It’s My Body and I’ll Tie if I Want To

When we found out we were pregnant with this baby, Mark’s immediate reaction was to declare his intentions on getting a vasectomy. While he loves me and loves our children, he does NOT love pregnancy’s effect on his wife – neither physical  nor psychological. While initially we both were on the same page with how many children we wanted (we discussed it in depth on our first date), after Dexter was born, he admitted that he was a little nervous to have any more. Once Daniel came into the picture, he was quite happy to stop there. And so when we got the big news earlier this year that we had yet another on the way, he was adamant that there would be no more.

I admit, as much as I love my babies, I can’t imagine going through another pregnancy. As much as I mourned our last chance to have a little girl, I can’t ever put myself through this again.

So when my OB asked at last week’s appointment what my plans were after this, I laughed and said, “this is it. No more.” She asked if I was sure, and I told her that Mark was already planning his vasectomy for as soon as possible after the birth. She asked if I was interested in having a tubal ligation, commonly referred to as having my tubes tied.

Right up until the very second that she asked, I hadn’t ever considered it an option. My mother had had her tubes tied after her third child was born, and when he died of SIDS at 3 months old, she had had to go through the ordeal of having a tubal reversal.  Knowing this, I have always said I would never have my tubes tied, “Just in case something happened.” But lately, through many talks with Mark and with my own understanding of my body and its limitations, I have realized that pregnancy is not my friend. I am great at actually giving birth. Both my kids have basically walked out of me, with little effort on my part and no rips, tears or scars to show for it. But the 9 months leading up to that point? Not good…

My doctor explained that if I opted for this option, it would involve them making an incision into my abdomen (providing my uterus was in the right place after the birth), pulling through my fallopian tubes and snipping them. Recovery would be fairly easy, and I should be able to go home on the same time scale.

She asked about my periods and whether I was regular. I told her that I am not ever regular, having dealt with PCOS my whole life, and she said that I needed to consider other birth control options. She strongly suggested I consider an IUD, which would last for five years and could be inserted 6 weeks after the baby came. She said it would make my periods lighter, regular and may even get rid of them all together. She was very enthusiastic about it, and she said she thought it may be a better option. Mark, too, thought that this was a good idea.

I decided to take the literature home and read about it and think what I wanted to do. But inside, I kind of already knew which way I was leaning.

When I really think about it, there are pros and cons to each decision. Mark will be having a vasectomy either way, just as double insurance since we clearly are INCREDIBLY fertile together. But a vasectomy can take months to become 100% effective, and even then it may not take.

So here’s what goes through my mind as I consider my options.

1. I really don’t like the idea of having a foreign object in my body. An IUD may be great, but the thought of it inside of me really freaks me out. Also, while you aren’t supposed to be able to feel the strings that hang down, and it’s supposed to be rather unobtrusive, the literature I’ve read says that you have to check it once a month and be sure it’s in the right place. This is hardly something I want to have to remember to do!
2. There have been reports of IUDs perforating the uterus and causing real problems for some women. That thought terrifies me.
3. Between 2 – 10% of women will have the IUD fall out in the first year. Could you imagine?? If I wound up pregnant again in a year, I don’t know how I would cope!
4. I know myself pretty darn well. I know how my mind works. After each of my previous children, I have been CONVINCED that I would never have another. And yet… here I am about to have a third. My mind will work to convince me that having another baby is a good idea somewhere down the road. If I have an IUD, the odds are that I would probably have it removed at some point and “leave it up to fate.” But if I have my tubes tied, I wouldn’t have this option. I am not about to have an unnecessary and invasive surgery in order to reverse it, which means that having my tubes tied is a PERMANENT solution that I don’t have to worry about again.
5. Sure, tubal ligation is not 100% effective. But combined with my partner’s vasectomy, I think the chances of further pregnancies would be pretty slim.
6. Having my tubes tied would be immediate and completely effective from the first moment. So as we wait for Mark’s vasectomy to work, we are protected.

The doctor warned me that tubal reversals are hardly ever effective, so if I changed my mind, I would probably still not be able to get pregnant. I had to laugh. I am the PRODUCT of a tubal reversal. My mother had hers done fairly immediately after my brother’s death, and while it took her a couple of years to actually get pregnant again, she did it. And after I was born, she even managed to do it again and have my little brother. It’s clear where my fertility comes from, isn’t it!?

At the end of the day, the worst fear I have about having it done is that something will happen to one of my children. This is a fear all parents have, and it’s horrible to contemplate. But I have unfortunately seen it happen to too many people to believe it can’t happen to me. And so I fear – if I’ve had my tubes tied and then the worst happened, would I want to have another baby?

The answer is hard… Of course I would WANT to, but I don’t think I would. I think I would be heartbroken and bereft, and I would try to convince myself that another baby was the way forward. But right now, I genuinely believe that I couldn’t do it. I know that I can’t go through it again, and the easiest way to ensure it is to have my tubes tied.

So next week, when I go back to the doctor, I will give her my answer. Unzip me and snip me! I am done.