Permanent Birth Control -- who should be involved in decision-making process?

M

MsEmotional

Member
Who should be involved in a woman's decision regarding birth control methods -- particularly methods that would be permanent?

Some backstory:

So my husband and I use condoms. We have two young kids and aren't interested in having more. I would actually be okay with having another one, but he's done and I am happy with our family as it is. We've been okay using condoms as our only method because they work for us and we know an unexpected pregnancy is something we can manage, even if it's not something we are hoping for.

We recently opened up our marriage. I have had sex a few times with the person I am seeing. We both insist on condoms, but I really don't feel comfortable with that being our only form of birth control. I have an appointment today to discuss my options with a physician.

I am interested in a permanent birth control solution because I have had bad experiences with hormonal methods in the past and I don't like the idea of an IUD.

My new partner does not have children and has said that he might want kids. Things with him are also very serious -- we are talking about A long term relationship. Do I involve him in my decision about birth control? Or do I assume that it's expected that I will take care of my body in whatever way works best for me and my husband? Am I to assume that if I have told him that I am not planning on more kids, that he understands he would need to find a different partner if he wants biological kids of his own? What are my responsibilities here?

Should I wait before doing anything permanent until I have a better idea of where this relationship is going?
 
Hmm. I don't think you have responsibilities to keep your options open if *you* don't want to have another chid - I, for instance, am *done*, as is Knight, and luckily for me Artist had already decided to be CF long long long before he met me which means he's fixed on top of us using condoms. If he was thinking about children, I'd still have a boundary of "not with me", because *I* do not want another child.

It doesn't sound like you're as 100% done as I am though.
 
MsEmotional said:
Should I wait before doing anything permanent until I have a better idea of where this relationship is going?
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Why? Do you want kids?

I'll admit, I'm not sure I completely understand the question. If you don't want children (more children) and want permanent birth control... what does that have to do with your relationship status with anyone? Are you a time share they all have a piece of?

I got my vasectomy because I didn't want kids and didn't want to worry about accidentally getting someone pregnant. *poof* I took care of it. Regardless of my relationships with other people, that decision is mine, 100% and in all circumstances. I'm an individual human being living out my life, there's no chance I'm sharing that kind of decision with other people.
 
Am I to assume that if I have told him that I am not planning on more kids, that he understands he would need to find a different partner if he wants biological kids of his own? What are my responsibilities here?
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If you are done having kids, I suggest you do what you need to do with your body/BC options. It isn't like you would be having kids with your husband or your BF. You are done. So... be done.


If lovers you have are wanting children, make them aware it is not with you. It has to be bio kids with other partners or adopting or whatever it is they choose for themselves.

Just because I'm someone's lover/partner doesn't mean I want to do the whole parent thing thing all over again. I'm looking forward to being done with that phase of life. I've enjoyed it a lot and I'm enjoying the teenage years. But I don't want to raise any more or start all over!

So if someone I'm seeing has young kids, I don't mind offering to babysit once in a while but I don't want to be an "active parent" again. If that's what they are seeking, they'd have to seek elsewhere. Dating people with adult children is different -- I just have to be polite to other adults in the room. It's not like actively parenting little ones. That's a whole other thing.

Galagirl
 
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MsEmotional said:
Who should be involved in a woman's decision regarding birth control methods -- particularly methods that would be permanent?
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The woman herself should decide, based on her own desire to not become pregnant or bear (more) children. I can think of no reason anyone should veto this decision, or pressure a woman one way or another.

MsEmotional said:
I am interested in a permanent birth control solution because I have had bad experiences with hormonal methods in the past and I don't like the idea of an IUD.
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A permanent method of birth control is only superior to other methods if you no longer want children. If you may want more children, and don't want to rule it out with current or future partners, why would you consider a permanent method?

MsEmotional said:
My new partner does not have children and has said that he might want kids. Things with him are also very serious -- we are talking about A long term relationship. Do I involve him in my decision about birth control? Or do I assume that it's expected that I will take care of my body in whatever way works best for me and my husband? Am I to assume that if I have told him that I am not planning on more kids, that he understands he would need to find a different partner if he wants biological kids of his own? What are my responsibilities here?
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Your responsibility is to understand your own desires and plans regarding future children, and to be honest with your partners about those desires and plans, as well as to be straightforward about what form(s) of birth control you use. It is also a good idea to talk with all opposite-sex and potentially fertile partners about what an accidental pregnancy would mean to each of you, and what you anticipate each person's needs might be in that potential scenario.

In other words, your responsibilities include honesty and communication, not giving anyone else a vote on ending your fertility.

MsEmotional said:
Should I wait before doing anything permanent until I have a better idea of where this relationship is going?
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If you think you may want children with this (or any future) partner, then you should wait.
 
Hi MsEmotional,

To me it sounds like you are wanting to be done having kids ... If that's the case, then I think you should go ahead with the birth control method of your choice. Your only responsibility, to your new partner, is to inform him that you are going to do that. This way he can make his own informed decision about whether to pursue the relationship further. He should be informed, and have that choice. At least that's how I see it.

Sincerely,
Kevin T.
 
Thanks everyone.

To answer some of the questions.....I am done having kids with my husband. He is done, so we won't be having anymore (at least not on purpose). I would be open to having another child with someone else who wants one, but I don't see how that could work. I mean, if I was living with my husband he would still end up as a primary caregiver even if he isn't the biological parent. A crying baby in he house is a crying baby in the house.

I guess what I am saying is that I am not dead set on never having more children, which is why I am ambivalent about making a permanent decision.....but ultimately even if I were wanting to have a baby with this new partner, I don't know how it could possibly work for me to have a baby with someone other than my husband while remaining married to my husband. So an accidental pregnancy is terrifying to me.
 
MsEmotional said:
I mean, if I was living with my husband he would still end up as a primary caregiver even if he isn't the biological parent. A crying baby in he house is a crying baby in the house.
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Since it seems like the only problem with getting accidentally knocked up by your boyfriend is the logistical issues of raising the kid:

Move in with the father of the kid and raise them there.
Move the father in with you and your husband so the husband isn't saddled with this responsibility.​
 
I am not dead set on never having more children, which is why I am ambivalent about making a permanent decision.
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So an accidental pregnancy is terrifying to me.
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Then choose reliable (but not permanent) BC to reduce chances of accidental pregnancy at this time.

I were wanting to have a baby with this new partner, I don't know how it could possibly work for me to have a baby with someone other than my husband while remaining married to my husband.
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Have the talks you need to be having with both partners to decide whether or not a bio kid with BF is on the table or not. Then you can decide if/when more permanent BC fits into your life.

Galagirl
 
MsEmotional said:
I am interested in a permanent birth control solution because I have had bad experiences with hormonal methods in the past and I don't like the idea of an IUD.
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Hi,

I hear you saying you would like a backup birth control method in case the condom fails. Furthermore, you don't want a hormonal method and you don't want an IUD.

I'm not sure what hormonal method you tried in the past. I think you can have an oestrogen and progesterone pill of varying strengths, a progesterone only pill (mini pill) of low strength, or a depot injection in the arm that lasts from months to years. The attraction of the mini pill is the low rate of side effects, but some people find that this means they have to take it within a 1-2 hour window every day or it doesn't work. The attraction of the depot injection is that it is a slow release depot over months or years and you don't have to worry about taking pills every day. All these methods have varying side effects on different people. They are also all easily reversible.

I suspect by "permanent" method, you are referring to tubal ligation. It's not actually permanent and can be reversed if you change your mind.

All of these methods are roughly similar in their ability to prevent pregnancy as a condom is (that is, none of these are foolproof). Also, none of them are permanent.

Anyway, that's what I remember from class. Could be wrong. Should probably check with a doctor.

Hope this helps,
Shaya.
 
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Shaya said:
I suspect by "permanent" method, you are referring to tubal ligation. It's not actually permanent and can be reversed if you change your mind.
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I would caution anyone contemplating a tubal ligation/ Essure to consider it as being permanent. Tubal reversals are expensive, not often covered by insurance and by no means always successful (same with a vasectomy reversal). Also, a pregnancy after a tubal OR tubal reversal carries a higher risk of implanting in the tube itself (an ectopic pregnancy - which can be a life-threatening emergency). (To clarify that is a higher risk than the average population, most pregnancies that do happen implant properly but the percent that don't is increased.)

Shaya said:
All of these methods are roughly similar in their ability to prevent pregnancy as a condom is (that is, none of these are foolproof). Also, none of them are permanent.
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Please be very careful how you interpret this! With "perfect use" most birth control methods can approach 99+% effective. "Perfect use" means the condom NEVER breaks/leaks/comes off/ or spills a DROP of semen anywhere near the vulva!

The reason that pills, patches, rings, shots are more effective than condoms is that it is easier to use them close to "perfectly" - yet still very many people DON'T. The less the "user" has to do, the lower the risk for "user error".

***********

It's a shame that the idea of the IUD doesn't sit well with you. The copper IUD (no hormones) is as effective as a tubal, IS reversible, is good for 10 years and can be replaced at the same time it is removed. (Personally I prefer the hormonal IUD since it gets rid of periods completely in most women - important to me because I have endometriosis).

Please note, though, that the risk of a pregnancy being ectopic (should one accidentally occur) is increased with the IUD as it is with the tubal/reversal.

***********

A diaphragm (with spermicide) might be a good adjunct to condom use in case of a semen leakage, but still has a high rate of "user error".
 
Thanks for the additional info, Jane. Essure is the permanent method I am considering. I think after all I have heard I am leaning toward the arm implant. I did the mini pill before (and the combo pill before that) and didn't like the side effects, but I am hoping that the steady stream of hormones will be better than the pill form.

I appreciate all the insights from everyone.
 
I used Implanon (the arm implant) for a couple of years. It was great not to have to worry about forgetting to take my pill, but overall I didn't like the side effects. My period was hugely irregular - which was great when it meant skipping it for a couple of months, but sucked when it meant week on week off for a while. I also developed painful blind pimples on my face and neck.

I eventually (after accumulating a decade's worth of annual requests in my medical file) talked my doctor into referring me for a tubal ligation, and haven't looked back.

If you have any inkling that you might want more children in the future then choose another form of contraception instead of a tubal. Not only would you risk finding that you're one of the ones unable to successfully have the procedure reversed, but you'd add to the statistics quoted by the "but you might change your mind" chorus who put a 10 year wait between me and my chosen form of contraception. I always knew I didn't want children, but it wasn't until I passed 30-something that I was able to find a doctor willing to let me get my tubes tied.
 
I'm quietly a condom fanatic. :) So many guys whine about how greatly rubbers reduce their pleasure, but IME it's merely different, not less -- besides, I enjoy LOTS of stuff, & reduced PIV doesn't traumatize me.

Having probably used around two thousand condoms, I've had exactly TWO breakages, with one corrected mid-session, & the other resulting in the birth of my son, but as the accident literally happened two weeks before we intended to TRY for pregnancy, it was no big deal. In total, I've caused exactly two pregnancies.

Breakages DO happen, sure. Seems to me that only a fool would think those flimsy little things are indestructible. But I don't mind stopping occasionally to check, especially if the intercourse has been energetic, or I'll simply pause to refresh.
________________

Anyway, as to the OP: at root, decide what YOU want. You deserve to control your body & your life as YOU see fit, rather than conform to someone else's expectations.

If you want to leave your options open, then do so, without worrying about hurting the feelings of some future wannabee Daddy.

And if there's someone you wish to be with, ASK what his actual plans are for you & your relationship & offspring. You're nonmonogamous: why would he NEED to reproduce specifically with YOU?

In return, EXPECT that anyone worth being with WILL respect you & your needs, for instance "maybe someday, maybe soon, but not right now." EXPECT that someone who claims to love you WILL work with you on this, like scrupulously using condoms until explicitly allowed otherwise, & not whine nor pout.
 
JaneQSmythe said:
I would caution anyone contemplating a tubal ligation/ Essure to consider it as being permanent. Tubal reversals are expensive, not often covered by insurance and by no means always successful (same with a vasectomy reversal). Also, a pregnancy after a tubal OR tubal reversal carries a higher risk of implanting in the tube itself (an ectopic pregnancy - which can be a life-threatening emergency). (To clarify that is a higher risk than the average population, most pregnancies that do happen implant properly but the percent that don't is increased.)



Please be very careful how you interpret this! With "perfect use" most birth control methods can approach 99+% effective. "Perfect use" means the condom NEVER breaks/leaks/comes off/ or spills a DROP of semen anywhere near the vulva!

The reason that pills, patches, rings, shots are more effective than condoms is that it is easier to use them close to "perfectly" - yet still very many people DON'T. The less the "user" has to do, the lower the risk for "user error".

***********

It's a shame that the idea of the IUD doesn't sit well with you. The copper IUD (no hormones) is as effective as a tubal, IS reversible, is good for 10 years and can be replaced at the same time it is removed. (Personally I prefer the hormonal IUD since it gets rid of periods completely in most women - important to me because I have endometriosis).

Please note, though, that the risk of a pregnancy being ectopic (should one accidentally occur) is increased with the IUD as it is with the tubal/reversal.

***********

A diaphragm (with spermicide) might be a good adjunct to condom use in case of a semen leakage, but still has a high rate of "user error".
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I personally use the Copper IUD myself. It was painful going in, but it was the 6 weeks heavy constant bleeding afterwards that was a bitch. After that though! It settled and i've had only THREE times ever of (no condom) PIV sex that resulted possible pregnancy that the IUD took care of in month 2-3. And this is over a period of 5 years. That's a lot of sex, i couldn't give you exact statistics but yeah it's very effective. That beind said i've heard of people putting in improperly because the person putting it in did it wrong OR the persons uterus was titled and didn't know, and if you have anything like PTOS or endometriosis or fibro this is probably a no-go. But for the general female population post kids it's a fabulous choice. No hormones, and natural spermicide and natural stopper/abortion method if the egg does get matched with sperm it un-encourages implantation. :)
 
I'd warn against Depo Provera. Many women react badly to hormonal birth control. Depression, rage, lack of sex drive, etc. With bc pills, you just stop taking them. With the shot, you have to suffer and go nuts for 3 months.

Sometimes though, you can go on the pill or get the shot and not notice how awful you are feeling and acting. Ask a friend or partner if they've seen changes you've missed.

I've heard great things about modern IUDs.

As for your new bf wanting kids: You've only had sex a few times? Unless you waited a year to have sex, it sounds like it's a very new relationship. Even if you feel like he's a great guy, being "serious" so early on seems a bit strange. It can take a year or two to really get to know someone.

And if he's poly, the best case scenario would be for him to have a baby with someone else. Ideally he can find this poly or poly friendly woman who would be cool with him keeping you in his life.

I'd advise against going against your husband's wishes and having a baby with new bf. You'd really have to move in with the baby's bio dad to help raise the new kid, at least for the first couple years, since you husband just doesn't want the work involved in another child. Then your current kids would miss out on a lot of mama time.
 
I think it should be entirely your decision, but you should then inform your partners about it. They can decide if they want to continue a relationship with you, given that they will not be able to have children with you.

If you are open to the possibility of having children with your other partner, then you will probably choose to hold off on permanent birth control methods. It's a complex choice, as so many people could be affected by having another child with a different partner.

Ultimately, do what's best for you, and accept any consequences of your choice.
 
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