Family health

A tubal ligation or endless possibilities?

Even though she's almost positive her family is complete, Kristin prefers remaining open to the unknown over finality when it comes to having more children

By Kristin Auger
A tubal ligation or endless possibilities?

Photo by See this World through Lenses via Flickr

I know it’s meant as a compliment, but every time someone asks me when I’m due (right about now) and then proceeds to proclaim with shrill disbelief, "But you're so tiny still!", my heart sinks.

It happens more often than I’d like.

Although the 22 pounds I’ve gained during this pregnancy fall on the low end of the norm, I’ve been measuring small at my OB appointments for several weeks now. I’m full term; in my 40th week of pregnancy (and last week) I was still measuring around 34 weeks. I lost seven pounds during my pneumonia bout over the holidays and I’ve been unable to gain it back.

Today at my last appointment with my obstetrician prior to my C-section surgery, I settle myself on the paper-clad metal table and pull up my shirt as my kind-eyed doctor squirts clear, thick liquid on my belly.

“I’ve been eating all kinds of healthy carbs,” I tell him as he listens to the baby’s horse-gallop heartbeat. "And the nurse says I’ve gained half a pound.”

He smiles, indulging me, and takes out the measuring tape. He scribbles something mysterious in the file behind him.

“Has the baby grown at all?”

He shakes his head no.

“But you’re not worried?”

“You’ve actually lost half a centimeter but he likely dropped a little more …you’ve gained a healthy amount of weight and you’re otherwise very healthy. I’m not worried.”

He calmly washes his hands and I think about newborns and sleeplessness and the tempo of years and changing of relationship dynamics.

I am days away from my scheduled C-section and I am so ready to meet this baby. I am so ready to not be pregnant. My stomach’s emotions exist only in high flips and low flops, I’m constantly buzzing with slightly terrified anticipation.

I think about asking my OB about paediatrician recommendations and he turns around and looks at me with one eyebrow raised.

“Have we already talked about tubal ligation, can you remind me?”

“About what?” I heave myself up, tissue paper stuck to my pants.

“Tubal ligation. While you’re having the C-section.”

I look at him mutely and he spells it out for my distracted, whirling brain.

“Your tubes tied. Permanent birth control.”

“Oh!” I just stare at him, wide eyed.

“No, we haven’t talked about it I guess,” he says.

“No,” I reply. ”I don’t think we have.” I suddenly wonder why I haven’t even considered asking him about contraception options. I am in my mid-30s and it already freaks me out that I’m considered to be of “advanced maternal age.” Corey and I have discussed the insanity of being outnumbered by our children and have both referenced this pregnancy as my last one. I have been on the pill for a very long time and they are probably not great for me, they’re definitely expensive, and since I’m prone to fits of absent-mindedness, they’re also potentially somewhat conducive to a subsequent pregnancy.

“I’m old,” I tell the  doctor. "And I’m pretty sure we’re done. But I …don’t know.”

The thought of having my tubes tied sends an inexplicable surge of sadness through me. "If you don’t know,” he says,”then we won’t do it. You need to be 100% sure.”

“Well — I think we’re pretty sure this is it,” I say and think for a second. "Isn’t it much less complicated for Corey to get snipped than for me to have my tubes tied?”

“Normally, yes,” he replied. "But since we’re already doing the C-section, it’s not very complicated to perform a tubal litigation at the same time.”

“Oh," I say and then, “I really don’t know. Let me talk to Corey.”

He nods and picks up my file. “We’ll see you Thursday.”

I call Corey on my way home.

“I’m still measuring small,” I say, "but the doctor is still not worried. My blood pressure was a little low. Also, should I get my tubes tied on Thursday?”

He’s quiet, so I start talking quickly.

“I mean we’ve said no more, right? But I could always just go back on the pill, it’s worked for a lot of years.”

He doesn’t say anything, which is pretty typical.

“I don’t mind taking the pill, though,” I say. “But, on the other hand, while they’re in there cutting the baby out anyway, it’s just as easy to tie off a few tubes.”

“But if you don’t do it, we still have options,” he says. ”It’s nice to have options.”

“It is,” I say, and relief floods through me because even though I don’t want to be 40 years old and pregnant and we don’t want to be outnumbered and childcare is expensive and we both want to maintain careers and lives outside of parenthood — the prospect of willfully ending the magic of the possibility of creating another human life is really kind of devastating.

I toss my cell phone into my purse and pull out of the parking lot and stare through my tears at the hill, down to the sun-jeweled ocean and the Vancouver skyline across the water. I think about my worries about small measurements and healthy babies and morphing relationships and shifting priorities.

I think about this baby, and about the fact that just five years ago, I wouldn’t have believed in the possibility of his existence, couldn’t have fathomed that I might find the love that created him. I drive home and I consider the power of possibilities, hope and choices.

I’ll be having this baby tomorrow, and he will probably be perfect and he will almost certainly be my last. But I don’t know that for absolute certain, and for the gift of the unknown — for the perpetual openness of amazing possibilites — I’ll always be grateful.

Photo by See this World through Lenses via Flickr

This article was originally published on Feb 15, 2012

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