No, we won't tie you!

LirW

I'm posting this here because I think it's a topic that might be interesting for women in general.

I had my daughter 3 months ago, was a scheduled C-Section. She's my second and we really don't want to have any more children. I'm in my late twenties. When it came to discuss the section, I mentioned about getting my tubes tied in the same move, because it's so much easier doing it.
You can guess what the answer was: "No, you're too young, you're going to change your mind."
Again when I went to the GP for my check up a few weeks later, the topic contraception came up. I can't take any hormones due to a medical issue and everything copper falls out too, because I have excruciating periods that make me vomit.

I really do want to know a very rational reason for being turned down after having children from taking care that I don't have any more because I don't want them. What does make me too young?

I'm so sick of hearing from every nurse, midwife, doctor, bus driver and neighbor that I'll change my mind. No I know myself and I won't.
Next time I hear this line again I'm gonna strangle someone.

Am I the only one that thinks that this is completely ridiculous?

sullivlo

LirW wrote: »

I'm posting this here because I think it's a topic that might be interesting for women in general.

I had my daughter 3 months ago, was a scheduled C-Section. She's my second and we really don't want to have any more children. I'm in my late twenties. When it came to discuss the section, I mentioned about getting my tubes tied in the same move, because it's so much easier doing it.
You can guess what the answer was: "No, you're too young, you're going to change your mind."
Again when I went to the GP for my check up a few weeks later, the topic contraception came up. I can't take any hormones due to a medical issue and everything copper falls out too, because I have excruciating periods that make me vomit.

I really do want to know a very rational reason for being turned down after having children from taking care that I don't have any more because I don't want them. What does make me too young?

I'm so sick of hearing from every nurse, midwife, doctor, bus driver and neighbor that I'll change my mind. No I know myself and I won't.
Next time I hear this line again I'm gonna strangle someone.

Am I the only one that thinks that this is completely ridiculous?

No. You're really not the only one who thinks it's completely ridiculous. I have friends who 100% do not want kids. Never have. Never will. Don't get gooey eyed when they see a baby and puke at the thoughts of a dirty nappy.

Yet they can't get tied either. It's nuts.

Peregrinus

The problem is an ethical one for the medics. Fertility is not a disease or disability, and therefore treatment to eliminate it raises ethical issues for them. In general doctors are supposed to cure, heal, etc. And sterilising somebody is, in effect, incapacitating them in one particular respect; it's taking a healthy functional organ and permanently disabling it. They're much more comfortable about doing this where there's a medical indication to support it.

If the OP has medical issues that reduce her contraceptive options, that might provide a sufficient medical indication. The OP could ask her GP to refer her to a gynecologist to discuss her options. (Possibly a different gynecologist from the one who has already declined.)

sullivlo

Peregrinus wrote: »

The problem is an ethical one for the medics. Fertility is not a disease or disability, and therefore treatment to eliminate it raises ethical issues for them. In general doctors are supposed to cure, heal, etc. And sterilising somebody is, in effect, incapacitating them in one particular respect; it's taking a healthy functional organ and permanently disabling it. They're much more comfortable about doing this where there's a medical indication to support it.

If the OP has medical issues that reduce her contraceptive options, that might provide a sufficient medical indication. The OP could ask her GP to refer her to a gynecologist to discuss her options. (Possibly a different gynecologist from the one who has already declined.)

Not liking the shape of your nose is not a medical issue, yet there are countless nose jobs performed each year.

I would consider not being able to tolerate contraception to be a medical issue, no? If I can't take hormone treatment because I am at risk for DVT or I have cholesterol issues, and I can't use the copper coil, or if I have a latex allergy so I can't use condoms, should I be abstinent?

Vasectomies don't have a medical indication any more so than female tube tying, why is there a difference in access?

Peregrinus

sullivlo wrote: »

Not liking the shape of your nose is not a medical issue, yet there are countless nose jobs performed each year.

Yes, I know. But having a nose of a different shape is not an incapacity or a disability. Being infertile is. Hence sterilisation raises ethical issues that nose jobs don't.

sullivlo wrote: »

I would consider not being able to tolerate contraception to be a medical issue, no? If I can't take hormone treatment because I am at risk for DVT or I have cholesterol issues, and I can't use the copper coil, or if I have a latex allergy so I can't use condoms, should I be abstinent?

I'd agree with all that. I think those kind of considerations would be relevant to raise when seeking a medical sterilisation.

sullivlo wrote: »

Vasectomies don't have a medical indication any more so than female tube tying, why is there a difference in access?

I suspect the answer is a pragmatic one. Vasectomy raises the same ethical issues, and many doctors are reluctant to do vasectomies (without a medical indication). But the operation itself is very simple and can be performed on an outpatient basis, so it only takes a few doctors who are happy to provide it to meet all the demand. Nearly all vasectomies are carried out in specialist clinics, and presumably doctors who are reluctant to do the operation don't seek positions in those clinics. So men who are seeking vasectomies are approaching doctors who are, in effect, pre-screened for their willingness to provide vasectomies. Women seeking tubal ligation (especially in connection with a C-section, like the OP) find themselves in a different environment.

sullivlo

Peregrinus wrote: »

Yes, I know. But having a nose of a different shape is not an incapacity or a disability. Being infertile is. Hence sterilisation raises ethical issues that nose jobs don't.

I guess it's all about perspective. Is it an incapacity if it's desired? Is the inability to have children really a disability? What about the other area of what if a woman can't follow through with a pregnancy for health reasons, I don't know say she has a heart complaint so can't sustain the pressure of a baby. Is that a disability? If she were to fall pregnant would she be guaranteed an abortion without question?

I have a friend who is genetically incompatible with her husband. They both carry a genetic mutation that says that their baby won't survive. She's had countless miscarriages. They want nothing more than to have a kid, yet it will never happen for them. They have made the decision to not try again because her doctor told her that another pregnancy could kill her.

Yet she can't get her tubes tied.

I'd agree with all that. I think those kind of considerations would be relevant to raise when seeking a medical sterilisation.

From the OP:

Again when I went to the GP for my check up a few weeks later, the topic contraception came up. I can't take any hormones due to a medical issue and everything copper falls out too, because I have excruciating periods that make me vomit.

That's medical grounds.

I suspect the answer is a pragmatic one. Vasectomy raises the same ethical issues, and many doctors are reluctant to do vasectomies (without a medical indication). But the operation itself is very simple and can be performed on an outpatient basis, so it only takes a few doctors who are happy to provide it to meet all the demand. Nearly all vasectomies are carried out in specialist clinics, and presumably doctors who are reluctant to do the operation don't seek positions in those clinics. So men who are seeking vasectomies are approaching doctors who are, in effect, pre-screened for their willingness to provide vasectomies. Women seeking tubal ligation (especially in connection with a C-section, like the OP) find themselves in a different environment.

I suspect that it's less of a pragmatic issue, and more of a "women don't have equal rights to medical treatment as men" issue, tbh.

If it were such an ethical issue, vasectomies wouldn't be done at all.

Peregrinus

sullivlo wrote: »

I guess it's all about perspective. Is it an incapacity if it's desired?

Yes, it is. If you're incapable of something, that's an incapacity. That's what the word means. Doctors are generally not prepared to render healthy organs non-functional purely because the patient wants them not to function, and they don't make an exception for reproductive organs.

sullivlo wrote: »

Is the inability to have children really a disability?

Yes, it is.

sullivlo wrote: »

What about the other area of what if a woman can't follow through with a pregnancy for health reasons, I don't know say she has a heart complaint so can't sustain the pressure of a baby. Is that a disability? If she were to fall pregnant would she be guaranteed an abortion without question?

She should be able to have a sterilisation if she wants one.

(And if she doesn't have a sterilisation and falls pregnant she should be able to have an abortion, but that's a different discussion.)

sullivlo wrote: »

I have a friend who is genetically incompatible with her husband. They both carry a genetic mutation that says that their baby won't survive. She's had countless miscarriages. They want nothing more than to have a kid, yet it will never happen for them. They have made the decision to not try again because her doctor told her that another pregnancy could kill her.

Yet she can't get her tubes tied.

She also should be able to have a sterilisation if she wants one. I am dismayed that she cannot.

sullivlo wrote: »

From the OP:

That's medical grounds.

Yes. I said as much in my reply to her.

sullivlo wrote: »

I suspect that it's less of a pragmatic issue, and more of a "women don't have equal rights to medical treatment as men" issue, tbh.

If it were such an ethical issue, vasectomies wouldn't be done at all.

You can't say that unless sterilisations weren't done at all, and in fact they are done.

The bottom line here is that doctors aren't slaves; you can't compel them to provide treatment that they think it unethical to provide. A woman can only get a sterilisation if she and her doctor agree on it; a man can only get a vasectomy if he and his doctor agree on it. In both cases, the patient needs to find a doctor who doesn't have ethical objections to the procedure they are seeking. Men routinely go to clinics set up to provide services such as this; unsurprisingly, they find the clinics are staffed by people who don't have ethical objections. Partly because the procedure is a much more significant one for women, they tend to seek it in a different context, and meet a different response. If they went to a specialist private clinic they would, I think, meet with a similar degree of information/counselling as a man seeking a vasectomy at such a clinic.

sullivlo

Peregrinus wrote: »

Yes, it is. If you're incapable of something, that's an incapacity. That's what the word means. Doctors are generally not prepared to render healthy organs non-functional purely because the patient wants them not to function, and they don't make an exception for reproductive organs.


Yes, it is.


She should be able to have a sterilisation if she wants one.

(And if she doesn't have a sterilisation and falls pregnant she should be able to have an abortion, but that's a different discussion.)


She also should be able to have a sterilisation if she wants one. I am dismayed that she cannot.


Yes. I said as much in my reply to her.


You can't say that unless sterilisations weren't done at all, and in fact they are done.

The bottom line here is that doctors aren't slaves; you can't compel them to provide treatment that they think it unethical to provide. A woman can only get a sterilisation if she and her doctor agree on it; a man can only get a vasectomy if he and his doctor agree on it. In both cases, the patient needs to find a doctor who doesn't have ethical objections to the procedure they are seeking. Men routinely go to clinics set up to provide services such as this; unsurprisingly, they find the clinics are staffed by people who don't have ethical objections. Partly because the procedure is a much more significant one for women, they tend to seek it in a different context, and meet a different response. If they went to a specialist private clinic they would, I think, meet with a similar degree of information/counselling as a man seeking a vasectomy at such a clinic.

The point is that there are circumstances when sterilisation should be allowed, but they're not. And that's the issue that people have. That it's next to impossible to get a female sterilisation done.

Sunny Dayz

My friend was in a similar position. I've known herself and her husband a long time and they've always said they wanted 2 children and that's it, doesn't matter what genders.
When she was expecting no2 she wasn't entertained at all about getting tied, she was early 30s. But no problem for husband to get the snip.

I've brought it up at the gp myself last year. Told I was too young and I might change my mind. True I might change my mind but it's my decision to make and if I do change my mind, it's me who has to live with it, not the medics.

tracey turnblad

I got mine done at 30 after 3 kids and hyperemisis on each child. I told them I never wanted to get pregnant again I would kill myself. Doctor asked me what would happen if all my kids were killed in a car crash? I was so upset after that question but though another babay wouldn't replace the ones I already have. Anyways I stuck to my guns, and got it done quite quickly after my consultancy appointment. Btw tubes tied didn't effect my periods in any way so that's probably what the doctors is thinking. Merina coul would be the most effective for that

LirW

tracey turnblad wrote: »

I got mine done at 30 after 3 kids and hyperemisis on each child. I told them I never wanted to get pregnant again I would kill myself. Doctor asked me what would happen if all my kids were killed in a car crash? I was so upset after that question but though another babay wouldn't replace the ones I already have. Anyways I stuck to my guns, and got it done quite quickly after my consultancy appointment. Btw tubes tied didn't effect my periods in any way so that's probably what the doctors is thinking. Merina coul would be the most effective for that

I think you're raising an important point here: Women seeking this procedure get belittled and turned down with ridiculous excuses much rather than explaining why this actually is a problem.

I've heard it before that women also get asked "What if your husband changes his mind" and "What if your next husband wants them". These are highly inappropriate questions for someone who spent a lot of time researching and weighing all the options.

I just can't wrap my head around why women have to put up with this behavior from medical staff, they are the ones who should know better. Birth control is getting more and more of a spotlight topic with many women deciding against kids and not responding well to hormones. We just don't want to get belittled for decisions we're very well capable of making ourselves.
It really doesn't feel good when you're very certain about something and you get told from everyone that you'll change your mind. No I won't, I don't want to be pregnant again, the last one had such an impact on my everyday life and I dread the thought of having to do this all over again (was worth it, but I'm choosing not to, also I don't see that we have the money or room to accommodate a third child the way we should).

Oh and because it came up a few posts ago: I have a faulty ovary that causes a strong hormone imbalance, which is the reason that I'm suffering from nightmare migraines and very heavy periods. Every attempt to get it under control with hormones backfired, it made it a bit better in the short term but had huge impact on my personality. It already took me years and years to find out that my heavy bleeding is not normal, also something nobody tells you about.

Anyway, it just makes me unhappy to keep going with condoms with my man in the long run, I just want to close this chapter for myself.
I feel for every woman that has to jump through a huge amount of hoops and is not taken seriously.

tracey turnblad

Don't let it go. Go back to your doctor and insist in a referral. You deserve to be in control of your body. I said I want no more kids ever even if I split up with my husband I was done. I had my kids young I want to live my life now. Stick to your guns. They call it 'counselling' and they are trying to get you to really think about it. If you get a referral don't tell anyone till it's done, nobody's opinion counts it's between you and your partner. Don't give up!

To play devils advocate, because it's usually an irreversible procedure it's probably a good idea for a doc to come up with all kinds of scenarios to see if it's been considered from all angles.

I'm not defending them refusing a well thought out and reasonably requested procedure, just pointing out that at the same time they'd be pretty poor docs if they didn't evaluate how well thought out the request was to begin with, even if it sounds patronising to most patients, there is likely to be a few who haven't given it the same consideration and it's up to the doc to tell the two apart.

That said, it should be much more accessible when it's established that it's a well considered choice.

Stheno

I go to a gynaecologist who works in the hose but has a private practice.

Have been going to her for years and none years ago when I was in my mid thirties, single and childless I asked about tubal ligation, having known me, she was happy do so it on the private system

She is neither Irish born or Christian

I didn't go through with it at the time but it was an option I had and cost wise would equate to the couple of grand I've since spent on contraceptives

So it can be done but is dependant on the doctor

rainbow kirby

The Irish healthcare system has an awful paternalistic slant, particularly when dealing with issues that concern women. This is another example of that.

.......

This post has been deleted.

Malari

....... wrote: »

This post has been deleted.

I had a similar experience when I discussed it. I wasn't pushing it, to be honest, I just wanted to talk about options. I ended up staying on the pill because I didn't like the sound of the coil, and we use the belt and braces method of contraception with a condom. I have an abortion backup plan in place if I do end up pregnant in spite of all that.

.......

This post has been deleted.

LirW

As far as I know you can go on a public list for vasectomy but it's a good bit to wait.

We talked about that and he's not against it, he just said he would like to have a year or two to get used to the thought. Fine by me because he needs to be 10000% certain about this decision.
Anyway, I'd still like to have this done on my side, because me and my uterus and fertility are no amigos and I'd love to close this chapter permanently.

Not2beconfused

I'm currently on a public waiting list to attend a consultant for female sterlisation and I know it will be done but it's a long long wait. My sister is currently on the same list but ahead of me and had her first consult and was told the entire tubes would be removed, not just a clamp or cauterized section etc

I googled this and found out it's called salpingectomy and proceeded to get procedure code and rang my insurance and confirmed that they will cover this procedure.

Rang clinic secretary to be told that the consultant will decide on a case by case basis what particular procedure will be done per patient. But knowing that this is covered by my insurance and that I can now go quicker via private - can I make the private appointment and specifically request this procedure??

Any obgyn consultants hanging about to answer?

whoopsadoodles

tracey turnblad wrote: »

Doctor asked me what would happen if all my kids were killed in a car crash?

I wonder if your doctor happened to be mine at some point.

I was done with having children. Nothing surer....then what do you know.....they were killed in a car crash!

I did then want to have more - and had great difficulty. But my god, such a rare scenario to be throwing at women.

I would like mine tied now, but have not gone down that road and reluctantly had the mirena coil inserted following DNC to help with excruciating and debilitating period pain. It has helped immensley to be fair.