Getting my Tubes Tied

Over the last few years I’ve noticed a slow trickle of media coverage of women who choose not to have children. It seems the tide of public opinion is finally beginning to turn, and women who choose to be childless are no longer universally viewed as failures, incomplete, or child-hating monsters. We’re getting to hear their reasons – many and varied, and all highly personal, not up for public debate.

On a side note, we don’t seem to ever need to hear from men who choose not to have children. Men aren’t seen as failures, incomplete, or child-hating monsters if they opt to remain childless; in fact, often they’re propped up on a pedestal if they shoulder anywhere close to 50% of the parenting load for the kids they co-create. Men, it seems, are off the hook entirely when it comes to the question of whether or not kids are an integral part of their identity.

So why do we women have to explain ourselves? And why does the conversation never seem to get off the starting blocks of “why?” and onto the nitty gritty of the childless path: how to back one’s decision with action?

That’s why I want to share my own story: the story of why I chose the radical action of surgery to ensure I can’t have kids. And, more importantly, what steps were involved in backing that decision with life-affirming action.

Why I chose not to have kids

While plenty of other women have told their stories of why they choose not to have kids, I feel my own contribution is also worth making to provide context for why I backed my decision with an irreversible surgical procedure. I’d like to keep it short and sweet, because “I don’t want to” should be reason enough, and no one is entitled to my private thoughts on the matter.

I’ve always known I didn’t want kids. And, like pretty much every other girl who knew this, I waited more than three decades before anyone started taking me seriously. Sure enough, lots of people don’t want kids when they’re young, and they change their minds when they’re older. Something about hormones kicking in, instincts taking hold, and, in not quite enough cases, being with the right partner, financially secure, and emotionally prepared for the trials and tribulations of properly planned parenthood. For me, the hormones clearly never kicked in, and the mothering instincts never took hold. I always knew they wouldn’t, because I’ve always been a warm, loving, nurturing person who simply doesn’t want to be responsible for bringing more humans into the world.

Warm. Loving. Nurturing. Not three words that immediately pop into the minds of most people when they hear the phrase “childless late-thirty-something woman”. But that’s it: I’ve never lacked warmth, love, or nurturing tendencies, and I think other people’s kids are awesome. Over my decade-plus of being a teacher, I taught hundreds of other people’s kids, and somehow managed to never make any of them cry. There were many who melted my heart, but none who made me want a mini-me of my own.

So you may be convinced I’m not a monster, and as a late-thirty-something, you may even be convinced that as the gate is closing, there’s not much chance of those hormones kicking in.

But do I feel complete without kids? Will I look back and see this as a missed opportunity? Well, I can’t say how I’ll feel in the future, but I can say that my twenty-something self was right about what my thirty-something self would want: a life full of opportunities to pursue dreams, and hopefully leave the world in slightly better shape than I found it. While many people arguably do those things and have kids, I feel that, for me at least, parenting would have to be the main priority in my life, and that it would therefore have to be my biggest dream if I were to pursue it at the (potential or actual) expense of all others. And no matter how many times I’ve revisited that question, children have never risen to anywhere near the top of my list of priorities. On that basis, I could not justify bringing any into this world.

And this is a heck of a world to be bringing kids into. A world where we’re passing down a trashed planet upon which we’re playing Jenga with the building blocks of life itself. A world in which the harsh reality of geopolitics and wars for resources mean some people’s kids get bombed while other people’s kids live in the lap of luxury and the rest are lucky if they muddle through as overeducated and underemployed, jaded and cynical before they’re out of their teens. Yes, that’s a bleak picture I paint, but stand there and tell me things are looking rosy, and I’ll happily provide a reality check. Just as I’d want to be sure of bringing my kids into a secure home – that is, financially secure, and emotionally secure, with two committed, loving parents – I’d want to be sure of bringing my kids into a secure world, in which they can have a stab at something resembling a bright future on a healthy planet. Adding more humans to our already overpopulated planet will only stretch our planet’s finite resources further, adding another set of feet whose western-sized footprint will further speed up the degradation of the biosphere. I can’t justify it.

But don’t get me wrong; I don’t feel I’m making a personal sacrifice by not having kids. Like I say, I’ve never wanted to have them. I prefer to leave the parenting of kids to those who feel parenting is their calling, and who are certain they can offer their children a secure start in life, and the prospect of a bright future. Hopefully those who do choose to have children will do their bit to ensure the planet they’re passing down is more liveable than the one they inherited from their own parents. I’ll also continue to do my bit on that score while lightening the load on us all.

Why I chose the most permanent, irreversible option

Of the women I know who have had tubal ligation surgery, all have had kids and decided they did not want more. I have yet to meet another woman like myself who fronts up about not wanting kids at all and backs their decision with the permanent solution of surgery. I know there are many more than just me, and hope that I’ll get to meet some others now that I’ve fronted up about my own choice. It’s only since talking about my own choice with others that I’ve even heard other women admitting out loud that they don’t want children of their own.

Of the women I know who don’t want kids, those who are sexually active opt for temporary forms of contraception – condoms, the pill, and the Mirena implant being the most common options. For me, condoms are simply a safety measure for not getting STDs, and aren’t rendered moot by any other form of contraception; they’re simply practical and sensible. The pill, however, is a chemical cocktail of hormones that simply doesn’t agree with every woman who takes it. I’ve had mixed experiences with various pills, ranging from no side effects to severe and frequent migraines. I’ve been on and off the pill for years at a time since I was 17, and came off it permanently when I was 29. I decided I no longer wanted to artificially alter the natural hormonal balance of my body, and after years of side effects, had grown increasingly skeptical of whether the benefits outweigh the risks. The Mirena has never been an option for me: like the pill it alters the body’s natural hormonal balance, but as an implant, it’s trickier to address adverse side effects.

So I decided that, for me, it made far more sense to go for what to many people seems like the more radical option: tubal ligation surgery. To me, the only thing that makes it seem more radical is its permanence. And if I’m sure of my decision, then a permanent solution seems fitting. What never made sense to me is to apply a temporary solution to a permanent decision, especially when that temporary solution has adverse side effects. So what seems like the more radical decision for many people seemed pretty straightforward and consistent to me: have one procedure, once only, and back my permanent decision with a permanent solution.

What getting tubal ligation surgery actually involves

I first dipped my toe in the water in January 2016, making a New Year’s Resolution to get the ball rolling for what I knew would be a long wait, with a fair few hoops to jump through. I was ready to face the skepticism, the attempted persuasion to try other options, and the potential judgment, not just of everyday people, but also doctors. It was actually easier than I expected. After I’d done some research into the nature of the surgery itself (keyhole surgery: 2-3 minor incisions in the abdominal wall to enable clamping of the fallopian tubes – relatively minor procedure, and no need for overnight hospital stay) and the potential risks (1 in 200 chance of failure, meaning pregnancy is possible… and chance of ectopic pregnancy is increased due to clamping of fallopian tubes….), and ascertained that the procedure could be done free of charge thanks to Medicare, I booked an appointment to see a doctor.

The first doctor I spoke to – a young Indian male doctor – first spoke to me about trying less permanent options, and strongly encouraged me to try the Mirena for a while before making a more permanent decision. I clarified with him that I was certain of my decision, and did not see a temporary measure as fitting for my permanent decision. He then ordered me a series of blood tests, a pap smear, and a follow-up appointment to ascertain whether my physical and mental health were conducive to going ahead with surgery. I think he just wanted me off his hands.

The second doctor I spoke to – a twenty-something young woman from South Africa – raised her eyebrows at my having been asked to run the gauntlet of tests. She looked me square in the eye, smiled, and said “you seem pretty sure you’ve made the right decision for you, and it’s only your decision to make.” She gave me a referral to the gynaecology department at the hospital right away, and was very encouraging of my right to make my own decisions, affirming that she was certain that by my mid-thirties I’d thought it through for quite enough years, and had my life – and my head – in order well enough to know what I wanted.

The third doctor I spoke to – another young woman, younger than myself, at the gynaecology department at Cairns hospital – was similarly encouraging and supportive. I’d waited almost a year for the referral to come good with an actual appointment, plenty of time to think things over further and solidify my decision. She remarked, with a mischievous twinkle in her eye, that I was by far the healthiest and most straightforward patient she’d seen all week, and that of all people I was the only one voluntarily opting for a childless future! She shook her head, and smiled as she signed off on the consent forms that backed my decision.

It took another year for me to actually secure a date for the surgery itself. I’d been warned that I’d be in for a wait, as the waiting list is triaged according to urgency of need. As my surgery was elective and not a matter of emergency for health reasons, I was way down the list; they prioritise those women who are in poor health and need to avoid pregnancy as a matter of life-and-death importance, and many of these women, apparently, don’t simply take charge of either their health or contraception. I was a rare case indeed.

Although I’m under no illusion that my pathway might have been littered with obstacles and potholes had I been ten years younger, I’m glad to say that I was taken seriously, treated with respect, and ultimately allowed to do what I chose with my own body. We truly are living in a different era. Literally. A friend of mine who had her tubal ligation after her second child 40 years ago told me she needed her husband’s written consent to go ahead with the procedure!

D-Day: the day I got desexed

I call it D-Day, the day I got desexed. Please excuse my humour if you don’t happen to share it; it’s mine to do with as I please, much as my body is 😉

Tuesday 30th January 2018. I entered the hospital at 7:15am, having not eaten since the evening before, and having reverently sipped my final drops of water at exactly 6am, the cut-off point before surgery. I’d scrubbed my body that morning and the night before with the Triclosan body wash they gave me to ensure no bacteria could survive on my skin and flourish in the tropical humidity to chuck a spanner in the works of my post-surgery healing. And I’d peed into a cup, and popped it into a sealed baggie out of respect for the nurses who would have to handle it.

After donning the ceremonial robes, aka rather roomy blue paper hospital gown (one size fits all…) and giant white paper undies (again, one size fits all…), I waited nearly five hours before I was finally treated to my fifteen minutes of slicing and dicing. I chose to spend much of that time in reflection over my decision, snuggled up in a dressing gown that had seen better days (better decades, perhaps?), and multiple pre-warmed blankets to ward off the hospital’s icy cold in which no germ shall have a chance at survival. Right up until about 11:30am I was painfully aware than I could, at any moment, opt out, and my cold feet would be taken seriously, and my decision honoured. Safe in this knowledge, I felt perversely even more secure in my decision.

Cairns hospital has a poor reputation, and I’d like to speak out in its defence here. My own experience was excellent. I felt safe, secure, well-respected, and well-informed at all times, and the staff were warm, friendly, down to earth, and supremely professional. Every single professional I worked with from beginning to end told me everything I needed to know, answered my questions patiently and precisely, and gave me ample time, as though they had all the time in the world for me. When I was finally brought into the pre-op room, every single member of my surgical team came in and spent a few minutes with me, each introducing themselves, explaining their role, informing me of what to expect, and asking if there was anything else I needed, or needed to know. I couldn’t have felt more secure or better treated. When a needle was inserted into my arm, I was told what it was for; when electrodes were glued to my chest, I was told why; and I was listened to when I explained I’m kinda allergic to the cold, and provided with extra pre-heated blankets and heatpacks, and the entire team were informed that I needed to be kept snug and cosy 🙂

When I finally went into the operating theatre things went slightly comical, as they decided not to wheel me in on the trolley I’d been lying on for the previous 45 minutes, but unceremoniously walk me in and hook me up to the IV and monitors in there. I lay down on the body-shaped table (it has moveable arms!) no bigger than a dentist’s chair, and the anaesthetist told me he was going to first give me a little something to relax me before putting me to sleep. I joked about my previous adverse experience with anaesthetic (a procedure in a Thai hospital where I wasn’t properly knocked out before they started operating…!), and then there was a short pause in which I felt very relaxed, and then I don’t remember a thing until I woke up an hour and a half later in the recovery room. I’d had general anaesthetics before, but this time was different – I don’t remember going under at all! No needle, no countdown, no slipping away of consciousness – just a complete mental blank from that pause after the anaesthetist got me all nice and relaxed!

The first thing I remember when I woke up all groggy from the anaesthetic was trying to focus on the clock to figure out what time it was. I recall trying to figure out how long I’d been asleep, and how soon I’d be able to go home. And then I realised how much pain I was in. I was given some water to drink, and after downing it coughed up an unexpected glob of phlegm, a side effect of having an anaesthetic-coated tube down my throat during the surgery. The nurse asked where my pain sat on a scale of one to ten. I think I said it was about a 4 – like the worst menstrual cramps I’d ever had. But shortly after I felt it had gone up to about a six or seven, and the nurse gave me a little more IV pain relief. She then returned with a little white pill for me to take that would cover my pain relief needs for a lot longer, but would take some twenty minutes or so to kick in. Shortly after, my pain levels were right up again, and I pushed the buzzer I’d been given to signal any need for immediate nurse attention.  For the first time in my life (I pride myself on my high pain tolerance…) I shamelessly asked for another dose of relief, which was administered immediately, and kicked in almost instantly. I found myself melding with the hospital sheets and feeling the most relaxed I’ve felt in my life, quite well aware of my pain and discomfort, but without a care in the world. Soon enough my breathing slowed and became inconsistent, and I found myself intermittently gasping for air, but not really caring whether I caught my breath; I’d become too chilled out to breathe properly of my own accord. The nurse quickly noticed where I was at, and hooked me up to a nasal tube, explaining that she’d noticed my breathing had changed, so she was going to give me some oxygen to get it more consistent. I remember being in total meta-mode, all observer and no substance, and commenting that “yeah, I’m so relaxed I’m not even breathing for myself!” and giggling to myself perversely before passing out for another hour and a half.

When I came to the second time around I remember an intense desire to get home as soon as possible, and made it my mission to convince the nurses I was ready to go. I summoned all the effort and coordination I could muster to sit up as much as I could and reach out with my right leg to hook my bag with my foot (it was sitting conveniently at the foot of the bed), dragging it far enough for my hand to reach it without having to use my sliced and diced abdominal muscles for support. I remember my meta-self commentating the whole while, noting that under the influence of anaesthetic and powerful opioid analgesics that I’d devolved into a social media-obsessed teenager, as my first impulse was to reach for my iPhone and make contact with the outside world via Facebook and Snapchat. I snapped a hospital bed selfie, and broadcast my drugged up grogginess, ripped hospital gown, bedhead and all, to the world of Facebook and Snapchat. Then I paused before texting for friends to get ready to pick me up… I needed to make some calculations: how many minutes or hours until release? What should I tell my friends?

The nurse gently urged me to hold my horses and wake up fully before trying to do a runner. I giggled over how far I’d likely get, staggering about in an opiate-induced and semi-anaesthetised stupor… I’d be lucky to find my way to the lift, let alone get out of the hospital without anyone noticing! She offered me drinks and snacks, and I settled on apple juice, commenting that ravenous though I’d been before surgery, I’d now sadly lost my appetite and couldn’t stomach caffeine on empty. I always seem to offer up more information than is really warranted… After downing my juice, I was allowed to get dressed behind the hospital curtains (I didn’t care about those – I wasn’t with it enough to notice any of what was going on around me other than the distressed woman who’d come over to chat through her worries about her daughter with me as they’d waited three days for her ovarian cysts to be operated on…). All dressed and ready, I was led out to what I nicknamed the departure lounge, where I was instructed to sit and wait, hydrate as much as I could, try to pee, and then have my blood pressure tested one more time before I’d get the green light to go home. My first attempt at peeing was unfruitful, and I staggered back to my armchair with remote-controlled footrest, shaking my head and pouting at the nurse in charge of my departure…

When Bridget and Geoff arrived to take me home, I had a last swig of apple juice, managed to produce pee on demand, had a couple of false starts at a blood pressure reading before I was able to sit still enough to do it properly (it’s pretty uncomfortable trying to sit up without the use of your abs…), and then waited patiently while my friends were instructed as to how to properly care for me post-release. I would’ve pirouetted on my way out if I’d had the coordination to do so.

On the way home we swung by the pharmacy to fill my prescription for Oxycodone (yay for that invention – I savoured every morsel of how delicious an opioid-induced dreamlike state feels!) to add to my swag of Naproxen, Paracetamol and Ibuprofen. Once home, Bridget lined up my pills and made me take them in front of her so’s we’d all be on the same page about what I’d taken and when, and gave me explicit instructions as to what to take next, and when to take it, saying she’d be back within the hour to check on me. Other friends also checked in on me, but I didn’t let anyone come over to actually supervise me taking meds or laying about like a ragdoll, drifting in and out of consciousness, because I prefer to dribble into the pillow without witnesses. I actually didn’t take any more meds (I felt I didn’t need any more pain relief and was plenty grogged up enough as it was), and that evening and night passed in a dreamlike blur of muted pain and delicious deliriousness. I experienced what it felt like to have not a care in the world, and a sense of total timelessness, interrupted only by a bedtime call from Bridget insisting that if I were to pop that second Oxycodone at any point, even at 4 in the morning, that I let her know so she could scurry over to supervise my breathing technique.

My recovery from surgery

I’ve always kind of prided myself on being extremely healthy and very fit, and expected a speedy recovery from surgery. So far I haven’t been disappointed. I’m five days into my recovery, and going great guns. I think there’s something to be said for preparing oneself physically as well as mentally prior to surgery, as a fit and healthy body bounces back faster.

I’ve managed exercise every day since surgery, and have gradually stepped it up each day without overdoing it. It’s important to exercise where possible, as exercise promotes the bloodflow necessary for healing; simply put, an active body will heal faster and more thoroughly than an inactive body. The day after surgery I only managed to walk about 4km, and took a fair bit longer than I normally would, feeling slow and clunky, and very frustrated. Every day since then I’ve managed at least 10km per day, getting faster and smoother each day, and pretty much back to normal speed as of today. I know 10km might sound like a long walk to a lot of people, but for me it’s the minimum to feel like I’m being active. I run 8-10km 4-6 days a week, and match it with 8-10km of walking every day. I figured just the walk would be a reasonable compromise while I work my abs back up to being able to handle a run again. Once I’ve got back into running, then I’ll try lifting weights at the gym again, but for now, weight has to be at a minimum, because I feel the strain even when I carry a bag of groceries from the supermarket that’s less than a 10 minute walk from my house.

Although exercise has got back on track quickly and easily, eating has been a slower burn. For the first couple of days I really didn’t have any appetite, and just ate arbitrarily to ensure I kept my energy up and my body well nourished for the sake of rapid healing. I was grateful for having prepared in advance with home-cooked freezer meals so I wouldn’t have to put time or energy into figuring out what to cook when my body wasn’t telling me what it wanted. Now, five days in, my appetite is back somewhat, but not back to normal yet. It might be a case of not really kicking in until my activity levels are fully back to normal, which seems to make sense. At the opposite end of things, I’m glad to say peeing got easier, but, uh, I went almost two days before I was able to poo! I feel this warrants a mention because I’m a super-regular vegan, and this ain’t normal. Dehydration causes constipation, and I was afraid of needing to strain those poor abs when they need to be as rested as possible! So, on Thursday, I resorted to coffee… Caffeine is your friend when you need to go to the toilet, and it worked a treat – I’m regular as clockwork again, and feeling fresh as a daisy 😀

I’ve been able to do everything as normal around the house since the second day after surgery, and being that I’ve mostly been stuck at home, I’ve made damn sure to keep it clean! Nothing like getting cabin fever in a filthy cabin…! I think I overdid it on the first day after surgery, and that evening and the next morning I was in a fair bit of pain, and needed a lot of rest. I realised I could’ve used one of those well-intentioned friends to make a few of my trips up and down stairs for me to save me the strain… Still, I managed, even if I did end up spending all of Thursday morning crashed out on the sofa, my only activities being sweating and dribbling. Groggy mess that I was, I managed to miss every single phonecall made to me that day except the most important one: the check-in from the hospital, which woke me up with a jolt from my sofa-stupor about one in the afternoon. I felt like a kid caught with my hands in the lolly jar, and did my best to feign a lucid state, convincing the nurse that all was fine and dandy, and life was returning to normal nice and quick. I felt guilty for being so desperate to be allowed to take independent care of myself that I’d white-lied my way to being left alone (I even lied and said I had someone looking after me, because I was supposed to, but really wanted to be left alone…)… and resolved immediately to get my shit together, go for a walk, and get me some social interaction to combat the cabin fever that was setting in.

As far as pain goes, I think I’ve got off lightly. I’ve honestly quite enjoyed experimenting with the cocktail of meds and their delicious dreamlike effects, but when the opioids ran out, I’d also run my course with them, feeling well ready to be totally lucid again. The second day after surgery I was only taking half my painkillers, as I didn’t feel I needed as much as they’d given me, and wanted to have some sense of where my body was at so I could gauge whether I was overdoing it at any point. I completely stopped taking pain relief on day four, and have been fine. I feel a little pain, but nothing to complain about, certainly nothing stopping me from going about my day or sleeping soundly at night.

My belly is still somewhat swollen, but not quite the watermelon-belly it was for the first couple of days. Right now, this is my biggest gripe. It’s ironic looking three months pregnant after a desexing op. But I’m assured the swelling will have gone down completely within two weeks, and I’m already fitting comfortably enough into my clothes, so perhaps I’m making a big deal about nothing because I’m a tad vain and don’t enjoy the look of a slightly rounded potbelly on this petite body of mine. I’m confident the incisions themselves will heal well, as they look nice and neat, and not likely to scar severely. They’re still covered with a thin layer of superglue that’s gradually peeling off at a pace consistent with recovery. Superglue, by the way, is an absolutely genius way of dressing wounds – especially here in the tropics. It’s waterproof, doesn’t need changing, and comes off when it’s ready, about the same time the stitches fully dissolve. Perfect! Medical procedures have come a long way, and I’m so grateful to be living in this day and age!

As I type, I’m feeling ambivalent about the Sunday night blues setting in… I’ll be back at work tomorrow, and life will be forever changed for me, although I’ll seem just the same on the outside to anyone who doesn’t know. Even though I love my work, I still get the Sunday night blues because I so enjoy my downtime on the weekends… but I’m going stir-crazy at home, so ready and champing at the bit to get back to normal, and grateful for the privilege of being able to.

The future from here onwards

Surgery, for me, marks a watershed moment in my life. Not only am I medically unable to have kids, but I am now also off the hook, practically speaking, from anyone trying to change my mind. With pregnancy now a practical impossibility, gone also is the possibility that any man I may become romantically involved with will waste energy on trying to persuade me to mother his children. Gone also is any point in anyone else trying to convince me that I should just give it more time for the mothering instinct to kick in before I write off the option of having kids.

While many folks may not understand my choice to make such a permanent and irreversible decision, for me it’s been immensely liberating. The psychological freedom I feel from this moment onwards is far greater than the physical freedom to do as I choose with my body. It is not simply that my body is mine to do as I please with, but my future is mine to do as I please with. And I am grateful to now have an impassable boundary in place whereby no one will ever again be able to disrespect my choice, my decision, my sovereignty. I am freed from the possibility of anyone ever again trying to persuade me to prioritise children over and above any other goal or dream I wish to fulfil in my short and precious life, and that is priceless.

 

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