URGENT: Pros/Cons Tubal Ligation

[Melbel]

I am scheduled for a CS this Monday, June 2nd at 8AM. At my routine OB appt. this morning, I learned that the hospital where I am scheduled to deliver, that was recently acquired by a catholic hospital, will no longer allow tubal ligations. We had planned on having my tubes tied all along, so this came as a big surprise. I can reschedule at another hospital for later next week in the afternoon with my same preferred doctor. While the other hospital is fine, it is much further from home, and I would be subject to the weekend staff for part of my stay. It would also complicate childcare for my DS and DD that I had all lined up. I also would be forced to fast into the late afternoon, which will likely cause major nausea and a migraine since I am very sensitive to drops in my blood sugar level. While I was willing to "take one for the team" during my CS, I am now reconsidering the whole tubal ligation decision. I am hoping for some input on risks/complications/recovery from tubal ligation surgery (particularly if done as part of a CS) and general input on tubal ligation vs. vasectomy. We are SURE (and I mean SURE) that we are ready for permanent sterilization, it is just a matter of who undergoes the procedure. I have to provide a final decision tomorrow morning so TIA for your prompt advice!!!!

[JBaxter]

Your DH can always go. Its an in office procedure for him. If everything is lined up then do it and send your DH. You will both still be done.

[bubbaray]

Well, personally, I decided long before my scheduled c/s with DD#2 that I had had enough procedures done to me (both girls are the result of IF treatments) and it was DH's turn to pony up to the scalpal. I had heard, anecdotally, from some women who had problems with their cycles post tubal. I have no idea if its just coincidence (ie., most women are older when they get tubals, not 18, KWIM?) or if there is science behind it.

Anyway, for me, I just thought it was DH's turn to be stressed about a medical procedure. A friend of mine's DH just had his snip last week and she said it looks like a cat scratch -- you can barely see it. IIRC, his was the no scalpal technique.

If it were me, I would stick with my original decision re hospital to deliver at, date of delivery, childcare, etc.. But, your choice might be different.

Good luck with your decision!

[kransden]

Yep, get DH to do it. It took my DH 30 minutes from leaving the waiting room to coming back out. He said it was done in <10 minutes. Bag of frozen peas, pain pills and he had to take it easy for for the weekend. The incision was about 1 cm. It didn't even need a bandaid. It will be two weeks on Friday and so far so good.

[Tondi G]

I know lots of guys who went in for the V lately... I guess a lot of couples we know are finishing up their baby making time! Honestly... tubals are a lot more invasive and I think can have more of an effect on women than Vasectomies do on men! I say let DH step up to the plate this time! Sounds like you have everything worked out as far as your C/S is concerned... I'd hate for you to have to change everything up and create stress for yourself!

Good Luck

[o_mom]

Tubals done as part of a c/s have a higher failure rate (though it is still very low). Laproscopic tubal is supposed to be fairly easy, also, so scheduling it later is an option. It should be an outpatient procedure and a few days of rest.

Having said that - as people said, DH can get a vasectomy and it's not a huge ordeal usually.

[lizajane]

my mom had a TL after a birth (not a c/s) and she said it was a terrrrrrrible idea. of course, it was 23 years ago (my brother is 10 years younger than me and a big surprise). she felt like she was run over by a truck. IMHO, let DH get the V. i know several men who have had them and they were pleased as punch with the experience/results.

[VClute]

For you, the procedure would involve general anesthesia and a surgical position that is NO FUN (and thank God for the general anesthesia then!) You'll be sore "down there" (from the device they insert to clamp your cervix to make your uterus easily manipulatable) and you'll be sore in your belly (puncture wounds and gas) and you'll be sore on your back and legs from having them hiked up and back so far.

Make him get clipped. There's MUCH LESS risk to health for his procedure vs. yours.

[boogiemom]

I had a tubal after my last c/s, which was just over 3 years ago. It added less than 5 minutes to my time in the OR. I had zero issues with it recovery-wise. I have had no problems with my cycle since. Honestly, if I didn't know they were doing it beforehand, I would have no idea it had been done. I was told that it is much more effective if done after a c/s. That makes sense to me as my Dr. obviously had full-access to everything while he was in there. It is extremely effective. We had fully intended to have DH go in for the big V because I had done everything else, so to speak. However, once we decided on a planned c/s, it seemed kind of silly not to do the procedure while they were in there as it added little time and little risk.

A good friend chose not to do hers during her c/s and her DH did go in for a V later. She regretted it because of the multiple visits her DH had to make to give "samples" and because of the waiting period of several months before they could be sure that they were in the "clear". They had a couple of nervous times when her cycle was a bit late and they were really sweating it, so that was difficult.

I'm sure everyone's experiences are different. You need to do what is right for your family. Try not to add extra stress during this time. I hope you come to a peaceful decision.

Good Luck! and ..................Congrats! :)

[karstmama]

yep with all above. statistically, tubals at time of c/s fail more often (though still a very small number), so imvho you changing all your plans...maybe not so worth it. tubal in about 6 weeks is not devastating, but really, childcare for everyone & rest for you for a couple of days just when you were getting into the swing of things? also imvho not the best plan. i'd also say the snip might be your best plan. remember to have him *keep* the return checkup to make sure no swimmers are getting through!

though all that being said, if he declines, the mirena intrauterine thingie has wonderful actual use numbers and isn't onerous on you, either - lighter or nonexistant periods & nothing goopy & nothing to remember.

but after weighing everything, i hope your right choice shines up at you. ;)

[Melbel]

Thanks for the prompt replies! After doing some additional research, and considering your insight, I decided to go ahead as scheduled on Monday morning, minus the tubal. Instead DH agreed to get the vasectomy, considering the last minute issues involved in changing hospitals, dates, etc. Of course, he was supposed to have gotten one 2 years ago and look where we are now! While I am thrilled about our "bonus" baby, at my age and with my bad back, we really are done now. I can no longer take BCPs or other hormonal BC due to migraines.

Considering I will have had to recover from 3 CS (not to mention my 3 back surgeries), I do not want to have another procedure. I will have to trust that DH will follow through this time. I suspect that I will have to set the appointment and clear his calendar. What is it with men and their unwillingness to get vasectomies? In my research, I noted that there are far more tubal ligations than vasectomies, notwithstanding the increased risk and recovery. One of my friend's husband remarked that it was "like putting a good horse down." Funny, but give me a break!

In case anyone is interested, this is a link to essure.com, the newer, less invasive procedure for women to block the fallopian tubes:

http://essure.com/Home/Comparing/EssureTubalLigation/tabid/65/Default.aspx?gclid=CJyw3ZqRzpMCFQWxsgod11sbjQ

Wish us luck on Monday! We are STILL undecided on our name (down to Alexandra Riley, Caroline Riley and Katherine Riley). You may recall our prior poll. Hopefully we will decide this weekend!

Thanks again everyone!

[Sillygirl]

Wow, I'm surprised nobody has mentioned that your husband will be put through an additional procedure because your hospital has all of a sudden decided it will start making medical decisions based on religious convictions - ones that you do not share. I'm glad you've come up with a plan that works as your second option, but it seems a shame that anyone has to get an additional procedure. A tubal during a scheduled C-section would have been probably the safest choice. I am really sad that that option is now only available if you choose a hospital that is farther away from your home. It's kind of a shame that the hospital is still getting your business and I hope you encourage your OB to no longer deliver there, since he's no longer permitted to serve his patients as well.

[cleo27]

Wow, I'm surprised nobody has mentioned that your husband will be put through an additional procedure because your hospital has all of a sudden decided it will start making medical decisions based on religious convictions - ones that you do not share. I'm glad you've come up with a plan that works as your second option, but it seems a shame that anyone has to get an additional procedure. A tubal during a scheduled C-section would have been probably the safest choice. I am really sad that that option is now only available if you choose a hospital that is farther away from your home. It's kind of a shame that the hospital is still getting your business and I hope you encourage your OB to no longer deliver there, since he's no longer permitted to serve his patients as well.

Agreed! I could not have said it better.

I wish you the best with your delivery!! I bet you will be so happy to have your little one. It is too bad that you have this extra stress to worry about at this particular time.

[bubbaray]

For you, the procedure would involve general anesthesia and a surgical position that is NO FUN (and thank God for the general anesthesia then!) You'll be sore "down there" (from the device they insert to clamp your cervix to make your uterus easily manipulatable) and you'll be sore in your belly (puncture wounds and gas) and you'll be sore on your back and legs from having them hiked up and back so far.



No, not true -- if they do the tubal as part of the c/s procedure, it does not involve GA (unless there are complications during the c/s that would otherwise require GA) and I was told that the post-op recovery is the same whether you have the tubal or not. She wouldn't have puncture wounds nor would they use gas, nor would her legs/back be sore -- the procedure is different as part of a c/s than it is laproscopically.

[tiapam]

When I started to research this, I was surprised to find that some women do experience some negative effects after getting their tubes tied. I am probably having a C/S soon and I am pretty sure I will not be getting my tubes tied. That is partly because I can't say I am 100% done, but I also don't think I will ever get one. I just don't need additional health problems. Hopefully DH will come around when we decide we are done.

[o_mom]

Wow, I'm surprised nobody has mentioned that your husband will be put through an additional procedure because your hospital has all of a sudden decided it will start making medical decisions based on religious convictions - ones that you do not share. ....

I was trying to focus on her original question, so I didn't go there. I do agree that it's a shame, but it is the hospital's right to refuse procedures that are not in keeping with their religion or ethics. I know many doctors fled from a local women's hospital after it was merged with a Catholic hospital for this very reason, though.

[Melbel]

I have to say we were a bit shocked by the mix up. When I first scheduled the CS, the acquisition had just gone through, so I do not even think my OB's office was aware of the change in policy. Hopefully, they will be more careful in preventing this confusion with other patients.

I do not necessarily fault the hospital for their policies, but just wish that they had been better communicated to us. Had we been advised of the change, we could have planned to be at the other hospital all along, even though it is further from home. At this late juncture, it is impossible, or at least quite difficult, to get a good day/time, juggle childcare and family travel plans.

My DH is the one getting the short end of the stick, so to speak. On the other hand, I have had a history of some pelvic pain issues (IBS, complex ovarian cysts), so after doing my research, I was a bit concerned about the complaints of post tubal ligation syndrome. While experts certainly disagree as to whether this is a "real" risk or not, there are enough women complaining to at least get my attention. Of course, most women do fine with a tubal, particularly during a CS. I guess I am trying to just look on the bright side - perhaps this was God's way of sparing me more pain (albeit at my DH's expense).

I know that I will feel a bit guilty when it is DH's time. Perhaps we ought to schedule while I am recovering from the CS. That way, when he starts whining (which he will do), we can just compare scars! :ROTFLMAO:

Now that we have made the decision, we can just get excited for the big day again! Now, if we could just pick a name...

[Sillygirl]

it is the hospital's right to refuse procedures that are not in keeping with their religion or ethics.

Then they should stay out of the healthcare business. Seriously, a vasectomy is a low risk procedure, but it does involve surgery, however minor, and that does have risks. I think it's unconscionable what the hospital is doing.

[JenaW]

Then they should stay out of the healthcare business. Seriously, a vasectomy is a low risk procedure, but it does involve surgery, however minor, and that does have risks. I think it's unconscionable what the hospital is doing.


While I totally agree that the OP was shortchanged (for lack of a better word), in the sense that the hospital changed its policies without adequate notification to its patients/providers, I personally am glad that hospitals like this exist. I would never try to enforce my beliefs on anyone else, and if a Catholic hospital is the ONLY one available, then I do agree it is not fair to non-Catholics, or those who do not agree with the teachings of the Catholic Church. However, as a practicing (and self-admitted conservative Catholic), I would go out of my way to support a hospital/health care practice that is consistent with my faith. To suggest that a hospital should stay out of the healthcare business simply because it protects the sanctity of life and will not provide sterilization or abortions is short-minded.

Melbel, I am sorry to hijack your post, and I do agree that what happened to you was not fair. I am glad you found a suitable alternative without too much inconvenience.

Jera

[VClute]

No, not true -- if they do the tubal as part of the c/s procedure, it does not involve GA (unless there are complications during the c/s that would otherwise require GA) and I was told that the post-op recovery is the same whether you have the tubal or not. She wouldn't have puncture wounds nor would they use gas, nor would her legs/back be sore -- the procedure is different as part of a c/s than it is laproscopically.

Oh, perhaps I misunderstood. I thought the OP was considering doing a tubal LATER since the hospital where she is to deliver won't do tubals anymore. Of COURSE, if possible to deliver where one had planned to anyway, a tubal would be a great choice, and no different, recovery-wise for mom as far as I know, from a plain old c/s.

[Sillygirl]

While I totally agree that the OP was shortchanged (for lack of a better word), in the sense that the hospital changed its policies without adequate notification to its patients/providers, I personally am glad that hospitals like this exist. I would never try to enforce my beliefs on anyone else, and if a Catholic hospital is the ONLY one available, then I do agree it is not fair to non-Catholics, or those who do not agree with the teachings of the Catholic Church. However, as a practicing (and self-admitted conservative Catholic), I would go out of my way to support a hospital/health care practice that is consistent with my faith. To suggest that a hospital should stay out of the healthcare business simply because it protects the sanctity of life and will not provide sterilization or abortions is short-minded.

Melbel, I am sorry to hijack your post, and I do agree that what happened to you was not fair. I am glad you found a suitable alternative without too much inconvenience.

Jera

Health care providers are given special privledges in this society in order to do their jobs. I can and do prescribe narcotics, ask invasive questions, even keep people in the hospital against their will (within reason.) With those rights come responsibilities. It is immoral for me to make judgements on who deserves my care. I have taken care of rapists, child molestors, terrorists. My job in society is not to play judge and jury.
Similarly, if I can't provide basic medical services because of my religious beliefs, I have no business being in practice, unless I can be absolutely certain all my patients share them. If it's okay to balk at a tubal during a c-section, how about the morning-after pill to a rape victim? How about pap smears for unmarried women? How about prescribing Viagra to an unmarried man? Or antibiotics to an unmarried teenager with an STD?

The OP has to chose a less safe option for her and her family because of the hospital position. To me, that is a primary violation of the mission of anyone in health care.

[bubbaray]

The OP has to chose a less safe option for her and her family because of the hospital position. To me, that is a primary violation of the mission of anyone in health care.


I'm actually not convinced AT ALL that having her DH have a vasectomy is a less safe option than a tubal during a c/s. From all of my research, a tubal, whether during a c/s or not, is a more risky procedure than a vasectomy.

[JenaW]

Health care providers are given special privledges in this society in order to do their jobs. I can and do prescribe narcotics, ask invasive questions, even keep people in the hospital against their will (within reason.) With those rights come responsibilities. It is immoral for me to make judgements on who deserves my care. I have taken care of rapists, child molestors, terrorists. My job in society is not to play judge and jury.
Similarly, if I can't provide basic medical services because of my religious beliefs, I have no business being in practice, unless I can be absolutely certain all my patients share them. If it's okay to balk at a tubal during a c-section, how about the morning-after pill to a rape victim? How about pap smears for unmarried women? How about prescribing Viagra to an unmarried man? Or antibiotics to an unmarried teenager with an STD?

The OP has to chose a less safe option for her and her family because of the hospital position. To me, that is a primary violation of the mission of anyone in health care.

I too am a health care provider (OBGYN PA), although I am not currently practicing, as I have 4 young children and a 5th on the way. I have no problems "picking and choosing" what I prescribe as long as I can be assured that my patient has access to her choice or treatment. For instance, I never participated in abortions and stopped prescribing the morning after pill after my conscience and spiritual advisor convinced me to do so. I do diagnose and treat STDs (regardless of whether the patient is single, married, or married and cheating) and do prescribe contraceptives. However, I also NEVER EVER forced (or even revealed) my beliefs on my patients, ALWAYS made sure they were properly informed of ALL their choices, and always gave them the name/phone number/address of another provider (if one was not immediately available in our office) if they chose an option we did not provide (my office did not do abortions, but others in the office would prescribe the morning after pill). I would never refuse to treat someone in an emergency, and agree that it is not our place to judge. however, as long as my patient can receive adequate care that is consistent with her (or his, but I primarily treated women) decisions, I do not feel that have to compromise my beliefs and values, yet I can still be an excellent care provider. I never had a patient accuse me of being immoral, nor did anyone ever suggest that I should not be in practice because I would not perform an abortion or write for the morning after pill. I simply do not believe that things have to be as black and white as you make them out to be. Again, while I never have and never will force my beliefs on someone else, I WILL have to answer for my actions someday. I can go to bed at night and still feel good about myself with the way I have practiced (and hope to continue practicing).

J

[o_mom]

Then they should stay out of the healthcare business. Seriously, a vasectomy is a low risk procedure, but it does involve surgery, however minor, and that does have risks. I think it's unconscionable what the hospital is doing.

Really, there is no "right to elective surgery". That is what we are talking about, elective surgery. This is not a life saving procedure and nobody is forcing the patient to choose anything.

There are judgements made all the time about what procedures and treatments are ethical and there is nothing that says everyone must agree on those. If we were talking about an abortion this wouldn't even be a question. That is also an elective surgical procedure for which the alternative (birth) is riskier.

[karstmama]

i worked with someone once who said she'd worked at different catholic hosps. one did no tubals at all in any way. :nono: one wouldn't do 'tubals' but would do 'uterine isolation' surgery. :shake: one leased out one or room to the ob/gyn practice so all tubal pts were done in that room, not on hospital property. :rolleye0014:

[jamsmu]

There's also a practice being done in many OB/GYN offices now, called Essure. Its done vaginally and, according to my doc, is a simple procedure done within a few minutes. I just started researching this: http://www.essure.com/ Don't know much about it, but its an option I'm considering.

[isaiahsmom]

I had a TL on the same day I had my daughter, but I delivered vaginally. I had an extra night in the hospital, 2 weeks of recovery, no heavy lifting, including my then 18 month old, no driving, just taking it easy. I found that I was much more tender than I was after I had my son. Kinda crampy, but nothing major. My DH wouldn't get it done, for reasons which he still won't explain to me, even when I gave him the rationale about it being less invasive for him than for me, etc. Rather than fight with him about it, or stay mad, I elected to have the TL, and I don't regret it for a minute.

However, if your DH will do it, as PP's have said, there are few side effects, and it's in and out for him, compared to your recovery.

Good luck to you!

[crayonblue]

Apologizing first to the OP because I have nothing to add about tubals but I wanted to chime in. In my opinion, it will be a sad day indeed if doctors/hospitals do not get to choose their moral stance. Whether I agree with someone's moral code or not, they have a right to decide what they will and will not do.

[SnuggleBuggles]

There's also a practice being done in many OB/GYN offices now, called Essure. Its done vaginally and, according to my doc, is a simple procedure done within a few minutes. I just started researching this: http://www.essure.com/ Don't know much about it, but its an option I'm considering.

My sister has had Essure for many years now and recommends it. If you have any q's I can try to answer them or pass them on to her to answer.

Beth

[wellyes]

In terms of pros/cons for TL - my mother chose to get a TL because she figured that a man's fertile years are so much longer than a woman's. She did not want to get pregnant again, so she was fine with TL. But she did not want to prevent my father from remarrying and having more kids if she were to pass away.

Of course vasectomys are reversible, and simpler, so I could see that being a good choice as well.