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

I was offered it a few times in the lead-up to my 3rd section (6 years after 2nd c/s so plenty time to heal). I declined because we thought we might have a fourth. Then my uterus ruptured as contractions started the night before I was due in for the section. I wish I'd said yes to sterilisation now, as there's no way I'd have a 4th now. Risk of uterine rupture increases with each section. Only reason I'm still here is because my uterus ruptured on the operating table just before the first incision.

I think its reasonable for them to ask during a consultation where you have the time and mental capacity to discuss the pros and cons, dangers of further c-sections. To ask someone just prior or during surgery is very unprofessional and unethical as you won't be able to give 'informed' consent.

I was shocked and caught off guard by this and felt pressured and had to explain and justify why I did not.

I'm not sure why you felt shocked, asking you at your third and then each subsequent pregnancy is probably quite normal practise. They are only doing it for your future safety, not as a judgement on your life choices.

I've just been booked for my third section and i was really surprised no ones mentioned it at all. I plan on getting sterilised after the section (heard better success rates) so would have happily had the conversation. You'll have had six abdominal surgeries, you can't deny the inherent risk in that.

It's entirely your decision but hcps should definitely ask you at a more reasonable time than on the operating table.
5 c sections sounds very risky to me though. I thought mums were advised to stop at 3.

How about instead of jumping all over the OP her right to bodily autonomy is respected? Her body, her choice. The doctors can make recommendations but she is under no obligation to act upon it and comments like "you need to stop breeding" or that she and her babies would have died in years gone by are cruel and unhelpful. OP hasn't asked for opinions on her choice to have children or multiple sections, she asked if she was being unreasonable to not be sterilised during the procedure and that she felt pressured to agree.

OP, YANBU. I recently had DC4 and was offered sterilisation by the surgeon who did my 12wk appointment, I said no. Was offered again when I saw the consultant after my 32wk scan and again when I was admitted at 36wks (that was for transverse lie rather than anything related to previous sections). Each time I said no and each time I was told that it's policy to ask. When the surgeon came to meet me on the morning of my section, while she checked my consent form was all in order, she asked if I was also being sterilised. I said no and her response was "good!" She went in to explain that having it done during a section is much higher risk than having it done as a separate procedure, that it makes for a longer surgery, higher chance of complications, higher chance of regret once the "I'm never doing this again" feeling of late pregnancy wears off, can increase healing time and it has a higher change of failure once everything shrinks back down to its pre-pregnancy state. She said if we wanted something permanent then DH should have a vasectomy as it's much lower risk and has a lower failure rate.

They are trying to keep you alive and you don't seem very grateful.
Do you realise how lucky you have been?

I was suited and booted for my 3rd section, complete with sexy pressure stockings when the surgeon came round to ask me if i wanted sterilizing too.
At the time I was shocked and said no, but I now wish I'd said yes. We don't want anymore and I don't want to put my body through it again so in hindsight it would have been the right thing to do.

To those saying that sterilisation during a section has a higher failure rate......just wondering, is that using clamps?

I only ask because as I said above I'm being sterilised during my section in 3 weeks and the random doctor that did my consent form (I was there for a growth scan) said that my Fallopian tubes will be cut not clamped when I mentioned I'd heard of the possibility of clamps failing. So in my head I've got visions of my eggs having to do a 'Thelma and Louise' style cliff jump to try and reach the other side and feel quite secure in my decision. Just wondered if I was right to.

I've had 5 C-sections and chose to be sterilised during my last one.
While the doctors never told me that I shouldn't have any more, the thought of dying due to complications terrified me into it.
18 months after dc5 was born I had t have an incisional hernia repair because the internal stitches had come apart and I had a hole that you could fit 3 fingers into.
My abdomen is a mess.

I understand the risk and the complications associated with multiple choice sections. My post is not asking advice on if it's safe for me to have further pregnancies. It is about refusing sterilisation multiple times throughout to go on and have to refuse it another 3 times again before being operated on.

I think it is individual cases as I know some ladies can have 2 section and it's then unsafe to have another, I have had 5 healthy pregnancies, the only complication being them breach.

It was not my cavalier attitude the surgeons will "fix me" it was the surgeons. When he was pressuring me about getting sterilised while they was prepingredients the room he said he could damage my organs but will fix them. I asked if they are under pressure to sterilise now, as when I said I want a coil he agreed that is the better option with less complications.
When he was operating I asked if I was a mess in there and he said no I'm in very good condition inside. On my 4th I lost 400ml of blood and 300mls on my 5th but this isn't about me having more. I am actually happy with my 5 children and don't wish to have more, I just don't think a decision like that should be pushed on someone at that time in a vulnerable position.

And if I would of agreed for the reasons he gave me, but then once he opened me up and seen what he suspected was not the case, would he of advised me as the basis for that decision wouldn't be true.

I have no wish to try and Sue the NHS what a ridiculous comment, I am very happy and greatfull for the surgeries that have safely deliveried my children and I have healed fantastically from.

I have discussed vasectomy with my husband which he does not want to do for the same reasons as me which I respect. I like it as a choice not to have more children rather then I can not. I also have researched female sterilisation and think the coil is a much better option with less complications.

Thank you to the people who understand what this post was really about.

I think it's ok to offer and discuss it, it was how many times I had to refuse it and explain that I feel it was wrong. On paper I should of been a mess but I wasn't so it is unnecessary surgery for me.

YANBU

I have had 6 c sections, after number 3 I was told by my consultant there was no issue with me having number 4. After number 4 I was told that although everything was in great condition they could not tell me that it was safe to have any more.

I went on to have another 2, I knew the risks and yes, I was lucky to have 6 sections with zero complications, however it is my body and my choice.

I have never felt pressured into a sterilisation (although I chose to be sterilised during my 6th section)

My consultant told me that there is no safe number, she had a patient die during her first section and yet had quite a few, like me, who had safely had 5 or more sections. Basically the risk increases steadily with every section and they judge the risk level at number 3 to be the maximum reasonable risk. It doesn't mean that if you dare to have more than 3 something terrible is going to happen, just that the risk of something terrible happening is higher.

My last section was no more complicated than my first and for a long time after my sterilisation I had big regrets (although this is subsiding now, I think I made the right choice)

My midwife told me she had been sterilised after section number 5 but deeply regrets it. Presumably she knows the risks better than most?

I think it is fine for a doctor to advise but if you say no that should be the end of it, I would not want the subject to be raised again.

And yes you are too vulnerable to make a decision like that, although I had already signed the consent forms for the sterilisation, my consultant required me to confirm that consent seconds after my baby had been born before he carried out the procedure. I had had such a tough time making the decision that this just felt like torture and I do not feel it was appropriate.

I have had 4 (for medical reasons) and was never offered a sterilisation.

I can well believe the research which found that many more women regret sterilisation carried out during C-sections than afterwards. I've had three relatively easily vaginal births and yet three utterly dreadful third trimesters - so if sterilisation had ever been offered (let alone pushed) as a possibility in conjunction with VB, I would have leapt for it each time (one of the main conversations during my stay on one antenatal ward was about how fair or unfair it was that a 20 year old with fairly serious medical problems was being refused it), and each time regretted it. There's a clear principle of medical ethics which states that "just because you can do something, it doesn't mean that you should do it". OP has already stated that there is no urgent clinical need for her to prevent another pregnancy. So by that maxim, no, YANNNNBU to wait until you feel ready (if you ever do) for sterilisation.

I don't ever want any more DC but I don't want to be sterilised. DH doesn't ever want any more DC and was going to get sterilised but is now unsure. There are plenty of nonsurgical long acting contraceptives that are far less risky than sterilisation. I'd be annoyed if a doctor kept pushing me to go on the Pill (for example) if I'd already said I didn't want to as they should be respecting a patient's decision.

Sorry but I would not want to be the surgeon performing a 6th section. All that scarring. No way.

But the surgeon at her most recent section told the OP that she doesn't have a lot of scarring. OP has also said she doesn't want more children/a 6th section so it's entirely irrelevant what her risks would be "next time". The question was is she unreasonable to not want to be pressured into sterilisation.

Yanbu. It's harassment and you have a right to not be hassled, even if it's against medical advice. I would complain x

..comments like "you need to stop breeding" or that she and her babies would have died in years gone by are cruel and unhelpful

Cruel and unhelpful comments, possibly. But it doesn't mean they are untrue.

Deciding someone ought to stop breeding has fuck all to do with anybody here, the OP hasn't asked for opinions on whether she should have another DC (and has in fact stated that she isn't planning any more). Women and babies dying in days gone by may be true, still doesn't warrant pointing out though.

Deciding someone ought to stop breeding has fuck all to do with anybody here, the OP hasn't asked for opinions on whether she should have another DC (and has in fact stated that she isn't planning any more). Women and babies dying in days gone by may be true, still doesn't warrant pointing out though.