiny woodland of oaklings. She dabbles in photography and considers herself an enthusiastic amateur.

Instagram: @paulajkstudio (illustration) @paulajknight (photos)

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Displaying 1 - 30 of 53 reviews
Profile Image for Dov Zeller.
Author 2 books125 followers
September 30, 2018
I came across this book because the writer has Myalgic Encephalomyelitis (ME) (aka CFS), an illness that I also have (and am homebound b/c of). I don't remember the details of how I came across the book, only that when I saw it existed--a graphic memoir by someone with ME with content about living with ME--I was really looking forward to reading it. (I tend to really enjoy graphic memoirs).
But I hadn't read anything by Knight before and no idea what to expect.

Once I picked "The Facts" up, I couldn't put it down. It's such a quietly absorbing and compelling book. A memoir about what it is like growing up as an afab person, constantly being barraged with all of these messages basically saying your worth lies in care taking others and in your future as wife and mother. I'm a trans guy, but I was "socialized as female" as some word it, and so I am familiar with these messages, but I have also been living as a queer person for nearly thirty years and one wonderful thing about being a queer trans person is that I have managed to get away from a lot of the social pressures that people often experience in more heteronormative communities.

It is hard to imagine the pain of being an adult and constantly being told your life isn't meaningful and will never be meaningful until you have children. And that you haven't fulfilled your duty as a human until you've had children. (Kind of a continual stream of comments from other people along those lines.) And then to either choose to not have children, or, to be unable to have children...

One thing I did notice while reading this is that there seems to be quite a bit of similarity in the way people treat you when you have a chronic illness like ME and when you are an adult cis woman who does not have kids. People are dismissive, intrusive, decide it is their business to "fix" your situation (regardless of whether it's a situation that they know very little about), people suddenly think they are experts on your life (and know more about your life than you do), and they also suddenly become medical experts (just without the actual expertise).

Anyway, this is a beautiful book. I love the art, the pacing, the honesty, the reflection, the celebration. Life is painful, and life with chronic illness can be deeply challenging (to put it mildly), and Knight acknowledges the struggles but also shows her search to find and celebrate meaning and joy and love in the life that she has (rather than focusing all of her time and spoons mourning the life that she doesn't have.)

Here is a GR Review by Sally Whitehead that I enjoyed:

It's quite difficult to put into words the impact a book like this can have.

For many who are "childless by circumstance" the process of 'acceptance' is indeed "a small quiet room" (thank you, Cheryl Strayed) and one which is revisited often in order to re-evaluate the complexities and paradoxes thrown up in one's life as a result of such circumstances.

Paula Knight "goes there", and she goes there with brutal honesty, warmth, humour, deep-rooted poignancy, and for many readers I'm sure, with painfully reassuring familiarity.

Some have criticised the ending of this memoir for reading too much like a "manifesto". But, to those for whom the social "otherness" alluded to is indeed a "fact of life", there IS a sense of needing to habitually assert your okay-ness in a world of norms which are often alienating and (albeit unintentionally) non-inclusive.

A powerful, compelling and important book. (less)
Profile Image for Stewart Tame.
2,483 reviews120 followers
August 30, 2017
In this memoir, Knight talks about her life, what it's like to be a woman, a partner, a mother ... almost. Starting with her childhood, she shows the societal expectations and role models that shaped her growing up. The book is about her individual experiences and choices and how they conform or not to other people's expectations. Names in the story have been changed, including her own, partly for privacy, and partly because it gave her the necessary distance to write about it effectively. This is a deeply moving, thought-provoking, simply fascinating book. Highly recommended!
Profile Image for Megan Baxter.
985 reviews766 followers
December 4, 2017
I am not a fan of trying to write reviews of graphic novels. That doesn't mean I don't like graphic novels, but the difficulty is similar to the one I have writing reviews of books of short stories. In both cases, the works I'm trying to comment on flash by too quickly. I do best when I stretch a book over several days - something I do quite purposefully, reading multiple books at once to prevent starting and finishing a book on the same day. I need the time and the space for my mind to stretch into the book, to think quietly about what I'm reading, to mull over what's going on. Only then do I feel like I can write a review.

Note: The rest of this review has been withheld due to the changes in Goodreads policy and enforcement. You can read why I came to this decision here.

In the meantime, you can read the entire review at Smorgasbook
Profile Image for Sally Whitehead.
209 reviews7 followers
March 25, 2018
It's quite difficult to put into words the impact a book like this can have.

For many who are "childless by circumstance" the process of 'acceptance' is indeed "a small quiet room" (thank you, Cheryl Strayed) and one which is revisited often in order to re-evaluate the complexities and paradoxes thrown up in one's life as a result of such circumstances.

Paula Knight "goes there", and she goes there with brutal honesty, warmth, humour, deep-rooted poignancy, and for many readers I'm sure, with painfully reassuring familiarity.

Some have criticised the ending of this memoir for reading too much like a "manifesto". But, to those for whom the social "otherness" alluded to is indeed a "fact of life", there IS a sense of needing to habitually assert your okay-ness in a world of norms which are often alienating and (albeit unintentionally) non-inclusive.

A powerful, compelling and important book.
Profile Image for Matt Graupman.
1,077 reviews20 followers
August 3, 2017
I remember listening to a podcast interview (I think it was Dan Berry's "Make It Then Tell Everybody") with cartoonist Julia Wertz where she explained that no publisher wanted her to do a book about her battle with lupus because it wasn't "a sexy disease." They explained that if it wasn't cancer or something similarly devastating then audiences just weren't interested. I thought about that a lot as I read Paula Knights semi-fictionalized-but-pretty-much-autobiographical memoir, "The Facts Of Life," about her struggles with infertility. While it may not be as sensational as something like cancer, infertility affects a lot of people and can be just as much of a gut punch, physically as well as mentally and emotionally.

The bulk of "The Facts Of Life" details Paula's- I mean, "Polly's" numerous miscarriages, hospitalizations, and doctor visits, all presented in a conversational, almost diary-like way. While I liked this section, for me the most interesting part of the book were the later pages, where Knight explores how ingrained motherhood is to a woman's role in society and how being childless (a term she actually hates) left her feeling like an outsider amongst her friends and colleagues. That facet is hardly discussed at all when people talk about infertility and I was shocked and saddened by how some reacted to Polly's decision to not continue to try and have a baby. A decision like that is intensely personal and it feels like a privilege to be let in so fully to Knight's thought process. After reading "The Facts Of Life," I was definitely able to more fully appreciate how easily my wife and I created two healthy sons.

I have family and friends that either can't conceive or have decided not to and, up until reading "The Facts Of Life," I've never really understood exactly what that entails; this honest and open memoir helped correct that. Everyone has a story to tell and I'm glad Knight - and her publishers - felt compelled to tell this one.
Profile Image for Melody.
2,669 reviews309 followers
November 14, 2018
This was wrenching and wonderful. I remember being on that roller-coaster of basal body temps and hopes and miscarriages and tears. I liked watching her journey through and out the other side. The graphic novel format worked well, I thought. I'd have liked a little more background on her relationships, but respect that those people are all living and have their own stories. Recommended.
Profile Image for Kelly.
22 reviews
June 3, 2017
This book was a wonderful portrayal of what going through infertility problems is like. Everything in this is something I've either experienced or felt. I'd recommend to anyone having fertility issues or for those that know people going through issues.
Profile Image for Emma.
36 reviews6 followers
March 12, 2017
I found this book thought-provoking and moving. As a woman of a similar age to the central character Polly, and having also been on a 'fertility journey' I found much to identify with: especially in the early section which deals with childhood and the influences and attitudes towards pregnancy and motherhood which girls born towards the end of the sixties were subject to.

In the latter part of the book there was much to chew on for me regarding pronatalism and how we define ourselves and are defined by society in terms of our ability to reproduce. However I don't want to make the book sound worthy: it's a beautifully written, drawn and designed graphic novel and I'm looking forward to re-reading it once I can get it back off my partner!


Profile Image for Brittany.
245 reviews36 followers
November 14, 2018
While I purchased this for the library's collection with patrons who may be going through a similar experience to Paula in mind, post-reading I see that there's something in this book for everyone. The topics addressed include having children, not having children, miscarriage, invisible illness, chronic illness, love, communication, friendship, and so much more. It packs a punch.

If you are going through (or have gone through) the processes of doubting, deciding, trying, recovering, you'll no doubt find a kinship with Paula as she shares very openly and honestly her experience. If you have children, but know people who don't, this book is a great eye-opener for the history behind our very child-centric culture and why certain phrases or "well-wishes" that might fall out of our mouths while talking to people who've either chosen not to have children or are having trouble conceiving or carrying to term should probably be left unsaid.

The art is lovely. While it is black and white, Paula's shading keeps you focused on exactly what she wants you to see at any given moment, and the small details really shine through. The narrative flows well -- she's good at transitions. I love that you can feel the tone shift with each new idea, decision, or concern she experiences. And I really enjoyed the part toward the end that talks a bit about the history of society's view of women as child-bearers and how over time we've cycled through viewing women as strong and powerful, then as a drain on the system if they were single mothers, then as failures if they didn't have children, etc. The way it influences even our language is fascinating. Really fitting end to the story and a call to action for us to consider those around us and make some changes.

I'd recommend this for any graphic medicine collection, graphic novel collections in general, and anyone who enjoys a good memoir.
2,738 reviews
Read
August 4, 2023
This one didn't fully resonate with me, but I'm glad it's out there and I hope it's helpful or a better fit for someone else. I've read a good number of books and memoirs about in/fertility, but this one takes place mostly at a slightly earlier time, which was interesting.
2,855 reviews75 followers
December 31, 2017

“Once you give something away freely, you must relinquish all claim over it”

This was a lovely book. It is a heart breaking but also heart-warming account of a woman’s life journey of sorts, as she takes us from her working class childhood through her teens, studentdom and adulthood to the start of middle age. She explores many issues in here, from the pressures of keeping up with peers to the difficulties of living with an unpredictable chronic condition. We see how through many of the trials and dramas she encounters, she still manages to soldier on and manages to draw inspiration and hope and so we do in turn. It’s rarely easy, but she always finds a way and always manages to salvage something precious or special and make something positive from her experiences.

She also talks about the prevalence of prenatal ideology through most of our media and culture and how the idea of women and children has been used many times throughout history, showing the ways it has been weaponised by religion and politicians as a means of power and control to serve various agendas, teaching and conditioning women to feel ashamed, guilty or isolated if they cannot or do not have children.

Knight uses some really playful and creative devices in her art work too, which help to keep the story fresh, original and engaging throughout. This was a hugely enjoyable piece of graphic fiction that put me in mind of the likes of “The Bad Doctor” and “The Nao of Brown”, marrying darkness, humour and positivity in many creative ways, making for a truly memorable and thoroughly enjoyable read.
Profile Image for Emily Harrison.
90 reviews1 follower
October 27, 2017
I adored this book so much. being a mother myself I was a little apprehensive about it as I had read some reviews that said it painted mothers in a negative light. This is not true at all.
It is a beautiful depiction of Knight's own struggle with choosing to be a mother, with pressures from friends and family and her own conflicting emotions. I found myself crying and laughing throughout. The pacing of the book was perfect, I felt satisfied with the size and the black and white illustrations captured the story wonderfully. I felt the frames were excellent, at times leaving much the the readers imagination but flowing perfectly from one to a other. Thoroughly enjoyable, I hope she does another!!! (hint hint*)
Profile Image for Fátima López Sevilla.
256 reviews22 followers
November 22, 2021
I got this book at the library two weeks ago, and I just needed to be in the right mental space to get into it, though I really really wanted to read it.
I am 32, and 3 years ago my journey of rare autoimmune diseases and having to rest after some normal activities and countimg spoons for things like going grocery shopping, cooking or washing my hair started.
And two years ago I started on a medication on which I should not get pregnant at all (all of my doctors are very adamant on this), as there is high risk of ectopic pregnancies, amongst other things.
All in all, I related to this book so much, and Paula told her story so beautifully and clearly, anyone who is wondering about whether parenthood is for them, if they should bend to societal expectations, if they are "less" for not having children, etc., should read this.
We are not alone.
And I am not childfree or childless... I am ME.
Profile Image for Juwi.
477 reviews88 followers
February 4, 2022
Love this Graphic Memoir!

You seriously do NOT have to have kids if you don’t want to and also mind ya business coz some people can’t have kids too!!!

Love that this book was all real talk about miscarriages, pregnancy and IVF and about wanting to have a child but not being able to and coming to terms with a childless life but that doesn’t mean you can’t have a fulfilling and happy life without kids!

Also, about living with a chronically illness (ME/CFS) and how difficult it can be but also how important it is to take each day as it comes and live in the present and appreciate the beauty of the now.

Highly recommend this to anyone who loves graphic novels and memoirs and just if you’re looking for something that is real and funny and set in the U.K.!
Profile Image for Dioni.
184 reviews39 followers
August 22, 2022
This book is an impulse pick up from the library. I flipped it through and saw a woman with her legs apart and a baby coming out of her. So I took the book home. There are really not many graphic novels by a female author, talking about female issues. Once I started reading, I couldn't put it down, it was a real page turner.

An autobiography by Paul Knight, who is a British/English author illustrator, The Facts of Life tells her struggles to survive in a society that values a woman based on motherhood. More tragically for her, she did indeed want children, and was not able to have one due to health issues. The book is a sharp and honest look into societies, the history of how we got here, and eventually an uplifting take of life and the world. I admire Knight's ability to put her thoughts into drawings that work just right.
Profile Image for Camilla.
37 reviews3 followers
September 2, 2017
I loved this book- I knew very little about it before I started reading and discovered it was largely based in my former home town, with passing mentions of where I live now. I'm a similar age to Paula Knight and although I've never wanted children I've gone through some of the things she talks about in her book. I cried on more than one occasion. lovely stuff.
Profile Image for Emma.
18 reviews2 followers
May 17, 2022
a beautiful telling of a topic that is (but shouldn’t be) taboo

Beautifully illustrated and with lots of vulnerability and honesty. Although I have a child, I appreciated the discussion around whether to have kids, and more importantly how to be more inclusive of those who can’t or decide not to have children.
Profile Image for Clare.
351 reviews7 followers
August 17, 2025
This book about choice should be mandatory reading for everyone, especially when teaching sex ed at school. An honest look at the pronatalist roots of British society and the damage it can do to women who are unable to or who choose not to have children as well as the impact this has on their partners.
Profile Image for Cathi.
225 reviews9 followers
August 22, 2018
I enjoyed this one quite a bit. So many fertility conception stories seem to go down the 'we did every treatment under the sun and finally it worked/we got pregnant the old fashioned way' and I love that this didn't (is that like research with no results not getting published?). I liked Knight's illustration style, and the way she took a holistic view of her life and societal influences as they relate to fertility and womanhood.
I really love graphic non-fiction- found this by looking at my library's selection, need to do some more searching in the genre.
This entire review has been hidden because of spoilers.
52 reviews
January 29, 2019
I loved this honest memoir as I've had fertility problems, though I was lucky to have a child in the end this made me think of how life could have been and how our choices lead us down different paths.
Profile Image for Hannah.
361 reviews
March 20, 2020
Beautiful graphic novel exploring infertility and childlessness. I liked how simple and easy it was to read. Interesting to hear what made her give up trying in the end too.
Profile Image for Rod Brown.
7,462 reviews289 followers
September 2, 2017
The author uses her personal experiences to put forth an interesting reflection on infertility and reproductive choices. This is a very British book that threw me a few times with its use of idioms.
142 reviews2 followers
April 15, 2021
A brave book, and beautifully written and drawn. I love that graphic novelists are tackling such taboo subjects.
Profile Image for Karah.
Author 1 book31 followers
April 4, 2019
I appreciate how Paula and her partner put an end to their suffering. I don't know if I could've been that realistic. Furthermore watching Paula blossom as an artist made me happy for her.
83 reviews1 follower
August 17, 2018
#british #graphicmedicine #adolescentjourney #growingup #bearingchildren #sigurros
Displaying 1 - 30 of 53 reviews

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