How tubal ligation fits into our family planning

Guest post by Olivia
Normal Fallopian Tube, Human

As I sat down in the exam room in a new gynecologist’s office, I prepared to have my blood pressure taken and to answer a few simple questions: When was my last period, how often do I drink alcohol, when was my past pap? Instead, the nurse looked at me incredulously and said, “You’re here for a tubal consult? Really?! …She’s not going to do it, you know.”

I bit back my irritation , gave the nurse a big smile, and calmly replied, “I’d prefer to let the doctor make that decision. Do you need me to take my hoodie off to take my blood pressure?”

I’d expected a bit of a struggle during this appointment, but it surprised me that it came so early, and from the nurse. However, her remark was not completely off-base. Here I was, ready to talk to a doctor about getting a tubal ligation at twenty-three and with no children. Many doctors will not even consider doing a tubal on a woman unless she is over 30 and/or already has children; they worry that she will one day change her mind. Yet my husband and I had known for months that this was what we wanted.

I wrote a post on this site last fall about my struggles with bipolar disorder and the realization that though I had thought I wanted to have one biological child before adopting children, that it was not in my or my family’s best interest. Since then, I have more than come to terms with that decision. In fact, turning my attention to a future of adopted children truly feels like coming home.

Growing up and into womanhood, I always felt strongly about adopting children — I knew that it was important to me to give homes to children already in this world, rather than creating new ones. Making the decision once and for all to not have biological children simply feels right to me. I am actually happy that I went through that trying time last year, because it forced me to get back to my core values. (I want to make sure to say that I don’t judge those who do choose to have biological children — just that this isn’t what I feel is right for me.)

After making this decision once and for all, my husband and I talked extensively about our birth control options. We knew I needed to get off hormonal birth control, since my bipolar meds reduce their effectiveness (and can seriously harm a fetus if I do get pregnant, which I covered in my other post). I thought about getting an IUD and for a host of reasons decided against it. So we were down to surgical sterilization. We determined I should be the one to have the procedure done, primarily because I have better insurance than he does and it would be fully covered. We decided to sit with this decision for several months to make sure it continued to feel right.

Fast forward to present day, with little old me sitting in that doctor’s exam room, waiting to fight for what I wanted. The discussion with the gynecologist went mostly as I expected — we talked about all my options, she asked me why I wanted the procedure, she tried to direct me to other options. Then the discussion took a turn I didn’t expect.

I was happily chatting away about why it was important to me to adopt and she interrupts me, saying, “You know those kids in foster care aren’t your responsibility, don’t you?”

I could only stare at her blankly; I was so surprised at what she had just said. After some deep cleansing breaths I simply told her that yes, it IS my responsibility to give permanent homes to children in foster care, that I knew I wouldn’t change my mind about the surgery. I then asked if she would do the procedure or if I needed to find someone else. She said she would do it.

I left without saying much else to her, but this is what I wanted to say: my children are out there somewhere right now. They are about to be born, or they are babies, or they are small children. I can feel them in my soul and I can honestly say I want them and love them already. What does the decision to have a tubal ligation mean to me? It is a promise to those children that I will choose them over any biological urge I might feel to procreate. It is a promise that they will have a forever home with people who love them, that the spot they are to occupy in my family won’t be taken by a biological child, that they won’t grow up neglected or abused or unwanted.

I know this choice may seem extreme and a lot of people — like my doctor — won’t completely understand it. For most people, it seems counterintuitive to get a tubal done as a family planning measure BEFORE having children. For me, though, putting this plan into action has made me feel more like an expectant mother than I’ve ever felt before. And really, once the children are here, who will care about how my husband and I got them, or the choices we made along the way to ensure things went according to plan? All anyone will see is a family, just as beautiful and loving as anyone else’s.

Comments on How tubal ligation fits into our family planning

  1. You are a much better person than I. I would have told that doctor to go fuck herself and kept looking for a new doctor. It’s one thing to explain your options to you, but to say things like that? That’s insane.

  2. Good for you! I had mine done at 26, after two children. My dr really didn’t want to do it because he said they he KNEW I would change my mind (he has 5 kids himself). I told him that I WAS going to get it done, and he agreed to do it. I don’t regret that decision at all.

    My husband and I start foster care training/classes in August! 🙂

  3. Thank you for sharing your story. You will be a great credit to the children who share their lives with you.

    As a Canadian it blew my mind to read that health insurance reasons played a part in your decision to have a medical procedure which is far more risky to you than a vasectomy would have been to your partner. It just shows me how much I have to be grateful for.

    • That is exactly what I thought. I mean, go for it if you’re sure that you’re not going to change your mind, but if you’re also sure you’re not going to cheat on your husband it seems insane for you to be sterilized rather than him based on “insurance”. So glad to have universal health care…

  4. I just wanted to say you are awesome. Not only have you made a decision that important to you, you didn’t back down when confronted either.

    When I was younger, I always wanted to adopt rather than biologically having children. I wanted to give a home to those who didn’t have one. I ended up with an unplanned pregnancy and a fantastic kiddo of my own.

    There are people out there who will support your decision, and even call you a hero. Thank you so much for caring about those lost kids out there and I am sure you will find your children.

  5. It sounds like you and your husband have a strong foundation, understand the challenges of foster parenting and adoption, and are committed to facing them as a team. Kudos for sticking by your convictions and following the path that’s best for *you*!

  6. I’m rather impressed that both the nurse and the doctor found it appropriate to express their opinions so frankly. I suppose we do pay them for their opinions but … those comments seemed highly unprofessional to me. Good for YOU for keeping your cool so spectacularly. What a great example of how to deal with such a situation in a very adult way.

    • I believe that part of the consult for an irreversible procedure like this is to challenge your stance in as many ways as possible just to make sure you’ve thought through everything and really are committed. Sometimes it may be about a doctor expressing their own beliefs, but I imagine a lot of times (especially when they agree to do it anyway), it’s just about making sure that you’re sound in yours.

      • This isn’t even rare, take it from a childfree woman. The worst I ever had was a GYN that sighed and said “What’s the point of being a woman if you don’t have babies?” pretty nasty.
        But my online friend takes the cake when a nurse said to her “What if your husband died and your new husband wanted kids? What would you do then?” C’mon!

      • This is how I would try to read her comment, even though to you (and me, and the people commenting) it sounded ignorant and unprofessional. In her mind she was probably just trying to gauge your certainty. Also, from my own experience: since you are at the right-out-of-college age, many (unimaginative) people will assume that you are full of youthful idealism which you will eventually “outgrow”. Something like coming out in college and being unable to convince people that you aren’t just going through a “phase”. Infuriating, yeah, but unfortunately common.

  7. I have known several families that have adopted and it brought their family CLOSER. Just a little FYI 😉

    You are an amazing person to recognize your heart-felt mission to rescue babies and give them a home. But even more so for standing up for what is right for YOU. Everyone is different and has a different purpose in life. Most of us forget this. (or we are un-taught it)THANKS FOR THE INSPIRATON.

  8. If children in foster care aren’t our responsibility, then who’s responsibility are they? Chances are good that their biological family has already failed them. Thank you for caring!!

  9. To be very charitable, your doctor has a point. Kids who end up in foster care have had a lot of trauma. More likely than not, they will come with a lot of bagage. It takes a lot of very bad behavior for a birthparent to lose all parential rights. That you’re willing to take on such a challenge and recognize that all kids deserve a loving home makes what you’re doing all the more wonderful. Still, the recommendation to seek out and talk with parents who have been through what you plan to do would be a great resource.

    • As a former foster kid who was adopted at 17, I am so happy for those people who decide “those” kids are their responsibility. The fact that kids like myself experienced a lot of trauma should only be one piece of the foster/adoption puzzle. Did I have emotional problems and baggage that complicated my relationships? Yes, but I also had/have parents who were and are willing to work with me and help resolve those issues.

      Frankly, the doctor had no right saying that to a potential adoptive/foster parent — he or she would never have thought to question someone having a child in a “traditional” way, and certainly kids born to biological parents can endure significant trauma of their own, yet you don’t see people questioning that decision. Most potential adoptive/foster parents are made well-aware of any issues their kiddos might come with. Better that a loving family works with those kids than allow them to not receive the love and attention they deserve, then have them kicked out on their own at 18. That is a vicious cycle.

  10. I am a former foster kid who would have given anything for a mother who cared half as much as you do. What an amazing decision you’ve made. I’d call it a self sacrifice but I don’t think you see it that way. I’d say its more like a small step to the bigger leap of becoming a mother.

  11. I have PCOS and as much as i want to have a child(ren) that are biologically related to me that may never happen. At the same time i don’t believe in biology, as crazy as it sounds, there is a small tribe of indigenous people somewhere in the world that believes that every child has several mothers and fathers in the tribe and the most important one wasn’t the birth parent it depended on the relationship to the child.
    Its the perfect senerio for foster care. Ive seen my little brother and sister fit perfectly into my family. My little sister has the exact skin color that i have, you can tell how she feels by looking at her eyes,just like you could do with me, and her hair is the same color as my moms, and my little bro is the boy child my dad has always wanted and is just like my cousin in every thing from looks to personality. They are in no way biologically related to my family but some how they are now.
    I’m so glad you said the line about you can feel your future children out there. Me too. I can’t wait for them to find their way home.

  12. this is awesome!

    i mean, guh to the unprofessional commentary, but *this* is awesome. i hadn’t thought about it before (seeing as birth control is built into my relationship), but i can see myself in your exact position were pregnancy a concern!

  13. Good for you, you’re taking the measures necessary to make sure that you are healthy and happy and you’re willing to do a wonderful thing that most people don’t even consider. I think your future children are going to be very lucky to have a Mom who put so much thought, effort and love into them before she even knew them.

  14. You made me tear up! Do you know how hard that is to do?! I think it was the line about knowing your kids out there waiting for you. You are probably right about your decision seeming extreme to some but it makes perfect sense to me (though maybe not FOR me). Know that there are some of us out here on the interwebs that totally support your decision, and congratulate you on it, and honor you for it!

  15. Congrats for standing up for your decision. I think more people need to be very honest if they don’t want biological children and not feel like they have to have them because of societal pressure. Many of the children in foster care do need loving homes with loving, thoughtful people. Every child should be a wanted child and that doesn’t always mean you have to give birth!

  16. I think it’s wonderful that you have made such a well thought-out decision regarding your future family. I wish everyone went into this process with as much forethought.

    It’s perfectly reasonable to want to remove the possibility of an accidental pregnancy, especially given the risks to a fetus and your mental state.

    I’m sorry the doctor treated you that way. It’s unfortunate that you are doubted because of the people who have regretted a tubal ligation.

  17. Have some respect for nurses! What she said was not appropriate, but she is a professional with skills and training that goes beyond merely taking your blood pressure. I am a nurse that does family planning and about 50% of young couples I counsel on early BTL or vasectomy who don’t have kids change their minds. It’s my job to ask all the questions, just like its my job to ask all the questions of other women making important reproductive choices. I don’t know new patients and therefore I can’t know what their decision-making process is like.

    Secondly, I grew up with a bipolar mother (pretty uncontrolled until recently–the highs are FUN; the lows suck) in a home with a revolving door of foster kids and foreign exchange students. Our family, and what it taught my siblings and I about love, is an indelible part of who we are as adults– most of us have chosen social service careers and plan to have similarly open homes. It is not a choice to be taken lightly at all as it has plenty of pitfalls and challenges. As a permanent youngster in an ever evolving situation, I am also grateful for the times when my parents had the presence of mind to give our family a break and let us regroup after a long term sibling moved back in with their birth family and when we chose to take breaks all together and focus on us.

    • I think the OP was very respectful to the nurse by staying calm. The nurse was not asking questions, she was making an opinionated statement that the doctor would not do the procedure. She was not qualified to make that statement, regardless of her skills and training, because it was the doctor’s decision not hers, which is all Olivia said, respectfully. As it turns out the nurse was wrong, causing unnecessary stress.

      • You’re right– it does sound like the author was respectful to the nurse when addressing her in the clinic. I don’t want to start a debate on the role of nursing (there are plenty of other websites for that) but this sentence “I’d expected a bit of a struggle during this appointment, but it surprised me that it came so early, and from the nurse” implies the author doesn’t think nurses play a role in pt. decision-making, which is simply not true. Nurses “care” is a frequent description of the profession, but, if we want to be accurate, nurses are charged with being patient advocates. And that goes well beyond blood pressure readings. If the “nurse” was actually a medical assistant, that is a different story.

        • I’m so sorry to have implied that. I have great respect for nurses. In that sentence, I was trying to convey simply that in my experience with doctor’s offices and nurses, I had never had a nurse make such an opinionated statement about what decision the doctor would make. I truly didn’t mean to imply that she was out of line or that she shouldn’t have an opinion, just that it took me by surprise since it had never happened before.

  18. You have really thought out your family planning and have found a way to commit fully to your future family without compromising your personal health(which of course only contributes to your families well being). You are such a bright young woman and your future family will be so very lucky to have you as a Mom. This is a lovely post! Wishing you all the best with your future kidlets! 🙂

  19. This is lovely, and I’m so glad that you were able to stay strong in your convictions. Congrats on this next step, and good luck finding your children!

    (This made me tear up too, I won’t lie.)

  20. I was wondering, if they aren’t too private, what are the “host of reasons” that you chose not to get a non-hormonal IUD? I don’t mean this in any way, shape, or form as a challenge to your decision or an attempt to make you “justify” it – I think it’s awesome that you have obviously thought it through so thoroughly and I’m sure you have come to the right decision for you. I just think that you rightly point it out as a sometimes-appropriate alternative to sterilization, and I’d like to know a little more about how you came to your final decision.

    • Sure! My primary reasons are as follows. I decided against the hormonal IUD (Morena) because there is insufficient evidence about whether my primary bipolar medication would interact with it and render it less effective. I decided against the copper IUD because I have severe metal allergies and sometimes (rarely, but sometimes) people with those allergies do not do well with copper IUDs. Also I’ve read about women with no prior pregnancies experiencing chronic pain or discomfort after the iud is placed.

      And again, unfortunate as it is, money also had to play a role. The surgical sterilization is covered fully; the iuds are not at all. Also, to be honest… getting an IUD doesn’t feel right to me, and I’m the type of person who believes it’s important to follow those from-the-pit-of-your-stomach feelings.

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