A word about permanent sterilization.

And now for something completely different.... I feel like this post is sort of a non-sequitur, but then I decided this is my blog and I can post what I want. So there you go....

In my capacity as a physician, I sometimes advise patients about permanent sterilization. Pregnant patients ask about it during their prenatal care and occasionally men will talk to me about it. I feel like I've had several conversations about it recently at work and I find that generally people who are considering it haven't always thought it through.

I am not opposed to it, by any means. And certainly, many of my current thoughts about it are colored by my own experiences with infertility. It is hard for me to even imagine right now ever considering having this done, but that is mostly just me and my issues.

What I would advise, though, is not just to think about if you are through having children and if you are satisfied with the way your current family is. This is a permanent procedure and while it is theoretically possible to reverse, it is not an easy procedure and there is no guaranteed success. One of my attendings advised that we should make sure people think about some of the possible scenarios that could arise. What if one of your children dies? What if your spouse dies and you remarry? What if there is divorce?  Obviously we cannot see into the future and can't plan for every possible scenario, but I do hate for people to rush into it. I have seen several times women in their early twenties get a tubal because they have already had three or four kids by different fathers. I don't know what will happen to these women, but I wonder if they get their act together, marry, and have a stable relationship if they will still be happy with their decision.

I just hope that couples really think about this decision and pray about it. And please, please do not take this as a criticism of you or a loved one if they have had this done. Again, I am not morally opposed to the procedure. I have several patients for whom I thought it was a good idea, who struggled with severe depression during pregnancy and postpartum or had other significant health issues that made pregnancy more complicated. I know plenty of people who have this done when they were "done" having children, and I'm also not opposed to it in those circumstances either. Like with any big decision, this is one to ponder and pray over.

...stepping off soap box now.....

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