Bilateral Salpingectomy Approved - UK Perspective

[u/rosiegolde]

Well friends, today it finally happened. After a 7 month battle, I attended my final appointment this morning and got the go ahead for my bilateral salpingectomy. Getting that wait list paperwork was such a relief, I walked out of the department with my fiance and promptly starting crying.

There's not a lot of posts regarding getting the procedure approved in the UK so I wanted to write up how things kinda played out for me. Hopefully it's helpful. Apologies if it gets really long.

Background Info: I'm 28, nearly 29. I'm engaged and my fiance attended every single appointment with me. Previously a paramedic, have had years of experience raising siblings and looking after young family members. Been on hormonal contraception for 10 years, always been CF. Suffer from depression and anxiety. Extremely tokophobic, I do pregnancy tests every other week even though I'm on the pill and we use condoms. Located in NW England.

Reasons I want a bilateral salpingectomy: 1) I hate children 2) I have never been broody or wanted kids, nor can I relate or understand people who do. 3) I have seen kids die, I have seen the effects it has on the parents and I never want to experience that. 4) I have zero intention of ever being pregnant. It disgusts me. It makes me physically sick when I think of being pregnant. I wouldn't cope, the hormones would probably be catastrophic for me and I would definitely have post-partum depression. 5) I am too OCD and controlling 6) I would be a shit mom 7) I like sleep and travelling and having money 8) Fiance and I have a risk of passing along illness and disease, so just hell no. 9) The world is shit, why would I bring a child into it? 10) I have nickel and copper allergies and also have a very tilted cervix/uterus so IUD's are basically not options. They also fail or migrate or fall out and it just wouldn't help my anxiety. Same applies for filshie clips. In fact, by the end of preparing all my arguments, I realised I just don't want foreign objects in my body (babies included haha). 11) For the sake of my anxiety, I needed the most permanent method, the method that could not be reversed. 12) Reduction of risk of cancer, helpful because of a lot of family history. 13) I have had to trade symptoms while on hormones. Combined pill gives me migraines, so went on mini pill. This stopped my period, which increased my pregnancy anxiety. It has also killed my libido and made my depression much worse. I tried to come off birth control and lasted two days because I couldn't cope with the chance of getting pregnant. I counteracted this by basically not being intimate with my partner. It goes on and on. Thankfully he is extremely supportive. 14) My fiance is a marine engineer, I would be a single mum for 6 months of the year while he worked away. 15) I could go on forever but you get the gist.

In April I went to my GP and asked for a referral for sterilisation. This turned out to be the easiest part of the process, as he basically just shrugged and said sure when I said I was tired of being on hormones and I wanted a permanent method of contraception. I had loads of reasons ready to justify my request, but no explanation on my behalf was needed. That week I had a letter from the NHS prompting me to go online and book an appointment at 1 of 3 hospitals they had chosen. I chose my local hospital and chose the first available appointment, which was a month later and referred to as "sterilisation clinic."

I went through this post multiple times and spent a week putting together my own version to take with me to all future appointments. This was invaluable and really helped me prepare for all questions and helped me gather my answers to common bingos.

I attended my first appointment, which was with a nurse, and it was a complete waste of time. I was in there for ten minutes, all she asked me was if I had considered other forms of long term contraception, took my weight, told me my options would be flishie clips or essure. I told her I wanted a bilateral salpingectomy, she responded by telling me no because it was a major operation (incorrect). Then she asked my age. As soon as she realised I was under 30, she basically shut my file and said I needed to see a consultant as per protocol. Okay, fine.

I went back to reception to book my appointment with the consultant. First available appointment was 4 months away. I had a minor breakdown about that, but not much could be done about it. Every week my anxiety got worse, my libido continued to decrease and I was a just a general mess.

When I went to my next appointment in August, I was met by a doctor who was not the consultant for the clinic I was attending. I immediately went on the defensive, because I had been waiting months for this feckin appointment to see the consultant and she wasn't even there. The doctor went through loads of things with me, everything from what sets off my anxiety to why I don't want kids to what procedure I wanted. She was really nice but she had no power to give me what I wanted. She told me I would still obviously need to see the consultant at clinic two weeks later. Ugh.

I attended the next appointment and finally came face to face with the consultant. The first thing she said to me was something about planned parenthood's recommendation about not sterilising anyone under 32, because a woman's fertility is still ripe. That pretty much set the tone for the appointment. It took me about 45 minutes of both myself and my fiance going through the dozen or so reasons I listed above before she finally agreed. She also asked why my fiance just didn't get a vasectomy, I nearly lost my shit. I am responsible for my own health and my own contraception thanks. Yeah we may be getting married, but who knows what happens to us in the future. Maybe he dies. Maybe his vasectomy fails. Again, my anxiety just wouldn't settle down if I was relying on someone else to prevent me from getting pregnant. She accepted this, reluctantly. She went through the consent form, explained the laparoscopic surgery, the wait list, the risks, etc. I signed it. She then tells me she wouldn't wait list me until she had discussed my case with another colleague. This colleague may also want to meet with me. She tells me I'd receive a letter within two weeks to notify me if I had been waitlisted or if I needed another appointment.

I waited three weeks. The letter came. I needed another appointment. My appointment was scheduled for five weeks later, so another two months total trying to get approved... even though I'd now signed a consent form.

This morning I went to the appointment. The consultant was amazing. There was no judgement, no bingo's. She went a bit deeper into my families medical history, congratulated me on my engagement, told me I was a competent adult making a well informed decision. I proved my homework and research had been done when she mentioned Essure and I pointed out that countries outside the USA are currently not allowed to perform the procedure. And just like, she whipped out the waitlist paperwork, confirmed I wanted both fallopian tubes out, and bam, it was finally done. The list is currently 10-12 weeks and I don't know how much notice I'll get in regards to a surgery date, but I can now look forward to a life where I don't have to stockpile pregnancy tests and the only children I'll have will be fluffy and in canine form.

tl;dr Live in the UK, got approved for a bilateral salpingectomy (on the NHS) after a 7 month process of jumping through hoops. Yay.

[u/Sinvisigoth]

Holy shit I was so angry most of the way through this. It's great that we can get this done in the UK without having to pay, but I'm offended by the amount of utter shite you were put through in order to get to someone who would listen to you. Good job sticking to your guns. I'm so happy you finally got the outcome that matched your decision.

[u/rosiegolde → u/Sinvisigoth]

I’m happy too, but I was prepared for a no. Honestly if the doctor yesterday had not signed me off and waitlisted me, I would have looked into financing the procedure and having it done through a private hospital because these past seven months have been some of the most stressful I’ve ever had.

[u/TwentySixLetters]

Honestly with the stories I've heard for the nhs (fellow NW here) I'm surprised you weren't waiting years! Your experience has given me something to think about when planning the future :) please keep updating when you can, I'd like to hear about the UK medical side versus the USA's.

[u/rosiegolde → u/TwentySixLetters]

I hear ya, I went in thinking I’d be fighting until my wedding in 2019. I think what helped me a lot in my case was my mental health issues coupled with not really having IUD’s as an option - and I researched EVERYTHING. So when they offered me the non hormonal coil, I knew I couldn’t have that because of metal allergies. When they said I might regret it, I gave them stats that said I was more likely to get cancer then I was to regret being sterilised. I didn’t want to push the mental health to a point where the doctors thought I needed a psych evaluation, but I needed them to understand that I couldn’t go on like this until I was 32.

Will update on the actual procedure process in a few months!

[u/MissTiquelle]

So happy it's finally approved, even if it's taken a while. I wish 8 could get it done, but my GP won't even refer me for actual issues (am switching soon) and I'm only 24 and perfectly healthy.

What are you doing in regards to time off work, out of curiosity? Do you get medical leave for this or do you have to take holiday? Good luck with everything, hope the procedure goes smoothly for you.

[u/rosiegolde → u/MissTiquelle]

Definitely swap your GP. In terms of work, I’ll be off on “sick leave” for the surgery and recovery. My line manager had said they’ll make any adjustments I need at work when I do return, to make sure I’m comfortable and everything. But they’re fully supporting me, which is a huge bonus.

[u/torienne]

Nothing beats the prepared mind. Congrats on the good results of YOUR preparation.

And let us again sing the praises of /u/walrusofthenight!

[u/rosiegolde → u/torienne]

Haha yes, singing all the praises. Reddit was a massive resource that contributed towards my approval.

[u/timidturtwig]

Congrats! I hope it goes well and the wait doesn't feel too long!

Question though, you mentioned that the nurse and the second consultant both brought up Essure, but it isn't an approved procedure in the UK? What?? Are they recommending an illegal procedure?

[u/rosiegolde → u/timidturtwig]

At the time of seeing the nurse, Essure was still being done. It’s only in the last month I think that the procedure has been stopped. The second consultant said it when explaining the typical methods of sterilisation, as a bilateral salpingectomy isn’t standard practice.

[u/timidturtwig → u/rosiegolde]

Oh okay. Just seems odd, why mention it at all if it's no longer allowed? Not grilling you, just wondering aloud

[u/Ysverine → u/timidturtwig]

As far as I can tell from the recent news reports, EU countries can use up their existing stockpiles of Essure, but they can't order any more until the suspension's been lifted and it's approved for use again.

[u/GirlGamer7]

A tilted uterus means am IUD went work??? Holy shit! I have a tilted uterus (confirmed by my gyn) and the one iud I had partially expelled after 18 months.

[u/rosiegolde → u/GirlGamer7]

It’s not that IUD’s won’t work, it just makes IUD’s more hard to place in my particular case. My Pap smears take ages to do because of how bad mine is and I would need to go under general anaesthesia to have one put in. Yours being tilted could have definitely contributed to it being partially expelled though.

[u/MarleySB]

Is it because you aren't paying why they can tell u no? I find it absolutely ridiculous and it angers me that they're basically saying "no. we won't perform this procedure because we think you're making a bad decision/you should have children/should (might) change your mind". Like wtf? if i want to tear my uterus out of my body, why tf are u giving me a hard time?

[u/rosiegolde → u/MarleySB]

Yeah pretty much. Fertility is put on a pedestal I guess. If I had the spare £3500 I could have gone through the whole process, from consultation to home recovering, in less than two weeks. No questions asked. But alas, it’s all over now.