No Kidding: Do You Still Have Your Uterus?

After I got my tubes tied last year, I got a lot of questions from friends (and strangers) about what a tubal ligation actually means. It's not a common procedure for a young (under 30), relatively healthy childfree woman to have, and most of my friends (parents and non-parents) rely on other forms of birth control, permanent or otherwise. I realize that a lot of Bitch readers know a lot about their bodies and reproductive health, but in the interest of clearing up some misconceptions about tubal ligations specifically (I'll get to other permanent birth control like Essure later this week), here are a few of the questions I've fielded and how I generally answer them.

Please note: I'm not a doctor or health care professional, and I'm answering these questions based on personal experience.

Do you still have your period?

Sure do! As I type, I'm surfing the crimson wave. Since I still have all of my reproductive organs (every organ I was born with too, lucky me!), there's no chance of kicking Aunt Flo to the curb any time soon. I should note that I did abruptly skip my period the first month after my surgery, but I chalked that up to post-surgery stress and my body readjusting to its natural cycle after a lifetime of birth control pills.

Do you still have your uterus?

See above. I still have all of my major reproductive organs. They all still operate in their respective ways, save my fallopian tubes, which have little clasps keeping them closed.

Did you have a major, complicated, invasive surgery?

Like any surgery, a tubal ligation can get complicated. I was lucky that mine did not. Mine was performed with lasers, and I only have two small scars from the operation, one in my navel that's impossible to see, and one on the lower left side of my abdomen above my pubic hair. I was put under general anesthesia, but I was fortunate that I didn't experience any side effects as a result. After surgery, I was in quite a bit of pain and spent about two days in the house recovering. My stitches came out ten days later, and even though a few were infected, I was able to ride my bicycle within three weeks of surgery. I probably could have sooner but I'm admittedly a bit of a wuss when it comes to pain.

Lots of women have tubal ligations after having a baby or two (or more!). Does my experience sound similar to yours, or to the experience friends have described? Since I'm the only intentionally sterile woman I know, I'd love to hear from women across the spectrum who have had their tubes tied or are considering it.

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Comments

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Wow!

My husband and I have made the choice to remain childfree, and as I'm nearing 30, I'd like to make the choice permenant so I can get off these damned pills...wondering if you met with any resistance since you're childfree. Has it impacted your health at all?

No/Yes

Hey Andrea,

I was extraordinarily lucky that I didn't meet any resistance trying to get my tubes tied, but I have heard from friends and read countless articles about how women struggle to find a doctor willing to help them. Men have a much easier time getting the snip, generally speaking, so I was happily surprised that the first doctor I asked believed I had the right to do whatever I wanted. If I had asked my longtime gyno in the States, I suspect she would have been open to the idea, mostly because we built trust over the years and she was an exceptionally woman-friendly doctor (should be a given with OB/GYNs, but too many of us know that isn't necessarily the case).

I got my tubes tied for a lot of reasons, but one was specifically for the health benefits. I've suffered from migraines since I was a little girl, and while acupuncture, herbal therapy, and some lifestyle changes/choices (no alcohol, no MSG) have helped alleviate a lot of my pain, I would still get migraines right before my period and suspected a link to the pill. Since getting my tubes tied last year, I've had maybe two actual migraines—an unbelievable change when you consider that I used to get migraines as often as several times a month. I can't exactly go around telling women that tossing their pills will improve their health—at best, you might get the same results I did; at worst, you'll experience different unwanted effects—but in my case, it's been, dare I say, revolutionary. If you have health issues that you think might be exacerbated by the pill, it's worth considering that your symptoms may improve without it.

Just to be clear, the flip side is that since going off the pill, my PMS has gotten worse (or rather, it now exists; I didn't used to have significant mood swings before my period). In fact, it can be quite brutal since I'm a person prone to anxiety and depression. Still, if you've ever experienced a migraine or know someone who has, you might be willing to concede that the pain is a fine trade for some crying jags. For me anyway, it still feels like I was given a gift rather than made to pay a penalty in terms of having a tubal.

As I said, it's likely that you'd find a doctor more willing to give your husband the snip, but I felt really empowered that I got my tubes tied instead of relying on my partner. (He also fears elective surgery, so I took the initiative to spare us a lot of awkward debates about our bodies. It was something I wanted and he supported, so for us, it was the right choice.) Life post-pill has been wonderful for me. I wish more women could improve their health by getting what they want from their physicians and health professionals.

Cheers! brittany

Other Options

Hi Andrea,

Tubial ligation is a great option; in the interest of general knowledge I thought I'd give you a few more.

I have a (copper, Mirena) IUD right now, which was a fabulous decision in my opinion. It is not permanent :( but is much cheaper than tubial ligation, lasts 10-12 years without any kind of upkeep whatsoever and has really no recovery time (it doesn't hurt). I also recommend it as an option for people in states / with doctors who believe younger women can't possibly make a voluntary decision to be sterile (*rolls eyes*)

The article also mentioned Essure, which is permanent. I don't have any personal experience with that one but from personal research it works much the same way as tubial ligation (blocks the fallopian tubes - this time by making your body create a blockage of scar tissue) and is supposedly less painful and possibly cheaper to have done.

best of luck!

Just gimme the laser, I'll do it myself

First, thank you so much for writing this series. As a 28 year old in the seattle area trying to convince the medical industry in my area to perform a tubal for me, these articles have been very inspirational and informative!
I only know one person who had the procedure as you describe above, and have talked expansively with her about it also. She had some different problems when seeking a provider than I, since she is fat (many doctors apparently tried to claim that it wouldn't work, etc fat shaming), but ultimately she believes they performed the tubal because she has 2 children, though she was 29 when it was done. The 2 week recovery time didn't seem to be too big of a deal for her--no aerobics or jogging, but light yoga was ok I guess.
The 2 days of pain seems pretty consistent...and honestly, that scares me. I'm a big wimp for that kind of pain, even though I have tattoos and piercings, surgical pain is something I've never experienced (unless wisdom teeth count, and that SUCKED) and I'm a little freaked out. It makes me sad that I can't express this concern to a doctor if I find one to do the tubal, too, since I'll have been denied so many times for other reasons.

Seattle Area?

Seattle area?

I know a great doc. :o) Dr. Rebecca Duke in the Swedish Hospital System. She works on the Cherry Hill campus. She's a fantastic doctor, listens, very knowledgeable, but most of all? The most respectful doctor I've ever met. I've never felt so listened to, affirmed and respected from a doctor before. And I know she works with LGBT patients as well. I'm sure she could refer you to a specialist who could help you through your decision.

And ask her about the Essure procedure (or research it yourself). It's not as invasive as a tubal, can often be done as outpatient surgery (in a doc's office) and most women experience cramping as the only pain, and it doesn't last very long. I did a lot of research and chose it for myself, but my circumstances changed and my partner ended up getting a vasectomy instead.

OMG I love you. Not the OP

OMG I love you. Not the OP but I also live in the Seattle area (down in Olympia) and my primary is in the Swedish health system. I'm only insured through my birthday later in March so I've been trying to save up for getting the Essure procedure done later on, but had no idea who I could find to perform it. Thank you!

Pain is tolerable

Hey Zinful,

Glad you're digging the series! You know, I was probably fortunate not to know that I'd be in such pain after my surgery. Thing is, I doubt it even compares to most major procedures. Like you, I'd only ever had my wisdom teeth out—never broken a bone or had really serious health issues that required long-term hospitalization or surgery—so I didn't know what to expect. I was relatively OK after my wisdom teeth, but again, I didn't have any complications that might have made that process more difficult.

As someone who has long lived with atrocious migraines, let me assure you: the post-surgery pain shouldn't necessarily keep you from getting what you want. I've dealt with other kinds of near-chronic pain (we're talking migraines that ended with me in the ER getting an injection of pain reliever) and a few days of post-surgery pain are worth it. Mine was a bit worse because my stitches got infected, but as MonZniFly and many others have pointed out here and in other comment threads, Essure is a lot less invasive and an option definitely worth checking out. Because I live in a foreign country, I simply used the language I thought would translate easily and got what seemed like a relatively universal procedure, but I don't doubt that Essure would have been a simpler option.

Did your friend mention the shoulder pain from the carbon monoxide? For me, that was the worst side effect from surgery. Didn't even begin to compare with the abdominal pain. I'm really sorry the doctors treated your friend so disrespectfully, even though I'm happy to hear she finally got what she wanted. It does seem true that doctors are more willing to tie your tubes if you'd had a few children. That's a topic for another blog post though...

Cheers! brittany

I did consider it....

My husband and I are child-free by choice and I did consider tubal ligation the first couple of years we were together when, at 35, I was booted off The Pill because I smoke. While he rarely goes off inside me, we were both aware that there was still a chance of an accidental and highly-unwanted pregnancy.

I never got around to it and last year he went through a 2nd round of testicular cancer (he's ok) and had to have chemotherapy. We were told that it would pretty much render him sterile (we shocked the oncologist with a happy high-five over that). That is one reason we no longer see much risk of pregnancy.

The other reason is that I have endomitriosis, which further lowers any chance of conception. And if I ever REALLY get worried about it, my gyno just gave me a prescription to (basically) medically induce a false menopause, to further cut down endo symptoms.

I have actually firmly believed for years (because of the endo) that I'm infertile (yay me), but just never really got around making sure of it and now it seems circumstances have taken care of it.

Intentionally sterile

I am a 38 year old woman who works in higher education in the Midwest.

I had the Essure procedure followed by the Novasure procedure when I was 35. I suffer from Polycystic Ovary Disease which caused me to have long, heavy periods unless I was on very strong birth control pills. My husband and I both have inherited diseases that we didn't want to risk passing on. We agreed that we did not want to have any children, preferring to instead focus any parental urges in the direction of helping our siblings raise their children.

I had the Essure procedure first, where inserts are placed in the openings of the fallopian tubes. Within three months, scar tissue grows around and through the inserts, permanently blocking the tubes. After an untrasound scan confirmed that the Essure procedure had been successful, I had the Novasure procedure (endometrial ablation) to end my periods. It is great to no longer have to take the pill and to never have to worry about my period.

People sometimes ask when we're going to have kids, but we just say that we're not planning on having any and it's dropped. I've actually gotten more crap about my decision to keep my maiden name than I've gotten over being childless.

Sad Confusion

I had tubal ligation at the same time as my third c-section, so I can't speak to the pain aspect - except to say that the whole thing was a lot less painful than my first c-section. Anyway, I was appalled at what people - people I thought were aware of their bodies and health terminology - said to me after my tubal. Five or six people seemed to think I'd had a hysterectomy while 2 or 3 others asked how long it would last. The lack of information on birth control options just astounds me.

me too

The pill was the only thing that did work effectively for me, when *surprise!* I got pregnant while on the pill, due to other prescription meds I had to start taking.

My husband and I decided it was a time when we could have a child and did, but I did NOT want any more, and although he accepted my decision, it seemed only fair that I should have my tubes tied if I felt that strongly about it. After all, we could split up or I could die, or...and he might want more children.

My procedure seemed about as "ho hum" as what you describe, and I don't remember much pain, just inconvenience.

BTW - I'm fat, too, so any doctor who's saying it can't be done due to that is full of SHIT - find another one! Search for a HUMAN BEING!

No matter WHAT the problem, question or procedure is, I've learned that WE are the customer and THEY are here to answer our questions and treat us with RESPECT! I've REMINDED a few doctors of that on more than one occasion, too. I strongly suggest that many, many more patients - especially women! - do the same!

What about vasectomy as a viable option?

I am not sure I believe that the right decision has to always fall on the woman. Tubal tubal ligation is actually surgery! There are health risks, like with any abdominal surgery. I am not sure why we aren't talking about vasectomies here, as I believe they are the safer, more cost effective option.

Sure, if you're not monogamous, this might be a place to pause, but I wish there was more info about vasectomies out there, and ways in which to get them for low-cost (because there are ways to do this)! Women should not bear the brunt of all reproductive burdens. If you are a mother, you've carried your children and birthed them.

What's wrong with asking your partner to help out in this process of having no more children, or remaining child free?

My partner had his vasectomy two years ago, and he always says that he wishes he had done it sooner. There were no complications, as it was done in the doctors office (ie; no hospital time), and he was back to his old self in less than a week. He was able to go to work really quickly (less than 2 days after the procedure). He has no scar and he functions normally.

I think men are sometimes afraid of this procedure, but I believe it is a viable option, especially if you consider the economy in its current state.

Just my two cents. :)

I agree - IF they guy also wants no more kids

This wasn't the case with my husband, as I mentioned. He agreed with my decision that *I* didn't want anymore, but - given some future alternate possibility - he didn't want to rule it out permanently for himself.

It doesn't seem fair, then, to ask HIM to permanently become sterile. If he had agreed, then, yes, I think the guy should have the less invasive procedure of a vasectomy.

My tubal ligation wasn't so much, but my pregnancy was TOTAL HELL, from start to finish, including delivery, and I said I was NOT going through it again, period.

While I might have considered adoption at some future point, my husband worried that he might not feel the same toward a child we adopted vs. our biological child, so that was out, too.

Tough to get?

Thank you for sharing! This is something that my husband and I talk about sometimes (and vasectomies). I'm 28 and I'd consider a tubal ligation in a few years. Did you run into any difficulty finding someone who would do it? I've heard so much about doctors not wanting to do the procedure because a patient is young or hasn't had any children. I feel like my doctor would laugh in my face if I asked about it.

Then you have the wrong doctor!

It's one thing for a doctor to voice a concern and offer suggestions or options you might not have considered.

It's quite another if they are paternalistic and condescending. Why would you PAY for that?

Essure?

I had the Essure procedue after the birth of my third child. I had no complications at all, no change to my periods, nothing. I look foward to your story on this!

The cost of all this?

I think an unmentioned factor in this is the accessibility of a tubal ligation or a vasectomy to different socio-economic groups.

Would you mind discussing the financial aspects of this procedure? Is it an expensive operation (okay, bad question, is it relatively more or less expensive than other procedures? Also, is this the type of surgery that insurance plans will cover? I have a hard time believing it is, considering how they love to check that "unnecessary" box.

Because money and cost are relative

Hey Casimir,

I actually haven't been touching on the money aspect a bit intentionally. It's not that I'm not empathetic towards the idea that many of us can't afford these things—I couldn't have shelled out for a tubal in the U.S., where I didn't have health insurance; it was paid for by my partner's state-run health system in Denmark. But I don't discuss specific costs because they vary by location, health insurance provider/coverage (if you have any), and cost isn't even an issue if you don't have a doctor willing to consider that permanent birth control is a viable option for you (a more pressing issue that many women seem to have). Many women who rely on programs like Medicaid, for example, often don't have choices about which doctors they see, so there's very little they can do to even change the dialogue about permanent birth control or voluntary sterilization if they're initially met with resistance. I'm not going to ignore this issue, but I'm never going to use specific numerals or data on cost because it's all too relative, subject to change, and inconsistently available. My own experience related to cost is also essentially worthless since as I mentioned, I was covered by a state-run system in Europe. I didn't pay a dime.

I hope that helps! Stay tuned because I'll discuss the interaction between voluntary sterilization and low-income women before the series ends.

Cheers! brittany

I've been sucessfully using

I've been sucessfully using fertility awareness as my main method of birth control for over 10 years. With a supportive partner and awareness of your own body you can avoid the pill and surgery and control your fertility for free... or maybe the cost of a good book on the subject. Condoms or other non-hormonal barriers are great for times when you choose to do the deed and you know that conception is a possibility. Speaking of a lack of awareness about options, I'm surprised how rarely I see this discussed and how often fertility awareness is confused with "the rhythm method" and other less reliable not-methods.