to think sterlization shouldn't be offered 30 mins before a c-section?

[Seasiderabbit]

A hospital registrar came to visit me on her rounds 30 mins before I went into theatre for an elective c-section. I'd never met her before. (Some context - I decided to have the c-section the previous day in conjunction with a hospital consultant for very good reasons. I'd signed the consent forms and done the pre-op etc.

So, with 30 mins to go before going into theatre, the registrar questioned my decision to have a cesarean and told me how difficult it would be to have a future vaginal delivery. I told her that with 2 children already and age 40, we have decided not to have any moe children. She then said "So, what you are telling me, what you are trying to say, is that you want your tubes tying at the same time as your cesarean." I said that no, I did not want that. She then questioned me about what contraception I'd be using in future.

I was vulnerable - in a hospital gown and nervous before going into theatre. She was standing over me, her tone throughout was passive- aggressive and hectoring. It was also clear from a couple of things she said that she hadn't looked at my notes.

AIBU to think this is out of order? Isn't sterilization something you need time to think about with all the relevant pros and cons?

YANBU, that’s really inappropriate.

Actually, given that you had just said you didn't want anymore, I don't think it's unreasonable to suggest or ask if you'd also like that procedure. However, the way she phrased it is odd and inappropriate.

Yanbu

Please make a complaint if you feel able.

I think that is out of order, yes.

Both in terms of questioning your decision to have a c-section when you are just about to have one, and in terms of raising sterilisation out of the blue. And in terms of not treating you as a mum about to give birth. Talk about shit bedside manner.

Very poor practice all around really.

As you had told her you had already made the decision then I don’t think it’s that bad. A bit insensitively worded maybe but not inappropriate

Ordinarily I would agree with you, but given that you had chosen to have a c-section the previous day, and this was the first time you had met the registrar - it would not have been possible for her to raise the possibility beforehand.

It is entirely reasonable to put the question at that time, as to do it another time would be to double up on NHS resources and put you through an operation that could be avoided by doing it at the same time as the c-section.

As you were clear on not having children it wouldn't be unreasonable to think that you had considered contraception going forward.

I think it’s ok. They could then do it when performing Cs. It’s not as if your Cs was planned a long time in advance and you could think about it before hand. I think she was giving you options in a clumsy way.

I was asked during my EMCSif I still wanted to be sterilised, I’d vaguely mentioned it at an appointment but hadn’t asked for it directly. Glad they asked as I said no, and had another baby since.

Actually, given that you had just said you didn't want anymore, I don't think it's unreasonable to suggest or ask if you'd also like that procedure. However, the way she phrased it is odd and inappropriate

Nope, this is utterly wrong. Sterilisation is not a decision to be taken on the fly when thrown at you as an unexpected curveball.
Its not like asking if you want a bourbon or digestive biscuit y'know. It requires a conversation about things like, have you considered how you would feel if your family were all killed in a car crash. These were the type of detailed questions that were asked by medics when a friend was a consultation about sterilisation. Totally unprofessional and utterly irresponsible to raise it as a snap decision at such an emotional time.

I also had a elective c-section which had been planned and discussed with consultant etc.- all good.
But then, when I went into hospital a few hours earlier than planned as I went into labour, I had a registrar trying to persuade me not to go ahead with the c-section and to try for a vaginal delivery instead.
It was completely inappropriate and I also felt very vulnerable- but thankfully stood my ground.
I should have reported it as it is bullying behaviour.
I'm sorry you had to go through this.

I actually think it was a fair question and I’d i genuinely didn’t want anymore I would of snapped her hand off as other contraception is not 100% so if your having a c section and don’t want more dc it’s a no brainier really.

I also think questioning a non emergency c section is fine too tbh

Difficult one. If you are sterilised at the same time as having your CS then it saves a second operation later. Some women might have already decided that they wanted sterilisation and would be glad to get it sorted there and then. However it sounds like her manner wasn’t great. You should have been able to decline it easily with no further pressure.

So:

YABU to think it shouldn’t have been offered.

YANBU to be upset that it was offered in what you felt was an inappropriate and aggressive manner.

If someone had offered me that option as I went in for my elective c section for my 3rd child I would have bitten their hand off! A friend was offered the option (3rd c section, didn't want more babies and advised not to have any more just like me,) but I wasn't.

I don't think the consultant was unreasonable

I don't think it was inappropriate, she is just doing her job, and her questions followed on from your answers. I was asked this question with each c-section (and during the fourth one, I did agree).

I think it would have been inappropriate if she hadn't asked you tbh.

Difficult one. If you are sterilised at the same time as having your CS then it saves a second operation later

Yes, because as we know, all women get sterilised when they decide they have completed their families.

Ps: good luck with the delivery!

As you were on the way to theatre anyway, there wasn't much time to discuss it. She should discussed it with you earlier.
Lots of women would be happy to kill two birds with the one stone.
I hope you are ok now.

What? No that sounds weird.

When you're going to have surgery imminently which most people find a stressful situation, it's not appropriate at all to

A. Try and talk them out of it and when they don't go for that
B. Start in at them to make a snap decision on extra, not previously mentioned surgery!

Was she in charge of the budget or something?
Pressing a woman to make a decision like that out of the blue, very quickly, and about something so major is bad.

Kind of reminds me of hard sell, you'd get a lot of women feeling that type of pressure, it's all known that it is hard to make rational decisions when there is time pressure and you are under stress.

I think it would be worth complaining.

How the fuck are you meant to make an informed decision with a lifelong outcome while awaiting surgery and about to have a baby in less than 30 minutes?

I do think it was hugely unethical of her op.

I have had a lot of operations and insensitive surgeons I assume they are just like that. I don't think what they suggested was wrong because you said you were not planning anymore they were in anyway but they just put it to you in a clumsy way.

I was not asked if I wanted to be sterilised during my emergency section,
Even though they were in there anyway

Not with my second planned section.

Most women aren't sterilised on completion of their family, are they? It's not standard or 'given' at all.

Don't women get the contraceptive talk after they have baby anymore?

As it was an elective C section you should have been offered a sterilisation when you were originally told about having a C section.

I don't think she was wrong to ask, if you were not sure you had the option to refuse as indeed you did.

I think it was wrong that this was not discussed with you at an earlier juncture.

Thanks everyone.

I'm with you @elfinblender, @NothingOnTellyAgain and @GreyBlueGeometry.

Her offer of sterilization was completely out of the blue and there would have been no time to make an informed or valid decision.

I've since read the obestrics guidance on sterilization and it's clear that the conversation between health professional and patient about sterilization is a process, not a one off. This is because it has a lifelong impact.

I think it was unethical, regardless of her intention.

I'm complaining RIGHT NOW.

Don't women get the contraceptive talk after they have baby anymore?

They don't usually try to steer you into a permanent contraception solution 30 mins before you give birth.

Fuck, you get a 14 day cooling off period if you sign up to a direct debit at your doorstep, so you should get just as long to back out of permanent changes to your fertility.

I'd have been worried she planed to do it anyway. She sounded like she was looking for consent.