tubal ligation/ c-section

June 29, 2007 8:28 AM

Tubal ligation during c-section?

Has anyone undergone tubal ligation during a c-section and experienced complications/ extra pain during recovery?

I'm also interested in tubal ligation stories in general...

I can say firmly that I am certain about not wanting anymore children after 3- so I won't have regrets about the permanence. I am interested in related health consequences, though.

posted by mistsandrain to health & fitness (17 comments total)

No answer from me, but a query that's bound to come up ... Are you in a long-term-relationship? If so, is a vasectomy for your partner an option?
posted by and hosted from Uranus at 8:31 AM on June 29, 2007

mistsandrain, my wife had the procedure done after our third, and no complications.

ahfu, I'm sure it's an option. But sometimes it just makes sense to have one operation instead of two...
posted by pardonyou? at 8:35 AM on June 29, 2007

My sister had a tubal done during her last c-section. She had no problems convincing her doctor (gave birth to twins, got pregnant less an two months after giving birth - funny enough on about the same day that the twins were due). The doctor actually said it was easier to do everything at once. My sister said that the recovery process was about the same as the c-section from the twins. However, I'm not sure how much more traumatic a c-section from twins may be, so the pain could have been the same simply because the first time around it as a little worse than typical.

However, she did say that the promise of having no more children made the c-section recovery significantly easier.
posted by banannafish at 8:42 AM on June 29, 2007

Oh! And to add more - I know my sister asked ahead of time and got it cleared so that they had the surgery room prepped for a slightly longer procedure, but one of my co-workers asked for it to be done while she was giving birth and the doctor balked slightly more but did it anyway.
posted by banannafish at 8:43 AM on June 29, 2007

My wife recently had this done. The only difference from her prior delivery-also a Caesarean-was that she was in the OR another half hour or so.

This was about nine weeks ago. She has experienced no additional pain or complications versus the first time. From my perspective, it's been completely straightforward.
posted by Chrysostom at 9:07 AM on June 29, 2007

Had it, no problems.
posted by thinkpiece at 9:28 AM on June 29, 2007

I had a tubal when I was 21 (33 now and nooooo regrets). Despite having to sign an entire forest's worth of paperwork, my doctor was rather okay with letting a single, unmarried, never had kids girl make a decision of this size.

The actual process:
The doctor went in through my belly button and a small incision about 6 inches lower, did the deed and let me go. It actually took longer to come out of the sedation than it did for the surgery.

Recovery was very easy. I had the procedure done on a Thursday and by Monday I was back at work/school. The only thing I had that was a negative was reaching to the top shelf the day after. Thought I was gonna die. No really. I haven't really had any health issues as a result. Still normal periods, still pms, just no possiblity of baby. It's about six weeks before you can have sex again, but with the c-section I think the recovery time is a little longer.

Also, discovered that the first period after I quit the pill was incredibly brutal. Although since you are pregnant that might be a whole different ball of wax.

Some doctors are hesitant because they don't want to be sued when you change your mind. However since you already have children, your experience may be easier than mine. I had to go to seven different doctors before I got one to listen to me and be willing to do it. You also want to make sure that they are not just cutting the tubes. If they just cut, the tubes can re-grow. A cut and cauterize or the metal clips are much more sure fire. But then again, anything can happen and sometimes pregnancy is one of those things.

Good luck.
posted by teleri025 at 9:36 AM on June 29, 2007 [2 favorites has favorites]

But sometimes it just makes sense to have one operation instead of two

Sensible indeed. For my wife and I, though, vasectomy seemed (and turned out to be) so completely non-invasive that we decided it was the less risky choice even though she was already "opened up" for the c-section. It also allowed us to put off thinking about permanent birth control for a couple months until life with baby became less hectic. /minorderail
posted by and hosted from Uranus at 9:41 AM on June 29, 2007

Tubal ligation at the time of c-section is offered much more commonly in the US than in Europe. The two main reasons for not doing it are:

1. Higher rates of regret when the decision is made during pregnancy. (And rates of regret are very high anyway; around 25% at one year.)
2. Higher rates of failure at c-section, because the tubes are oedematous and swollen.

In terms of immediate surgical complications, the c-section carries all the risks, not the ligation itself, so you shouldn't notice any differences. It takes only 5-10 minutes extra to get done. Having it done in one go is definitely slightly safer than having a subsequent laparoscopic sterilization. If I personally was in your position I would consider a MIRENA coil when you have finished breast feeding instead.
posted by roofus at 9:43 AM on June 29, 2007

Wife had it done during the section and it was no problem, (says the husband). Make sure if you're giving birth at a Catholic hospital that you get cleared for the tubal well in advance. The nun whose job it was to ok our request was out of town up until _right_ before the section, and we almost didn't get it in time.
posted by monkeymadness at 9:56 AM on June 29, 2007

My wife did the tubal after the birth of our second. (it wasn't during a c-section, though the birth itself was a vbac.)
No health issues from the tubal. That was 16 years ago.

In what kind of medical system is it necessary to get the approval of a nun before having a procedure?
Many (most? all?) Catholic hospitals won't do any sort of contraceptive operation without approval. It's a private hospital. It's Catholic. The Church still frowns upon contraception. Thus...
It's not a medical decision. It's a dogmatic decision.
posted by Thorzdad at 10:25 AM on June 29, 2007

Roofus: It's worse than you think.
posted by footnote at 10:39 AM on June 29, 2007

Had the exact same experience as teleri025, with recovery, timing, everything, except that my gynecologist did not hesitate to allow me to get that done. I have had a few surgeries and that one was by far the easiest to get over. I slept all afternoon after the surgery (thanks morphine) but the painkillers they gave me (hydrocodone and 800mg ibuprofen) did the job so well I kept forgetting to be careful with myself.

I strongly second her experience of the next period, though; it was definitely extra heavy and painful. I was mildly wary because of what I've seen online about tubal ligation syndrome. I have experienced changes with my period since the surgery--they're shorter, heavier, and occasionally crampy whereas they used to be pain-free--but they found endometriosis during the surgery, so I guess I'm dealing with that now. I'd had no idea.

Overall, though, no regrets. Contraception has always been a pain and it's wonderful not to have to worry about it anymore. It was definitely worth the investment.
posted by zebra3 at 11:12 AM on June 29, 2007

I had one done almost two years ago now, while I was still on the table from the c-section. Right before actually doing the deed, the doctor asked me three times if I was sure. I agreed and everything seemed to be fine. When they started to put in the internal stitches, my epidural wore off. I would not recommend going through that, or the anesthesia they used to put me under once they heard me.

The lack of stress regarding birth control has made things much easier. The recovery time and pain after after this c-section versus the first was worse, but I expected that because this baby was healthier and (much) larger.

The first four or five periods I had were pretty bad, including nausea, but my period has always been bad. It's still worse than it used to be, but it could be much worse.

Still...if I had my choice now instead of then, I'd have my husband get a vasectomy. Every time my period is even a few hours late now, or if I have any tenderness in my breasts, my first thought is "What if it didn't work?" It's a terrifying thought, because of the medicine I'm on, that could potentially harm a fetus. I still would like to have another baby, but hopefully I won't. Right now, I keep the baby lust away with thoughts of nieces, nephews and eventually, grandchildren.
posted by mitzyjalapeno at 11:42 AM on June 29, 2007

I had it done with a second C-section. No problems whatsoever. Although, around 8 or 9 months, around the same time my second child was weaning, I regretted the decision. But not for long. I think I was especially emotional because of hormones.

The recovery was a cinch. They say recovery is better with each consecutive c-section, and they were right. I didn't have a problem at all. I was up that evening, walking around my room, taking care of the baby, and had only a small amount of discomfort.

I did have a hysterectomy three years later because of a precancerous uterine tumor. Completely unrelated if you ask me.
posted by LoriFLA at 12:06 PM on June 29, 2007

You can find my thread on tubal ligation here along with my story.

Still no regrets, no significant health consequences. I was not on birth control pills at the time so the first period post-op was a non-event. I was warned by my gynecologist that my period would probably change but she couldn't predict how. Mine is now slightly shorter in both duration and recurrence.

One thing I should mention is that many doctors are more willing to give a tubal to women who have had children than to women who have not, but statistics seem to indicate that women who never wanted children are less likely to feel regret than women who have children and want to stop at a set number. (I state this mostly for the benefit of future readers. Far be it for me to criticize your decision after watching my GP choke out the world's weakest "Congratulations" after she realized that her referral actually gave me the procedure I asked for.)
posted by deadlypenguin at 1:03 PM on June 29, 2007

Anecdotally...
A good friend/coworker had a tubal almost 4 years ago, soon after the birth of her second child. Last month she felt weird, took a EPT test, and it came back positive. She had an ectopic pregnancy. Sperm could get up into her fallopian tube, but the egg couldn't get down to her uterus. She wishes she would've had her husband get a vasectomy as well.
posted by clh at 4:11 PM on June 29, 2007