health

Hannah always knew she never wanted to have kids. At 31, she got her tubes tied. 

I had so many strange questions before I got my tubal salpingectomy and I discussed them pretty openly with the people around me.

One night over the holidays I was sitting with my partner and my dad at a bar and were all talking about how interesting and unusual it was.

“So they take out the whole tube?”

“Yes, the whole tube. No fallopian tubes.”

“Where do… the eggs go?”

“Probably just like, into your body? They’re really small.”

“No, that can’t be right.”

Turns out, it was right. Your body does keep producing ova after the procedure, and they just kind of get spit out and dissolve.

All the annoying things people who don’t want kids have ever heard. Post continues after. 

Video by MMC

Over the month between when I finally got approval for elective sterilisation and when I actually had the procedure done, I learned more about my reproductive organs than in any sex ed class or My Body, My Self-esque book.

Like, for example, I learned that the picture we often see of a uterus leaves out a pretty critical piece of the organ.

Most of us have seen a picture of a uterus that looks like this:

Tubes-Tied
Image: Supplied.
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But in reality, the ovaries are actually anchored to the uterus and elsewhere in the body by a series of ligaments, including the infundibulopelvic ligament (IP ligament) and the broad ligament of the uterus.

Tubes-Tied
Image: Supplied.

Yeah. Your uterus basically has wings. Do you want to know how I learned that? When I asked my doctor to take a picture of my insides while he was in there.

And he did. It was very cool.

On the day of the surgery, I pulled out my phone to look at the To-Do list I’d made of questions. Questions would come to me in the night, like how big even is a fallopian tube? What does it look like? Can I keep one in a jar?

The answers were, in order: Very small, a bit like an inch worm, and no, but that was from my partner who, while patient with my sense of the creepy and macabre, drew the line at a biohazard as bedside decor.

By the time I was handed the really gross sterile wipes to use the night before surgery, I’d gotten down to the granular questions about my body, my organs, and my recovery.

By the time I was getting wheeled around a hospital at 9am in a paper hat, I had already asked all of the Big Stuff.

I’d been trying to get to that day for a decade. I’d exhausted the basics.

Why I got sterilised at 31.

I know there are going to be some questions about this decision, but I want to assure you, I’ve already answered them and you are very much invited to seek out those answers.

To start, here’s a story on Medium about why, even though I really love kids, I am not having biological children of my own AND I hold no judgement of people who do.

The long and short is, though, I got to a point of wanting to get sterilised because I wanted to a) stop being told by doctors what I actually wanted, and b) be able to say “see, now I CAN’T change my mind, so what else have you got to say about it?”

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People take this choice - one that doesn’t impact them in even any mild way!—really personally. They view it as a judgement of their own choices. And honestly, after doing All Of The thinking about it for the last, oh, third of my life, I’m kind of done dealing with it. I’m done walking judgemental busybodies through it and justifying it and thinking about it myself.

And there are some really real emotional spaces to be aware of, too; I know for families who have struggled with fertility issues, pregnancy loss, miscarriages, etc, hearing about someone who’s electing not to have kids can be painful, and I try really hard to be kind about it.

But this is also my ~journey~ and I want to be able to share it with folks who are on a similar path. I think there’s space for both and I don’t think it’s a zero-sum game. I think we are all allowed to have our own feelings about our uterine experiences and shouldn’t see them as competitive with one another.

I wanted the surgery because every time I had to deal with my birth control (I remain a big supporter of IUDs and other long-acting contraceptives for this same reason, except that they can also be truly terrible), I was reminded that the thing I really wanted—to not have children—required constant investment of time, money, and physical pain and labor.

Mamamia's daily news podcast speak to women going on birth strike. Post continues after. 

How could the absence of a thing require so much effort?

So that’s that. I got sterilised at 31 because I wanted to. That’s the answer. And since then, since I’ve been talking about it, I’ve heard from SO many people who have wanted to do the same, because they are done having children or are not having children to begin with or because WHO CARES, IT’S THEIR WINGED UTERUS.

And they have questions like I had questions. Some are basic and some are big.

Here are a couple of the answers I have received (these are real questions!). Mind you, I am not a medical doctor. I am just a person with two cute little scars and ova shooting off into my body like comets, burning up.

What, exactly, did you have done?

My doctor performed a bilateral tubal salpingectomy (BS), which means he removed my fallopian tubes entirely. This prevents the ova from getting to the uterus and thus, prevents pregnancy (in almost all cases, but folks with endometriosis or high risk of ectopic pregnancies will want to have a much more serious conversation).

Typically when people talk about this kind of thing, they refer to a bilateral tubal ligation (BTL) aka getting one’s tubes tied, which is where the tubes are clamped or snipped, but tubal material remains.

My doc and I talked about it and I did a lot of research and opted for the BS (I know, I know). And yes, I did title this article something about getting my tubes tied, but that was because I am positive most people would not click on something about a salpingectomy.

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Anyway.

One of the main reasons for a tubal salpingectomy is that there’s a body of research which shows it is responsible for a reduced risk of ovarian cancer; one 2017 study published in the Journal of Minimally Invasive Gynaecology (riveting!) reported that “BTL has been found to decrease the risk of any ovarian cancer by 13 per cent to 41 per cent, compared with 42 per cent to 78 per cent for BS.” So that’s significant!

I have a long history of aggressive cancers in my family and, while I tested negative for the BRCA gene, I still wanted to do what I could to reduce my risks of other cancers.

Plus, I didn’t really need all that tube floating around.

Of course, I’d encourage everyone to talk to their doctor about the options. But that’s what I did.

How did you even find a doctor who would do it?

Persistence. And research.

I don’t want to blow up the spot of the borderline underground network that shares this information, but if you look for childfree communities, you’ll find them. Some doctors are definitely more accepting than others, especially if you’re young, and you will likely have to go to a few before you find one. I saw five different OBs before I found one who would do it.

If you really are having a hard time, message me and I’ll give you more information. It’s wild that it’s so cloak-and-dagger when we’re dealing with a perfectly legal procedure that is COVERED BY HEALTH INSURANCE A LOT OF THE TIME, but here we are.

The fact is, a lot of doctors don’t want to set themselves up for lawsuits and/or they just don’t trust women, which is, like, par for the course. ¯\_(ツ)_/¯

What was the surgery like?

Very quick. I was in and out in a couple of hours.

My doctor performed the surgery laparoscopically, so it was pretty minimal; I have two very small scars on my hip bones (less than an inch long) and they went in through my navel (!!) so there’s technically a scar there but you’d have to be literally navel-gazing to see it.

I think the actual time spent under the knife was an hour or less.

I was up and walking around pretty much immediately, though it was uncomfortable to wear jeans for about three weeks. I got very creative with stretchy pants and recommend increasing your stock of jeggings before going under.

To be honest, the thing I was most self-conscious about in the weeks after surgery when I was going to meetings and seeing people was the massive bruise I had on my hand from my IV. But that’s just surgery stuff I guess?

Was it expensive?

Not really. The actual procedure was covered through my health care (which I pay for myself because I am self-employed) and I got it done in January (HELLO, DEDUCTIBLE!) to set myself up for the rest of the year.

The only thing I had to pay for was, oddly, the anaesthesia? Which was a little expensive but definitely not as bad as it could have been, all things considered.

Especially since my birth control was often NOT covered or was still super-expensive and also painful and crappy. So do the math for your own life, but definitely check to see if it’s covered!

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Did you go into early menopause or anything?

Nope. Unlike a hysterectomy, wherein a person has their entire uterus removed, the removal of tubes or tubal material doesn’t create any kind of hormonal change. If anything, my periods have been shorter and lighter but that could just be post-copper IUD life.

So no, you won’t need any kind of hormone replacement or whatever. But if you’re a person who uses hormonal birth control for non-contraceptive reasons (i.e. for your skin, painful periods, etc), you could still totally keep taking them if that works for you.

My recovery suite aka my office aka my bed. I spent a lot of time here for a week or so.

What was the hardest part?

After actually finding a doctor who would do it, the hardest part was taking time off of work.

I had the surgery on a Friday and was able to write and stuff by Monday, but I would get really tired and I was very aware of my stitches. I also was not allowed to do strenuous exercise for four weeks, which was kind of tough because I like to move around a lot.

But it was also good to like, make space for myself. I’ve heard that a lot of men get their vasectomy during March Madness because they can just like, chill. And that’s an outpatient procedure that is much, much less invasive. So I highly recommend that folks with uteruses just build it in to some other time off and give themselves a few days or a week to recoup.

Another hard-ish part was talking about it. It was weird to tell people I needed a few days off for surgery and not give, like, more information. But also, as I said at the top, at this point I’ve been on this tip for so long that I’ve shaken off most of my uncomfortable feelings about it.

Now it’s just dealing with OTHER people’s uncomfortable feelings.

It’s about four months after the surgery and most days, I don’t think about it at all. I don’t think about the pills I do or don’t need to take. I don’t think about my IUD trying to escape or the way I swore I could feel it poking my insides.

I don’t think about where I am in my cycle except to my sure that the menstrual cup I FINALLY figured out how to use is like, clean.

I don’t think about it at all. Which is exactly what I wanted all along.

So mostly what I learned is that if that’s also what you’ve wanted all along, you have a choice. You are not too young to make a decision for your body. You don’t need to keep trying different pills and patches and devices to assuage the discomfort of others.

Some of us never change our mind and we take steps toward that end. And that’s just something that everyone else can learn to live with.

The feature image used is a stock photo.

This post was originally published on Medium and was republished here with full permission. Follow Hanna Brooks Olsen on Medium @mshannabrooks or on Twitter @mshannabrooks.

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