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?

So name change fail (all over the place because of having to re log in on various devices due to the data breach).
@user2019 - think it’s a fallacy. It made absolutely no difference to me regarding age etc

I meant to say I’m cheesychips from up thread !

Urm no your friend is talking rubbish I chose to be sterrilised for health reasons before i was 30 I didn't feel old my periods were normal im now late 40s still with a cycle but on HRT sounds like your friend might have other issues going on.

My friend went for both at the same time but due to family history of womb cancer but hers was discussed months in advance. Complain op..timing was wrong!

As an adult woman who is pregnant, a doctor would assume you had had discussions already

It's rather dangerous for a doctor to assume anything..........

I think that there is a big difference between not wanting any more children and not wanting to retain the possibility of having any more children.

I don't want any more children - I am happy with the two I have. But I recognize that, very sadly, things happen that can make you re-evaluate whether you want another baby. This means I don't want to be sterilised.

Sterilisation isn't a straightforward decision about whether your family is complete, and that's why there are guidelines around it. I'd be concerned about the abilities of a surgeon who didn't recognise this - it's hardly rocket science, where else in my care might they be showing poor judgement?

Completely inappropriate. How horrible for you OP. I'm sorry.

Nico, there will be a Trust Policy regarding consent.

I’d definitely complain, you need way more than 30 minutes to think about something so huge.

I recently saw a consultant who gave me a date for a planned section. She spoke about me having a sterilisation at the same time, I explained my DP would be having a vasectomy (he was there and agreed that’s what we have decided) but she was quite pushy and has put down I’ll be having one even though I didn’t agree. She said I can opt out on the day 🤔 Quite annoying as I’ll definitely have other things on my mind. But I am opting out, I’ve been through enough, I don’t fancy even heavier periods and possibly it not even working. DP can step up!

dinsey70 There is a consent policy, just says consent for elective procedures should be sought at the outpatient appt. doesn't say it must be and doesn't specify any time periods.

I totally get what you're saying and I agree that technically it went against the spirit of the policy but it's worded a bit ambiguous really. Especially when the patient is insisting that she was counselled and gave consent at the outpatients appt. she was furious and I didn't blame her!

In our hospital the only women who are sterilized at the same time are those who have had 3 or more c sections and therefore at risk if pregnant again.

You are definitely not being unreasonable

I understand sterilisation being offered, but why not during the previous conversation with a consultant? Strange for it to not even be mentioned then yet have it offered 30 minutes before.

I also disagree with pp that it was reasonable to be questioned on choosing an ELCS. Why on earth should a woman have a lengthy discussion with a consultant, make the informed choice for an ELCS (which the consultant approves) then arrive at hospital for the scheduled surgery and, once ready and gowned-up, have a dr they’ve never met before interrogate and question their decision/try to change their mind. Completely unnecessary and unfair.

kind of odd right before your cs
my ob/gyn asked me at about 6 months if i wanted to have it done during my cs and said he liked to check well in advance as he needs to book a longer OR time slot as it takes some time and that i cant just decide on the day it needs to be organised

I had them ask me about 30 minutes before I had my last. I was in premature labour and going for a section as they couldn't stop it. I didn't even think about how inappropriate it was til reading your post. You're right, that should never have happened.

100% inappropriate. Make a complaint if you can. X

Before both of my c sections, the same morning, I was given a leaflet on getting my tubes tied. I was 22 and 26. There was no discussion but I was asked and when I said no I was given the leaflet.

I wish i had thought of this before. I had an emergency one so probably they wouldn't have sterilized me but insist I had said before hand or being asked, "if you have a c section do you want your tubes tied." If havr jumped at it.

That’s awful. And the story CheesyChips tells is hideous too! Considering how many women struggle to get approval for sterilisation when they’ve put month, years even, of thought and discussion into it, it astounds me that it’s offered freely to women who’ve had so little time to think it through.

I’m glad you’re putting a complaint in OP. Regardless of it it might have been a sensible conversation to have when talking to a 40 year old woman having a section, the fact that you hadn’t had that conversation in the previous lengthy meeting and also that she had no consent form stating that is what was to be done, should have been enough for them to work out that you didn’t want it or hadn’t had the chance to discuss it fully. I don’t think even from the meeting the previous day they’d have consented you for sterilisation less than 24 hours later. It’s a massive discussion that needs a little bit longer than that! And even if you’ve expressed a wish not to have more children, that is a far cry from saying you wish to remove your fertility forever without possibility of reversal. Not everyone who is done with children gets sterilised! Mostly because it’s bloody hard to get them to agree to it (unless of course you’re 30 mins out from having a baby or are laid in theatre feeling like some sort of medical dissection and the conversation is had with your husband, apparently!). I can’t believe this goes on when you hear so many stories of how hard it is to get done!! I hope you get a good response from your complaint!

That's way out of line, so inappropriate.

I know people who've had it done during a planned section but it was a choice made way in advance and thoroughly discussed with the consultant.

Is it really the case that women get counselled by consultants about sterilisation as a routine thing when pg? I have 3 three dc and this has never happened to me. It was literally after birth, about 3 days later, the mw would do a visit and say "do you know what you're doing for contraception now?" And I'd say yes and that was that. I was consultant led for last pg and had 4 weekly or 2 weekly appts throughout and sterilisation was literally never mentioned once.

So is it really normal for a dr to expect that a woman has discussed this properly at an earlier point.....?!

I asked for a sterilisation during elective c-section (and made sure it was noted) at each and every one of my MW and consultant appointments. I was armed with all the arguments but in the end it was OKd really easily (I think he said 'hmm, given you have two children already and your age' 36....).

The difference is that the registrar who appeared to actually do my c-section on the day was very negative about the idea and reluctant, until I pointed out it had already been agreed.

I don't think you have any reason to complain op. I think they thought they were being helpful, especially if you'd said it was your last baby.

Absolutely the best thing for me and my family.

YANBU. it's not like she was offering to wax your eyebrows as part of your facial, this is a significant separate procedure with life changing consequences. I hope you get a decent response.

I’m confused (not read full thread) she asked you said no, did she continue to badger you about it?? If not why are you making a formal complaint