Remember: It's Permanent!
Things to think about before you decide...
Since I put up my web site a year ago I’ve gotten hundreds of emails and guestbook entries from ladies who are in the same place I was. They are living with the regret of having a tubal ligation. They feel that their families are incomplete and desperately wish their tubal ligations would fail, too. I know all too well the pain and sorrow that those women are feeling. I’ve sat in front of my computer countless times reading an email from one of those ladies, crying right along with them. I know that most of them will never be as lucky as I was and it is so unfair. I want so badly to do something for those women, to be able to share the good fortune that I’ve had, but I just end up feeling so helpless and frustrated. Except for lending them my shoulder to cry on and letting them know someone out here knows exactly how they feel, there’s really nothing more I can do.
Maybe there is something that I can do to prevent other women from making the same mistake we did though. I got an email from one woman that said she was considering having a tubal ligation done, but changed her mind after reading my web site. That made me feel so wonderful! To know that there would be one less woman who would be joining our ranks made me so happy. I think that’s the answer – fixing the problem before it becomes a problem. Now, I’m not saying that tubal ligations are wrong for everyone. They’re not. Many, many women have tubal ligations and live out the rest of their lives very happy with their decision. There are a percentage of us, however, that will live out the rest of our lives battling the depression that having a tubal ligation has caused. There are some of us that will forever feel our families are incomplete and that mourn the loss of a child that can never be conceived.
Based on my own personal experience and the experiences of those many women who’ve been kind enough to write to me and share their stories, I have come up with some things that I’d like women out there considering tubal ligations to think about. These are things that my doctor didn’t talk to me about and that I’m sure your doctor won’t talk to you about either since most of them fall outside of the scope of medicine. They are things that I never even thought about when making my decision. If I had thought about them, maybe I wouldn’t have made the choice I did. Maybe none of us living with tubal regret would have made that choice. Ultimately the decision is up to you and please know that I’m not trying to talk you out of having a tubal ligation. It might well be that having the tubal ligation really is the best choice for you personally. But I do want to make sure you are making a fully informed decision, one that you’ve thought about from every angle and one that you’ll never live to regret.
Are you making this decision while you’re pregnant?
If I had waited until after birth and recovery, I’m fairly certain I never would’ve had my tubal ligation. During that pregnancy I was very uncomfortable and hormonal. I was sick for a good part of it and I’d gained a lot of weight. I had a scare with gestational diabetes and placenta previa. I thought I would never want to go through all of that again. Even women who had very easy, pleasant pregnancies have written to tell me they should’ve waited until afterwards to make the decision. Looking back, many of them decided that they didn’t want that pregnancy to be the last one after all. But by then it was too late.
I know that especially for those having c-sections, it’s much more appealing to have the tubal ligation at the same time as delivery. Still, maybe you can consider waiting to have the procedure at another time – after you’ve had the baby and have recovered from the birth. Tubal ligations are a permanent form of sterilization. Such an important decision demands that you give it as much time as possible to be sure you’re making the right choice. If you’re making this decision while you’re pregnant there is a definite deadline as to when you have to decide for or against it. It isn’t necessary to put that kind of pressure on yourself. If you need more time to decide – to be certain – then take more time even if that means having a separate procedure. Don’t force yourself to make the decision before giving birth. Also, gaining some distance from the situation we are currently in often changes our perspective of it. So, maybe waiting until after your pregnancy and recovery might be a better idea.
Are you making the decision for financial reasons?
Many women have told me they decided to have their tubes tied because, at the time, they couldn’t afford to have more children. Honestly, I think that’s an excellent reason to limit the size of ones family. For many people who’ve had tubal ligations, they will never regret their choice because they simply cannot afford to raise another child. However, your income can change. Though you may be struggling today, you may not be tomorrow. Especially for young couples, finances can change dramatically during your child bearing years. Ask yourself, if in a few years you can comfortably afford another child, would you consider having another baby? Even if your answer is just “maybe”, you might want to hold off on having the tubal ligation. There are so many long-term, reversible forms of birth control out there that there’s no reason to go the permanent route if you aren’t completely certain.
Are YOU making the decision or is someone else making it for you?
You wouldn’t believe the amount of emails I’ve gotten from ladies saying that their mother-in-law, mother, sister, aunt, friend, doctor, etc., pressured them into having their tubal ligation. So many women were talked into the decision and regretted it even before they had the surgery. Even though they never wanted to have the tubal ligation, they went through with it to make someone else happy because they were made to think it was “the right thing to do.” While their family or friends may have been well-intentioned, that doesn’t make the decision any less painful for the woman living with her infertility. The reason for the pressure to have the tubal ligation range from, “Don’t you think you have enough children?” to “you can’t afford the ones you’ve already got” to “your marriage won’t survive another pregnancy” and every reason in between. Maybe some of the reasons brought up are valid. Maybe at the present time it really wouldn’t be wise to have another baby. That is YOUR decision to make though. It’s your body, your family and your decision. If you don’t want the tubal ligation, do NOT have it done. Don’t let anyone pressure you into it.
Are you making this decision because it’s what your spouse wants?
Another common reason that women have a tubal ligation is because their husband wants them to have it. The scenario is often something like this: She isn’t sure if she wants more children in the future or not. He, on the other hand, is very sure and says “NO WAY” to the idea of having more. So, she goes ahead and has the tubal ligation. This scenario has gone badly for so many different reasons. Anytime you allow someone to make a decision like this for you, it can open the door to resentment. I’ve heard from women whose husbands, just a few years later, have changed their minds and thought that maybe another baby wouldn’t be so bad. A little late for that valuable information! I’ve heard from women who, even though they’re still not sure if they’d want another baby, are upset that they no longer have the choice. I’ve heard from women who suffer from Post Tubal Ligation Syndrome, who just don’t feel whole anymore, or who are now remarried and want children with their new husband. So many times I’ve heard from women who had a tubal ligation because they thought it’s what their husbands wanted, only to end up regretting the decision while struggling with feelings of resentment. Even though they know the decision was ultimately theirs and that they can’t blame their spouse, those feelings are still there. Don’t let anyone make this decision for you, don’t make this decision to make someone else happy, and, again, don’t let anyone pressure you into it. If your spouse insists that he doesn’t want any more children and you have doubts about having a tubal ligation, maybe suggest he have a vasectomy instead!
Are you making this decision because you’re in a bad relationship?
Many women have written to me saying they chose to have their tubal ligation because they were in a bad relationship at the time. For a myriad of different reasons, those women chose to have a tubal ligation so they couldn’t have another child with their current significant other. By the time those women write to me though, they’ve long ago said goodbye to those bad relationships and are now very happily in love with someone else. And they want to have a baby with that someone but can’t. I’ve never heard of a relationship being saved because the woman went through with having a tubal ligation. So, maybe you can use some other form of reversible, long term birth control until life is happy again. Then you can make the decision because it's what you really want to do, not what you think you have to do.
Have you gotten a second opinion?
I’ve heard from several women who had their tubal ligations done because they were told they couldn’t safely carry another child. Many times these women were not ready to stop having children, but made the sacrifice for their own personal health and safety. Years later, after talking to a specialist or just a different obstetrician, they’ve found out that they really could have carried another baby with minimal risk. In some cases the new obstetrician simply disagreed with the previous obstetrician’s conclusion and in some cases technology and technique have changed now making it possible for them to carry safely. If you do not want to have a tubal ligation, but think you have to for medical reasons, definitely seek a second opinion. Be sure of your diagnosis and know all of your options before making any final decisions.
Do you have even the smallest doubt in your mind?
I have talked to so many women online who are planning to have a tubal ligation, but say things like, “I’m pretty sure, but sometimes it makes me sad to think this will be my last baby” or “I’m not really sure, but it’s probably the best thing for my family” or “I’m 99% sure I want to do this… but every now and then that 1% makes me wonder.” Please, if you have even the tiniest doubt in your mind DON’T DO IT! That doubt can grow and grow over time until one day you wake up and realize you desperately want another baby. Or maybe you just wake up one day and wish you still had the option. If you are not absolutely positive, don’t have the sterilization done just yet. Consider another long-term form of birth control and allow yourself some time to think about it until you are sure. This is something that is permanent – reversing it is extremely expensive and often unsuccessful – so you need to make sure you are certain!
Have you considered your age?
Young age at sterilization has been a consistent predictor of regret in many tubal ligation studies. One of those studies was done in 1998 by the U.S. Collaborative Review of Sterilization. The younger the woman, the greater the likelihood of regret. For women under the age of 25, the rate of regret reported within 14 years after sterilization was as high as 40%. For all women under the age of 30, the rate of regret reported within 14 years after sterilization was just over 20%. Compare this to the over 30 age group whose rate of regret reported within 14 years was only 6%. This report also released findings that coincide with some of the other points I’ve addressed in this article. Specficially, “The regret rate was also high for women who were not married at the time of their tubal ligation or when tubal ligation was performed less than a year after delivery.” If you are under age 30, and certainly if you are under age 25, maybe you could consider waiting a few years before choosing a permanent form of sterilization. Reducing the chances that you’ll live with a lifetime of regret would be worth the wait!
Have you ever heard of Post Tubal Ligation Syndrome?
There is still controversy in the medical community about whether or not this condition even exists. Thousands of women insist that it does, however. I am one of those women. For the 3.5 years that my tubes were tied, I experienced many of the symptoms of Post Tubal Ligation Syndrome. I suggest you visit http://www.tubal.org/ and learn all there is to know about Post Tubal Ligation Syndrome. Talk to your doctor about it, research some other sites on the internet – even sites that say it does NOT exist. Knowledge is power and the more informed you are about your decision, the less likely you will be to regret it.
What makes you feel “whole?”
This is something I’ve heard repeatedly from women who live to regret their tubal ligations. They report that, since having the surgery, they no longer feel “whole.” I don’t know how you measure something like that, I don’t know how you can predict something like that, and I don’t know what the warning signs are. I do know that many women, maybe because of hormonal changes in their bodies, maybe because they’ve left one phase of their lives behind, maybe because part of what they used to associate with being a woman is now gone… whatever the reason, having the tubal ligation left them feeling incomplete, less of a woman, and less whole. Consider how being infertile might make you feel as a woman. Most women say they simply would feel relieved not having to worry about birth control anymore. If you think it might make you feel differently, consider waiting to have the procedure so that you can explore those feelings more.
Have you thought about the things none of us wants to think about?
This is the hardest one to talk about, which is why I left it for last. These are the most heartbreaking stories of regret. A few women who’ve written to me regret their decision to have a tubal ligation because their baby died after having the sterilization performed. This is not something anyone can predict or plan for. Fortunately most of us will never, ever have to deal with this kind of tragedy and most of us will never be able to imagine how we would feel if we did. The women I spoke to know that one child will never replace another. They know that they will always grieve for their lost child and there will always be something missing from their family. However, they always imagined that they would have that number of children and they always imagined their other child(ren) would have a sibling. They have space in their home and hearts for another child and desperately want another. I won’t ask you to even consider how you might feel in a situation like this. I just want to share all of the stories of regret that have been shared with me so that it might help anyone else reading this.
Much less tragic, much more common, and somewhat more imaginable is the event of divorce and subsequent remarriage. Of course, no one plans that one day in the future she and the spouse she’s so madly in love with today will not be the person she’s with tomorrow. Unfortunately, it happens all the time though. We’ve all heard the statistics, I’m sure – half of all marriages end in divorce, right? A large percentage of the emails I’ve gotten are from women in this situation. They had their tubal ligation while in an old relationship, that relationship ended, they are in a new relationship, and now they want a baby together. If you were ever to get remarried to a man who wanted children, can you imagine you’d be willing to consider having more? If you could see it as a possibility in that situation, maybe you could look into other long-term, less permanent forms of birth control for the time being.
If after reading this extremely long (but hopefully not too painfully boring) article, you are still confident that tubal ligation is the right choice for you, then that’s great! It probably really is a good choice for you. However, if something you read created or magnified uncertainty or doubt, give yourself some time before committing to anything. Take all the time you need to make this decision. If it means canceling or rescheduling a surgery, then so be it. This is a big decision and you need to be absolutely sure before you do something that can’t be undone. I am obviously very passionate about this issue. I do not think tubal ligations are bad. I think it’s wonderful that it’s an option for women and I think that, for many women, it’s an excellent choice. However, tubal regret can be devastating. I don’t want any more women to live with the pain and suffering it caused me and so many other women I’ve met. Be sure. Be sure you’ve thought it through completely. Be sure you’ve researched any questions you might have about it. Be sure you’re fully informed. Be sure there are no doubts in your mind. I wish you the very best with whatever decision you ultimately make.