Tubes tied during c-section or vasectomy?

[Decisionstomake1]

I guess I am posting for traffic! But maybe also AIBU to think tubes tied during c-section would be a good option? Has anyone had it done?

Currently pregnant and will be having a planned section same as my previous pregnancy (high risk - baby will need to come early).

I was going to ask about getting my tubes tied during the procedure. My thinking being if most of the risk of tubes tied is the operation itself and I’m already being cut open maybe it’s a good idea! or is there a lot of risk outside of this / was the recovery very bad?

I did aged 31 during second section, 3rd child. DH would have had a vasectomy but this seemed simplest.

My pain was worse than previous section, but I was relying on paracetamol as they prescribed me Oxycodone which knocked me out. (In US.)

No regrets. I had a hysterectomy 3 years later too.

I had mine clipped 10 years ago and it was one of the best decisions I’ve ever made coming of the reproductive treadmill, the fears of miscarriage, the hormonal rollercoaster.

There is NO connection with perimenopause. For a pp this is a coincidence.

Risk of pregnancy from tubal ligation at Caesarean 1:150, Mirena at LSCS 1:800, vasectomy 1:2000.
Personally I would go Mirena - you can easily change your mind if circumstances change, reduces risk of (very common) endometrial cancer, can be used for HRT in the future, 90% of people will have no periods and you can check whether it’s there yourself.
Also be aware that funding can be difficult to get for ligation.

I considered this and discussed it at the hospital during my third and last pregnancy, but in the end decided not to go ahead and my partner had the snip instead. I was advised there was no increased risk of infection, but there could be more pain and bleeding...and I just felt I would be going through enough already with recovering from a c-section plus a new baby to look after. Also I much preferred the odds of getting pregnant again after a vasectomy...1 in 2000 apparently, but 1 in 200 after tubal ligation. Good luck whatever you decide!

Not me but two of my friends had it done during a c-section with their 4th (both have 4 children). Apparently they were told that there is a slightly higher chance of it failing if done during a c-section (your body is very different when heavily pregnant I guess - perhaps things "move around" for want of a better word post partum, which might potentially cause the clip to move or if stuff shrinks after I don't know I'm guessing). Recovery was the same though they said and in both cases it was fine 9 & 6 years (depending on friend) on no more pregnancies. Personally I'd go for both i.e. husband too but that is of course up to you. I'd ask your midwife or consultant about it. Congratulations on your baby!

Both.

Suggest he goes now for vasectomy, he will be recovered by time baby comes to support your recovery and no more children. Share the risk. He's happy to let you have risky surgeries he should be insisting he also shares the responsibility of not having more children.

I tried to word it kindly.

Babies are not pot plants, but many women wish to fill empty arms, and not even having the chance to try again is something that needs to be considered. Sadly I know too well, and the majority of people that I've met in my situation have wanted to try again.

Although from reading further it isn't actually relevant to OP as she would need IVF.

I did at 35, during cs#3. Cut and cauterised, so no clips or foreign body in me. Best decision ever. Ten years on, no sign of menopause yet either.
My consultant was fine with the idea but the registrar who performed the cs was sniffy about it - although soon changed her tune when I had a complicated cs, a lot of blood and she had to bring him in. I imagine I probably have a scarred uterus that resembles crepe paper. She did admit that it was probably best that I didn’t have another after all.
There’s no way I’d persuade DH to have a vastectomy and I know his brother experienced a lot of pain and issues afterwards.

@ImNoSuperman he has said he will get a vasectomy happily - but he couldn’t do it until after baby is here as if anything was to go wrong and we did want to do more ivf he would need a surgical procedure to get access to the sperm and the quality might also be affected. If I don’t do the tubes tied he will do the vasectomy but I just started thinking maybe I can just get it done during the section and then we are sorted.

i would say our chances of natural conception after tube tying are less than the 1:200 as we’re technically infertile!

@TinyRebel yes I don’t want my DH to experience pain or issues as I want to get intimacy back! I also know my DH would also be amazing re my recovery if it was longer. He is taking two months leave when baby arrives and he will take care of everything so I can just rest and be with baby.

im glad you had no regrets or issues. I will be sure to ask what kind of surgery they would do - I didn’t realise there were different types re clips etc.

@khaa2091 I’m not sure re Mirena. I have very painful smears and can’t even use tampons comfortably.

I’d go with having the tubes tied during section, because it will solve the problem once and for all. If your current relationship should end and you meet someone else you’ll be in the same situation as before.

Personally I wouldn't tie my tubes. I know someone who had their tubes tied, somehow sperm got through but egg couldn't get out resulting in an ectopic pregnancy behind the tie. Nearly killed her, and she never really got over losing the baby that she could have had had it been able to implant properly. Maybe it would have always been ectopic but still blamed herself.

Maybe they've changed the procedure to avoid outcomes like that. I don't know. But I'd not take the increased ectopic pregnancy risk.

The Mirena can be inserted during the Caesarean. It is much easier to remove than insert, taking about 15 seconds, and can be done by most GPs (unlike inserting coils).

I had my tubes tided during my second c section, it added an extra 10 minutes onto the op. To be honest I wouldn't have known I had it done, as recovery from c section is painful anyway. It's been 6 years now and no regrets. They sent my tubes off to the labs to make sure they removed them correctly, due to the fact that everything is swollen ect from the pregnancy, it makes it a little bit more complicated.

It’s obviously your choice but I think vasectomy is the safest option all around. I’ve known people who had their tubes cut that have had all sorts of complications. Of course you could be absolutely fine, but why risk complications and maybe further surgery one day when vasectomies are much easier and contraception should not fall solely to you anyway. I think you’ve more than done your bit. Let DH do his.

I wish I’d done it!

They didn’t mention it until 36 hours before the caesarean and I hadn’t realised it was a possibility. 36h didn’t feel long enough to make a considered decision so I didn’t go with it. I’ve kicked myself ever since.

The benefits of tube removal (which is what they’ll suggest over just segmenting and ‘tying’ is that it vastly reduces the risk of a secicifc cancer (might be cervical) as it firstly develops in the tubes. So no tubes = no cancer.

this was my first choice too when I had my second baby. They agreed and said I could have it done if I needed another c-section (which I did)

I actually ended up being so fed up of no progressing and just wanting to be in, out and done that me and DH decided we wouldn’t bother having to sign extra forms and having chats ect before the operation and we ended up booking him for a vasectomy instead.

To be honest. I regret it. I wish I’d done it the vasectomy is obviously fine as an alternative but I just think.. I was already being cut open. They were goth there and it wouldn’t have taken much longer to remove my tubes. I was just being impatient.

So, if your definite you don’t want anymore kids, and you’re already having a section it’s definitely only going to benefit you to have your tubes removed

Recovery wise, c section with tubal ligation usually had a more painful recovery, but not excessively so in most cases.
Consider insertion of coil during section, I think it's usually the copper coil. They directly insert it into your uterus so no fiddling with your cervix required. And provides 10 years protection and easily reversible

I asked about this before having a Csection with DS2. I was told they were very reluctant as women may feel that way whilst pregnant but then change their mind. DH and I knew we always only wanted 2, so I was a bit pissed off.

DH had a vasectomy just before DS2's first birthday

When I had my last, at my maternity appointments the male obs just always assumed I'd have ligation. When I checked in, the very feisty female obs gave my dh hell, why was I having it done, why wasn't he having a vasectomy? Why wouldn't he make the sacrifice? And she was right. Hed never even considered it.

@Ohwhatfuckeryitistoride was this for a vaginal birth though or c-section? If I was going for a vaginal birth I wouldn’t consider it either it would definitely be a vasectomy.

There is a higher risk of failure for sterilisations carried out during c-section than later after a birth, so I opted to have mine done after 2 years. DH got the snip in the meantime, so we are both covered.

An advantage of your DH getting the snip is that if you later split up (or you die), it reduces the risk of him starting a second family with a new partner, which would cause a financial disadvantage to your existing dc. But I also liked having the reassurance of having control over my own fertility, so I still went ahead with my own sterilisation.

"Sterilisation at the time of Caesarean Section may carry a higher chance of failure than sterilisation done at other times due to changes the uterus and fallopian tubes undergo during pregnancy."

https://www.nth.nhs.uk/resources/permanent-contraception-steralisation-during-caesarean-section/

An advantage of your DH getting the snip is that if you later split up (or you die), it reduces the risk of him starting a second family with a new partner, which would cause a financial disadvantage to your existing dc.

WTF??!

I lost my tubes during IVF so I didn’t need to make the decision, but I’d tend towards getting them removed during the section as you’ve got frozen embryos and would need IVF anyway.

Make sure they remove them (salpingectomy) - there is a really substantial decrease in ovarian cancer risk once removed.