Why a Tubal Ligation?

I’ve always known that I didn’t want children. Or rather, I’ve known since the moment that I realized it was an option.

I grew up in a rural, conservative area where raising a family is an expectation. The only people I knew who didn’t have children were those who were not able to. Still, by the time I was 14, I had decided that I never wanted to be pregnant or have my own biological children. I didn’t particularly like kids under the age of about 10 or 12, and I figured that it was more socially responsible to foster or adopt anyway.

After I moved to the city for college (and was exposed to a wider range of people and ideas), I realized that I could choose to simply not have children at all. I could focus on a career. I could travel the world. Finally, my future seemed exciting — and most importantly, right.

I did a lot of research on sterilization and I heard the horror stories of not being taken seriously. I lost hope that a doctor would trust my ability to make my own reproductive decisions before I was in my late 30s. So, when I became sexually active at 22, I simply went to Planned Parenthood and started oral contraception.

My experience on hormonal birth control went from scary (depression, anxiety, & suicidal thoughts), to manageable (breast/nipple discomfort & possible decrease in libido), to potentially destroying my life & relationship. My depression was back, my sexual desire & arousal was non-existent, my ability to lubricate naturally had stopped, some of my favorite artificial lubricants suddenly started to burn, and insertion/orgasm ranged from uncomfortable to downright painful.

I was desperate to find a solution to my problems — and getting my body off of hormones seemed like the perfect place to start. A friend recommended me to a gynecologist who believes in reproductive autonomy (Dr. Kasper in Indianapolis), I mentioned permanent sterilization at my annual exam, and we scheduled surgery. Simple as that.

The rest of this post will be a chronicle of my surgery experience, primarily for those who want to know what to expect when going in for a tubal ligation.

The Night Before

The night before surgery, I did all of my prep work. I avoided food & drink after midnight. I showered with Hibiclens, removed my dark nail polish, and took out all of my piercings. I tried to do my “deep breathing” homework, but got distracted and figured that falling asleep to some ASMR videos would be just as helpful.

Surgery Day: Pre-Op

5:30 AM – We arrive 2 hours early to the hospital, as per my instructions. I check into the registration desk to receive my hospital bracelet and sign my consent form. Then I take my paperwork down to the basement where I give permission for the doctor to notify Andrew (my partner) when surgery is over. We sit down in the waiting room and wait.

6:00 AM – We get brought back to my pre-op room. I get asked a lot of questions about my medical history, current medications, and allergies — which I will repeat several times to multiple nurses, residents, and fellows throughout the morning. I pee in a cup so that they can do a last-minute pregnancy test. I wipe my entire body down with wet wipes that the nurse provided for me and then put on my hospital gown and grippy socks. I had started my period the day before, so I also receive the most ridiculous & uncomfortable pair of mesh underwear that absolutely will NOT cooperate with a maxi-pad with wings.

My nurse comes back to put my IV in, for which I promptly request that all needles stay far, far away from my hands. She inserts it into my forearm instead, near the radius bone — which might not have been much easier. From then on, it’s a waiting game.

7:00 AM – Shortly before my doctor arrives, I get informed that she has started to do bilateral salpingectomies in place of tubal ligations. (Recent research is showing that it may help to prevent ovarian cancer in the future. And removing the fallopian tubes altogether obviously reduces the risk of ectopic pregnancies.) Thankfully, I was prepared for this question.

A friend of mine went in for a tubal with the same doctor just a few weeks before and agreed to the salpingectomy. I had spent the last couple of weeks trying to get information from the nurses (who insisted that a last-minute change would never happen) and compare coverage through my insurance company. My friend & I are still waiting for our respective bills, but from what insurance told me, the salpingectomy would not be considered preventative care according to the Affordable Care Act — and would therefore not be covered 100%.

I explain this whole confusing & somewhat disappointing ordeal, my doctor agrees to the original plan (a laparoscopic tubal ligation with cauterization), and I am wheeled off to the operating room.

7:30 AM – I think that the nurses were a little surprised that this was my first time having surgery, because of how calm I seemed. My bravery only softened a little once I was actually inside the operating room; suddenly, I started shivering. To be fair, they had told me that it would be very cold and would soon be covering me in blankets. But it didn’t seem that cold.

The room is full of medical staff, all working swiftly on their individual tasks. They push my bed as close to the operating table as possible and help me shimmy over. They put special wraps on my legs to maintain blood flow. And then they inform me that they have started my anesthetic. It only takes a few moments and I am out.

Surgery Day: Post-Op

9:30 AM – I start to wake up gradually in what I assume is the Post-Anesthesia Care Unit. I don’t remember much aside from overhearing two nurses: One asks what procedure I had done, the other responds “She had her tubes tied. Yay!” I smile.

10:00 AM – I am somewhat awake and they wheel me back to my private recovery room. My nurse from before is there and asks about my pain; I tell her I’m probably only at a 4. She then asks if I want my “husband” to be called back. I giggle on the inside, but am still too sleepy to correct her, so I simply say yes. Once he’s there, she gives me some Sprite & crackers and he helps me eat & drink. (I don’t remember much of what we talked about during this time, but I know he was cracking jokes because I gave him the bird when my nurse wasn’t looking.)

I can’t leave the hospital until I pee, so I ask for another Sprite and wait. Eventually, I think I can go and my nurse helps me out of bed and down the hallway. I’m surprisingly unsteady on my feet and very slow. My nurse confides in me that her & her husband also decided not to have children and I instantly develop all the warm fuzzies for her. She asks if I think I’ll need help in the bathroom, but I insist that I can manage. I pee, she helps me back to the room, and then it’s Andrew’s job to help me get dressed in my pajamas again.

Thankfully, my friend had suggested that I bring my own baby wipes with me, so we’re able to get most of the orange surgical stains off my skin. I have 3 incisions: one on either side and another inside of my belly button.

11:00 AM – My nurse sits down with both of us to go over my discharge & recovery instructions. Andrew signs the paperwork, since I am still a little loopy. Another nurse arrives with a wheelchair to transport me back up to the hospital pharmacy for my anti-nausea & pain medications.

My prescriptions aren’t quite ready yet, so Andrew & I decide to relinquish the wheelchair and wait by ourselves. When they’re ready, he insists that he will take care of it so that I don’t have to move around more than absolutely necessary. He then helps me shuffle my way back to the front doors of the hospital and finds me a place to sit while he gets the car. After a long morning, we’re finally on our way home.

For details on my recovery, the amazing effects of going off hormonal birth control, and potential insurance battles… click here!