Getting tubes tied vs IUD

[dottedcircles.livejournal.com]

Hey ladies,

First I want to say thanks for existing.. You are all so supportive and sweet. I love this community!

My post is behind the cut because it's lengthy, I don't want to stretch your friends lists too much...




I just found out I'm pregnant. I am going in to the Dr. tomorrow for a "real" pregnancy test and to talk about all my options on prenatal care. I'm really, really excited! This is my first (and hopefully only) pregnancy.

I have been wondering about getting my tubes tied and if that is even an option. I will be 24 after delivery, I am tad bit overweight and not really interested in having anymore kids. This one wasn't planned, and it's not that I don't want any more kids, I just don't want my more of my own. I plan on adopting or fostering in the future.

I do not have health insurance right now and plan on going on the Oregon Health Plan. My girlfriend has also given me the option on going on her health care as her domestic partner. I haven't decided which one to chose yet though. Does insurance (state or otherwise) usually cover this procedure?

What is your opinion on this procedure at my age? I know it's permanent, but I don't think I will change my mind. My mother had this done after me (age 23) but she already had 3 kids.

Does it affect your horemones at all? I have been known to get really down with even the slightest change in my horemones. (Main reason I'm not on BC, have had some really scary episodes with depression.)

Now about IUDs..

I have been thinking about getting one for a while. When I was 19 I went in to PP in California and they told me I had to have at least one pregnancy to qualify. I spoke with a friend in Oregon last year and she said that they didn't ask for that qualification in Oregon. That doesn't really apply to me anymore I guess though... Have options changed?

I have been worried that it will affect my sex life. I usually have orgasms by really deep intercourse against my cervix. I have been with one woman that had an IUD and I was actually able to feel it poking out of the cervix. Is that normal? I have a feeling that it will effect me in such a way that I won't enjoy the thrusting against my cervix anymore.(I'm also concered about this after pregnancy, like my cervix won't be as sensitive as before.. Did you notice a change in the way your cervix felt pleasure after you delivered?)

All the questions I'm looking for answers to are in bold for easy replying.

Thanks for taking the time to read this!
xoxo
Mamma Co!

Comments

[wife-and-mom.livejournal.com]

I have been wondering about getting my tubes tied and if that is even an option.

I was 25 when I had my son. They asked me before and after the baby was born if I wanted a Tubal Ligation done which I said no. I don't think age should really matter, I think that is entirely your decision. Of course, the doctor will probably sit down and discuss your options with you before you make any decisions that are permanent.

I was 27 when I had my daughter and they asked me again which I refused and took an IUD instead.

Have options changed?

Some doctors and PP's will give you an IUD without any pregnancies and some won't. It's always good to call around to check which ones will do it. There's plenty of women in iud_divas who have IUD's and never been pregnant. Also, I suggest you join that community, they are great for all IUD related questions.

When someone else has an IUD and you insert your fingers, yes it's normal to feel it. What you are feeling are the strings that we are supposed to check to see if it's still in place and also the strings for removing it. I have a Mirena IUD which has a small dosage of hormones and lasts for 5 years but there is also the Paragard which is hormone free and lasts for 10 years. It hasn't effected my sex life at all other than making it better. I don't feel worried about pregnancy and I can't even tell it's there. My husband never notices it unless he has his fingers in there but again that's normal. Rough sex, where my cervix gets hammered, does sometimes make me ache afterwards with occasional spotting afterward but it's nothing bad. I still enjoy it.

As for changes in your cervix after delivery. Mine actually felt more sensitive which helped me enjoy sex more. I've always had issues having orgasms from penetration alone. After delivery, it seemed like my g-spot was easier for my husband to hit and my cervix is sensitive enough so that now I can orgasm from penetration alone when it's hit.

Don't worry, your body will go through some changes but it's nothing that you will really notice after you've had time to heal. You'll be fine and congratulations.

Sorry for the long comment lol. :)

Oh, also wanted to add my opinion on a tubal ligation at your age. Like I said above, I don't think age really matters as long as you know what you want and are 100% positive. Do your research before making any decisions and know what your options are and go from there. Personally, I chose the IUD because I didn't like the idea of something being permanent when it comes to kids because I could change my mind later down the road. At first I did want the tubal but once my baby wasn't a baby anymore, I missed it and decided to have another. At the moment, we don't want anymore but I like leaving room for change.

[ever-abstract.livejournal.com]

If you are 100% POSITIVE that you never want to have a baby in the future, then I'd tell you to consider the tubal. However, if you think that you're "pretty sure" you're done, or "don't think" you'll change your mind that you don't, I'd opt for an IUD instead, just to be sure.

I know that a lot of doctors don't like to do tubals on primiparous women, for the reason that if a woman decides to change her mind years down the line, reversing a tubal is a lot more complicated (requiring surgery) and a lot less (50-65% of pregnancy) effective than, say, removing a Paragard (which prevents against pregnancy for 12 years). If your situation changes down the line, and you decide that you want to have another baby biologically, you might have to use services such as IVF to conceive. That's a big pain in the ass if you wouldn't have had to it in the first place.

My other concern about getting a tubal post-partum is that from my experience, many doctors prefer to perform a cesarean section to make the tubal ligation an easier "open" procedure, rather than doing it via laparoscopy or mini-laparotomy. In my opinion, avoiding unnecessary cesarean section is extremely important for all child-bearing women. My other concern is the effects on anesthesia while breastfeeding. Not because it's unsafe, it is. However, after giving birth, you're going to be tired and you're going to have a baby to take care of.

Having a tubal won't affect your hormones. You will still go through menopause when you were originally going to. You'll still release an egg every month. You'll still have regular periods. Only some private insurance companies cover the procedure (which can run $2000-$7000) where nearly all insurance companies cover IUDs (I got my Mirena while on Medicaid)

I'd recommend the community, [Bad username or site: @ livejournal.com] for IUD questions. After my son's birth, I've found myself a lot more orgasmic generally than before. Yes, you can feel your IUD strings outside of the cervix. Some women just tuck them back behind the cervix so that they're not noticeable. Other women (like me) who engage in a lot of manual stimulation choose to have their strings trimmed inside of their cervix so that they can't be felt at all. This makes removal of the IUD slightly more uncomfortable, but given that I don't have to worry about it for years, it's not something that concerns me at all. If your IUD is placed properly (ie: in your uterus, not your cervix) it shouldn't affect the way your cervix feels at all. After giving birth vaginally, your cervix changes its appearance, but other than that, I've noticed no difference.

[mrsnoname1999.livejournal.com]

I have been wondering about getting my tubes tied and if that is even an option.
I was 26 when I got my tubes tied, though at that point I'd already had 4 children. When I'd had the third, I was the same age as you, and it was an option we considered - so yes, I would think it would be an option for you.
Does insurance (state or otherwise) usually cover this procedure?
Mine did. (I had UniCare HMO at the time.)
What is your opinion on this procedure at my age?
Well, since I was barely older than you when I got mine done, I think you can guess what I'm going to say. ;) Seriously though, if you're absolutely sure you don't want another child, I'd say go for it. But like the other responses so far have said, if you're not absolutely, positively 100% sure, I'd go with the IUD instead. For myself, after already having had 4 children, I knew there was no way we could have another.
Does it affect your horemones at all?
Not in the slightest. Your reproductive organs still work the same way they always did, it's just that the egg is basically trapped in the fallopian tubes, where it's eventually re-absorbed by your body.
Have options changed?
From my observations, the rules on IUDs are different depending on location and doctor. It seems to be one of those things that not everybody can agree on, so you'll find some doctors saying there's no way a nulliparous woman could have an IUD, and some others will say there's no reason she CAN'T have one.

Since I've never had an IUD, I can't really answer the rest of those questions, though.

One thing I wanted to add, though, is that what ever_abstract said about tubal = cesarean? Not true. Not for everybody, in any case. I'm sure there are probably doctors out there wanting to make a buck (or 20,000) and will perform unnecessary procedures, but when I got mine, the plan was for me to have my tubal the day after delivery, via laparoscopic procedure. (I did end up having a cesarean, but that had absolutely nothing to do with the planned tubal.) The one thing I found odd was that my husband had to sign a form giving me permission to get my tubes tied. THAT was strange. But since you're not married, I don't think it would be an issue for you.

Oh, one last thing. And my doctors made sure I understood this before signing any of those forms: a tubal will make your periods "worse" than before. It's my understanding that in some women, it lessens over time, but it's been almost 7 years for me and they're still horrible. I bleed profusely (if I use a tampon, it's soaked through in 1-2 hours) and I get cramps from hell. Like I said, some women seem to "grow out of it" after a while, but unfortunately for me, that hasn't been the case. But I'm still glad I was warned about it beforehand.

[paraxeni.livejournal.com]

Not answering questions in order, just randomly! Anyway, I'd say Mirena is preferable for a few reasons, it's instantly reversible if you have negative side effects, it can stop periods or lighten them significantly, and it's rate of contraceptive efficacy is actually higher than that of a tubal. Also, no risk of post-tubal syndrome which can be quite nasty.

Also, although you can feel the strings sometimes they usually curl up around the cervix, and soften after a few months. My girlfriend has to go pretty deep to find mine. Partners can't feel the actual IUS, if that's poking through the cervix then it's because it's expelling! I've had mine in for three years, never been pregnant, and it's stayed put through fisting, rough sex of all sorts, and fun with metal and glass toys. If they can't dislodge it, well it's obviously staying put!

[atalanta0jess.livejournal.com]

This is what I was going to say. Getting your tubes tied is significantly more invasive, and yeah, post-tubal syndrome. I'd try the IUD and see how it goes...and if that doesn't work out, maybe then move on to the tubal. Personally, I wouldn't jump to the more invasive option.

[miss-almost.livejournal.com]

I have no experience for any of your questions - however, i do not ever plan on having children and instead of having my tubes tied, i am looking into getting tubal implants. MUCH less invasive, as they require no surgery.
http://www.essure.com/Home/Understanding/WhatisEssure/tabid/55/Default.aspx
this is the brand my doctors office uses, but all implants work the same way. this kind can just be inserted without general anesthetic, and can be done in-office.
each insurance provider is different, and have different policies by state.
as far as being a candidate for permanent birth control - id image that you are one. in my experience pursuing permanent bc the main qualifier for it is having already had a kid.

[miss-almost.livejournal.com]

i skipped a question - whats my opinion on you having permanent bc?
i'm all for it. im 22 and decided when i was still in my teens that i never wanted to produce a child.
(more on that here...http://www.vhemt.org/ )

i do plan on raising kids (either from my partners pervious marriage/relationship, or by adopting) and do not understand the need to actually have DNA in common with the child i am raising.
the main reason doctors are hesitant about permanent options is because the fear that you will later change your mind. personally, if i change my mind and it is such a problem that i cannot have chromosomes different than the kid im raising, i think i have more serious mental issues to deal with than to squeeze 'one of my own' out.

[bibliophile0614.livejournal.com]

If you are really sure you don't want anymore of your own kids, you could also consider Essure.

http://essure.com/

The Essure procedure does not require any cutting into the body. Instead, an Essure trained doctor inserts small flexible micro-inserts™ through the body’s natural pathways (vagina, cervix, and uterus) and into your fallopian tubes.

The procedure can be performed in the comfort of a doctor’s office without general anesthesia, and most women resume their normal activities within one day.

During the 3 months following the procedure, your body and the micro-inserts work together to form a natural barrier that prevents sperm from reaching the egg. During this period, you must continue using another form of birth control (other than an IUD or IUS).

Three months after the Essure procedure, a doctor will perform an Essure Confirmation Test, to confirm that the tubes are fully blocked and that the women can rely on Essure for permanent birth control.

Unlike birth control pills, patches, rings, and some forms of IUDs, Essure does not contain hormones to interfere with your natural menstrual cycle. Your periods should more or less continue in their natural state.

[absolved.livejournal.com]

I got my tubal at 29, no kids. Had I found my wonderful doctor sooner, I could've gotten it done younger. I really wish I would've found her instead of wasting my time with other doctors!!

The tubal hasn't change my hormones at all. I had bleeding issues before the tubal, and I still have them.