Having a Bilateral Salpingectomy Done After my 3rd C-Section

Finding out I was pregnant again 4 and a half years after my second child was a surprise! I was just completing my last semester in school getting ready mentally and physically to work outside from home, because I’ve been working from home for the past 6-8 years and here I start having Hyperemesis Gravidarum symptoms. I also had Hyperemesis Gravidarum for Both of my girls, and that was my worst nightmare for getting pregnant again. 

Now that I already know what to expect from my usual morning sickness, the only thing that helps with my anxiety while I am hoping for this to be over in my early or mid-second trimester is to hear my baby’s heartbeats. At first, the pregnancy excitement wasn’t there yet because I had other plans. Here I am falling in love with my baby a few months in my first trimester and telling myself everything happens for a reason. As I am going to my pregnancy follow-up and my doctor asks what method of birth control I plan on using after giving birth. I automatically say to “remove my tube because I don’t want to have any more children”. This pregnancy was going to be my 3rd c-sections and my 3rd baby girl. As a mom of 3 girls, one of my goals is to enjoy motherhood by planning fun activities and traveling together. While completing my last semester in school and working full-time, I’ve noticed the lack of time and affection I expressed to my two older children. Due to the nature of my Hyperemesis Gravidarum and the amount of stress I was into during this pregnancy, I decided right away that this is going to be my last pregnancy. I feel fulfilled and thankful to have 3 kids and I just love them the best I can and be happy with them instead of keeping having more.

As we are getting closer to my due date, all of a sudden I started feeling sad. The feeling became more overwhelming as I rubbed my belly, wondering if the recent decision of having a bilateral salpingectomy done after my third birth was the right thing to do. I tried to assure myself that going through that procedure was good and necessary, considering that I have only been giving birth to my lovely children through C-sections. Yet as I thought about my lovely family, I couldn’t help but wonder if my decision hadn’t been selfish. I mean what if I had done this same bilateral salpingectomy right after giving birth to one of my lovely girls before? Would I have had the chance of giving birth to them in the first place? What if my parents had also done this during their own time? Would they have been able to give birth to me or my ever caring and loving siblings? Am I not kind of selfish in my latest decision? I just can’t believe that I would no longer be able to have any more children of my own. And yet a good part of my mind still knew that what I did wasn’t wrong if indeed I really wanted to be there for my family.

Back to when I started having to give birth through Caesarean section, my husband and I knew that it was just a matter of time before my body tells me to stop. Though not that C-sections are bad or totally unsafe, but some women like me just don’t have the bodies to sustain giving birth through such a procedure for long. Even though all the C-sections that I’ve been doing had all been surgically perfect, but I’ve been told that the incessant use of the procedure to give birth can cause several side effects on a woman depending on her body.  Now I and my husband later decided to have a third baby but he wasn’t as keen as I was to have yet another child. That issue alone nearly caused a rift between us but we found a way to patch it back. I knew he respected my decision but was only worried about my safety. I got pregnant the third time but it wasn’t as smooth as the first two.

And looking at the way my beautiful children are now growing, I always try to remind myself doing the salpingectomy was not just something I wanted but it was also something that I and my family needed. So for any mother that might have experienced the same thing, I want you to know that it’s perfectly normal to feel unsure about whatever decision you are making for your family planning as long as it doesn’t endanger your life and that of your child. You may feel guilty and be emotionally frayed at the beginning, but I can assure you that you’d later look back just like I’m doing now with no regrets and happiness at the decision you had taken.

ABOUT CAESAREAN BIRTHS

Before we discuss the need for having a bilateral salpingectomy after multiple C-sections, it is logical to understand the reasons why some women only opt-in for the surgical alternative to the vaginal procedure. These reasons usually include distressed baby or babies in the womb, underlying health conditions, mechanical obstruction, having a case of Placenta Previa (when the placenta has covered the cervix’s opening) Cervix not opening well despite long hours of having strong contractions, too many babies to deliver, stalled labor, abnormally positioned baby, having the umbilical cord slip ahead of the baby, and having no past complications with having Caesarean section births.

All of the above are exemplified reasons why some mothers chose or were forced to do birth by C-section. However, having some of the medical problems listed above doesn’t mean going through C-section deliveries, especially multiple times to deliver your babies is complete without side effects. For some women, their body can take having multiple C-section deliveries while some others cannot take more than one C-section delivery or only a couple of times of it.

According to the mayo clinic, Each repeat C-section is generally more complicated than the previous one. However, research hasn’t established the exact number of repeat C-sections considered safe. Though everything about the medical procedure is still determined by the body and health of the pregnant woman involved. Also, the surgical cut method being used for you during your Cesarean section can be a determining factor. There are three types of C-section surgical cuts, namely the high vertical cut, the transverse cut, and the low vertical cut.

Women who have had multiple repeats Caesarean deliveries are at increased risk of the following: Problems with the placenta, Postpartum hemorrhage, surgical injury, Uterine rupture which is the spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity, and occurs around the scar, complications related to adhesions used in sealing your surgical wound, incision related complications, etc.

One of the medical solutions commonly used by some women trying to save themselves from having health complications from continuous C-sections or wanting to quit having C-section births altogether is known as Salpingectomy.

WHAT IS A SALPINGECTOMY PROCEDURE?

Salpingectomy surgery is the surgical removal of either one fallopian tube (unilateral salpingectomy) or both (bilateral salpingectomy). The surgical procedure is also called Tubal Ligation. Your doctor may recommend having your Fallopian tube(s) removed as a treatment for fertility problems or tubal disease, including cancer or infection.

Postpartum sterilization is sterilization performed after the birth of a baby. After a woman gives birth, the fallopian tubes and the still-enlarged uterus are located just under the abdominal wall below the navel. Postpartum sterilization ideally is done before the uterus returns to its normal location, usually within a few hours or days following delivery. For women who have had a cesarean delivery, it is done right after the baby is born.

A salpingectomy involves removing a blockage or creating a new opening – also known as a stoma – for the Fallopian tube. It is often used when a patient’s tubes have been damaged by disease, past surgery, or adhesions. Adhesions are areas of scar tissue that cause organs to stick together.

The number of C-sections you’ve had can also affect your future delivery options. A trial of labor isn’t recommended after three or more prior C-sections.

WHEN IS IT USED?

This procedure is done shortly after you have had a baby when you are still in the hospital. If you have a cesarean section, the tubal ligation may be done at the same time. Tubal ligation is only done if you have asked for it. Although it is more than 99% successful, about 1 in 250 women get pregnant after a tubal ligation. It is very difficult to reverse the procedure and make it possible for a woman to become pregnant again. Because of this, you should have this procedure only if you are sure you do not want to become pregnant again.

Healthcare providers generally recommend a permanent form of birth control, such as tubal ligation, only if:

  1. You have had as many children as you want.
  2. Being pregnant might be dangerous for you.
  3. You have a high risk of passing on a serious genetic disease.
  4. You cannot use other birth control methods.

Examples of alternatives to having the procedure just after delivery are: trying other forms of birth control, waiting 2 months after the birth of your child to have a laparoscopic tubal ligation, or other types of tubal sterilization, having your partner get a vasectomy, etc.

-You should ask your healthcare provider about these choices-.

WHAT CONDITIONS CAN A SALPINGECTOMY TREAT?

A salpingectomy procedure can be performed to treat several serious gynecological conditions, namely:

  • Endometriosis
  • Infection due to sexually transmitted or other diseases
  • Tubal adhesions
  • Scarring or blockage due to previous tubal surgery
  • Ectopic pregnancy
  • Blocked fallopian tube
  • Ruptured fallopian tube
  • Hydro salpinx
  • Fallopian tube cancer
  • Infertility
  • Diagnostic laparoscopy (user for fallopian tube damage inspection)

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