How the hell are you meant to "qualify" for sterilisation?!

[MsFrizzle]

I'm in my 20s. Never had a child and I don't want one - I don't have the energy. I'm disabled and I have endometriosis so I'm likely unable to have children but the risk is still very much there (not everybody with endo is infertile and my doctor who diagnosed me said that it's not the end of the world and may be possible even as an accident). I went today to discuss my issues and that I'd like a saplingectomy and that I've thoroughly considered my options and the future. I was told I wouldn't be considered unless I was above 40 (which seems odd as pregnancy can begin to become difficult after 40-45 from what I've heard) or if I already had a child. I was also told to consider my future partners!

The point is I can't handle a child, physically (disabilities) or mentally (depression, suicidal tendencies and GAD), and while I'm pro-choice I don't desire an abortion! Has anybody navigated this before? Second opinions are difficult as there's very few doctors in the area I live in.

I've had a pregnancy scare before and I'd not like to go through it again.

How did this thread end up being about ops employment status??? I'm reading tft. Sorry to hear about your condition op. I think you deserve stress free sex in the very least!!!

So they'd rather fund an abortion or a child she doesn't want and cannot afford to support?

Female sterilisation is not 'hugely expensive' compared to the cost of even one complex pregnancy and delivery.

And it doesn't have a massive failure rate.

The Mirena fucked me up royally. Thankfully, my husband was able to have a vasectomy, just as well, our son was diagnosed with autism. We did have a daughter who died. But children are not replaceable. Her death did not change his or my mind, because he knew his mind, he never wanted to have another child. Hormones didn't agree with me and I didn't want heavier periods from a copper coil.

'My surprise #3 is asleep on my lap having fallen pregnant with a Mirena fitted. Never happens eh'

I have two close friends who became pregnant on the Mirena.

'Ive never seen a female poster who hates women as much as you do.'

This, with bells on.

Part of the reason for reluctance to go to sterilisation is it is a surgical procedure (so higher risk and more expensive than hormonal contraceptives/copper IUD or condoms) than contraception and has a high failure rate; higher than vasectomy (significantly) and hormonal or barrier contraception. So it is more expensive and less effective... which is why it is not routinely offered on the NHS. With funding as it is at the moment, rationing exists and treatments which are more expensive whilst less effective are simply not going to be funded on a routine basis. They may be offered to some women on an exceptional basis.

Of course, it would be helpful if this rationale was explained to women instead of being made out that it may be because you "might change your mind" or similar nonsense. Incidentally, I have turned down women requesting sterilisation- but have never, ever suggested to a woman it is because she doesn't really know what she wants or because she might change her mind. I have always explained the reality of the situation- not routinely funded for previously stated reasons.

If you require a hysterectomy or salpingo-oopherectomy for medical reasons then you would get it. If you are young, gynaecologist is highly unlikely to want to do a BSO as removal of the ovaries would induce early menopause- it is done when required but not done lightly. And never for contraceptive purposes. If the medical problem you have is related to the ovarian hormones, salpingectomy will not solve this as the ovaries will remain and still produce hormones. So again, it would be for sterilisation purposes... and we get back to the funding issue.

My first deletion

I was offered a sterilisation in the event that I had a section because they would already be in there 😂. I decided against it as I wasn't certain, and I then didn't have a section anyway.

Second vote for endometrial ablation, although I have heard it’s not always successful.

I have severe endo too and can’t take any hormonal treatments due to progesterone intolerance and estrogen stimulates the endo to worsen. Rock and a hard place.

Hysterectomy btw is not a treatment for endo, it treats adenomyosis, NOT endo. Excision is the gold standard of treatment for endo, please be wary of any gynae who suggests a hysterectomy to treat endo, you’ll just be back

Op you mention suicidal ideations, are they linked to your cycle? If so, please research pmdd you may be progesterone intolerant or estrogen dominant.

My CCGs quote re sterilisation

• Vasectomy and female sterilisation
Due to ongoing financial scrutiny of non-core services, the community vasectomy service is being reviewed by the CCG as a service with no or limited clinical value – rather it is considered as one of many forms of contraception. Both vasectomy and female sterilisation will however be available in cases of complex health needs.“

I got referred for one at 36, after many years of asking.

2 dc, 2 terminations, very bad MH, had tried all other contraception options.

When I asked in my twenties it was a flat no.

The two most effective long acting reversibles are the copper coil and mirena. Both can be painful to fit and have side effects. The implant is linked to osteoporosis

The implant is not linked to osteoporosis. You might mean depo.

I used a diaphragm for years with no pregnancies. Yes the failure rate is quite high (we were planning to conceive in 2-3 years) but if you used condoms & natural family planning it could work well.

It is shit CCGs are trying to save money like this. Especially as the wait to get long term contraception fitted is 3 months at my local surgery. And obviously that’s not an option for everyone.

I was also told to consider my future partners!

But a MAN might disagree with it sometime in the future. Think of the men, silly little woman.

The disparity in provision for female health is abhorrent

DH went to ask about a vasectomy after last DC was born. He was asked "what if there was a horrible accident where your wife and children died then you meet someone new and she wants children?" DH told them that if this horrible accident happened he would be killing himself as soon as possible and following us rather than finding a new wife. No further discussion or persuasion, he was referred and two weeks later snipped.

Meanwhile my friend, four DC, lives in the same health Trust, adamant she wants no more children as the last was unplanned and her DH has two from a previous marriage so their hands are very much full. She went to the GP (same bloody GP as DH) and asked to be referred for sterilisation. GP refused as "what if your husband wants another in a few years?" and "what if you split up and your new partner wants a baby that is his rather than only yours?" and then the kicker "you'll be laid up for a few days after the surgery, who will look after the children?"

It's shit.

I am like you - hormonal contraceptives of any kind send me loopy.

I have had the copper coil fitted for a year now and love it. I do have one day with 3 or 4 bits of cramping (nothing major, maybe every 3rd month it may be bad enough to get some painkillers, but mostly goes away without needing them). It is a side-effect I am happy to take though as I get hormone-free hassle free contraception.

I'm excited because I'm due to have my ablation and sterilisation tomorrow!

Another poster has reminded me of the conversation I had with the (female) doctor that went along the lines of:
Dr: do you have a partner?
Me: why?
Dr: we need to make sure he is on board with the procedure...

Needless to say, I don't think my response was exactly what she was used to. It went along the lines of "I'm sorry, are you saying that in 2017 a 44 year old woman has to get a man's permission to sort out her periods?"...surprisingly all of a sudden her attitude changed.

This was after she had spoken to a male consultant that I heard tell her that I would have to have the coil fitted first. There was no way that was going to happen. I was very adamant. I told her (quite loudly so he could hear in the next room) that I was pretty sure if a man had been bleeding out of his penis constantly for six months, I'm sure something would have been done by now.

Sorry for the rant. It's very outing! But I am a strong minded and confident woman and it annoys the hell out of me that we have to go through all this and if I were less confident or English was not my first language or I had mental health issues, I would still be being fobbed off and treated like a silly hormonal woman that doesn't know her own mind.

And breathe.....

@Cesntoots I’m really glad you’re getting your procedure.

But I disagree with the fact you’ve got it because you’re “strong and confident”. I am too. Im currently taking legal advice to push further, but it doesn’t matter HOW confident you are if the practice rules are “no”.

Jacques, I might just have been lucky that they backed down, but I still think they would have fobbed me off if I hadn't been so pushy.

They've been fobbing me off for 20 years so I guess I should be used to it!

It's shocking that you are having to go down that route and I do hope that you get the result you want. The whole process is depressing and women should not have to go to these lengths.

Endometriosis
Mottling on my womb
Erosion of my cervix
HPV and abnormal cells from my smear
Mum died from cancer

But apparently I'm not a high enough risk and too young (at 37) for a hysterectomy.

Sorry OP I can't help, but if you ever get an answer I'd love to know!