The Next Chapter

I can't tell you how hard of a time I had coming up with a title for this post! I had so many ideas in my head and actually made a list of possible ones to use. I wanted it to be something intriguing and most of all signify the depth of what I had planned to write about. Once you get through this whole thing, you'll see what I mean (hopefully!)

On that note, this is a warning that this is a LONG post and also a *very* personal one. I am leaving no details out because I feel that once I decided to make this part of my life a public platform, it is only right that I give you the nitty gritty. So here goes...

I am currently recovering from an elective procedure and I mean freshly recovering, I had the surgery yesterday, 9/22. I decided to have an outpatient laparoscopic tubal ligation (fallopian tube removal) and my provider didn't just snip the ends or anything, they are totally gone- adios! I know I kind of just put that right out there and made it seem nonchalant, but I will have you know that this decision wasn't made on a whim. And before anyone thinks that I had this done just so I could have blog content, I am going to stop you right there and give you the whole story of how I got to this point and decision.

If you have read my prior posts you already know that Darren (my husband) and I have been pretty set on being #childfree for the last several years. It was only recently that I became comfortable enough to start openly admitting that fact and sharing about this choice with others. I have been on birth control for years, I'm talking well over a decade and have tried various methods to find what worked best for me. The pill, NuvaRing (that was a big no) and currently the Nexplanon/Implanon birth control implant in my arm. I have absolutely loved this method of birth control for myself personally because I don't have to remember to take it every day and it actually prevents me from having periods altogether. Just like any birth control, it doesn't work for everyone and some people spot from it or have irregular periods, but for me it has been a dream and I am on my third device. It has to be changed out every few years and my thought is, why fix what isn't broken? I will circle back to this birth control topic at the very end!

Are we to the point that this post is TMI already? Buckle up!

We all remember the day that Roe V Wade was overturned right? June 24, 2022. Not to hash that all out again because I already did a full blog post about it, but this day is important in my story because it is the day I messaged my OB/GYN and got this all in motion. I literally saw the news hit the internet and social media outlets and was outraged. I immediately logged into my patient portal and sent a message asking If I could set up a consult for a tubal ligation. My OB/GYN responded that very day and said "absolutely" so my initial appointment was made to discuss this option to see if it would be a right fit. Darren was on board and supportive from day one with my desire to seek more information about this. In fact, a few months prior he actually had a consult scheduled for a vasectomy which he was totally willing to have done, but that appointment had to be cancelled because he started a new job and it just wasn't feasible at the time to proceed.

Prior to my consult, I did a bit of digging on my end by reaching out to my insurance carrier to get a cost estimate for the procedure if I did decide to proceed and ensure that I had in-network facility options lined up. I also did some online research about the procedure itself, recovery time, etc. I work in the health insurance industry, so this is a PSA to anyone that is considering having a procedure done of ANY KIND- please reach out to your insurance company and check network status to make sure you get the best cost savings for your plan. You do not want to have a procedure and then find out after the fact that the surgeon or facility were out-of-network which means more cost for you. Shout out to the A1A Member Advocate and supervisors that helped me out with all of my personal inquiries (shameless plug for the department that I am proud to work for!) Insurance can be complicated and until you need to use it, most people (myself included) have no idea what the coverage and cost will be for medical care and you don't want to be surprised when all of the bills come rolling in, trust me!

The day of my consult, July 11th (oddly enough our 12 year dating anniversary), I specifically remember asking my OB/GYN, "Am I crazy for considering having this done when my husband is willing to have a vasectomy?" To which she responded that although a vasectomy is obviously an easier/cheaper/less risky procedure, that him being snipped would do absolutely nothing for me if I were to ever get assaulted. Obviously no one wants or predicts that happening, but this is the world we live in. On top of that, because of the changes made to abortion laws there is a possibility that I wouldn't be able to do a damn thing about that outcome if I did ever get assaulted and became pregnant because of it. Now that is a lot of *ifs*, but already being firm in my decision that I don't want kids with my actual spouse, I sure as hell don't want kids from someone else against my will. Although laws can change, I did also have to consider the fact that we are hoping to move somewhere outside of Ohio eventually and certain states have even tighter laws and regulations. I have also worked for a religious affiliated hospital before that would not cover birth control for their employees, so who is to say if I would even have the option to get this procedure in the future if I ever changed jobs for whatever reason, and I didn't want to risk that. My provider also felt totally comfortable moving forward with the procedure because her and I have spoken for several years about Darren and I not wanting to have kids, so this wasn't just something that came up out of the blue.

We spoke about how having this procedure would obviously be a method of permanent birth control but may also serve a dual-purpose due to the fact that I have a family history of female reproductive forms of cancer. She explained to me that there has been some evidence indicating that ovarian cancer often starts in the fallopian tubes, so by having them removed I could essentially be reducing my risk of cancer. There are no guarantees of course, but if I don't plan on utilizing them anyway, I figured they might as well be taken out. She told me to think about it and let her know if I would like to schedule the procedure or not. I left that appointment fairly certain that I would have it done, but didn't want to make a hasty decision.

*I am not an oncology medical professional or a doctor. I am only sharing what my provider told me. I am also aware that by NOT having children, my risk for certain types of cancer, specifically breast cancer could be increased. However, I have completed a BRCA screening in the last few years and that came back negative. Again, no guarantees but it was important for me to weigh the risk vs. reward of this decision.

After talking to Darren, some close friends and my mom, I decided to proceed with scheduling the surgery. I had too many fun things coming up during the remainder of the summer that required me to be on a plane and in a bathing suit, so I knew it couldn't happen right away. The surgery date was set for a few months out and as soon as it was officially scheduled, all sorts of anxiety bubbled up inside of me. Not so much anxiety about never having kids, but things like "what if something goes wrong and I have health complications?", "what if Darren and I separate in the future and I am damaged goods?", "what if my stomach looks awful and I am a flabby ugly mess for the rest of my life?" These were thoughts stressing me out so bad that I literally didn't get a good night of sleep for almost a week and also had bubble guts constantly (more TMI, sorry!) I shared these fears and concerns with Darren and like the true gem he is, he put me totally at ease and helped me get out of my own head.

Here's the thing- none us know what will happen tomorrow, a month from now, a year from now, or decades from now. I decided I couldn't let my fear of what may or may not happen stop me from doing what I felt deep in my gut was the right decision for myself. If any of the above 'worst case scenarios" present themselves, I would deal with it and figure it out. And by the way ladies, having scars or removing the parts of your body that "make you a woman" doesn't make you ugly, diminish your worth or make you less wanted or valuable. Never forget that!

I attended my pre-op appointment 9/8, two weeks before the surgery to get labs drawn, discuss the procedure in full detail and go over all of the possible risks. For someone my age and in good health, it is a very low-risk procedure but of course unforeseen things can still happen. At the end of our conversation, my OB said "and now we have to talk about the biggest risk yet, the risk of regret" This is permanent. There is no stitching the tubes back on once they are removed. If I want to have my own biological children one day, I will have to complete IVF to do so. And I have to tell you, I appreciated her being so raw and real and for not sugarcoating this aspect because that is a very real risk that needs to be discussed before anyone considers going down this path. I have so much respect for my OB/GYN. I fully trust her, feel confident in her abilities and wanted her to be the one to perform this surgery more than ever.

Anyhow, as summer came to an end and the procedure date got closer, I became more and more at peace with my decision. Even the day before and the morning of- I truly was not nervous. I was just ready to move forward with this and begin what I felt would be the start of a new chapter. This didn't happen to me, it was happening for me and is happening as a direct result of my personal choice. No one else was dictating this decision. Tubal ligation is a fairly routine and minimally invasive procedure but that doesn't mean that it's an easy choice to make. Whether you get it done prior to having any children or once you feel your family is complete and you don't want anymore kids, it still has a major impact on your life because it signifies the end of or possibility of motherhood (at least without major intervention or adoption etc.)

I had to arrive to the outpatient facility in Dublin at 5:45am for a 6:30 start time. First thing I had to do once I got back to the pre-op area was to take a pregnancy test. It was negative, but could you imagine if it had been positive?! Gulp, that would have obviously been a major change of plans. Darren was my ride and was able to be with me until they took me back for the procedure. Pre-op meds were given (a few for nausea which I am so grateful for) and they put me under general anesthesia when I got back to the OR. Last thing I remember was them telling me to take a few deep breaths into an oxygen mask and then I was out. I woke up in the recovery room and as soon as I came to I truly felt like I was going to vomit all over myself, thankfully I didn't- just a bunch of dry heaving. They gave me some more nausea medication and it worked like a charm. I was only in the operating room for 50 minutes and in total, I was at the facility for a little less than 4 hours, pretty speedy in my opinion! I was back home on the couch around 9:30a and slept on and off all afternoon.

The pain has been pretty minor so far, more pain on my right side incision than my middle or left side, and my stomach has some bruising in these areas. I did have some shoulder pain which they warned me about since they had to fill my stomach up with air to move organs out of the way. I still feel a bit bloated from the gas but they said that should go away pretty quickly. I plan to be off work for a total of five days, 3 days PTO and then 2 weekend days, I have a spare day of PTO I can take if needed. My provider felt like this would be enough time off since I work from home and am not on my feet all day. I have activity restrictions for two weeks of no heavy lifting, intense exercise, sex, taking baths, etc. This will be costing me approximately 5-6k when it's all said and done which factors in the facility fee, paying my OB/GYN to perform the surgery, anesthesia, lab draws, follow up appointments and pain meds. My post op appointment is set for a little less than 4 weeks out from my procedure date.

I am so incredibly grateful for Darren and my mom who have both helped take care of me and let me rest. My mom came to stay with us for a few days and it is so nice to have her here! Who doesn't want their mom when they aren't feeling well, am I right?! I love you both so much, I am a lucky lady! I am also super thankful for my friends that have known about me getting this done and have been so supportive and checked in on me. You know who you are and I appreciate you more than words!

In closing, if you have stuck with it and read this whole thing- THANK YOU! I am sharing my full experience for various reasons. One of those reasons is because maybe there are readers that have been thinking about moving forward with this themselves and wondered what it would be like. To anyone in that position, feel free to message me directly and ask me any questions you have, I am an open book! The other is to purely raise awareness about tubal ligation being an option that can possibly have other benefits besides just permanent birth control. This isn't the right or best decision for everyone and I am certainly not trying to convince people to go this route as there are risks and financial repercussions. Each person must decide what makes best sense for their life and live accordingly.

With that being said, It's officially official now that I am a #childfree woman and will be for the rest of my life. I honestly feel like this is the start of a new chapter for me. One in which I made a very big and life impacting decision for myself. I didn't let society or anyone else's opinions sway me. I'm living life on my own terms and am going to continue living it to the fullest and enjoying the freedom that this decision has granted me.

This #choosingchildfree lifestyle isn't for everyone and I absolutely respect that, but for anyone that relates to any part of my journey I hope you know that it doesn't make you selfish or a bad person. I hope you find peace and comfort in whatever decision you make, whether that's to have kids or not.

Recovering and writing from the couch,

-Holly

Footnotes:

To circle back to birth control real quick and for anyone wondering- because I still have my ovaries, I will continue to have a period and my hormones have not been impacted in any way. I will not go through early menopause or have to take hormone supplements. Because of this, my OB/GYN offered to keep my arm implant in and I agreed because I like the aspect of not having periods (personal choice). I will likely get it removed when it is due to come out in a few years and will re-evaluate from there if I want a new one inserted or not.

Not all providers will complete a tubal ligation. Some require you to be of a certain age, have already had children, have spousal consent, etc. You will need to discuss any requirements with your specific OB/GYN. Mine had absolutely none of the mentioned requirements which I appreciated because that aligns with my personal thought process that I am capable of making this decision for myself, and as a grown woman, I should have the right to make my own choice.