How to advocate for yourself at the GYN
Disclaimer: I am not a medical professional and this podcast does not offer medical advice. Please consult your doctor when making medical decisions. Mom of None is not responsible for any decisions you make after listening to this episode. The goal is to give you information to make the decision that’s best for you. And whatever you decide, know that I’m here to cheer you on.
To date, this has been the hardest podcast episode I’ve done, and in my opinion the most important one.
What happens when you go to your gynecologist and ask for permanent birth control and you’re 19 or 25 or 32 with no previous children?
In Episode 9, I reviewed To Kid or Not to Kid, a documentary about choosing to be childfree and there was a woman in her 20s living in the UK, who had decided not to have children but was having a difficult time because she couldn’t find a doctor who would do the tubal ligation because she was so young and may change her mind.
Has this happened to you? Well, it’s happened to me. I had decided in my early 30s, I didn’t want to have children and talked to my gynecologist about my options. At the time I was unmarried and not dating anyone seriously. He was not forthcoming with information and I spent most of the time defending my choice. I left feeling defeated with my prescription for birth control pills. I should have changed doctors. After I got married and went for my annual visit, he said aren’t you glad you didn’t decide on permanent birth control? When I told him my husband and I had decided to have a child free marriage, he was visibly shocked. Still wouldn’t discuss permanent birth control because we were newly married and likely change our minds but agreed to give me an IUD, which was not the best option for me and had it removed. Again, I should have changed doctors. This went on every year until recently. I’m currently in the process of changing doctors. Will I have a doctor who listens to me now that I’m in my mid forties and they know that baby ship has sailed without medical intervention.
I reached out to some medical professionals, whom I’ve decided to keep anonymous, to find out how you can advocate for yourself at the gynecologist office. The most important thing is to arm yourself with information. Had I had the information I’m about to share with you, maybe I would have had a better experience.
I came up with a few questions that I thought would help get the information we need to advocate for ourselves. The professionals I spoke with are registered nurse practitioners and physicians and I’ve consolidated their answers. Keep in mind the rules and policies may be different depending on where you live and what your insurance covers.
Are patients discouraged from permanent birth control (tubal ligation) if it’s not medically necessary if they are young/unmarried?
The short answer is yes. We have a very religious, patriarchal and political healthcare system. These are views that are passed down through clinicals. Doctors regardless of gender think you’ll change your mind. You’ll fall in love and want to have a baby. You’ll get older and think of the, wait for it legacy you’ll leave behind. In some cases, insurance doesn’t cover it unless you already have children.
Even women who have children and want tubal ligation after their c-section, having completed all the applicable paperwork are asked to verify their decision right before the doctor does it. Like on the operating table… Are you sure? Many doctors fear “buyers remorse” and the lawsuit that may come with it as tubal ligation is not reversible. Options for pregnancy post tubal ligation is IVF which can be very expensive and may not be successful.
Are patients discouraged from having a baby if they are young/unmarried?
The short answer: no. Doctors don’t ask are you sure you want to keep this baby? Abortions are not recommended. Babies are a gift from God. Women are encouraged to have a baby regardless of quality of life because babies will change your life for the better. One medical professional I spoke with works with victims of sex trafficking and she says these statements just don’t apply.
When talking about family planning and a patient expresses they have made the decision not to have children, are they given options of permanent birth control?
A doctor will take into consideration the patients relationship/marital status, prior pregnancies, children and reasons for this decision. The doctor should discuss the pros and cons of tubal ligation. Temporary birth control is often recommended, like an IUD, so you have time to think about it.
Are doctors biased in assuming all women will eventually want children therefore discouraging permanent birth control?
The short answer, yes. As I said earlier, it happened to me. But a doctor can not and should not force their paternalistic/maternalistic views on you. Consideration should be given to alternative family constructs but in most cases, they are not. Many women are forced to consider childbirth. If you have a vagina, it is assumed you will want to give birth at some point.
How can patients advocate for themselves at the gynecologist?
The first step is to have this conversation in the doctors office, not in a paper gown in the exam room. You should arm yourself with a reproductive health plan, similar to a birth plan for moms to be. One of the professionals I spoke with came up with this idea and I love it It outlines what you want to do for short and long term birth control and what mental and physical support you have for your decision. Do your own research, what may be good for someone else may not be good for you. Learn about the different types of birth control and the associated risks. Some short term methods include implants, IUDs, shots, vaginal rings, patches, and pills. Because it’s true, some women change their minds. And that’s ok, you have the right to change your mind and no one should fault you for it.
You should be aware of the local laws as far as age and guidelines for consent as well as your rights as a patient. Some localities may require counseling and/or a waiting period. You should feel empowered to remind your doctor that it is your decision, not theirs and if they don’t support your decision, you will find a doctor who will. Birth control is not only a woman’s decision, it’s much easier for a man to get a vasectomy because it’s cost effective and in many cases reversible. This option is often recommended to married couples or those in long term relationships.
I really hope this podcast has encouraged you to do your own research about what is best for you and helps someone feel more confident when speaking to their doctor about their birth control options. Just like the decision not to have children is your choice, the process of the choosing the best reproductive health plan for you is also your choice.
I want to thank the medical professionals who took the time to answer my questions, your insight is appreciated.
Their credentials are:
CRNA, Nurse Anesthetist
APRN MSN FNP-C IBCLC
Maternal Fetal Medicine Specialist
Registered Diagnostic Medical Sonographer
Have you experienced a doctor not listening to you when it comes to your reproductive health? Have you realized your doctor may not have discussed all of your options? Do you have an amazing doctor who respects your choices and works with you to provide the best healthcare options? Leave a comment below!
Episode 9: Film Review - To Kid or Not to Kid
Please share this episode with 3 friends and spread the word so doctors become more accustomed to self assured women coming into their offices to speak confidently about their birth control options.