Sterilisation or coil during C-section help me choose.. 10 days to go!

[frostyfeb1]

I am almost 36 weeks pregnant with my 4th baby. This will be my 4th C-section. Sadly my first baby died the day she was born from complications in labour which resulted in a crash C-section hence why all births have been csections.

I really don't want any more children after this baby I've had a complicated pregnancy and for lots of reasons 3 at home is our limit (finances, time etc).

I was geared up to have sterilisation at the time of my C-section and this was approved and discussed with more than one consultant during my antenatal care. However on my last visit the lead consultant has said she is very against performing sterilisation at the time of C-section as there is a 1 in 100 failure rate and it can increase the rate of ectopic pregnancy. She also said given my age (30s) there is a chance we could want to try again and gave the example of if this baby died from SIDs etc would I like to try again. I understand why she's said this but given the loss of my first baby I cannot get it out of my head.

She recommended vasectomy but my DH will not consider this. She then suggested the coils Mirena or copper as long acting and she claims better at preventing pregnancy than sterilisation at time of C-section. I don't want the mirena coil as hormonal contraception has not agreed with me in the past both physically / mentally so the other option I'm considering is the 10 year copper coil. I've gone down the online rabbit hole though and read lots of horror stories aboht people experiencing constant pain, flooding through every hour and bleeding 20 days a month, perforated uterusues or dislodged coils and unexpected pregnancies etc but of course I know many people use it without those effects.

Basically I can't decide should I get sterilised at time of section (consultant said she wouldn't recommend but would do it if I decide) or go for the copper coil also inserted at time of section?

Anyone who's had either done or has any advice welcome

Hi OP. I’m so sorry to hear about your loss.

I haven’t had the procedure during a CS but I really loved the copper coil - BUT not the insertion in a sexual heath clinic, without any pain relief. I have to admit the insertion was worse than childbirth and I was induced with a hormonal drip. But it was absolutely fine a couple of hours after the insertion and zero complications or hormonal side effects. Periods like clockwork while I had it. So I will definitely have one done with a spinal block eventually! (I will also go for another CS after my first was an EMCS due to complications.)

Congratulations and all the best with this pregnancy.

I's so sorry for the loss of your first baby.That must have been devastating.
I had a copper coil for years, and had no problems at all really, apart from the pain of insertion without pain relief, and cramping for a few hours afterwards.
Lighter periods, less pain, so it was good for me.

Where I work, we remove the fallopian tubes at C/S, not tie/cut/clip them. This removes the risk of ectopic pregnancies. It also lowers the risk of ovarian cancer. I'd ask for this if I were you.

Sterilisation if you do not want any more children.

Mum went through this in the 80's as part of c-section after having me and my bro nearly killed her. Appreciate times were different then but it served my Mum well until she needed to have a hysterectomy some 20 years later x

What a lot of stress for you OP.

I have a Mirena coil. It's been brilliant for me - no periods! And the hormone is very localised. I would say try that first, and if it doesn't agree with you, try something else. It doesn't have to be all or nothing.

I have a copper coil and insertion was panel but quick and manageable. I understand the protocol re pain relief has now changed and you are entitled to it.

You've been through a lot, I'm so sorry about your first child.

Why is your husband refusing a vasectomy? That would surely be the most straightforward option?

I wouldn't go against what your consultant recommends and risk your own health and well-being.

I would probably go for sterilisation. It's all done at the same time so no need for a second procedure to get a coil put in, plus it's permanent so no having to have anything removed and reinserted.
I hate my copper coil and want it removed. It isn't the worst contraception I've had and no "horror stories" but my periods have been much heavier and more painful than ever before.

From personal experience I would not have a coil inserted during a cs.
I had it done, they don't trim the strings properly, you come back for that at a later appointment. So that was very uncomfortable. It spent the next few weeks slowly departing my womb. If I had known how painful and uncomfortable it was, I would have waited and had it inserted a few months later.

Oh, apologies, I didn't realise you could get the coil inserted during a c section. I've never seen that done before! So no second procedure, but I would probably still go for sterilisation personally.

I had sterilisation during c section on my 2nd child 12 years ago at 36 and no problems since.

I would go for sterilisation but I wouldn't do it during your c section. I am the 1 in 100 who had their tubes cut during the c section of my third child and was pregnant again 6 months later.
I was never told that the failure rate is higher if done during a section as everything is swollen down there.
When I had a section for my miracle 4th baby, the consultant said my tubes had fused together on one side. I was sterilised again and my husband raced off to have a vasectomy, something he had refused to do before!

I didn’t want the birth of my baby to be anything but that so decided against sterilisation. BUT my husband was on board for a vasectomy. In your situation I would probably opt for sterilisation.

I waa sterilised during second c-section, third child as my first was vaginal delivery. No problem, although hysterectomy required 3 years later for unrelated reason. My tubes were clipped.

I personally wouldn't want a coil instead of sterilisation if it might not last my fertile period.

I'm so sorry for your loss.

I was sterilised at the same time as having a c-section. They kept trying to talk me out of it! I'm so glad I did it. Only added 5 minutes on to the birth. Good luck

I got sterilised during my fourth section. Best thing I have ever done. It did not impact my recovery at all. But I was 100% sure that I do not want any more children.

I know you say hormonal contraception hasn’t agreed with you in the past, but the Mirena coil works locally so the hormones aren’t charging around your body as much as they would be with the pill, for example. No periods and contraceptive cover for eight years (or 10 years if you have it fitted over the age of 45!)

I would never go for a copper coil personally, the periods can be absolutely horrendous for some women.

I'm sorry to hear you lost your daughter xx

I was sterilised during c section. They gave me the same information, they have to. However, what they also do is send off the tubes they remove for testing/review to see if they have removed enough to ensure the risks are minimised. If there were any concerns they would advise.

Good luck with whatever you decide, and good luck with your new baby x

I would have the IUD, but I've had several IUDs and got along fabulously with them. The only reason I don't still have one is that... DH had the snip. If you have fairly heavy periods already, I would try the IUS as the hormones are so localised, it's not like, say, the pill or the injection. But your surgeon is right that female sterilisation is less reliable than vasectomy or IUD/IUS, even more so if it's done during a C-section. So it does partially come down to how much of a disaster another baby would be for you.

I haven't had sterilisation so can't comment on that but have had an ectopic pregnancy so definitely wouldn't recommend upping your risk of that. Especially as now she's said it you will be worrying every month that this is your fate. I have had the copper coil twice and found it to be the best method of contraception I'd had. Insertion was like mild period pains, removal, well that wasn't fun but if you go to the sexual health clinic they are probably more practised than my gp surgery. I'd still be on at my husband to shoulder the load and get the snip though. Jeez, you've suffered enough, his turn now.

I'd still be on at my husband to shoulder the load and get the snip though. Jeez, you've suffered enough, his turn now.

I must admit I agree although I also understand “his body”…

Thanks everyone.

I'd no idea they tested to make sure the sterilisation worked. I'm thinking I might have the copper coil inserted during the C-section then ask to go on the waitlist for steralistion not at the time of the op which apparently doubles the effectiveness from 1/100 to 1/200.

Interesting to know the mirena is lower dose and more localised but especially straight after having a baby I'd be wary of having hormonal contraception that may take 6 months to settle.

For those of you who think DH should get a vasectomy I agree but that doesn't look like it's on the cards at all at the minute anyway.

No vasectomy, no sex is what I'd be saying!

I got a coil during my section and it fell out 2 days later.

This. You have gone through more than enough, it’s his turn to take one for the team.