Post pregnancy contraception (of the permanent kind)..

[ohthegoats]

... condoms I expect, at least initially. But I used to have a coil - I don't want one anymore, they hurt to put in, and give me more painful periods.

I'm 40, we can't really afford to have more children, boyfriend is happy with just the one child too, and obviously there is my age to factor in. Do you reckon I'm a candidate for sterilisation? I suggested he could have the snip too, to which he replied 'doesn't sound very nice, but I suppose I could'.

If you're sterilised, what made the decision for you?

I have been told by a gp friend that you really have to battle as they have seen too many people change their mind. Especially after one child I would have thought (not saying that you will). She said that they would massively push coil and implant over sterilisation.

Not that impressed by 'not nice' as an answer from your DP though. Your body has been through a lot. Should he not do some proper research not dismiss it out of hand (and effectively ensure it is your problem).

You need to be absolutely sure that your family is complete before considering surgery to remove fertility. And ideally that's a joint decision for you as a couple.

If you are sure it is, then it just comes down to when and which one of you. Best practice guidelines state that the procedure should not be done within a year of life changing events (as they count childbirth amongst that), but in practice there is a great deal of flexibility.

There are quite a few threads in the Family Planning topic about female and male surgery. There are risks and benefits with both.

Tubal ligation is effective from the next month (unless Essure, which takes about 3 months and occlusion should be confirmed by scan). Sterility after vasectomy needs to be confirmed by semen analysis and it typically takes around 4-6 months for an all clear (though it can take over a year).

Failure rate of vasectomy is 1:2000 (though about half of that comes from abandoning contraception before the all-clear), Essure, I'm not sure, as it's a new procedure but it's up at around the 1:2000 or even lower. Traditional tubal ligation 1:200.

Serious (enduring) effects of vasectomy are much higher than often thought, at about 1:10, and there are next to no treatment options if your DH is one of the unlucky ones (read the NHS Options page for more info on this). Side effects of tubal ligation have decreased a lot with modern techniques, though of course a GA always carries risk. And if female sterilisation fails there's increased risk that the PG will be ectopic.

I found the implant to be very positive and only needs renewing every 3 years. It also made my periods stop which I was pleased with but I know other people have had more problematic side effects.