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. This is so beautiful! Thank you for sharing so honestly. I loved what you said about your children being out there somewhere. It really made me think of adoption in a different way. Good luck in your journey!

  2. Good luck with your journey. I was inspired by your desire to adopt and the way you are dealing with a difficult situation calmly and confidently.

    I want to adopt before having biological children and I was worried that not having my own children although I can would count against me. But I also feel a sense of responsibility towards children in foster care.

  3. I’m in a similar situation and made the same decision. I have a heart condition that makes pregnancy possible but very risky for me and the fetus, and I have always felt it was silly for me to go through all the risks when there are plenty of kids out there that need homes. When I was actually ready to have kids, I went to doctors and asked questions-mostly just to say I had done a thorough check. We decided to go with an open adoption, and 5 months ago my son was born. I have never ever, even before he was born, doubted or regretted this decision. You know in your heart what is the best path to parenting for you. And know that for all the rude doctors you encountered, there are a dozen who think you are wise for being so thoughtful about having kids.
    I highly recommend the agency we used if you are interested in open adoption:

  4. Props to you, not just for making the monumental decision to adopt or for sticking up for that decision, but also for being brave enough to recognize that you have a condition that in one way or another could have negative effects on your family if you were to have biological children. My own mother had 3 children to 3 different men, long story short, by the time I was 15 she had proven over and over again that she was just not suited to being a mother. She had lost my older brother when he was 7, so my entire life he had always lived with his dad. When I was 15 and my younger bro was 13 we were removed from the home and placed with step-family. Their hearts were in the right place for the wRong reasons so after a year in their home social services finally found my father for me(my mom had nevEr told him about me) and let me live with him. The younger bros dad was mia by choice, my older bro had to step up at 23 and finish raising our brother. We found out through all this that our mom is bi-polar. Had she chosen to go on medication a large part of our story would be different. 13 years later she still refuses to accept she has an issue. None of us our able to keep her in our lives, it is just to stressful and creates to many issues now that we have our own families. My point in sharing this is two-fold: you are a hero in my mind for accepting your disorder and protecting yourself and your family from any negative problems associated with it. And also, in your quest for children, please don’t forget about the teenagers out there. So many have not experienced what it feels like to be loved or included in a family and many truely are good kids that just need some guidance and understanding, just because they will soon “age out” should not disclude them from feeling the love of parents. So from the bottom of my heart, THANK YOU.

    • Thank you so much for sharing your story. I fully intend on adopting teenagers in the future! Our plans are to adopt one sibling group of two or three younger children (anywhere from toddler to grade school age) in a few years when the husband is finished with his master’s. Then several years later we’d like to add another sibling group of older children and teenagers to our family. At this point right now I feel I am too young to parent a teenager, but I absolutely want to provide a home for some in the future!

  5. Why don’t your husband and you have the same insurance–especially if you’re covered better? How would it work for when you have kids? Best of luck in finding your future children!

    • My insurance is expensive but necessary due to my need for continual prescriptions and mental health coverage. My husband gets his (incredibly cheaply) through his university, but it is very basic. Once he’s out of school, he will hopefully get a job with good benefits for the entire family.

  6. When I had a non-hormonal IUD put in my first OBGYN said “don’t you want kids that look like you” when I expressed my want to adopt. I was floored and walked out. You have a plan run with it.

  7. I love this! I wish we were in a financial position to adopt. The sad truth is that it is much cheaper to have bio children than to adopt. My dad and husband were both adopted though and I really admire your choice!

    • Agreed. My husband’s mother and her sister were both adopted, and I love the idea of adopting — but by the time we’re financially stable enough to adopt (and I’m talking like, 5 years minimum; we’ve still got about three years of college left here) I don’t know that we’ll really want more children.

    • Hi! I was actually concerned about this when we started thinking about it, but I found out it’s not always true. Yes, if you wan to adopt internationally, or if you want a private adoption (especially of a newborn), it can cost a lot of money in agency fees. However, if you choose to adopt through the foster care system, as we have, the only costs are the costs associated with changing the child’s last name. Also, at least in Ohio, many counties provide monthly money to foster parents before the child legally becomes yours. Our plan is to use this money to pay the legal fees, and then put the rest into college funds! No money out of our pockets! 🙂

  8. This is very inspiring and I fully support your dreams of adoption! I was wondering though, it you’ve done any research about restrictions on fostering/adopting as a result of your bipolar disorder? I only ask because where I’m from, being diagnosed with a mental disorder excludes people from public adoptions (my cousin tried).

    • Great question! In my county, and the counties surrounding, there are either no such restrictions, or the county simply requires documentation from your psychiatrist that you are medicated and stable. That’s too bad for your cousin 🙁

  9. I just want to thank everyone for their words of support and encouragement. You all are beautiful and wonderful and make me so happy to be a part of the offbeatmama community.

  10. Thank you for posting this.I have postural orthostatic tachycardia syndrome, premature atrial contractions, and 2 congential heart defects. While those defects occur “naturally” in 1 of 100 babies, if YOU have one, the chances of giving it to your children is 1 in 20. My FH and I have discussed having this procedure done as well. I’ll have to show it to him later.

  11. This brought tears to my eyes. I have to say, I don’t know you at all, but I wish so much that I could hug you.

  12. Thank you so much for sharing your story. I can relate when you 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.” I felt the same way before I conceived. I knew somewhere inside me was the ovum that would become my child. I wanted that child and loved them already. I hope you find your babies soon. They will be lucky to have a mama like you. 🙂

  13. What a beautiful Mama you already are. Your future children are so lucky and I believe in loving them before you’ve met them (in person). I felt the same way about my husband and son I didn’t know I’d have. I don’t think many people can grasp that concept but it makes your heart huge and receptive.

    Such a wonderful article. Thanks for sharing!

  14. I have never read this sentiment put so logically or so perfectly before. Most people wouldn’t bat an eyelash if someone who wanted bio children said they already love their future children. SO why should it be any different for a future adoptive parent to say it? And yeah, that does make your future children your responsibility, just like my once future child was my responsibility when I was someone trying to conceive. Insensitive doctor, ugh.

  15. I don’t usually comment here but I had to say what a beautiful post this is. Well done for choosing the path that’s right for your family and I wish you all every happiness.

  16. Your words were so amazing. I am so happy that you stood up for yourself and you were able to actually decide without the pressures of others. I fostered to kids when I was 23. Sadly, I was unable to adopt them. One day I plan to do it again and become a forever mommy to someone. I say go with your gut congratualations on your decision.

  17. This realllly struck a cord with me. I also had a tubal ligation at the age of 23 with no kids. When I was diagnosed with a genetic disease for which there is no cure or treatment, I started looking at my options. Its not fatal or anything (except in rare cases) but it is disabling, even though I don’t “look sick” whatever that means. I use a wheelchair part time, and a pregnancy might push that part-time status into full time even after birth. There is also a higher chance of miscarriage and complications, and (and this is the kicker) a whopping 50% chance to pass it down. There is also no genetic test for it, so I would be that overprotective crazy Mom looking at every bump and bruise my kids had and wondering if it might be my disease. We might get a surrogate, but because I don’t want to use my DNA we would also have to get a donor egg, and it is hella expensive…why not just adopt kids that are already made? Anyway, those are my reasons.

    My experience was a little different than yours. I went into my OBGYN and presented my case, expecting to argue and prepared for the worst. Instead, my wonderful doctor asked me a few basic questions, then told me she though I was making a very responsible, wise, and mature decision, then started telling me my options. I was shocked, but I found out she herself actually has a medical condition that made her decide also to not have biological children, so she completely understood. However, the day of the procedure the nurse doing my pre-op asked me what I was in for (which they have to do for security reasons, to make sure they don’t remove the wrong appendix or something) then started asking me random judgmental questions about why I was having it. My Mom was back with me and heard the exchange and was furious, so she told my doctor and my doctor yelled at the nurse. I mean, come on, my doctor obviously approved it and it is an emotional decision, don’t make me second guess it while you are starting my IV!

    3 years later and engaged, I don’t regret my decision at all. My fiance’ now was my boyfriend at the time of the procedure and he was completely on board the whole time, so that was not an issue. I did, however, go through a grieving process in the few months after the procedure. It didn’t help that I was taking 2 classes that semester: in one of them the teacher was pregnant, and the other one was medical ethics where we literally discussed the ethics of situations exactly like my own. I grieved for the children that never were and the loss of a chance of a normal pregnancy I never would have been able to have. I just wanted to tell anyone who is considering having a procedure like this done to prepare yourself for a period of mourning. I still get a little upset sometimes when people ask me, knowing I am about to get married, when I will start popping out babies. It is pretty daunting to think that in order to have kids I will have to fill out a bunch of paperwork, talk to lawyers, probably fork over a lot of money, etc. to convince someone that I am fit to be a mother, rather than just having sex and getting pregnant. But it is nice to not ever have to worry about buying maternity clothes or remembering to take my birth control pill.

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