Sunday 21 July 2019

Female sterilisation: 'Three children was our limit: my family was complete'

Female sterilisation provides permanent contraception, but medics advise that women hold off until they’re older before getting the procedure done. Mother-of-three Sarah Doyle (41) tells Arlene Harris why she wanted to have her tubes tied

Ultrasound
Ultrasound

Jennifer Zamparelli is no stranger to the headlines and she made the news again recently by revealing that she has had her 'tubes tied' after she and her husband Lau decided that their family is complete.

After giving birth to her second child Enzo last year (she also has a four-year-old daughter called Florence), the 39-year-old presenter got 'stitched up' as she believes there is enough going on in her life without having to worry about contraception.

Jennifer Zamparelli revealed recently that she had her ‘tubes tied’ Photo: Gerry Mooney 20/8/16
Jennifer Zamparelli revealed recently that she had her ‘tubes tied’ Photo: Gerry Mooney 20/8/16

"My tubes are tied," she said in an interview with VIP Magazine. "I had a C-section and while the surgeon was down there - job done. Lau really didn't want to have any more. Life is busy enough with two and with work. And the jobs that we are in, they're not steady jobs."

Having a busy lifestyle is certainly one reason to put a cap on the amount of children you have. And this is also the reason why accounts assistant Sarah Doyle underwent the same procedure before her third child was born as she decided "enough was enough".

"We had only intended on having two children and while we were naturally overjoyed with the news that our third was on the way, the reality of pregnancy does cause you to reevaluate where you are going in life, how you will cope with the pressure and how you will manage time and finances," says the 41-year-old.

"Having my tubes tied wasn't something that I undertook lightly as it is a big decision to make. But both my husband and I felt that three children was our limit. We had planned the first two and although we were being careful enough not to conceive again, it happened anyway and was more than an unexpected surprise.

Dr Peter McKenna
Dr Peter McKenna

"But while we were very grateful to have had three healthy children, we felt that we would be pushing our luck in that regard if I was to become pregnant again as due to my age, the chances of something going wrong would be considerably higher."

So the Dublin woman discussed the next step with her doctor and then during an elective Caesarean section underwent a tubal occlusion procedure which blocks, seals or cuts the fallopian tubes to prevent further fertilisation of eggs.

"Having decided that we definitely wanted to down this route, I spoke to my doctor, who went through all my reasons for having it done," she says. "But my family was complete and as I am a mature woman in a happy relationship, it was agreed that we could go ahead and have permanent sterilisation."

So in February of this year, Sarah welcomed her third child and underwent the procedure to ensure she didn't have any more. And while there was some discomfort afterwards, she has suffered no ill-effects and does not regret the decision.

"I was allowed home after a couple of days and told to rest as much as possible," she says. "This was mainly due to the section as the other procedure didn't really add much more discomfort. I am now totally back to normal and while I have to admit that it feels strange to know that I cannot have any more children, there is a great freedom in it as well because it allows us to have a sex life without worrying about getting pregnant. And much as I adore my children, the fact that I won't have any more is strangely liberating."

There are no official statistics regarding how many women undergo permanent sterilisation like Sarah has, but Dr Peter McKenna, clinical director of the National Women and Infants Health Programme, says figures have gone down in the past two decades.

"The need or demand for tubal ligation by laparoscopy was far greater in the past," he says. "But since the advent of the Mirena coil, we see a lot less of it as it is very effective - it has answered a demand, can be fitted better without anaesthetic and is more efficient. About 20 years ago, laparoscopic sterilisation was a fairly common occurrence whereas these days we have seen an increase in it (sterilisation) being done during a planned Caesarean section.

"On that note, I might add, that it would not be considered good practice to perform this procedure during an emergency section as this could lead to regret if the decision was made quickly and under pressure. So it is not advisable for a woman to undergo sterilisation if she is feeling stressed or in any way rushed."

The consultant obstetrician and gynaecologist says there are rarely any added complications following tubal ligation performed during a Caesarean section, but while the procedure can be reversed, there is no guarantee that future pregnancies will be successful.

"If done at the same time as a C-section, there are no added complications and the recovery time would be as expected for a section," he says. "But the failure rate of female sterilisation is about one in 200 as the cut end of the fallopian tubes can end up linking back together with the passage of time - so it is not always a guaranteed success. And of course, the younger the woman is the greater the chance of this happening. So it is definitely not a decision to be taken lightly.

"There is also no guarantee of it being reversed, so women need to be very sure of their decision to undergo this procedure as if they change their minds and want another baby, this might not be possible. And in some cases, if this does happen, it could result in an ectopic pregnancy.

"Some women also cite heavier periods afterwards but this is more likely due to the fact that they have probably come off the contraceptive pill which will increase the menstrual flow."

Due to the finality of sterilisation, Dr McKenna, formerly the Master of the Rotunda Hospital would advise women to hold off having it done until they are older.

"The younger a woman has this procedure done, the greater the long-term failure rate," he says. "So it is also fair to say that the older she is, the less chance there is of regret as it is less likely that her world will change and she might want more children. Whereas in her twenties, all sorts of things can happen, she might have a new partner or have a change of heart. So it is advisable to wait until she is totally sure that this is what she wants."

Mother-of-three, Sarah Doyle, was sure that she wanted to be sterilised and says she can now enjoy her life without worrying about another pregnancy.

"I'm very happy that I've had the procedure done, but I'm also glad that I waited until now," she says. "My husband and I had discussed it in the past because we were adamant that we only wanted two children, but now that our third is here and is healthy and happy, we are profoundly grateful that we waited until he arrived.

"Everyone is different and circumstances change, so my advice to anyone else considering sterilisation, is to make sure they have either completed their family or they definitely don't want children.

"We feel very blessed with our three children and now that we have removed the chance of pregnancy, I'm sure we will experience a lot more freedom in our physical relationship in the future."

WHAT IS FEMALE STERILISATION?

⬤ Female sterilisation is an effective form of contraception which aims to permanently prevent a woman from getting pregnant.

⬤ It is suitable for most women, but sterilisation is only recommended to be considered by women who don't want children at all or have completed their families as it is very difficult to reverse the process.

⬤ Sterilisation is usually carried out by blocking the fallopian tubes using a technique called tubal occlusion - this can be done using clips or by tying and cutting the tubes.

⬤ Hysteroscopic sterilisation is another form which involves inserting implants into the fallopian tubes.

⬤ Sterilisation does not protect against sexually transmitted diseases, so if you are concerned about a partner's sexual health, it is advisable to still use condoms.

⬤ It is possible for the procedure to fail, particularly over time.

⬤ There is a very small risk of complications, including internal bleeding and infection or damage to other organs.

⬤ The procedure can be done under the public health system during a Caesarean section.

⬤ Costs will vary under the private health system, depending on participating hospital, but averages at around €1,500

⬤ For more information visit hse.ie

 

Irish Independent

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