Getting your tubes tied

No, I’m not planning a tubal ligation; I think that there will be more children in my future (although not any planned for the immediate future). I read a blog post about women wanting to be sterilized, and being turned down because they were childless and single and “may change their minds in the future.”

While I understand that people change their minds, and the way they feel today does not prove that they will always feel that way (look at how people are keeping tattoo removal places in business!), I wonder at the condescending attitude displayed by the doctors who refuse to sterilize a woman who absolutely does not want children. The kicker of this blog post is that it displayed comments by women who had undergone multiple abortions, and were desperately trying to find a doctor to do a ligation so that they could not get pregnant again. There were comments from women who had had 5 and even 10 abortions. Some of the women had been on chemical birth control and/or used condoms all the time, yet still ended up pregnant. Sometimes they said they used the birth control perfectly; other times they did not (a week late for a Depo-Provera shot, for example).

I can understand doctors being reluctant to perform such an procedure that will forever prevent a man or a woman from having a child (reversals happen, but they’re not guaranteed), but it almost sounds like the doctors are “patting the little girl on the head” — “Oh, honey, I know you say you don’t want children, but you’re young and single and you’ve never had a child — how do you know you won’t change your mind some day when you meet Mr. Right?” It’s not a procedure to be taken lightly; but neither is an abortion — which was the alternative these women chose. They seemed to be commiserating how difficult it was to get their records to prove their past abortions, in order for them to show a doctor just how serious they were about not wanting children and never wanting children.

Tubal ligation is an elective procedure, like plastic surgery or gastric bypass — it’s not to be taken lightly, and the patients should be screened to make sure they’re serious and that they understand what they’re going to be going through — protecting patients and doctors — informed consent and all that. But why is there such a hurdle for these women?

There is no guarantee that a married woman with children will not change her mind, regret her tubal ligation decision, and wish she had more children. My mom had her tubes tied after she had me, because 4 kids in 6 years was just plain tough… but she said she sometimes regretted her decision and wished she could have had more children. At the time, she didn’t know anyone with larger families, but when I was about 6 we changed churches and met families that had 5, 6, 8, 9, and even 12 kids. Had she had such a group around her, she may have made a different decision at the time. Then there are women who get divorced and remarried and wish they could have a child with the new husband. Or women who lose their child(ren) in some way and wish they could have more — when the tsunami hit Asia a few years ago, there were thousands of women like that — all of their children died in the wave, but they were sterilized and couldn’t have any more. Or a child gets cancer or some other disease and the parents wish to try for another child for a good donor match of some sort, since full siblings have the greatest likelihood of being good matches.

When one of my friends had her first baby, she was asked as a matter of form after the birth if she wanted her tubes tied; she said yes (she’s not a big fan of birth, to say the least). Her husband shook his head, so she changed her answer. She didn’t really want her tubes tied — she was just asked that question at a vulnerable time for her. Going into her second labor, she told her doctor not to even ask the question, because she knew she’d say yes but wouldn’t really mean it. It’s just surprising to me that one doctor would ask a first-time mom right after birth if she wanted her tubes tied while another doctor would refuse that procedure to a woman who had had multiple abortions because just didn’t want children.

And you know what’s even worse? Doctors performing C-sections on mothers and then refusing VBACs, which may effectively limit the size of their family to two or three children, for little to no good reason. I’ve heard some women be told that they could only have 3 C-sections; and the risks increase exponentially with every surgery. But why do doctors refuse a tubal ligation for one gyne patient because “she may want [more] children later” while doing an unnecessary C-section on another patient despite the fact that she may want a large family? Just ridiculous.


12 Responses

  1. I’m considering that whole thing (tubal ligation) right now, and it’s a very conflicted decision. I would keep having kids forever, but I just can’t take more of this blasted morning sickness – and I know that statistically, it will be with me as long as I choose to have more kids, and will probably get worse. But the prospect of having no more kids EVER is also bleak. It’s a hard decision. Thanks for your thoughts on it! There are definitely some weird politics mixed up in the whole thing.

  2. …and I thought doctors were quick to do tubals… way too quick. I’d prefer doctors to be a little more hands off when it comes to planning a women’s family size.

    I sometimes wonder if tubals screw up a women’s hormone balance resulting in heavy and abnormal periods. Woman should seriously consider not having tubals. I enjoy exposing woman and couples to NFP. Many are so receptive and appreciative.

  3. This really brings me back to the very strange (yet standard) conversation I had with the doctor after my son’s birth. She brought up birth control, and I felt like I had passed the afterbirth a moment before. To be fair, it was the next day . . . but what kind of message is that sending to women?

    That kind of pressure really infers a negative message:
    “Wasn’t that birth a terrible experience? You wouldn’t want to do THAT again soon, huh?” OR “Just like all aspects of your health and reproduction, your future fertility should be under tight control based on OUR assumptions about how you should live your life. So, do you want the pill, the patch, the shot, or what?”

    The doc didn’t say any of these things, but she warned against the barrier method being ineffective, and even brought up STD’s . . . which don’t mean anything to someone in a steady, long-term monogamous relationship ESPECIALLY since testing for common STD’s is now a standard first step when ‘dealing’ with a new pregnancy.

    I WISH she’d told me about Natural Family Planning, breastfeeding amennorhea and natural child spacing through ecological breastfeeding. I wish someone had handed me Cycle Beads and said, “You don’t need extra hormones. Just use the ones you’ve got. Get in tune with your body, and you can be in charge of your own reproduction, have better sex, and trust your body more.”

    Better yet, all this information is what we should be teaching young girls, so that they have the knowledge to work WITH their bodies and their cycles so they don’t have to depend on anything outside their own bodies in order to maintain reproductive health.

  4. P.S.

    Diana, check out this book about pregnancy sickness, if you haven’t already:

    It’s called Pregnancy Sickness: Using Your Body’s Natural Defenses To Protect Your Baby-to-be, and I highly recommend it. It explains the biology of pregnancy sickness, but also has strategies which can help manage extreme sickness.

  5. Both of my midwives gave me the standard “you should avoid pregnancy for several months, or preferably at least a year” after I gave birth. I didn’t listen to their advice the first time. 🙂 But I know statistically, mothers and babies do better when there is at least 12 months between pregnancies (although I know a woman who had her two sons NINE MONTHS APART).

    Anyway, I do agree that women should use other forms of birth control, and I also prefer NFP because it is non-invasive, empowering, and avoids artificial hormones.

    I was one of those women who did *not* experience lactation amennorhea, though, so I always give that caveat when I speak of pregnancy avoidance after birth.

    Leslie, your comment about “wasn’t that birth just so awful, so don’t you want your tubes tied?” reminded me of stories I’ve read of women back in the 60s and 70s (typically lower-income and black) who signed for a tubal ligation when they were still basically out of it and groggy after their general anesthesia births. Basically, a doctor or someone else would come up to them when they were just waking up and say, “That sure was bad, wasn’t it? You don’t want to go through that again, do you? Well, just sign right here, then!” Sounds like a used-car salesman, rather than a doctor, doesn’t it?

    I’ve also heard of women who have C-sections have a much higher percentage of both hysterectomies and tubal ligations — “While we’re in here anyway, let’s just take care of this.” Of course, many women have necessary hysterectomies because of surgery complications, but a lot of women get pressured into it — especially by doctors who want to put a limit on how many C-sections they’ll do, and won’t do VBACs. I can imagine a conversation going like this, “Well, you had a C-section your first time, so you have to have a repeat C-section this time; since there are a lot higher complications in a woman who has three or more C-sections, let’s just tie your tubes when you’re in surgery this time, so you’ll be safe.” Blech. “Informed consent”? — yeah, right!

    • i can agree in some instances its wrong to push tubal ligations it is a womans choice but in some instances its also necesary. during my last pregnancy i almost died they had to do a emergency c section to save my life.i am only 25 and even though i know that i want more children one day, i cant, its not safe.i am pregnant now and its a miracle nothing bad has happened even thouh i have had several health complications. my drs are greatly encouraging me to have my tubes tied. and even though i may not want to i know for my health and well being i have to.
      its not right when drs pressure women to do this, but sometimes (not all the time), its necesary in order to protect the health and well being of the woman. just my opinion.

    • I was wondering why my doctor keep pressuring me to have a Tubal ligation when had my c-section. I was wondering if it was because it would benefit him by doing it while I was already having a c-section and he could just make more money by doing an extra surgery then. I told my doctor several times at my prenatal visits that I was not wanting my tubes tied during my csection. I consistantly told him I didn’t and he kept asking on my last few visits. So I did end up getting them tied after he put the paper in front of me and asked me again while the needle was in my back as I was getting my spinal block. I regretted the decision and resented the doctor.

  6. “reminded me of stories I’ve read of women back in the 60s and 70s (typically lower-income and black) who signed for a tubal ligation when they were still basically out of it and groggy after their general anesthesia births. Basically, a doctor or someone else would come up to them when they were just waking up and say, “That sure was bad, wasn’t it? You don’t want to go through that again, do you? Well, just sign right here, then!” Sounds like a used-car salesman, rather than a doctor, doesn’t it?”

    It sounds like Eugenics to me.

  7. Tubal reversal, according to a testimonial I read, is such a great hope for people having problems conceiving a child. I read that at
    Gary S. Berger, M.D. is the most widely known expert in tubal reversal procedures. I hope this helps.

  8. I totally agree! I’ve read at that many couples will have trouble with becoming pregnant. As many as 12% of couples will suffer from infertility and tubal reversal is mostly their last resort.

    It’s interesting to note that, according to the blog, when infertility exists, 50% of the time is is a male related problem (low or absent sperm count) and 50% of the time it is a female related problem. And with all the many reasons of infertility, it’s comforting to know that there’s tubal reversal to give people some great hope.

  9. I had a tubal ligation done. And had 3 abortions prior to my last birth. I too was refused a tubal after my first birth. Which is insane! However after the tubal ligation I have had awful pains that shoot all thw way from my lower back to my feet during menses. Bleeding is heavier. and I know it is all to do with the hormones. My tubal was done at the age of 37. I do wish I had been listened to after the first baby. There is simply no excuse for this ignorance!

  10. I’M on baby number 5 an i do want this to be my last baby my family is complete but i’m scared to get my tubes tied but im going fourth with it i just hope i can breast feed an everything be ok can anybody that had there tubes tied already give me any advice about it?

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