Dear Dr Mitchell,

Do I need to give birth to qualify for having my tubes tied? Or can I just request it? I am 100 per cent sure that I do not want children, and at 33, would like this permanent method of birth control.

Tubal ligation is a permanent method of contraception. This is done by cutting the tubes and then suturing the ends, or putting rings or clips around the Fallopian tubes to effectively seal off both ends of the tubes where the rings or clips are placed. In some cases where the amount of tube that is destroyed is minimal and the tube is not damaged by infection, a reversal of the procedure can be achieved successfully. However, there is an increased risk of an ectopic pregnancy which can be life threatening if it is detected late or managed inappropriately. This is a condition where the fertilised egg is lodged in the damaged area where the Fallopian tube was repaired. This can cause a rupture of the Fallopian tubes and massive blood loss.

I know you have said that you are completely sure that you do not want to have children and that you are now 33 years old. However, your situation can change and you could move on to a new relationship where your partner wants children. It is always good to have options even if you do not plan to have children. There are other methods such as the use of the Intrauterine Contraceptive Device (IUCD). There are IUCDs that last up to 10 years and can effectively provide the contraception that you need long-term. There is also the implant that is inserted under the skin and this is effective in preventing pregnancy. These long-term reversible options will allow you more time to be absolutely sure that you do not want to have a child even if your circumstances change.

You do not have to deliver a child to qualify for a tubal ligation. It is a personal choice, but the doctor doing the procedure has to be absolutely sure to counsel you about your options since this is considered a permanent procedure. With ready access to invitro fertilisation, you can still have a child after tubal ligation. This would involve stimulating the ovaries to produce eggs, retrieving the eggs under ultrasound guidance, fertilising them, and putting the embryo directly into the uterus. This can be expensive but it is a definite option if you change your partner later on in life.

With full informed consent you can definitely do a tubal ligation without having any children. You could also consider having your partner do a vasectomy since this is a much simpler procedure and is just as effective as the tubal ligation. This is also a permanent procedure and should only be done if he is absolutely sure that this is what he wants.

Consult your doctor who will advise you further.

Best regards.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Avenue, Kingston 5 or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.