I’ve had kids…two, to be exact. My pregnancies were welcome reprieves from what have always been horribly painful, highly irregular mentrual cycles which have wreaked havoc on me physically and mentally since I was a teenager. It’s actually amazing that I even got pregnant in the first place. I might start my period in 15 minutes. I might start next week. I might not have one for six months.
I am one of those women whose physiology reacts badly to hormonal birth control. I’ve tried probably 6 types of oral contraception, each of varying degrees of hormone levels and types, and the patch. They all make me sick. Like throwing up sick.
I asked my OB/GYN about the possibility of having my uterus removed (leave the ovaries, please). He may as well have patted me on my little head and told me to get back to my embroidery for all the help and compassion he offered.
He did say that he could tie my tubes, then lightly chuckled when I pointed out that tying my tubes would have zero effect on my mentstrual cycle.
If, in the case of Canada and I believe the UK, the woman doesn’t have the ability to doctor shop, the doctor should not have this choice. It is none of his business if sterilization is in the woman’s best interest because it isn’t a medical choice (most of the time). When it isn’t a medical choice, no doctor has any idea if the surgery is or is not in the patient’s best interest. Despite what they tend to think, doctors are not God.
No, not just frustrating, it is also dangerous. I was on the Pill for 16 straight years, back in the day when there was only one strength (strong) because I wasn’t able to tolerate any other sort of birth control that was likely to work. 16 straight years of high dose hormones messed up many things in my body with others possible to come and all because I didn’t “know my own mind” and “would regret it”. Sorry folks, I hate children and the younger they are the less I am able to tolerate them. Do ya think I’d ever change my mind? And what finally got me my tubal at 33 was going completely bonkers insane in the doctors office (another thing 16 years of hormones will do to you) and committing violence on his person, then - er - asking him if he thought I’d be a fit mother. None of that should have had to happen.
I seriously doubt this is true (and it certainly isn’t any definition of fair). Women who are 14 can ruin their lives by having and keeping a baby, but physicians seem to have no trouble with it. The fact is that women are expected to adore babies of all shapes and sizes, and this is reinforced every day of a woman’s life. Women who do not leap up from their desks to coo at a baby brought into the office, or who do not melt at their pictures or sonograms are at best ignored and at worst shunned. Day time ads aimed at women always have a child(ren) in them, usually a baby, no matter what is being advertised. So, doctors who get a woman in who wants a tubal and has never had a child are assumed to be temporarily insane and all they need is “the right man”.
Why not? Folks try to make decisions for others all the time for all the wrong reasons. Look at those that are trying to force me to say Merry Christmas for example. If this is something only you can do for your friend or child and they really want it, why are you forcing your opinion on them? Why should any adult assume they know better than any other adult?
The lies of the old world - that the only way to happiness for me was a husband, 2.5 kids and a white picket fence - did not convince me that was true for me. I grew up in a world and a family that expected that all women would have children as soon as they got married, which was preferably young. The belief that only abnormal women would refuse to do this was so strong that I no longer speak to my family. I was in no way “wired” to desire children in any form, despite the time frame that I grew up in. The “lies” you speak of these days are simply the realities being openly spoken of - women do not have to be slaves to ancient expectations.
I know evensven has posted that she’s left the thread, but for the others who feel similarly - on what basis do you think people should be able to be sterilised? I’m not talking about forcing doctors to do the surgery, I’m talking about what guidelines do you think our doctors should be using (guidelines, not rules - they aren’t going to be forced)? What do you think should be considered ‘best practice’? What are your concerns about sterilisation being freely available and accessible? I’ve already posted regret statistic, so I could understand if people thought that a scenario of a shaky marriage, under 30 and one child showed statistically enough increased risk to warrant a 6 month waiting period. Or am I off the mark here and there are other concerns I’m not addressing?
IMO, being legally an adult, and informed about the procedure and its permanent nature pretty much covers it for me.
When this topic comes up, people often act as if doctors all share a brain. There are some docs out there who won’t sterilize anyone who is under 30, but there are definitely doctors out there who will sterilize young people with no kids (here’s an example of a list compiling such docs: Childfree Resources' Journal - a small list due to its obscurity, but just showing that these docs do exist if one wants to find them). If you really are serious about getting sterilized, making an effort to seek out a doctor who is like-minded will go a long way towards showing you really do mean it. It could be that the fact that one must be a bit persistent and aggressive in seeking sterilization out if you are a nulliparous youngster is why the regret rate is so low among the sterilized childfree: maybe that process weeds out those who don’t want it badly enough and would turn out to be regretful later.
It is offensive to me when people talk about trying to force doctors to perform certain procedures without regard for the physician’s clinical judgment. I don’t think most people would want me to dictate to them how I think they should do their jobs, yet a lot of people think that having read an article on WebMD means they know as much as their doctor. Sometimes, a medical issue is not as straightforward as it seems without the benefit of years of medical training and experience dealing with patients.
A few reasons I can think of for why a doc might not want to sterilize someone that have nothing to do with sexism:
Forced sterilization has in the recent past been used as a tool of eugenics, and it is possible that some of the trend towards being hesitant to sterilize people lightly is a pendulum effect from that.
There ARE many reversible birth control options nowadays that are quite effective. The Mirena IUD is in fact more effective than the traditional tubal ligation, so it is quite reasonable for a doctor to suggest it to someone who is serious about not wanting to have kids.
People tend to think of tubal ligation as permanent, and most of the time it is, but fallopian tubes can sometimes grow back together over the years, especially when a tubal is done in younger patients who have more potentially fertile years ahead of them. For that reason alone, a doctor might make a judgment call that tubal ligation is not in the best interest of a young woman who is at a higher risk of experiencing an ectopic pregnancy years down the road from a failed tubal than a 35 year old whose fertility is tapering off anyway.
While the issue of litigation is definitely a huge one in ob/gyn, it may not be the only reason a doctor doesn’t want to deal with regretful patients. Regrets after tubals do occur. While I do not think there is any scientific credibility to their claims, just do a google search on “Post tubal syndrome” to find a lot of hysterics from women who regret getting sterilized. Even IF a doctor can show such patients a legal waiver and say, “Tough shit, you ASKED me to sterilize you, so live with it, fool!” (paraphrasing of course ) most doctors do have some desire to “help people” and don’t want to lead people into situations that might cause them regrets. “First, do no harm” is kind of a big thing to some docs.
Personally, if I were an ob/gyn, I’d be willing to sterilize pretty much anyone over the age of 21 years who could demonstrate a serious understanding of sterilization’s risks and benefits, and who could coherently explain why reversible birth control is unacceptable to them. However, I don’t blame other docs for simply making the decision that they do not feel comfortable being involved in a permanent procedure on someone they are not convinced is going to benefit from it. Again, there is that “First, do no harm” thing. Doctors go through a lot of years of training so that they are able to make decisions for their patients. If you don’t trust your doctor’s judgment, find a different one. If you don’t have freedom to choose a doctor who has compatible views about sterilization, that’s a failure of the system, not of the doctor.
How is telling a 32 year old woman she doesn’t know her own mind a doctor’s clinical judgment? What about elective sterilization requires any clinical judgment other than whether or not the patient is healthy enough to survive the procedure?
WebMD has zero to do with whether or no a woman can get sterilized without a fight. As for whether most people would want you to dictate to them how to do their job? If I am not doing my job the way that I signed up to do it, you had better believe quite a few people would be happy to tell me what I am doing wrong, and they would probably be right.
Can you come up with any medical reason why a healthy young woman should not get a sterilization if she wants one?
Oh please.
Mirena says right in their ads that it is for women who have already had at least one kid. Plus it is hormonal birth control. Why should a woman who knows she never wants any children be forced to put up with the side effects of hormonal birth control for decades, until some doctor finally decides that she actually knows her own mind enough to “allow” her to be sterilized?
I had my fallopian tubes completely removed, nothing left to grow back together.
I can google probably just as many hysterics from folks who regret getting plastic surgery, and a goodly number who regret having children. Why is patient regret only considered in sterilization? How about the women with endometriosis and other issues that are crippling and could be cured by a hysterectomy, but the doctors decide they haven’t had enough children yet? Should we talk about the regret those women feel?
How is that going to make a woman refused sterilization by the only doctor she can see feel any better? There are whole countries where the woman has no choice of doctor, and large areas of the US where there are very few doctors willing to do any female sterilizations.
I think the problem is not that we are asking physicians to disregard their own clinical judgement. We are questioning the biases and misconceptions that inform some, not all, physicians basis for making a decision. I can see no valid reason why, out of all the gynes I have seen since being diagnosed at around age 20 with endometriosis, I should have had to jump through inumerable hoops all in the hope of preserving my fertility. That the Mirena worked for me is more a stroke of luck than anything, I’ve had gynes suggest using drugs to put me into early menopause, I’ve been on year round birthcontrol pills to stop my period, I’ve taken depo provera and had the commensurate terrible side effects. There is evidence that pregnancy can help endo symptoms, and so one doctor suggested that I have a baby first before getting a hysterectomy to see if that would fix the problem. This, in spite of my repeated assertions that I was not trying to preserve my fertility. I was emphatic that I would not have children. Something is askew here, and I am not alone in this experience.
I completely agree with you here. I wanted to add, however, for the interest of any women reading this thread, that while Mirena is recommended for women with at least one child (like other IUD’s), some doctors are willing to insert it in women who have not had children. The concern my gyne had was about the pain level (this is the same doctor who was willing, if this failed, to do the hysterectomy). This blessed woman, hands down the greatest gyne I’ve seen, actually inserted my Mirena when she was on a surgery day at the hospital – she put me under so I wouldn’t have to feel the pain, and told me that when it comes time to take it out, she will do the same. I miss her so very much. A good doctor is worth her weight in gold.
I won’t lie to you, it was not a comfortable procedure. Iwas in a great deal of pain for a few days after. I can’t imagine how much it would have hurt without the kindness of being put under for the procedure.
I also wanted to add - re: Mirena being more effective than a tubal ligation. Some women experience horrible side effects with the Mirena. I, for example, had terrible lower back pain. However, it was so minimal compared to the pain I had been having that it was worth the trade off for me. Also, there is apparently some risk of rejection (term?), where the IUD can come out or “drift”. Once it is out, it cannot be put back in, so you’re out the money it cost - which, for me, was about $600 as I recall.
Some women just don’t respond well to horomonal birth control, and if they arent planning on having kids, why subject them to it for an unnecessary length of time?
That’s what we are talking about–that the system itself is misguided. When dealing with psychological fallout, there have been many standard medical practices which we now see as outdated and counterproductive: doctors used to keep women from ever seeing their stillborn babies, they used to present only what they considered the best alternative when talking to women about cancer treatments or birth procedures, they used to unilaterally make decisions about circumcision and vaccinations without any discussion about alternatives. And in many cases they were right, their judgment was better than that of their patients, they were working from the purest of motives. But it is still wrong.
Doctors are not bad people if they don’t do sterilizations on women. However, it’s a bad system that has no protocol, no policies, no mechanism for a woman to make this choice–instead, we have a bunch of traditional, conventional wisdom, a handful of doctors who may well be performing sterilizations unwisely, and women forced to rely on word of mouth to find them. It’s a relic of an earlier, unfortunate era in heath care, and it ought to be changed.
Well, the complaint here is about those doctors who think women all share a brain. I don’t think anyone is accusing those doctors who do sterilization on request of being sexist or outdated, or even those doctors who clearly take each request on its individual merits.
(We really need to make this an internet axiom: If you’re (or your doctor or your child or your pit bull are) not the kind of person named in the thread, then we’re not talking about you!)
All of your reasons are perfectly possible. But none of them apply to every woman. And it’s the forming a predetermined position on that woman there based on what you think you know about women in general that is sexist. Pure and simple.
A risk which is, I believe, higher in childless women than for those who have already reproduced. Also, haven’t there been a number of doper women complaining about how hard it is to get an IUD if they’re young and childless? “Come back when you have children” isn’t exactly the best thing to tell a woman who is asking for a way to avoid getting pregnant. You might as well tell a depressed patient to come back when they’re feeling better.
As a single male age 35 I asked for the big V and was denied, the doc saying there was too big a risk that I would change my mind later and sue.
At 45 when I asked, my doc told me he knew surgeons who would do it. (I didn’t get it done at that time because I was not sexually active. But if I find a woman, I will think about it.)
Something is being overlooked here, which is that hysterectomies are often about more than just birth control. Try to imagine you were suffering from a painful disease, one that robbed you of your quality of life, was unpredictable, caused extreme mood swings, severe depression, irrationality, rage. On top of all that there was actual physical pain that was very difficult to eradicate. Say you went to your doctor because you were absolutely miserable, you had tried multiple different medications for years in an attempt to treat it, some of them with painful consequences that rivaled the original disease, and nothing worked.
However, there is this one procedure that could absolutely make your horrible symptoms go away, but it has the side-effect of causing permanent sterility.
Your doctor looks at you with a straight face and tells you that in spite of all your suffering, this obvious cure is not an option because there’s a chance you might want to have kids some day.
Now maybe you understand where some of us are coming from. At this point the quality of my life is so poor that the issue of having children is a secondary concern.
I know from experience, from my family history, that these problems are only going to get worse. Both my mother and my grandmother had the procedure after they had children–my mother was 40 and she still had to fight, her doctor was extremely condescending but she badgered him into the procedure. He went so far as to tell her that after they were done he would show her how she had imagined everything… and inside he found a world of horrors. She was originally supposed to have both of her ovaries left intact, but one of them could not be saved due to the severe endometriosis and tumors. I don’t want to tell you what hell it was to live with her until she had this procedure–she was absolutely insane in addition to the fact that she was constantly suffering physically.
I have a close friend who is a lesbian with no interest in having kids. She is 28. She has endometriosis as well as some other horrible uterus disease that makes her bleed constantly. She has had three surgical procedures, all the same procedure, to do ongoing ‘‘maintenance’’ of this problem. Basically they let it build until she is constantly bleeding and in severe pain, then they let her do this procedure and wait until she is really suffering to consent to it again. She cannot find a doctor who will consent to a hysterectomy, because she is of childbearing age and may change her mind about having children later.
My latest attempt to fix my own problem was with a Mirena IUD, and that resulted in a year of a whole new kind of pain and suffering. I have not yet broached the subject of a hysterectomy with a doctor because, like many people I know who are childless and in extreme pain because of their uterus, I will probably get laughed out of the office. It doesn’t matter that I’m happily married for nearly three years, have always desired to adopt children since I was 9 years old and have a loving husband who is fully on board with my reproduction plans. I have decided I am going to pursue this; I will have to start with Planned Parenthood I suppose, but I am less than optimistic.
So this is what we are really talking about. Do I believe a woman should be entitled to have this procedure just because she doesn’t want to have kids? Absolutely. But the point I am trying to make, is that many doctors, even when it is obviously medically necessary, still deny women this treatment option because of their grasp on antiquated ideas about women and reproduction. We are talking about demonstrable cases where women are forced to continue to suffer serious chronic illness because the doctors will not accept that there are some things really a lot worse than never being able to have children. I was outraged about this before I came to the conclusion that a hysterectomy was a good choice for me. Now it’s reprehensible on a whole new level.
) most doctors do have some desire to “help people” and don’t want to lead people into situations that might cause them regrets. “First, do no harm” is kind of a big thing to some docs.