Highly pressured to be sterilised at c section. AIBU

[Deathstarevicki]

I have had come sections due to my children being breached and never gone into labour naturally. On the consultation for my 3rd I was asked, so are we sterilizing you at the same time? I was shocked and caught off guard by this and felt pressured and had to explain and justify why I did not. Then on my 4th the same again, I declined. I have always been advised that my insides are in good condition and I'm fine to have more if I wish by the surgeon.
Iv just had my 5th that went perfectly with no complications or issues but felt incredibly pressured all the way through and had to decline it at least 5 times. AIBU to find this practice out of order?

If I wasn't having a section I would need to see a councillor and be referred to make sure that is the right decision for me.
This time 2 consultants got stroppy about ithe with the surgeon who performed the surgery trying to talk me into 3 times. So I had to refuse and explain 3 times before my op why I did not want this. I really think it's wrong to spring this on woman in a vulnerable position when they may not of even considered this as an option. His reason were "I was going to be a mess inside with my organs fused together, he may damage them getting my baby out but he will fix them after". While he was performing my section I asked if I was a mess in there and he said no I'm fine it's not bad at all and that my choice of marina coil is probably the best option for me.

Am I missing something and medical professionals are now on a quota or commission to sterilise c section mothers as there is I believe unfair pressure on the mothers. I am in the uk

Have you had five c-sections?

I think they're being a bit heavy handed with you but five sections isn't generally considered great for your body

5 c-sections?!
I can see why they're trying to stop you having more, isn't it only recommended you have 3

More than 3 sections is starting to get dangerous. If you chose to have a 6th your risk of scar rupture and death to both you and your baby is significant. They are not doing it to be horrible. They are trying to keep you safe

My friend has been offered sterilisation. She has 7 children. I don't think it's unreasonable to discuss it at least.

I had an emcs with ds (baby 11) and a Dr (not my consultant) tried to push me to have my tubes tied at the same time. I only knew at 8am that I was having ds at 12 and they hit me when I was a vulnerable to say the least. I said no. I won't have more dc but wanted to decide for myself not be told! She was quite off and kept pushing. . I said no.
Next day my consultant came and apologised on her behalf.
Would have been better from her but hey ho.

Stick to your guns and complain if you wish.

I'm on my third section and hoping they do offer as it's my last pregnancy. If you don't want it done you don't have too though.

I always thought there was quite a bit extra recovery time involved with one although I suppose with the section at the same time they might tie in iyswim.

I don't believe for a second that anyone is pressurizing you to have a sterilisation. You may be reading it that way and they might be recommending it as a option for whatever reason but it doesn't mean you have to do it. If they believe that you should have one for medical reasons then they are definitely not in the wrong to suggest it. I expect they have told you what the reasons are and why they recommend a sterilisation and i think you're not saying the whole story here.

How dare medically trained people recommend what is safe for your body?
It's only 5 major abdominal surgeries, which get riskier and riskier each time, on a Mother with dependent children at home but seems determined to ignore medical advice on the wise judgement "It'll be alright, and if not they can just deal with it and fix me"

I guess they're assuming your family is complete and the multiple offers are there to document medicolegally that it was offered even if it was declined should you have a praevia/accreta/percreta or uterine rupture next time

Since the risks go up astronomically with each C-section I think you are being pretty U to your existing children TBH.

My sister was offered it at section number 3, she refused. Pregnanvy number 4 she had a massive haemorrhage at 32 weeks. If she'd arrived at the hospital 10 minutes later she and baby would both have been dead. She'd have left behind 3 young children.

They are offering it to keep you safe, your body has been pit through 5 major surgeries. There is a higher chance your uterus can rupture with each pregnanvy/c section. Don't be so quick to dismiss the offer.

I've already had it mentioned (by my consultants registra) that I should be having a sterilisation following this baby (#5). All spontaneous vaginal deliveries previously albeit following complicated pregnancies. I politely told him that dh will be having a vasectomy (which is true) & that I won't be discussing the matter again.

They should be explaining to you why they want to sterilise. The maximum you should have is four, it gets very dangerous the more you have because of the possibility of scar tissue rupturing. That puts you and your baby at risk. With all the kids you already have you'd be very wrong to put your life at risk like that. Having kids isn't just about squirting as many out as possible. You have a responsibility to stick around to raise them as well.

5 sections?!?! Do you have any idea how unsafe that is?!?!?!

Its your body. You can't be forced to do anything with it that you don't want to.
I'd be calling it professional bullying and putting in a complaint

I think you're being irresponsible. They aren't offering the procedure for shits and giggles. You've already gone over the medically approved amount and yet seem to have a cavalier attitude that it's ok because they can always "fix" you.

According to the RCOG:

Option for sterilisation if fertility is no
longer desired. Evidence suggests that the
regret rate is higher and that the failure
rate from sterilisation associated with
pregnancy may be higher than that from an
interval procedure. If sterilisation is to be
performed at the same time as a caesarean
delivery, counselling and agreement
should have been given at least 2 weeks
prior to the procedure.

From the Green Topped guidance on Birth after Previous Caesarean Birth

(Not an OB, reading it for personal reasons last night)

If I'm reading your post correctly and he tried to convince you during the surgery I would complain.

I think stating the risk is one thing, but keeping the pressure up possibly all the way to theater is unacceptable as it starts to get into decidedly uncomfortable territory.

Are you planning more children OP? It wouldn't be unreasonable to think that after 5 you might be done.

I was asked on c section 2 (on the day of the surgery) if I was planning on being sterilised at the same time. Whilst we don't plan any more children, I declined, I'd want to keep my options open for now. I don't have the time or money for more than 3 children so I'd definitely opt for it if we had another.

I had the opposite experience. CS#3, the registrar (not the consultant I was booked in with, who should have been doing the op) was a bit sniffy eurgh me when she discovered that I'd been requesting sterilisation since my booking in - and that it had been agreed to.

Soon changed her tune after she and the consultant, (who'd made an appearance to help unpick all the adhesions and save my bladder before extracting dc3) spent over 2.5 hours trying to sort me out as I haemorraged on the table.

I'd left 5.5 years and 27 months respectively between each baby, so (I thought) had given my body plenty of time to heal between each cs.

I thought 3cs was pushing it, but 5?! As much as another baby would be lovely, I'm grateful to still be around for the ones I've got. It's major abdominal surgery and a sixth would be incredibly risky. Sorry, but hope your life insurance is up to date OP.

I was offered it at my 3rd csection. I thought it was because of my age (i was coming up to 35 then). I said no. Husbands had the snip.

No OB who likes having a licence to practice would be stupid enough to sterilise someone on the operating table if a patient has suddenly changed their mind and asked for it there and then. But the conversation would have been had antenatally.

Yes YANBU, they should not be pressuring you.
Incidentally 9% of women who have 6 C Sections, have to have a hysterectomy. But it is very individual and it sounds like you have recovered well from yours.

YABU.

People are being unfair on the op here. She has said she is having a Mirena coil, so she will have contraception. Yes the rates of complications increase with each section, but the Obstetrician at my vbac counselling appt said he performs 7th and 8th sections and whilst not desirable, he thought that was acceptable (I was asking whether I needed to vbac successfully as we plan 3-4 children).

Also asking for consent for irreversible surgery whilst the patient is on the operating table is poor. If she consents then is it valid consent? When she is emotional, possibly woozy from medication, perhaps feeling intimidated by the surgeon standing over her? If she has refused sterilisation all through her pregnancy how likely is it that she will genuinely change her mind on the day of surgery, as opposed to a change of mind being a coercion?

Although you may disagree with OP's decision if she wants to have another baby, she is an adult and shouldn't be coerced into surgery she doesn't want when she is vulnerable.

Also female sterilisation has a higher failure rate than Mirena coil. When my family is complete I will decline sterilization and get a Morena.