A Surprising Reaction to Facts on the Tubal Ligation Procedure Added: 11/23/2006

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In the autumn of 1988, one surgeon affiliated with UCLA had an interesting patient. She was a patient who had come to the surgeon to request a tubal ligation. The one thing that made her visit a particularly noteworthy visit arose out of her reaction to the information on the tubal ligation procedure. She essentially offered no reaction at all to the specifics about that surgical procedure.

The surgeon made a point of sharing with the patient the usual details about the tubal ligation procedure. He even told the woman that during the operation he would need to make a small cut on both sides of her lower abdomen, in order to get to her ovaries. Each fallopian tube would be tied at a point close to the ovary.

The surgeon expected that the woman in his office might wince a bit at the mention of a cut on her lower abdomen. When she did not show the expected reaction, he offered an observation about the tubal ligation procedure. He reminded his patient that such surgical cuts would cause scarring, and that she might thus want to refrain from wearing a two piece bathing suit in the future.

The surgeon then learned why his first mention of the surgical cuts had not elicited a noticeable reaction. The surgeon discovered that the tubal ligation procedure could be seen as far simpler than the surgery that his new patient had had a number of times in the past. His patient had a ventricular shunt, a tube that drained fluid from her skull cavity into her peritoneal cavity.

More importantly, at least one operation had given the woman sitting before the surgeon a large, obvious abdominal scar. Upon learning the facts about his new patient’s medical history, the surgeon could see why she did not flinch when hearing him describe the tubal ligation procedure. The surgeon thought that he might have a patient who would later be willing to try a tubal ligation reversal.

Rather than ask outright, however, concerning his patient’s possible interest in a tubal ligation reversal, the surgeon presented his new patient with a question. He asked her why she had not thought about asking her husband to get a vasectomy. He explained that the vasectomy provided a couple with a much easier method for obtaining a permanent way to prevent further pregnancies.

Then the surgeon got some further surprises. Then the surgeon learned that the woman before him did not expect to have a baby with any man in the future. She had discovered that any shunt placed in her body had a limited lifetime. She considered herself very lucky to have managed to stay with one shunt long enough to give birth to two sons. A later surgery to fix a broken shunt had forced the couple to loose a third child.

For that reason, the woman in the surgeon’s office did not think it wise for her to plan on again becoming pregnant. For that reason, she wanted a surgeon to carry out all of the steps in a tubal ligation procedure. For that reason, she had elected to have her own reproductive system, and not that of her husband, altered by a sterilization procedure.

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