Q re: tieing my tubes.

Today I received some less then ideal news at the OBGYN. (This will be our 6th baby and 6th C section) Thus far, I have had very little scar tissue, but today at my appt I had an U/S and was told the baby implanted on my scar and the placenta was going through the scar wall (accreta) and that the scar tissue was thining. There is a GREAT chance for dehiscence (uterus rupture) which could cause me and baby death. :eek:

I knew this was a risk of course after our 2nd c section and had been practicing NFP when i conceived number 4. I was on BC when I conceived number 3(before becoming Catholic) and this last baby kinda snuck up on us as we had recently weaned precious baby number 5 from nursing, so my ovulation had been irregular and I admit to not tracking as diligently as I should have been anyways. :blush: (dh and I had sort of reserved ourselves to allowing God to time our children anyways sense He seemd to be already lol ) :thumbsup:

Anyways, I have a boat load of health issues surrounding this baby including a Kell antibody requiring close monitoring and possible in utero blood transfusions, the accreta with possible dehiscense, and d/t placenta placement now a complete previa (meaning placenta covers cervix which is NOT good). At this point the DRs said I can expect to deliver between 25-36 weeks or sooner dependign on how long my uterus can hold togther. Needless to say this is a difficult time for us. Medical termination is OBVI NOT an option for us. however the DR has said it is time to seriosuly consider tieing my tubes during this 6th C section.
Is the tieing of my tubes allowed in the church d/t this grave medical concern? I can not afford to have another surprize NFP baby, as this very pregnancy could be the death of me–and or baby as it is. please, I have been crying all day. I just dont know what to do or think anymore. :bighanky:
Thank you for any words of wisdom u could share.

No the Church does not allow for what you describe. But there is good news. You can use NFP which is very effective. My first advice is to find a good pro life OBGYN. ANd then you need to check out something like Couple to Couple league.
HERE: ccli.org/

Also contact:
Napro technologies, here: naprotechnology.com/

NFP is very effective when used properly. In fact, some Catholics in India are using it and their unplanned pregnancy rate is close to 0!

  1. Make sure you take a class. NFP is not the rhythm method; you need to learn to use it properly. Your cycle will not always be the same length each month, so you cannot simply “guess” when you’ll ovulate. And of course, when you guess wrong, pregnancy can occur.

  2. Do not take risks on “iffy” days unless you don’t mind another child. The couples I’ve known who’ve had unplanned pregnancies while using NFP, had them because of those “iffy” days.

This sounds like a case for one of the stricter NFP regimens, for instance phase 3 only with extra days of temperature rise to be very sure. A good instructor can give you ideas and there are some possible rules for life-threatening situations in the Kippleys’ Art of NFP book (4th edition pages 134-136). Some sort of NFP with use of a fertility monitor might also be helpful.

I would definitely be very, very, very careful during the postpartum/breastfeeding amenorrhea time, with lots of abstinence, especially during the transition from amenorrhea to normal fertility during weaning. When signs are ambiguous, 100% abstinence may be necessary for quite some time. Things will probably become easier once normal fertility resumes, but judging from posts I’ve seen on CAF, perimenopause is quite challenging, as well as being very lengthy.

Best wishes and a safe delivery!

Since you’ve already had two babies despite using NFP, I can see where you just wouldn’t trust this method. Personally, I used NFP to try and conceive and it didn’t work at all. My charting was all over the place, and the doctors say that this hormonal mess has been a lifelong part of me - my body just doesn’t follow normal paths. But I digress… The point is you may or may not have been doing the best job with NFP, or you may be one of those women who’s body just doesn’t have normal hormonal cycles at all, like me.

My thought was if your uterus is as damaged (thinning out) as the docs say to the point it could rupture with this birth, then perhaps this is out of your hands? Has the OB/GYN discussed the possibility of them having to do an emergency C-section when they deliver this baby? Or is a uterus with a thinning wall perfectly safe as long as you don’t get pregnant again? Is there any way to remove the scar tissue that seems to have been the source of your current problem so future pregnancies would be safer?

If I were you, I’d get a second opinion from another specialist as this is a pretty serious thing. Is your current doc exaggerating the danger to encourage your to get your tubes tied? Or is he soft-pedaling the thing and you are in more immediate danger than you realize.All reasons to really flesh this out with a 2nd and maybe a 3rd opinion.

And I’d consult a priest before accepting the judgment of any of us on on this board. Your “next” pregnancy could result in two deaths and that is no small matter. I certainly could not urge you to refuse getting your tubes tied knowing two lives hang in the balance.

Talk to your doctor about a partial or total hysterectomy. With all the scarring, you are at serious risk for the kind of endometriosis where the cells migrate into your abdominal cavity and cause benign but debilitating and painful tumors to attach to various organs and necessitate more surgery.

You’ve done your duty to God and Church, now think about how to be a healthy, strong wife and mother to your lovely large family. This is between you and your doctor. Husbands get to weigh-in. You decide. Living and taking care of your health is also required of a Catholic.

Thank you Julia Mae for clarifying the thoughts swirling in my head. The “thinning of the uterine wall” part rang some alarm bells in my head but I couldn’t place 'em in the right places. If a full or partial hysterectomy would be a good health decision, it would be OK in the eyes of the Church as any sterilization would be a secondary result.

This was also my concern. Therapeutic hysterectomy is not forbidden by the Church. If the uterus is diseased or damaged in such a way as to endanger the life of the mother, even without a pregnancy, then removal of the organ is permissable. Of course, we are not allowed to be surgically sterilized as the primary reason, but the fact that your uterus has been perforated sounds very threatening to your long-term health.
While we cannot dispense medical advice (nor am I at all qualified to do so), I would encourage you to seek some more medical counsel, perhaps get more information as well as more doctors’ opinions. Also, discuss this matter with your pastor, and with your husband. Your situation is very unique and complicated and an internet forum is not the place for you to get the opinions necessary for an informed and prudent decision on a matter of such gravity.
Saying a prayer for you. God bless you and guide you through this difficult time. I am so sorry for your struggles. :frowning:

This would have to be diagnosed by the Dr, we cannot tell her here whether or not she is at risk for anything. If a partial or total hysterectomy is medically needed, not because of the need to avoid pregnancies, but because she would need the hysterectomy even if she wasn’t sexually active, then yes, it would be simply treating an issue in the body, and the unintended consequences would be infertility. If the need to remove the uterus is great enough, the unintended consequences can be “tolerated”.

but she didn’t. She admitted to not tracking diligently.

Using NFP to conceive when you have a “hormonal mess” does not in any way put any blame on NFP for not working.

It is very true that this would be need to be diagnosed by a doctor who is an expert; however, I think the OP would be wise to bring it up with the OB. Many OBs out there are wonderful, but there are many threads here and elsewhere about medical professionals who could care less about pro-life or Catholic issues…and sometimes even a woman’s health. How many women with PCOS or other gynecological issues are told to just take the Pill and shut up? Or told to abort their children by “caring” doctors, even in Catholic hospitals? :shrug:

OP: I would suggest bringing up risks outside pregnancy to your OB, and possibly getting another opinion (especially if your OB is adamant about tubal ligation being the “only solution” to your problem) and contacting Napro technology as Moore11 suggests.

First, id like to say thank you for all the posts thus far. :slight_smile:

The DR has asked me if I would be interested in having a partial hystorectomy (leaving the ovaries) so that I wouldnt have to take medicine (hormones) for my entire life. So, yes this is an option for me. This is not something I take lighly, or is having my tubes tied. We have tried so hard to be diligent in the truths of the church. The idea of either A) sterilization or B)hystorectomy (which would still lead to sterilization) deeply wounds me. being open to children and being a mother is my identity. The prospect of closing this chapter in my life saddens me but also terrifies me. The idea of not having my uterus even makes em feel less like a woman and I am already mourning the loss of it while still trying to be happy about the newest budding life in me whilst mainatining an arms length away from the baby in case we do deliver before 25 weeks (due to the rupture) and we loose our precious baby.

I think what some have failed to grasp is the severity of the situation. I know some posts refernced the fact about ‘future’ babies or ‘surprize’ babies. There is a question of whether I and the baby will survive THIS pregnancy. There CAN NOT be another pregnancy. My sister has told me to go on chem birth control or use a barrier for a few years while the medical feild continues to improve and maybe in the future we could have more. Chem BC is NOT an option because I suffered a mini stroke during my last preg and so as a result can niot take chem BC (and I know this is not allowed anyways) and I also know barriers are not allowed. My DR (who is Catholic) told me he would never suggest tieing my tubes but that allowing me to die on the table d/t church dogma was also something he was not comofrtable with (he is a father of 4 himself) and that eh felt this situation was dire enough that he felt sterilization was neccessary. I think the idea of tieing my tubes scares me less because i am only 28 and it feels less permanant. (I could ahve a reversal some day even thought the odds of thata er pretty much ziltch) where as a partial hysterectomy …there is just no going back…:sad_bye:

Considering the failure rate of artificial contraception (which you have already experienced), I would be less trusting of that than of NFP (since the failure is probably less predictable). I am sorry that you are experience this scary risk, and having to face such difficult choices. I would like to suggest that if a situation is truly dire (and it sounds like yours is), then the extreme choice to be allowed would be total abstinence rather than intentional sterilization. Of course a “therapeutic” hysterectomy would also be allowed morally - as long as it truly is being used primarily to treat a problem other than being fertile. But total abstinence, while extreme, is something that should be brought to the discussion table, when the risks are high enough. It may be that you don’t need to go that far though. It may be that you need to abstain after the baby is born until your cycles are normal. And then it may be that you can get away with once or twice a month. Personally, I am the careful type - if an NFP rule says you are safe 4 days after peak, and my risks were severe, I would wait 6 or 7 days post peak. In fact, I would probably wait as long as I possibly could and try to use the last day of my cycle. I would probably use multiple methods (Creighton and Sympto-Thermal), and cross check them with my “rhythms” (meaning if there was a month that was not typical, I wouldn’t just trust the symptoms, but I would be even more careful). It can be a cross for sure. I will pray for your decision, and especially for the health of you and your baby.

If you were dying on the table, they would remove your uterus, NOT perform a tubal. You Catholic doc needs a refresher course. HE doesn’t get to choose a tubal for you.

The severity of your situation has no bearing on whether a tubal ligation is moral or not. In all cases, it is immoral. What is moral is if you have a medical need for your uterus to be removed.

One of my sisters was in a very similar situation. She had 4 emergency C-sections that resulted in 4 classical (vertical) incisions. She had her tubes tied during the 4th C-section because of the fear another pregnancy would kill her. Starting about 2 yrs after her youngest was born, she began having severe “female” problems. After dealing with these problems for 5 years she ended up needing a hysterectomy.

Now, many people have told me that her problems were due to the repeat C-sections, not getting her tubes tied. I don’t buy it one bit. I’ll tell you why, she’s the only person I know who has had any C-sections at all, but I’ve met 11 women who have told me that they have had their tubes tied. Out of the 11, 6 have ended up needing a hysterectomy within 3 years and another 3 needed one within 5 years. So yes, 9 out of 11 have had hysterectomies. I don’t think it is AT ALL coincidental.

I can’t tell you what to do. Morally I am opposed, but I can not judge. I understand and I’ve been tempted myself. Talk to your priest, get a 2nd opinion, and then a 3rd opinion. And remember that there is no easy “fix” or answer here. It is very personal and easy for those of us not in your shoes, your home, your family to tell you what you already know, but we are not there to make the decision. Just remember that nothing is solved by having your tubes tied and you may in fact be inviting more health issues and invasive procedures into your life by having it done. Doctors don’t tend to tell you the negatives of contraception. Please know that you are in my prayers and don’t let the doctors fool you into believing there is only one answer here

Let’s not forget that even tubal ligation is not 100% effective as birth control.

“There is a slight risk of becoming pregnant after tubal ligation. This happens to about 5 out of 1,000 women after 1 year. After a total of 5 years following tubal ligation, about 13 out of 1,000 women will have become pregnant.”

webmd.com/sex/birth-control/tubal-ligation-and-tubal-implants

That’s slightly more than 1 in 100 women getting pregnant within 5 years of a tubal ligation.

Intentionally sterilizing yourself for contraceptive purposes (and not merely as an unintended side effect) is immoral. It’s not merely “church dogma,” it’s natural law and Christ’s truth.

The situation does indeed sound very grave. But even grave circumstances do not justify recourse to immoral actions. Your options really are: 1) Complete abstinence until menopause (a cross, to be sure, but not impossible) 2) the strictest NFP or 3) asking about the medical necessity of a partial or total hysterectomy. In the last case, it’s a medical necessity only if you would need one even if you were not sexually active. In other words, the fact that another pregnancy will have such dire consequences does not factor into the decision.

If it were me, I would go to confession and communion to pray for wisdom and courage. If you were confirmed, the Holy Spirit is available to give you these gifts.

This is true!!! And even more often, vasectomies “fail!” Ft. Campbell, KY is full of babies born after Daddy got snipped. And yes, Mommies were 100% faithful to Daddies. It just happens. My neighbor had fraternal twins 11 months after her husband had his vasectomy. It’s not unusual. Another reason to look into the “negatives” of contraception that doctors don’t like to talk about. And to bypass procedures that won’t resolve the problem, especially since they CAN cause even more harm in the long run

We’re forbidden to provide medical advice, but I should note that my wife has been counseled by a high-risk OBGYN that if she were to get pregnant and there was an implantation on the scar… their usual course of action is a partial or complete hysterectomy after delivery.

The risk climbs with each successive pregnancy for women who have classical incisions, even if the classical cuts are “just” on the inside like it is for my wife.

My point is that I concur with the other posters who say you should ask your doctor about the possible need for a hysterectomy. I know it’s a seriously painful thing to consider, but it’s not some loophole to get around the Church’s teaching. Uterine rupture is not a small thing.

DISCLAIMER: The views and opinions expressed in these forums do not necessarily reflect those of Catholic Answers. For official apologetics resources please visit www.catholic.com.