Weird question about tubal ligation

[Mrs Tiggywinkle Again]

My coworker announced this morning that she’s pregnant with twins after having her tubes tied ten years ago.  She’s had an ultrasound to rule out ectopic pregnancy which is when they discovered it’s twins. She is…not happy. I asked which doctor did her tubal and it’s the same one who supposedly did mine during my c section in 2015.  She’s also the fifth woman I’ve met who had a pregnancy a couple years after this guy tying her tubes. He gave me a lot of crap about tying my tubes at the age of 34 with a preemie about to be born and a high risk pregnancy(and my third child). My coworker had six children when she got hers done and he also tried to talk her out of it. I know he’s been sued but honestly he’s a high risk OB and they usually get sued.

In any case: I want to double check that (a) I had a tubal ligation and (b) it’s still there.  Where do I start? I sent a message to my primary care provider who pretty much blew me off but said it’s on my medical records from 2015(they list tubal under surgeries though it was done in a c section).

Probably I’m overthinking this. DH had a vasectomy as well and Im on Yaz and haven’t had periods on that at all, but I have a history of weird things happening, and I am starting to suspect this doctor has not actually been doing all the tubals or doing them crappy for me to have met five women who have had his tubal ligations fail.

Edited July 11, 2023 by Mrs Tiggywinkle Again

[Kassia]

Wow, that's incredible.  I'm so glad you haven't been using that as your only form of protection!  I wonder if anything can be seen with some kind of imaging - u/s, CT, MRI?  

I know for sure mine were done because I had a lot of pain at first and I have a high tolerance for pain.  Mine were cauterized and, based on the pain I felt post-op, there's no doubt that mine were thoroughly taken care of.  

[wintermom]

In the meantime, you could use additional BC methods just to be sure. 

You could also research the type of surgery actually done. Mine involved the tubes being severed, but nothing removed. I can't remember if any actual "tying" off of any tubes was involved. 

I've always assumed that my surgery wasn't going to be 100% preventative. There'd be the slightest chance that an egg could still make its way into the uterus and become fertilized. 

Edited July 11, 2023 by wintermom

[Mrs Tiggywinkle Again]

Just now, wintermom said:

In the meantime, you could use additional BC methods just to be sure. 

You could also research the type of surgery actually done. Mine involved the tubes being severed, but nothing removed. I can't remember if any actual "tying" off of any tubes was involved. 

According to my provider they can’t access the surgical notes anymore, but I don’t honestly know if that’s true or not.  It just lists tubal in my records, but I suspect this guy is just doing them sloppily or quickly.  I know he’s got a reputation for trying to talk women out of sterilization, which seems weird to me for someone who’s a maternal fetal specialist.  
DH can get his count checked to make sure nothing has regrown, just to put my mind at ease, but this failure rate of people I’ve personally met seems way too high to be coincidence.

[wintermom]

It sounds like your current methods of BC are appropriate with or without the tubal. It's not like you are going to have yourself cut open just to confirm, and/or have more surgery done, right? I wouldn't stress about it too much. 

[catz]

It seems like it would be hard to confirm potentially even with imaging?

I'd want to send the DH to confirm a zero sperm count.

[Bambam]

When I had my tubal done, they did some sort of pathology test to make sure it was a Fallopian tube that was cut (this has been 20+ years, ago, so memory is a little fuzzy). I only know this because OB/GYN mentioned it at my 2 week followup. I thought that was weird (surely everything in there is labeled or different colors so it is obvious what everything is - just like Operation, RIGHT?) Maybe check the medical records to see if anything like that exists? Or would that be enough to make you feel more sure? 

[Forget-Me-Not]

I think the test you’d need is a hysterosalpingogram (HSG) with dye. I had one during infertility testing to check for a blockage in my tubes. 

[Danae]

35 minutes ago, Mrs Tiggywinkle Again said:

According to my provider they can’t access the surgical notes anymore, but I don’t honestly know if that’s true or not.  It just lists tubal in my records, but I suspect this guy is just doing them sloppily or quickly.  I know he’s got a reputation for trying to talk women out of sterilization, which seems weird to me for someone who’s a maternal fetal specialist.  
DH can get his count checked to make sure nothing has regrown, just to put my mind at ease, but this failure rate of people I’ve personally met seems way too high to be coincidence.

The notes probably wouldn’t tell you anything anyway. It’s not like the guy would record that he did a half-assed job or just faked it because he doesn’t approve of sterilization.  

[Faith-manor]

I have never known anyone who had a failed tubal. I have known of three failed vasectomies none of which were with the same provider. So I don't blame you for being suspicious.

I wouldn't trust the medical record because it sounds like he has a personal probpem, and is not professional. This makes me think his notes also be unprofessional, potentially even lying.

I think you need a scan with dye if you need the confirmation. But, testing your dh is a lot less invasive and expensive. 

Back in '81 when my surprise sister was born, my mom told her doctor he had to remove her actual tubes, and show them to her after surgery. I was a teen and thought, "Gee mom. This what the doc does. He isn't going to mess it up." Now I am thinking she was spot on. I don't remember her ever saying if he actually showed her proof he removed those tubes.

[MercyA]

34 minutes ago, Forget-Me-Not said:

I think the test you’d need is a hysterosalpingogram (HSG) with dye. I had one during infertility testing to check for a blockage in my tubes. 

Yes. That was what I was going to suggest. According to ACOG, it is used to check tubal ligations as well:

https://www.acog.org/womens-health/faqs/hysterosalpingography#:~:text=Why is HSG done%3F,tubes have been completely blocked.

Edited July 11, 2023 by MercyA

[wathe]

The operative report should be in you hospital record.  Health records dept should be able to pull it for you. 

The standard here for saving medical records for adults is 10 years.   It's likely similar where you are.  Records from 2015 should still be accessible.

ETA:   Never mind.  I see that in New York it's only 6 years.  Records from 2015 might already have been purged.   (Though my hospital keeps electronic records indefinitely, and in 2015 an operative report was likely a dictated note that was stored in an EMR.  So it's quite possible the record is still in the hospital system and available for you to request)

 

Edited July 11, 2023 by wathe

[wathe]

If you are doubting whether the procedure was done at all:  Filshie clips will show up on a simple xray

[Faith-manor]

This thread has me nervous. My stupid ovaries refuse to give up. I am 55 and have managed to have two periods.this year. Stupid ovaries!!! Dh's vasectomy was 23 years ago. Do 20+ year old vees fail? Is that a thing?

If men had ovaries, these daft things would have an on/off remote control switch by now!

Edited July 11, 2023 by Faith-manor

[MEmama]

How horrifying! 😞 

[kbutton]

2 hours ago, Mrs Tiggywinkle Again said:

but I suspect this guy is just doing them sloppily or quickly.  I know he’s got a reputation for trying to talk women out of sterilization, which seems weird to me for someone who’s a maternal fetal specialist.  

When DH was snipped, his doctor (just a family doc) laid out all of his own personal stats on vasectomies very clearly. He had only one failure that wasn't explained by patient lack of compliance (not coming back for the check, not refraining from activity, etc.), and that man had bifurcated tubes. The doctor now looks for those. He also uses multiple techniques for getting the job done.

In light of that, it's not at all odd to question this doctor's skill or ethics around the matter with what you are saying, especially since a pregnancy in a vulnerable person could cost a life!

I think you're probably fine with all the extra things, but I would probably discourage anyone I knew from using him for getting tubes tied.

[LifeLovePassion]

2 hours ago, Forget-Me-Not said:

I think the test you’d need is a hysterosalpingogram (HSG) with dye. I had one during infertility testing to check for a blockage in my tubes. 

Same, I'd want this done as well. 

[sassenach]

I know one person with a failed tubal. Honestly, if you were to get pregnant while on birth control, with a vasectomy and a tubal (even a questionable one)- I would be flabbergasted. I'm not sure how much more a person can do to not get pregnant short of a hysterectomy.

[Melissa in Australia]

I got pregnant close to 3 years after a tubal, miscarried at 12 weeks  then had some terrable pain (worst pain I had ever experianced)  went back to the gynaecological. He discovered that one side the clip had ripped right through tube and was  imbedded in ovary. He removed most of that ovary  and on the other side he put dye in 4 times,  he told me after that a very small amount of dye went through. He thought my chance of getting pregnant were pretty low  but chance of having a tubal pregnancy if I got pregnant were greater than 50 %. 

Well about 3 months later I got pregnant with ds 19.. I haven't used any  other birth control and haven't got pregnant since

Edited July 11, 2023 by Melissa in Australia

[Brittany1116]

When I had mine 7 years ago, they gave me literature that said there is a high failure rate after 11 years. 

[Brittany1116]

My tubal didn't involve clips or clamps, but I have a family member who did have clamps. 

I know my brother's old teacher had a pregnancy like 14 years after a tubal, and someone I went to church with once had a bbay more than a decade after. 

I'd be more concerned if it was your only BC method. Vasectomy and pill are added layers. 

[ktgrok]

On 7/11/2023 at 4:25 PM, Forget-Me-Not said:

I think the test you’d need is a hysterosalpingogram (HSG) with dye. I had one during infertility testing to check for a blockage in my tubes. 

This. it is an outpatient procedure. 

[Mrs Tiggywinkle Again]

DH called today to get a recheck. He's humoring me, but I'd rather feel better just in case.

Every single woman I know who has had a pregnancy post tubal says that the doctor tried to talk them out of it like he did me.  I just feel really weird about it.  

[Danae]

5 minutes ago, Mrs Tiggywinkle Again said:

DH called today to get a recheck. He's humoring me, but I'd rather feel better just in case.

Every single woman I know who has had a pregnancy post tubal says that the doctor tried to talk them out of it like he did me.  I just feel really weird about it.  

I think you have reason to feel weird.  Or rather, you shouldn’t feel weird about taking extra precautions. They seem warranted.

[Faith-manor]

1 hour ago, Mrs Tiggywinkle Again said:

DH called today to get a recheck. He's humoring me, but I'd rather feel better just in case.

Every single woman I know who has had a pregnancy post tubal says that the doctor tried to talk them out of it like he did me.  I just feel really weird about it.  

That just sounds so weird. When I had an insanely high risk pregnancy with my last, the OB actually pushed quite hard for permanent measures. I was able to have baby vaginally, and was not even remotely a candidate for an elective tubal. My OB did Mark's vas, and showed me that he removed literally inches of the tube...not reversible, and doubtful it could ever grow back together. Then he tied the ends after he burned them. That man was serious about me NOT having another baby. But this thread makes want to make Mark go get checked. 

I think you want to listen to your instincts. If his sample comes back suspect, I think you should follow your heart and have a dye and scan to confirm the tubal.

Edited July 12, 2023 by Faith-manor

[stephanier.1765]

16 hours ago, Mrs Tiggywinkle Again said:

DH called today to get a recheck. He's humoring me, but I'd rather feel better just in case.

Every single woman I know who has had a pregnancy post tubal says that the doctor tried to talk them out of it like he did me.  I just feel really weird about it.  

My doctor did too but not until it was time to actually do it. My last was born prematurely and his lungs collapsed upon birth so that he was whisked away to the NICU almost immediately, so my doctor said to wait since we didn't know what would happen with the baby. I was adamant. We compromised. Instead of doing directly it after birth, we did it the next day. The whole time I was thinking that, even if something happened to my son, I wasn't going to have another baby to replace him. It was ridiculous to my mind. I'm glad I stood my ground. 

[Annie Elle]

I heard of some ladies getting pregnant after a tubal. Everyone was when they had the tubal with the c section or within a few days of birth. I always thought it was due to womens’ amazing ability to heal after birth. 

[Mrs Tiggywinkle Again]

1 hour ago, stephanier.1765 said:

My doctor did too but not until it was time to actually do it. My last was born prematurely and his lungs collapsed upon birth so that he was whisked away to the NICU almost immediately, so my doctor said to wait since we didn't know what would happen with the baby. I was adamant. We compromised. Instead of doing directly it after birth, we did it the next day. The whole time I was thinking that, even if something happened to my son, I wasn't going to have another baby to replace him. It was ridiculous to my mind. I'm glad I stood my ground. 

That was almost exactly what he said-I had had a difficult pregnancy, PPROM at 28 weeks, was trying to hold on and the morning I went into labor the doctor was like you don’t really want your tubes tied, this baby might not live.

WTF. I mentally could not have gone through another pregnancy, especially if that baby died(he is fine).

[Momto6inIN]

This dr sounds like a whacko, and I'm glad your husband is willing to get checked. And I don't want to discount anyone's experience who had a child whose life hung in the balance and still knew without a doubt that they didn't want any more children whether that baby lived or died.

However, I do think many doctors will try to dissuade their patients from a tubal under those circumstances because they have seen so so so many more cases of it than we have and they have seen many many women who *do* decide they want more children afterwards. I personally know of several women who lost their babies and couldn't fathom ever being pregnant again but eventually changed their minds and now do have other children. Not replacement children, just more children.

And TBH postpartum - esp when things haven't gone the way you planned - is not generally a hormonally and emotionally stable time to be making permanent decisions 😉 At leat I know it wasn't for me. And drs know it too, which is probably why they are reluctant and pushy in those situations.

That doesn't make it feel good to the mom who is grieving and it doesn't mean they're always right. But it does explain why they do it.

[Faith-manor]

1 hour ago, Mrs Tiggywinkle Again said:

That was almost exactly what he said-I had had a difficult pregnancy, PPROM at 28 weeks, was trying to hold on and the morning I went into labor the doctor was like you don’t really want your tubes tied, this baby might not live.

WTF. I mentally could not have gone through another pregnancy, especially if that baby died(he is fine).

I have a word for this doctor.

Prick.

That is what he is.

[Faith-manor]

15 minutes ago, Momto6inIN said:

This dr sounds like a whacko, and I'm glad your husband is willing to get checked. And I don't want to discount anyone's experience who had a child whose life hung in the balance and still knew without a doubt that they didn't want any more children whether that baby lived or died.

However, I do think many doctors will try to dissuade their patients from a tubal under those circumstances because they have seen so so so many more cases of it than we have and they have seen many many women who *do* decide they want more children afterwards. I personally know of several women who lost their babies and couldn't fathom ever being pregnant again but eventually changed their minds and now do have other children. Not replacement children, just more children.

And TBH postpartum - esp when things haven't gone the way you planned - is not generally a hormonally and emotionally stable time to be making permanent decisions 😉 At leat I know it wasn't for me. And drs know it too, which is probably why they are reluctant and pushy in those situations.

That doesn't make it feel good to the mom who is grieving and it doesn't mean they're always right. But it does explain why they do it.

I understand that. But if the father of that lost child walked in the day after and said, "Give me a vasectomy", there would be no question. This isn't about a doctor being concerned she might change her mind. So what. It is her mind and her body. She has a right to make the decision, and a right to regret it later. This is misogyny plain and simple. Women can't have total control of their bodies until all the men with opinions have been jacka$$es about it.

BTDT with the very 1st OB I had. Will not tolerate it again. It is not the doctor's business if I do not want to have more children. He just thinks it is because "guy". And unfortunately, far too many female practitioners have picked up on this attitude and talk down to women because that is the medical school culture.

I get what your saying, but the motivation of the medical industry on this is not about the best interests of the patient but paternal/patriarchial attitudes.

 

[Mrs Tiggywinkle Again]

9 minutes ago, Faith-manor said:

I have a word for this doctor.

Prick.

That is what he is.

The odd thing is that he’s active in pro choice causes and provides first trimester surgical terminations, so it’s not like he’s some quiverfull mysoginist who believes women don’t actually have autonomy over the bodies and should pop out all the babies.

But I’m convinced that he’s not doing some tubals correctly. My coworker makes $22 an hour, forty hours a week, and already has six kids. She’s engaged to someone who has two kids making about the same amount, and now they’re having twins.  She did the responsible thing and thought she had a tubal ligation done.  This is a crappy situation for her.

[Faith-manor]

Just now, Mrs Tiggywinkle Again said:

The odd thing is that he’s active in pro choice causes and provides first trimester surgical terminations, so it’s not like he’s some quiverfull mysoginist who believes women don’t actually have autonomy over the bodies and should pop out all the babies.

But I’m convinced that he’s not doing some tubals correctly. My coworker makes $22 an hour, forty hours a week, and already has six kids. She’s engaged to someone who has two kids making about the same amount, and now they’re having twins.  She did the responsible thing and thought she had a tubal ligation done.  This is a crappy situation for her.

I feel so bad for her!

I think many OB's can be involved in pro choice. But that doesn't negate the years of paternalistic medicine they learned in school. I feel like a ton of them need to take a step back and evaluate themselves. Even the NP, a female, at my husband's doc's office, is an absolute misogynistic twit. She is literally Dr. Jeckyl with the men, and Mr..Hyde with women. To the point that people in the community have complained to the doctor and to the hospital, lots and lots of complaints. She won't change, nor will she be fired because of a lack of practitioners out here in the sticks. The misogynistic attitude absolutely permeates medical school.

I think you are right that he is not doing them correctly. Something is off with it. His failure rate seems to high, and your friend is in a horrible position.

10 kids on a combined $44 an hour is NOT good! My heart weeps for her.

[wintermom]

This culture of pressuring women to be physically able to have more babies must vary across locations. My OB, who was my dr for four c-sections, asked each and every surgery if I wanted to get my tubes tied. I finally did have them tied when I had a d&c procedure done. It was annoying to be asked every single time. Kind of the reverse of what others have experienced. In my mind he was my benevolant "cookie pusher" trying to make my life easier. 🤣 

[JustEm]

41 minutes ago, wintermom said:

This culture of pressuring women to be physically able to have more babies must vary across locations. My OB, who was my dr for four c-sections, asked each and every surgery if I wanted to get my tubes tied. I finally did have them tied when I had a d&c procedure done. It was annoying to be asked every single time. Kind of the reverse of what others have experienced. In my mind he was my benevolant "cookie pusher" trying to make my life easier. 🤣 

I got the same question with sections 3,4,5, and 6

[MagistraKennedy]

On 7/11/2023 at 3:51 PM, Mrs Tiggywinkle Again said:

According to my provider they can’t access the surgical notes anymore, but I don’t honestly know if that’s true or not.  It just lists tubal in my records, but I suspect this guy is just doing them sloppily or quickly.  I know he’s got a reputation for trying to talk women out of sterilization, which seems weird to me for someone who’s a maternal fetal specialist.  
DH can get his count checked to make sure nothing has regrown, just to put my mind at ease, but this failure rate of people I’ve personally met seems way too high to be coincidence.

Nurse hat on, and I call bullshit. 

You can contact medical records at the facility where you had the procedure performed, sign a request/release, and get a copy of your surgery report.  Barring some sort of catastrophic event where the facility and records were destroyed, they're still out there. Maybe off-site, but still available. 

As far as 'how would I know if the tubal was really done' --- you could check with an HSG. I don't know if insurance would cover it, etc. 

https://my.clevelandclinic.org/health/diagnostics/22254-hysterosalpingogram#:~:text=An HSG can also allow,the procedure was successfully reversed.

As far as your friends who have had tubal failures, they may want to file a complaint with the medical board.