birth control alternative

satanmyselfandi  asked:

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.

I would appreciate it if (well-meaning) Catholics would stop spreading the myth of “you can only space your skids if you have a grave/serious reason to do so”.  The words serious and grave are never used in Humanae Vitae when explaining reasons that would allow a couple to use NFP to avoid pregnancy, whether temporarily or permanently.

Humanae Vitae, the encyclical that goes over the Church’s stance on artificial birth control and alternatives to child spacing, refer to “well-grounded reasons for spacing births” for reasons relating to the physical and psychological health of one or both parents, or of external circumstances surrounding their ability to care for their family.

This means you don’t have to face absolute poverty or fatal medical conditions to discern with God whether you should put off the next baby. 

It could be something as simple as, “I am unable to handle my three very young children already, I want to make sure I am in good mental and physical health for my next pregnancy” or “My husband and I are on the rocks right now, we need to focus on our marital problems and work on fixing them before we add another little one to the family”. 

Your reasons for spacing your children need not be extreme, serious, or grave, only well-rounded. And it is not our place to judge a family’s size whether they are big or small. 

Birth Control and Blood Clots

alternatively titled: my life for the past year

Three-hundred and sixty-five days ago, I went to the Emergency Room. It was around four in the morning, and my dad was out of town, and my little brother had band camp approximately four hours later.

He didn’t wind up going. 

See, for the past week or week and a half, I had been in pain. A lot of pain, actually. It started with a feeling akin to bruising your tailbone, or when you’ve been sitting down for too long. I didn’t think too much of it at the time, since we had just come back from a long road trip, and maybe I had been sitting down too long.

I hadn’t. 

I went to the doctor for a couple of shots and a staph infection from a nasty pedicure, and my pediatrician couldn’t find anything visibly wrong with my rear. She poked and prodded and generally made me feel like a slab of pork, but sent me to a Cook Children’s imaging center for some x-rays. By this time, the pain was moving, radiating from either my tailbone or lower back. The x-rays didn’t find anything, and I began attributing the pain to a side effect of staph. Then the swelling started. 

Three-hundred and sixty-six days ago, I was taking selfies, complaining about how I was stuck on my bed since my leg was so swollen that I couldn’t get up, let alone make it down the stairs. I went to bed that night knowing I had a doctor’s appointment the next afternoon. 

Never did make it back to the pediatrician. 

I woke up around two with pain in my left leg unlike anything else. I hobbled downstairs, took an Advil, and then tried to sleep on the couch with an ice pack wherever it hurt. After an hour of that, I (while texting m0toko, bless his heart) made my way to my mom’s room and tried to sleep while she rubbed my back and wiped away my tears. But, after I couldn’t for the life of me fall back asleep, she rounded up my brother and I and got us to the nearest hospital. 

A few hours later, I was diagnosed with Deep Vein Thrombosis, otherwise known as a blood clot. What I didn’t know, and didn’t ever think to check on, was that birth control, which I had started at the beginning of summer for monstrous cramps, is a clotting factor. Specifically, estrogen is. 

I began blood thinners immediately. Two shots of Lovenox in my stomach (God, was that an ordeal) twice a day–as close to twelve hours apart as possible. No more sleeping in, and no more doing fun teenage things at night, like sleeping over at friends’ houses. Unfortunately, it wasn’t working, and six weeks later, the clot had gotten bigger. Although I had (miraculously) not felt a single twinge of pain, I started taking the grown up equivalent of Lovenox: Xiralto. 

Nine months of hematologist visits, blood work, ultrasounds, and unadulterated fear at any pain in my leg later, I was basically home free. The clot wasn’t gone, but had become scar tissue, and my body had learned to work around it. For all intents and purposes, I was fixed. 

I can never take the pill again. Estrogen based birth control is so very out of the question for me, which means my options are somewhat limited in the future. The point of me sharing this isn’t to scare you out of birth control, or to tell you that it’s a bad idea, because for many women, it’s a great solution to very real problems. The point is, when you start estrogen based birth control (or, I would imagine, hormone therapy for trans women) listen to your body. Read the instructions and side effects for your pills, and be very aware that leg pain means you should go to the doctor as soon as you can. Catching something like this early is always better. 

I spent three days in the hospital, and another week not being able to walk without assistance. Nobody deserves to go through that, so I hope that you all take this into consideration. Talk to your gynecologist, and look into your family history. While in my case, clotting wasn’t genetic, it certainly can be. Be safe, and, above all, know yourself.