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Get your opinions off my fallopian tubes

Me: I really don’t want to have a caesarean. I don’t think I’ll need to, but if I do, I’d like it on record that I’d like my tubes tied while they’re in there

Doc: (guffawing) You’re what, nearly thirty?

Me: Sorry, how is that relevant?

Doc: Well, it’s just that that’s a pretty major decision to be making at this point in your life…

Me: Uh…so is having children isn’t it?

Doc: Have you umm, spoken to your partner about this?

Me: (raising an eyebrow) I don’t think any partner of mine would have a problem with what I want to do with my own body.

Doc: (stares at me oddly)

Me: The father’s only concern is that I might want to have more children at some later point, with other people.

Doc: Oh (fiddling with pen, as if trying to decide whether or not to probe this statement further). Have you thought about how you might feel about having had this done if something were to happen to one of your existing children?

Me: (mouth dropping open) I assume by that you mean what if one of my children dies. No, that’s generally not something I choose to sit around thinking about. You’re right of course, I daresay that if, god forbid, something happened to one of my children, the logical response would be to simply pop out another to replace them.

Doc: Sorry, it’s just that you really need to consider the implications of this decision.

Me: In any case, I was wondering whether it’s at all possible to note down on my file that I’d like this done, in the event of a caesarean…

Doc: I’ll tell you what, why don’t you think about this a little more. You’ve got plenty of time. And then, if you’re still of the same state of mind in a few months, we’ll talk about it again.

Me: I’ll tell you what, why don’t you think about this a little bit more, and if you’re still in the same state of mind in a few months, we can talk about the fact that I’m an adult and perfectly capable of making my own medical decisions and that, consequentially, you should take your archaic opinions off my reproductive system.

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Maxine Beneba Clarke is an Australian author and slam poet of Afro- Caribbean descent. Her short fiction collection Foreign Soil won the 2015 ABIA Award for Best Literary Fiction and the 2015 Indie Award for Best Debut Fiction, and was shortlisted for the Stella Prize. Her memoir, The Hate Race, her poetry collection Carrying the World, and her first children’s book, The Patchwork Bike, will be published by Hachette in late 2016.

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  1. I’ve had similar conversations with my own doctor. I’m thirty, my child is what they term ‘special needs’, and it’s been recommended I don’t have any more children… but still he insists I’m being rash. I can’t help but get frustrated when he says thirty is too young for the procedure, as I had my son at twenty-one. It also infuriates me when he says I may want to have another if something were to happen. Wouldn’t that be rather irresponsible considering I’m older now, and have this predisposition where my offspring are concerned? My doctor seems like a lovely, educated man, but sometimes I wonder. I know he has a duty of care to my body and well-being – as do I, but I don’t believe he has any ownership over MY life choices.

  2. I wonder how many young(ish?) women have had the same experience Bel. I know that several of my friends have, some even with female GPs. I find it baffling, and really insulting that any doctor could think that such a request was made without seriously considering the implications/consequences.

    Imagine if happily pregnant women visited their GP only to be asked: ‘Have you seriously considered the implications of having this baby on your lifestyle and future, your finances, the environment? Maybe you should re-consider. What if you don’t like motherhood and you regret not having an abortion? Go away and come back in a couple weeks after you’ve thought about this.’

    Surely there would be an outcry.

  3. Well, the major problem is that if the doctor does not get you to consider the procedure more thoroughly, then they live with the fear that you will come back and sue if the patient suddenly changed their mind.

    It has happened in the past with the excuse of “the doctor just pushed me to do it” after regretting the decision they made as informed adults.

    Everyday doctors walk through a mine field of legalities, and there are people who just want to palm responsibility onto the doctor.

    So don’t blame your doc, blame the sue happy minority who think the world owes them a favour.

  4. I don’t know any woman who hasn’t considered all the issues involved in decisions like this since puberty. I suppose it isn’t a bad thing that a doctor “double checks” to make sure the decision is final, but it is the “Have you talked about it with your partner?” that gets me. Is that a question about how honest you are with your partner, if you even have one, or (at the extreme) does it suggest that you shouldn’t have such a procedure done against a partner’s wishes? Even if it is just to check that you have gotten “second opinions”, the implication remains that a grown woman might not be able to reach an informed choice independently.

    My own favourite experience of a patriarchal/patronising doctor was when I went to refill a prescription for the pill (which, incidentally, I had been on since I was 14 for medical, not contraceptive, reasons). After being lectured for an hour about all the dangerous side effects the doctor asked, and I quote, “Are you virginal?” When I said no, he wrote out a prescription on the spot without even taking my blood pressure. Hmmm. Methinks his concerns were not about the side effects after all. :D

    At the time, these things are infuriating but in the end, I just find myself laughing. As I laughed (sorry – it was sympathetic) when I read this.

  5. The “have you talked about it with your partner?” question is also used for vasectomies. Men as well as women are encouraged to discuss these “big” decisions with their families.

    Granted it may be seen as patronising and I think I can safely assume that it is often put in a patronising manner. For the Doctor needs to show that they gone through the complete cycle of care to ensure they don’t get sued etc.

    I must say though, Lani in regards to your story – Methinks that doctor is a little bit bullshit.

    • I’m sure, ethically, most of us would agree that being honest with a partner about any reproductive decisions is the way to go but I do think the partner question is beyond the scope of a doctor’s duty of care, regardless of sex. It contains far too many assumptions and implications.

      Change the question to “Have you discussed the issue with a partner or a family member or a friend”, perhaps? I still don’t think it is a necessary question to determine whether the patient has reached an considered decision or not, but at least it doesn’t contain the implication that the decisions you make about your reproductive system should be contingent on the desires of another person.

  6. I don’t think the desire for legal indemnity excuses the second-guessing of medical professionals on matters of women’s reproductive health – particularly as a lawyer myself. Doctors effectively fulfil their obligations by providing reading material and requiring forms to be signed. And as Lani says, this is the sort of issue that I’m pretty confideny many women have thought about since puberty.

    I also agree with you Lani, that the ‘partner’ question has awful connotations…the implication being, as you said, either dishonesty or that (assuming I had a partner and assuming, perhaps, that partner was male) if my partner objected, I should reconsider.

    I think the vasectomy issue is different for many reasons. One of them being that pregnancy and childbirth (and unfortunately still in today’s society also child rearing) have a whole set of different health and social implications for women and their bodies.

    • Nicely said, Maxine.

      It’s high time there was a change in the way medical professionals approach these issues with women.

  7. Maxine, even though you are a lawyer, you clearly do not understand medico-legal matters. A doctor providing reading material does not fulfil their obligations. Informed consent requires that the patient understands the procedure. It is the doctors responsiblity to make sure this happens, and by giving a patient reading material does not mean that they will read it, or understand it.

    Also, I think your comment that the vasectomy issue is different, is quite pretentious. Just because you have female reproductive organs and not male ones does not affect the doctors responsibilties.

  8. What I mean is Shane: This conversation (as with Bel’s conversation), clearly went beyond any required medical knowledge. All that needs to be understood are the medical implications of such a decision (ie: any side effects and the fact that clearly, you cannot have children after such a procedure).

    My opinion is that moral issues/judgements (ie: discussion with a partner, or whether one is ‘too young)can be more appropriately conveyed through literature, if people are at all interested (the consensus seeming to be, from the women who have thus far posted, that they are not).

  9. I think my favourite story about clueless doctors is from a female friend of mine.

    Doc: Are you currently sexually active?
    Friend: Yes.
    Doc: Are you using birth control of any form?
    Friend: No.
    Doc: Are you trying to become pregnant at this time?
    Friend: No.
    Doc: *begins lecture about safe sex and pregnancy* *interrupts to ask* Is there any medical reason you’re unable to conceive?
    Friend: Yeah, my girlfriend has a pretty low sperm count.

    ’nuff said.

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