To think it's unfair that I can't get my tubes tied?

[saggybaggy]

It is my body at the end of the day right?

I have two beautiful DCs and I'm happy with just that. DH and I definitely do not want any more children and I chose to get sterilized.

So I went to the GP for my 6 weeks check up and had asked to get my tubes tied only to be refused because of my age (22) "Youre still young, you may change your mind" bullshi..!!

I'm happy with my decision so I think it's bloody unfair for my GP to refuse. Even if DH and I divorce (God forbid!) I won't all of a sudden feel 'cheated' as I personally do not want anymore children, even if the worst happened.

AIBU? It's our right, right?

[goodasitgets]

Does seem a bit mad. But I was when last year age 29 with no DC I was offered sterilisation as an option

[Mignonette]

Charming.

'Young lady?'

[OafOrForksAche]

pubes you're just being pedantic now and a complete twat.

And no fucking need to welcome me to mumsnet, I've been on here for a good 2 years, I've just NC recently out of boredom.

The reason why I won't comment on shelaghs case is because I'm not the GP involved whereas I was in the young lady (for which I've changed a few details as per GMC guidelines) therefore had all the details. Without all the details of case it would be foolish to comment on it. Duh

And yes, laparoscopy IS abdominal cutting. It's not a walk in the park to recover. I've had one myself, it hurt like fuck. The reason I included that as pubes implied hysterectomies are always massive laparotomy procedures, they aren't.

Ongoing risks of a hormonal coil? Gosh how hysterical. Yes some women don't respond to it well which is a real shame. But at least if Mirena users who don't want kids change their mind about kiddies they can whip it out and ttc. After my child was born I was adamant I never ever wanted another child ever and was 10000% certain of it (to my evil MIL's relief) But I had a Mirena instead of asking for sterilisation because IMO there were less risks there for me.

I've since changed my mind and I am planning to ttc next year. No one was more adamant than I was that I never ever wanted any more children!

Anyway my dear pubes I'll leave you to it. Enjoy yourself.

Oh and please don't worry about my bedside manner, my patients love me. I sure you'll doubt that but I don't fucking care

[PlentyOfPubeGardens]

Yes mine was laparoscopic. I suppose that is technically abdominal cutting (not vaginal anyway). For me I would much prefer the one off risks of a GA and a quick laparoscopic procedure than the ongoing risks of a hormonal coil that is there all the time.

I wonder why Oaf has so much to say about her individual case involving a 'young lady' but won't comment on Shelagh's situation

[Mignonette]

Er, sterilisation is often done via Laparoscopy and as far back as 94 I was offered this method. Unfortunately for me, my previous ruptured bladder and uterus had caused too much damage for them to proceed so they opened up my abdomen.

Even in 94 it was done on a day surgery basis.

[PlentyOfPubeGardens]

' just swearing' oh whatever pubes that's ok then is it? No it is not and you know it.

Yes it fucking well is. Welcome to Mumsnet

It wasn't your opinion I found patronising it was the way you expressed it and I said 'your posts come across as very patronising' (which they do, to me at least) not 'you are patronising' (I have no idea whether you intend your posts to come across in that way. You say not, so ...) In my experience a lot of GPs do come across as patronising when speaking to patients even though most of the time that is probably not their intention at all. A bit more self-awareness in GPs could remedy that to a great extent.

Your 'current guidelines' do not reflect what is written on the nhs site, neither do they reflect people's experiences that they have shared on this thread. This is why I'd like to see the NICE guidelines on this. I think a lot of women (men too, apparently) are being fobbed off and denied a very reasonable request.

I am pleased you have found your mirena so awesome. I am sorry that is not the case for all women who try one. No one method of contraception suits all people which is why the NHS offers 14 different methods.

[OafOrForksAche]

Oh and comments 'do you speak to all your patients like that'? And 'you are patronising, are you the patients GP'? aren't rude and personal then? laughs it's interesting you cannot see that you are being as bad as you think I am being pubes.

[OafOrForksAche]

' just swearing' oh whatever pubes that's ok then is it? No it is not and you know it. And don't you dare try to say I'm implying that you or anyone has a learning difficulty by saying 'duh', how despicable.

It's very clear why I included the hysterectomy anecdote - an irreversible gynae procedure that affects fertility requested by a young patient and even the private specialist said no. I do actually know sterilisation and hysterectomies are different (although actually sterilisation is not yet commonly done endoscopically and requires abdominal cutting but hysterectomies can be done vaginally) it was to highlight the private surgeon refusing an irreversible gynae procedure due to age.

I was quickly listing the current guidelines off the top of my head, nothing patronising about that at all. I certainly wasn't trying to be, it seems you are rather over sensitive about this topic if someone who has an opinion that differs from yours is 'patronising'. In fact I wasn't stating my opinion, I was stating where the land lay currently on referral.

I'm not going to comment on individual cases such as Shelagh. My only opinion is that I love the Mirena, I've had 2 myself and they have been awesome for me.

[PlentyOfPubeGardens]

Oaf - wtf is just swearing whereas 'duh' implies you think someone is stupid (or worse, implies they have a LD) - it's rude and personal.

When I said I found your posts patronising in tone I meant all the stuff like 'this is a nono', 'that is a nono', references to 'young lady', telling us it's all terribly complicated ... do you speak to your patients like that?

What do you think of Shelagh's situation? She and her DH are 42 and are still being fobbed off with hormonal contraception they don't want!

[todoaboutnothing]

I can't touch any form of contraceptives. Life had been a nightmare with this. I had my tubes tied at 25, without having any children at all. It was a push but I got it done. I think your doctor is behaving terribly. I am so happy that I managed to get mine done, I don't regret it at all. I don't see any reason for them stopping if you feel your family is complete.

[OafOrForksAche]

plentyofpubes well your attitude isn't exactly wonderful (wtf have hysterectomies got to do with anything) if you can't take it, don't dish it out :D

I'm stating the facts, nothing patronising about that. You asked about guidelines, I explained how the land lies with sterilisation referrals.

[differentnameforthis]

The mirena is more suited to many people who can't tolerate the side effects of the implant because it releases the hormone in a much smaller, localise dose

It's smaller, but it isn't as localised as you think.

[ShelaghTurner]

i read this thread yesterday but didn't have anything to contribute. However, DH has just come out of the doctor's having gone for a chat about a vasectomy. She refused to refer him for one and told him to tell me to come in for the mirena instead. We're both 42, have two children and definitely don't want more. We've discussed this till we're blue in the face and I don't want the bloody coil. It's infuriating.

[itsbetterthanabox]

If something is equally effective and doesn't involve as much risk it's fair enough doctors suggesting it. The mirena is more suited to many people who can't tolerate the side effects of the implant because it releases the hormone in a much smaller, localise dose.
I think we should have the right to sterilisation but try other less invasive things first. That's the same with all medicine. We don't go in hard unnecessarily.

[BettyOff]

Your body, your choice what to do with it is all well and good but it's not you doing something to it, it's a surgeon. Doctors have to take into account all the risks of a procedure and have every right to refuse it if there's a safer reasonable alternative which the IUS/implanon is. Gynae are refusing to do many sterilisations now unless there is a clear medical reason someone can't use alternative contraception or have tried it and had to stop. You may be 100% sure and you may not ever change your mind but the huge amount of people that do change their minds say the same thing and then have the risks of reversal surgery, the huge chance of this failing, ectopic pregnancies and IVF that could all have been avoided by alternative contraception. Plus you mention the risk of uterine perforation with a coil but that's a much smaller risk than the risks of a laparoscopic procedure under general anaesthetic.

I'm sure it's massively frustrating not being able to get the choice you want but is having 2 coils (5yrs each) and then being sterilised if you still think it's a better alternative such a terrible thing?

[TillyTellTale]

If antenatal care and assistance with childbirth was only free for the first couple of pregnancies, I think it would cost the NHS more in the long term, wouldn't it? An ounce of prevention is worth a pound of cure.

Or are people suggesting that third, fourth, fifth, etc children are barred from accessing NHS treatment for the rest of their lives?

[TillyTellTale]

The

[PlentyOfPubeGardens]

This thread has reminded me though that when I was first considering having mine done, I encountered a lot of quite angry reactions from friends and family, which never seemed to be based on any rational reason. It was quite odd and I still wonder what that was really about.

[PlentyOfPubeGardens]

Why should she have to pay for it? It's offered on the NHS along with 14 other contraceptive methods - everybody is entitled to free contraception on the NHS and I would imagine sterilisation works out a lot cheaper than years of pill prescriptions. If she's suitable she should get a referral.

This is from the NHS page on female sterilisation:

Who can have it done?

Almost any woman can be sterilised. However, sterilisation should only be considered by women who do not want any more children, or do not want children at all. Once you are sterilised it is very difficult to reverse the process, so it's important to consider the other options available before making your decision. Sterilisation reversal is not usually available on the NHS.

Surgeons are more willing to perform sterilisation when women are over 30 years old and have had children, although some younger women who have never had a baby choose it.

Goodness me, it makes it sound as if this is something women are allowed to choose!

[Lottapianos]

Sterilization is a highly responsible choice if you don't want to have any (more) children. Why are some posters making the OP out to be some kind of spoilt diva for asking for this procedure? Should we all have to pay for our own contraception too?

[Lagoonablue]

Pay for it then. As someone said though in medicine there are guidelines and assessments to be made. Voluntary sterilisation isn't a right on the NHS. Additionally it is a costly and medically intrusive procedure.

[PlentyOfPubeGardens]

duh Gosh, that's nice Oaf

I still don't see the relevance of hysterectomies to this discussion. Women don't have hysterectomies for the same reasons as they have sterilisation, it's a much bigger operation with very different risks and implications, especially if ovaries are removed too.

... the evidence that there are better contraceptive choices out there ... Surely the best contraceptive choice will vary from woman to woman depending on her body, lifestyle, situation and personal preferences. Sterilisation was the best contraceptive choice for me once I didn't want any more DC, along with lots of other women.

It would appear that I was very lucky to be able to get one under the age of 30 after only two DC. There are women on this thread who were refused the operation when -

• they were much older
  
• they had more DC
  
• they had a very tough time with PG, birth and after effects
  
• PG would have been dangerous
  
• their other contraceptive choices were limited
  

There doesn't seem to be any consistency in who's 'allowed' to have one and who isn't. I think this is shit and it's why I'd be interested in what the NICE guidelines say.

Oaf, your posts come across as very patronising, are you the OP's GP?

[TheDoctrineOfSnatch]

Different, I assume in some cases the swelling may be low enough to make it possible, or that more likely to fail means 1 in 160 vs 1 in 200 or similar.

[differentnameforthis]

I don't understand the reluctance to refer a woman post birth & then the willingness to sterilise during a section.

My team told me that they rarely sterilise at the time of a section as everything is too swollen & the failure rate is much higher, yet they sterilised my friend at her section.

Why do it for anyone at all, at that stage, if it is more likely to fail.

[OafOrForksAche]

Well I think it's terrible you weren't offered counselling Mignonette.

I don't get why it's being suggested sterilisation is refused because patients don't know their own mind. It's nothing to do with that, no one is casting aspersions on patients immaturity.

Referrals, operations, guidelines...all very complicated. Has to go on evidence, necessity and yes, funding. There are individual cases that differ from the norm but without evidence based guidelines (in this case the evidence of regret, the evidence of the amount of sterilisation reversal requests and the evidence that there are better contraceptive choices out there which are less invasive and can be reversed) we'd be up shit creek without a paddle.