I am 21 years old and very confident that I never want to give birth myself, but may one day look into adoption. I have seen 8 doctors about getting my tubes tied and have faced a lot of discrimination for wanting this procedure. I did cave and get an IUD, in 4 years I am going to have to get a new birth control method. Any ideas on what to say to doctors in order to convince them to preform this completely legal and safe surgery?
(Please excuse the long answer, I could talk forever about patient centered care and shared decision making.)
Issues like this are so common in women’s health, and I’m so sorry you’ve struggled in ‘convincing’ your doctors that you know what’s right for yourself. To quote one of my heros, TRUST WOMEN!
I like to say – ‘I’m your doctor, not your mom. It’s my job to tell you about the risks, benefits, and alternatives to surgery. It’s your job to tell me how those risks, benefits, and alternatives fit into your life, and which r/b/a you value the most.’
The fact is that ‘regret’ is common after a tubal ligation. Many physicians struggle with this, and are understandably distressed that some of their patients may go on to regret their tubal ligation. This manifests itself in some physicians refusing to perform tubal ligations in some women – due to age, or number of children they’ve had. While I can understand the prospect of an unhappy, heartsick patient giving a physician great pause, I am committed to the concept of ‘patient-centered care’. I come to work every morning (and lets be honest, many nights) with the understanding that I can never fully comprehend the complexities of a patents individual situation, and I have to trust that each women is the expert on her own life. I trust women to make the right decision for herself.
In my practice, any time I perform surgery, we talk about the risks, benefits, and alternatives to surgery. In the case of tubal ligation, regret is a risk of surgery, and I discuss it openly and honestly with my patients.
If a patient has heard what I have to say about the risks (including regret), benefits (for example, permanent birth control), and alternatives (iud, pills, etc) of sterilization, and she voices a desire for sterilization at the end of our two-sided conversation, I am comfortable performing the procedure.