I don’t know about the rest of the country, but it’s damn near impossible to find a doctor who’ll even discuss the option around here. Hell, my new family practioner (soon to be my former FP for a variety of reasons) won’t even discuss the possibility of an IUD because it might impair my fertility. I had to bite my tongue to keep from yelling “Do you promise, or are you just jerking me around?”
(The fact that IUD’s don’t, in fact, impair fertility in nulliparous women is a whole other issue.)
Cool. I hoped you weren’t being taken advantage of or anything (I assume that because I’m cynical about people, nothing personal).
I had my daughter when I was 21, so I can relate to people looking at you funny. I looked 16, so people always gave me the “poor little pregnant girl” look. Now my daughter is 7, so it’s great. No more baby stuff for me.
Sorry, Goo, about the misidentification. I am astonished that the attitudes of doctors are so patronizing in some places regarding sterilization. I had really thought we put all that behind us years ago. I am guessing that maybe in those parts of the country it is difficult to find a Planned Parenthood branch, too. If one were really determined, and had the time, money, and resources, presumably you could go to a major city and find someone there. But it should not be necessary. Terrible situation.
That was me. 
It is legal for me to get sterilized, since I am of sound mind and over 21 years of age, but it’s extremely difficult to find a doctor who is willing to do the procedure. In the last seven years I’ve talked to around 40 doctors who have flat out refused to perform a sterilization because they either consider me too young, they won’t do that for someone who hasn’t already got kids, it’s not right for an unmarried woman to make that decision, some day I’m going to ‘meet Mr. Right’ and want children, etc ad nauseum.
Doctors in Pittsburgh, Philadelphia and NYC have not been any help, and it doesn’t seem to matter if the doctor is a man or a woman except that the female doctors tend to look at me with more horror on their faces when I tell them my biological clock will never tick because I don’t have a biological clock. The female doctors also tend to tell me they ‘feel bad’ for me because they believe I’m ‘missing’ something and that I’m unhappy about not wanting kids.
I have been unable to explain to them that I’m not lamenting anything, I just want to get sterilized. Perhaps the worst I ever got into it with any doctor of an attitude was one in NYC who told me that the very fact that I didn’t want kids was proof that I wasn’t making that decision of ‘sound mind’ because it’s totally unnatural and a ‘normal woman’ wouldn’t decide what I did. He told me that I should see a psychiatrist to learn to like the idea of having children, and that I’d be fine once I had a couple of them and realized how wonderful they are. He also told me that at 23 (which is how old I was at the time) there was no possible way I could know myself that well, and that as soon as I met ‘the right man’ I’d want to settle down and have some kids.
That was the only time in my life I ever ripped a doctor a new asshole, but he needed one very, very badly. I told him he was a megalomaniac fuckstick whose god complex should’ve kept him out of medicine considering the damage he’s doing to people who need help, not lectures. Then I thanked him on behalf of any abortion clinics who would get business from me later on due to his refusal to perform a procedure with less risk and less side effects than abortion and asked him if he had any friends who were proctologists who could help with that slight recto-cranial inversion problem he was having.
I know doctors do not always agree with patients about what is in the patient’s best interest, but for crying out loud it’s an elective procedure, not a reason to get condescending, patronizing and insulting. If you want to refuse, do so pollitely and send me on my way. Don’t sit there and tell me I’m a messed up head case who needs to be put into therapy to learn to want kids. It’s not mainstream to want to be child free, but for fuck’s sake that doesn’t mean it’s wrong.
So, that sums up the last 7 years of me trying to get fixed. I’m 25 now. I went up for rejection last in December and will go again in June (I do this every 6 months). I told the last doctor, who I have been to many times before, that if anything should prove my desire to get sterilized is well thought out and genuine, it should be that I’ve stayed the course for seven years. shrug
Again, I am astonished. I believe you, catsix, but I am still astonished. And again, is Planned Parenthood of any help?
Certainly it is “normal” for a woman – or a man for that matter – to want children in the sense that it is the usual condition. It’s abnormal to not want them only in the sense that it is not common. Just like it’s abnormal, in a sense, to be 7 feet tall or to have an IQ of 145. Doesn’t mean it’s wrong.
It is also possible that you will change your mind; I’m sure many people who are 35 will tell you that their ideas about a lot of things are different now than they were 10 years ago. At the same time, you seem very sure. And some of us are either emotionally or physically unable or unwilling to meet the demands of parenthood. It is certainly much more responsible to take permanent action than to expect to be 100% celibate, which is almost the only 100% guarantee of remaining a non-parent! Abortions, while properly legal, are not without phsychological and physical risk either, as I am sure you know since you are trying very hard not to ever need one.
Incidentally, I personally know two women who each had their third child after having had tubal ligations. One did not realize she was pregnant for about 4 months since she had gotten so used to being “sterile” that she didn’t even think about the obvious signs for quite a while. In both cases the children were born, loved, cherished, and grew up into very fine people, but in both cases the parents did want children, just not that many. It could have been quite different if they had never wanted one.
Other than celibacy, age (if you’re female) or actual removal of the appropriate organs, there are no guarantees!
I cannot defend doctors who act patronizingly toward their patients, especially those who flat-out refuse to discuss issues like this. CrazyCatLady has had bad experiences along these lines, and there’s just no excuse for it.
However, it’s important to understand that a fairly large percentage of women who get tubals (I can’t find any data on just how many right now) eventually ask to have them reversed, especially among those who get it done before age 30. There isn’t much aside from age to predict who will eventually desire a reversal, although the majority of those who seek one have found a new partner/husband since the original procedure was done.
“But I know that I’ll never want children/more children,” a lot of people say. That’s true, but it’s also true of everybody who gets a tubal, and thus everyone who eventually gets a reversal. People change a lot over the years. My wife and I are 27, and we are adamant that we don’t want children, ever. Still, I look at who we were ten years ago, and I can’t even predict who we’ll be ten years from now. That’s why I don’t want to be permanently sterilized right now.
It’s wrong for a doctor to assume that you’re going to change your mind and refuse to discuss the issue. However, it’s also wrong for the doctor to assume you won’t change your mind and proceed with no further discussion. I’m just glad I’m not an OB/GYN, because I’m not sure what my policy would be, as a doctor.
Dr. J
The decision to have one should my birth control fail has already been made, and it was made a long time ago. Whatever the side effects, they can’t possibly be as bad as being pregnant and having a kid, at least for me. Other people’s mileage varies.
Having my doctor say that to me is rude and disgusting. What it tells me is that my doctor doesn’t view me as a person, but as a set of statistical odds, and it indicates that person shouldn’t be my doctor. If someone can’t be troubled to at least listen to me as an individual when I speak to them as my doctor, that person does not have my best intrest in mind and definitely doesn’t need to be providing health care for me.
Do people who were gay become straight? What do you figure the possibility is that ten years from now you’ll be a gay man? To me, the knowledge that I am not made to be a mother is the exact same thing as the knowledge that I’m heterosexual. It’s not a decision I made, it’s something I am, and something that even if I wanted to I couldn’t change.
How much discussion (which usually means ‘Trying to talk me out of it’) would be fair? Is it fair enough to treat it like other types of elective surgery such as rhinoplasty, breast augmentation or facial implants? The thing is, those ‘discussions’ aren’t really discussions, they’re an effort to wear a person down and change their mind. IMO, the entire discussion should consist of informing the patient of the risks associated and determining whether she understands that it is a permanent procedure. No doctor would spend months discussing with a 25 year-old patient who was trying to get pregnant and have a kid what a ‘permanent’ decision that is and tell her that she’s too young to know for sure that she wants to spend the rest of her life as a mother, would they?
The decision to have a kid is equally permanent as the one to be sterlized, so why is so much energy spent on discussing one and not the other?
“Rude and disgusting?” I understand your ire, but I think that’s a little harsh. I would consider it bad practice to not inform women under 30 seeking a tubal that a significant percentage of them will eventually want it reversed, just as a matter of informed consent.
Good medicine includes applying “statistical odds”; we apply what we’ve seen before (personally and in studies) to the people we’re seeing now. No man is an island. Seeing the patient as a person separate from the categories he can be placed in is part of the art of medicine–but the art without the science is worthless.
Tell me this: do you feel that a doctor should know, after discussing the issue with you, that you will never change your mind about wanting to have children? If so, what is it about your circumstance that should convince him, to the degree that he shouldn’t even bring up the risk of regret? If he isn’t 100% convinced that you’ll never regret it, is he still wrong to even discuss his experiences with you?
He should absolutely listen and speak to you as an individual. He should also apply his experience and advise you appropriately as to the risk of what you’re doing.
I know that ten years ago, I thought I would probably have children. I knew that I only wanted one, in fact. My experiences since then, my relationship with my wife, and my personality overall have led me to the conclusion that I have no desire to be a parent. I could not change that, right now, if I wanted to, but ten years ago, I could not have concluded that I never ever wanted children. I am 99.9999% sure that I will feel the same way in ten years, but I would be being dishonest with myself if I didn’t acknowledge the possibility.
The fact that you are absolutely convinced that you never want children does not change the fact that many, many people have been just as sure as you are and have gone on to change their minds.
Don’t get me wrong–if I were your OB/GYN, I would do your tubal, but only after I discussed the pros and cons with you, one of the cons being that a lot of people who get it eventually want it reversed. It’s a risk just like the risk of bleeding and infection, and just like those, I need to know that you’re willing to accept that risk.
Again, I would want to inform you of the risks, including the risk of desire for reversal, and understand that you are willing to take those risks. I would have you sign the usual informed consent form acknowledging that we discussed those risks.
I would also want to be sure that you were aware of the other options. You’re at the SDMB, which means you’re probably more well-informed on most issues than 90% of the population; I would expect you to come to my office telling me exactly why you don’t want to use oral contraceptives, an IUD, Depo, etc. You wouldn’t even make an appointment to talk tubal before you had considered those things.
I would want to make sure your info was good. A lot of people get their birth control information from their mothers, which is like getting advice about cars from my father–great advice, as long as your car was made before 1977. Birth control has come a long way. You’d be shocked at how many doctors out there don’t know anything about modern IUDs.
If everyone were as well-informed, my job would be easier. However, you’d be at one end of a very wide spectrum. Some people don’t know that options besides OCPs and tubals exist, and information about OCPs is often incomplete. I would just want to make sure that you knew all the options and you still wanted this one.
Finally, if you were part of a couple, I’d make sure you had considered vasectomy for him, which is generally a simpler procedure.
You’re preaching to the choir there, my friend.
Dr. J
MLS for us it’s not an issue of not being close to a PP; it’s an issue of what our insurance will cover. More specifically, of who our insurance will pay for us to see. Our insurance won’t pay for us to go to Planned Parenthood, and we can’t afford to pay for the procedure out of pocket, so I’m stuck with finding an approved doctor who won’t treat me like a drooling moron.
The FP mentioned in my earlier post sat there and listened to me say that I didn’t really need an OB/GYN referr for routine care and birth control, since we weren’t ever having kids. Her immediate reply, “Well we can take care of that for you, then in a year or two when you want a baby we can give you the referral.” We just won’t even discuss the other idiocies that came out of her mouth, as that’s bad for my blood pressure.
Harsh? To people who have told me there’s something fundamentally flawed about who I am and that I need psychiatric help to fix the fact that I don’t like or want kids? I don’t think I’ve even begun to get harsh.
How much convincing would any other issue of informed consent take? Am I going to have to spend seven years trying to get him to understand that I know what risks general anesthesia pose to my health? If I know the procedure is permanent and can comprehend the concept of permanent, and I still tell you ‘Yes, I want this procedure. I understand that it is permanent and that like all surgery the risk of a reaction to anesthetic, bleeding and infection exist, and I am consenting to surgery.’ would that be good enough? Would it be enough for me to sign the forms? See the thing is, I’m an adult and I have been making permanent decisions about my life for a while now. Every one of them comes with the risk that I will later regret that decision, but they are still my decisions. I am old enough and wise enough to know that sometimes I make right decisions and sometimes I make wrong ones. I accept full and total responsibility for the risk that I might regret a wrong decision. If I went to the doctor and assumed the risk of allergic reaction to anesthetic to have a breast reduction, and I had a reaction and it caused permanent damage to me, it wouldn’t be the doctor’s fault beause I knew such a thing could happen and made the decision to go ahead with the procedure. It’s not my doctor’s job to parent me and try to protect me from ever doing something I will regret, no matter how compassionate he or she thinks such an act is. My days of being sheltered from choosing for myself and screwing up are long over.
So would you go to more, less, or the same length to tell me about how many people want a tubal ligation reversed than you would about the risk of bleeding and infection? In other words, if I’m intelligent enough to understand the physical risks of surgery the first time they’re told to me, and to sign the informed consent forms, would you consider it enough to just say ‘These are the statistics’ and leave it at that?
I have a very severe reaction to hormone birth control in which my immune system will start to attack the hormone and make me extremely sick. I get covered in hives that will not go away (I had them for 10 solid months), my blood pressure shoots up, and I have difficulty breathing. I considered Depo, but have read enough literature on the side-effects to believe that with my already hyperactive immune system, it would be a bad idea. I ruled out the IUD because I am single (and it’s not recommended for those with more than one sexual partner), my immune system reacts badly to copper and some other metals, I have heavy periods already, I’m iron-deficient anemic and in light of the fact that I plan to never have children, the side effect factors don’t seem worth going through if I can get sterilized and eliminate them. I’ve considered the options, and the best one for me is to have the surgery.
I ruled it out for several reasons. One, right now I am single so there’s nobody to have the vasectomy. Two, it won’t help me in the case of rape. Three, if I’m ever in a long term relationship with one person, or even married, that person may change his mind about having children (which would mean the end of the relationship, as it has before) and it would make life easier for him if he didn’t have to get a reversal, and the last reason is probably considered trivial, but it is better for my mental health to know that I have personally taken care of preventing myself from getting pregnant. I want the peace of mind that I have removed that worry.
After having that discussion with a doctor and then being told ‘But you can’t possibly know what you want, you’re too young, you’re not married, and you don’t have kids. You’ll just change your mind like all these other people.’ can you see why I consider the attitude I’ve gotten from doctors to be rude and disgusting?
I think you’re maybe misunderstanding what DrJ meant, cat. In response to his first post, when he pointed out that he’d have to at least mention the statistics, you said that was rude and disgusting, which sounds like you object to any mention of the statistics ever being made. Frankly, that is a little over the top, even as rabid as I am on the subject.
I don’t think he’s objecting to calling docs who listen to your whole situation then tell you that you don’t have any idea what you really want rude and and disgusting. It sounds more like he objects to you calling anyone who brings up the statistics rude and disgusting.
Firstly, sorry to the OP, this has gotten a little off-topic, veering into one specific choice for family size.
Concerning the discussion on statistical likelihood of changing your mind after the sterilisation, here are some links I’ve found that I’m taking with me to my gyn appointment :
National Institutes of Health News Report
So we’re talking about only 6 -7 % I wonder what the regret-rate is for breast augmentations ?
Sterilization, by Nancy Snyderman MD
These links show to me that the amount of reticence to carry out this procedure is unwarranted and a little misguided and pronatalist. It seems amongst medical circles (in America, from what I’ve read) that there is still the opinion that every woman wants children. I think those doctors who are letting this prejudice get in the way of good appropriate medical care are wrong. If they honestly think a particular person hasn’t thought it through or isn’t fully informed, I am happy with them turning away that individual or suggesting the individual return in six months with more information. If they are just applying a blanket assumption from prejudice or social mores, I think they are a disservice to their profession.
DoctorJ, vasectomy often isn’t the better option. And now with access to the Essure procedure, it isn’t even the simplest procedure anymore.
Fingers crossed May 5th for my Essure consult 
Goo, great cites! Please do a thread or something (or bump this one) about your Essure consult. Having all the children I want, and not wanting to be on the Pill for 10 more years, it’s something I’m interested in myself.
Good luck!
Back to the topic, I have two kids, all of my neighbors have two kids. I am the only one of them that has stopped at two kids. They all want more and insist that I must want more too. One of them went so far as to sign me up for a baby magazine because she was convinced that I was fighting my baby urge. That really pissed me off. If I had another baby I would love it but I don’t WANT another baby. I decided I can love and raise two kids with ease so that’s it for me, any more would be a hardship and there would be a chance that one of them was missing out if I had more. All I know is now people better watch out when they talk to me about kids, I got some PARENTING magazines I can slap them around with
That is so bizarre, MamaHen. Learn something new every day, I guess. I figured those with the ‘standard’ two kids wouldn’t get shit from either side, and it was those who had less or more than that number that would come under fire. But no, there are even people out there who feel you shouldn’t have two.
That’s it. I give up. The world is full of arseholes who think they know better than you how to run your life.
[hijack]Norinew, I will be dancing and screaming about my great good fortune in my own brand new thread, should that beautiful sterile day come Never fear, this board will be informed 
[/hijack]
[url=http://www.absurdnotions.org/page33.html]“Barren.” I’m “barren.”
Argh.
I love the barren strip, but for some reason the stereo love goddes bit just cracks me up.