Laparoscopic Bilateral Salpingectomy For One

Growing up, I assumed one day I would be a parent. Another milestone on the road of life. I enjoy children. Tiny, adorably chunky humans, sweet and curious, easily entertained. Small children, delightful chaos agents. Preteens and teenagers, comical and engaged once they warm up to you. I volunteer my time to them regularly. Yet, the maternal longing never came. I love my childfree life and want to maintain it. The most effective method: laparoscopic bilateral salpingectomy.

Life is hard and parenting is even harder. Getting there is terrifying: pregnancy and childbirth. Both are life threatening, having the necessary parts doesn’t make it easier. The latter stage especially horrifies me. Followed by sleepless nights, school germs, homework, trying to reason with someone whose frontal cortex is developing, and fearing for their safety. It should be viewed as a lifelong commitment to aiding in the development of another human being. I know that I am more useful in support of parents and their children than being one myself.

Also, my life would no longer be solely mine. Possibly losing myself in motherhood is an abysmal thought. I revel in the ability to do what I want whenever I like. My home is orderly and quiet, a sanctuary. Joy comes from dedication to my hobbies. My existence will take any shape I conjure; I am the magician. I refuse to relinquish peace of mind, quiet, and freedom. If you’re chafed, I won’t apologize. I know there are other childfree people and parents who understand what I mean. 

The Decision

Over the last five years, being childfree settled comfortably in my mind. Then I saw women sharing about fallopian tube removal. It sounded intriguing but intimidating, a permanent procedure. My curiosity grew with each story and when the incoming administration was still just a threat, I knew I couldn’t waste any more time debating. I requested a consult with my OBGYN’s office at the end of May in 2024 and an appointment was set for August. My questions weren’t about the procedure but if it could happen. 

A woman shared her long journey which included being required to get an evaluation from a psychiatrist. She lived in a different state, but I needed to know if mine had similar barriers. The name for surgical removal of one or both fallopian tubes is salpingectomy. Salpingectomy can treat ectopic pregnancy or infection. It can aid in lowering the risk of ovarian, fallopian tube, and peritoneum cancers. The procedure is also a form of permanent birth control for people who don’t want future pregnancies.

My choice was a bilateral salpingectomy, removal of both fallopian tubes for permanent and irreversible sterilization. The surgery is typically performed as a laparoscopy. Three small incisions are made on the lower abdomen, the laparoscope (an instrument with a light and camera) is used as the surgeon inspects and removes the fallopian tubes, and once removed, vessels are sealed, and incisions are closed with sutures and/or medical glue. Laparoscopy is minimally invasive, and patients can go home the same day. Typically, after two weeks, they can return to all normal activities.

My decision was firm and thankfully my consult was quick and easy. My OBGYN had no issue with performing the procedure and there were no hoops for me to jump through. Due to my prior research every question she asked me was met with a yes. You’re certain you don’t want any future pregnancies? Yes. You know this is not reversible, some patients have come back and asked? Yes. You aren’t interested in other forms of birth control, right? Yes. None of the questions were framed to make me second guess or question my choice. They were all meant to ensure that I knew exactly what the procedure meant and would entail.

Next, I spoke with the surgery coordinator. She said it was likely that my insurance company would cover the procedure in full as preventative care. We would have to see but the idea alone eased my concern about the surgical cost. The original surgery date moved from September to November. November worked better for my mom who would drive me home and take care of me while I recovered. The change also made better use of my sick and vacation days, a win all around.

Countdown

I spent the three months leading up to surgery proud of myself. It was the first time I pushed for what I wanted to shape my life in a major way. I shared my plans with a few close friends. They were a bit surprised but fully supportive. I deeply appreciate check-ins leading up to, the day before, and the day of surgery to see how I was feeling. I happily attended my linesister’s baby shower while thinking that I would never have one. Celebrating a new chapter for someone I love, filled with peace knowing I made the right decision for myself.

My body, specifically my uterus, sought preemptive revenge. Seven years on birth control and yet the last two cycles before surgery turned me every way but loose. Sorry doll, I know what you’re made to do but we aren’t going that route. Salpingectomy can prevent many things, but it doesn’t interrupt the menstrual cycle. Any eggs released are reabsorbed by the body, like Cell. She has years to put me through it before menopause starts her dance.

Get Ready, Stay Ready

At my pre-op appointment, I was joined in the waiting room by two expectant mothers and their families. It was one mother’s birthday, and she received the news of twins.  The other mother was further along with a very active baby, occupying herself with deep breathing and pacing. I hope both had a good night’s rest. Again, a calm awe filled me. I’m choosing a different, permanent path.

Pre-op was another quick appointment. My doctor reconfirmed my decision and explained the full procedure to me. Lack of a proper list meant I only had two questions: what should I use to treat the scars and can I see my fallopian tubes. Vitamin E oil and my doctor would take pictures. I kind of hoped they would go in a jar, but they’re sent out for pathology and then discarded. The jovial pre-op nurse called two days later to confirm my medical information and advise me on how to prepare for surgery. No eating after midnight but water is fine until a specified time, 6:30 a.m. for me. Bring my insurance card and driver’s license. No nail polish, lotions, powders, or perfumes, deodorant was fine. I might be ashy in the cold but not musty thank God. No jewelry or metal on body and wear loose, comfortable clothing.

I looked forward to surgery and the rest it required. The day before I planned to leave work early to pick up my mom from the airport. Instead, my friends read my laments as mommy’s flight went from delayed to cancelled to rebooked to delayed again. She made it to Atlanta, unfortunately the connecting flight left without her and several other delayed passengers. For the first time my joy balloon deflated a little.

Surgery Day

The next morning, I awoke cranky. My mom was already on the airport shuttle to catch the first flight out and would arrive to the surgery center by the time I was in recovery. I wasn’t afraid, more so annoyed and concerned that arriving alone would be an issue at the surgery center. Thankfully, it wasn’t. The front desk receptionist and I shared bad flight stories and then I was escorted back to a pre-op room.

All surgery team members and center staff were excellent. Each personable, kind, and considerate. My vitals were taken and consent forms signed. Before changing into a gown and grippy socks, I wiped myself down with two wet wipes. My belongings were locked in a room for safe keeping during surgery. Tylenol was administered to help with post-op pain and a scopolamine patch, for nausea, placed behind my ear. It must be potent because the explicit instructions were to not touch it, keep for 72 hours unless experiencing dry mouth, dizziness, or visual disturbances. Upon removal wrap it up, throw away, and wash hands thoroughly.

The veins in my left hand refused to cooperate, but my right hand accepted the IV. My one irrational fear was waking up during surgery, fueled by a news story I saw as a preteen or teenager. My anesthesiologist humored me and said that was possible for trauma patients but extremely rare for patients like me. In the surgery suite, I laid on the table in a “T”. I looked up at the ceiling and then opened my eyes to see a curtain in recovery. The procedure was complete, and my mom had arrived.

My OBGYN spoke to my mother and then myself, sharing my pictures. Still woozy from the anesthesia and without my glasses, I couldn’t see them but understood the information. Turns out I have a few tiny fibroids, but they aren’t disruptive. In the post-op room mommy wheeled in with her luggage, I was unhooked from the IV, given recovery orders and a discharge packet, and changed back into street clothes. Take short walks every 1.5-2 hours, don’t shower alone, don’t go up and down stairs alone, or drive for 24 hours.

On the Mend

I’m grateful that my recovery period was uneventful. Abdominal soreness didn’t evolve into pain and 600mg ibuprofen was enough to keep me comfortable. The top of my throat was irritated for a few days from the breathing tube. Coughing and gargling salt water dulled the irritation. Some heavier spotting but spotting is expected so no concerns. I didn’t realize how much I use my core until I actively tried to not overuse it. My arms and hands did all they could to compensate. Slightly bloated for a few days, also expected. The best part was extended, uninterrupted time with my mom and Thanksgiving at my house, joined by my dad and sister.

At my 10-day post-op appointment I received copies of my pictures. I could see my uterus, ovaries, fallopian tubes, and appendix before and after surgery. The fibroids were visible on top of my uterus. Remaining medical glue was removed from my incisions. My OBGYN gave the all-clear to return to physical activities, running and taking it easy in pole classes. The first post-surgery run was on my birthday. Very slow but steady, proud of myself for trying. My first pole class went well until my belly button area suctioned to the floor. Slight panic but no issues once freed.

The total surgery charges came to $17,122.95. An earlier estimate from the hospital system placed my projected responsibility around $3,000. When the final bill arrived, my balance was $85.27. In my mind that is full coverage as predicted. Overall, I am relieved. I feel free now, I will never worry about pregnancy, childbirth, or parenthood again. My life will take any shape I want. I can support my friends and their children while fulfilling any dream I fancy. My hope is that other people who choose sterilization can do so without barriers, legislative or financial. We all deserve the right to build lives and families as that fit our lives. I am grateful my choice has been honored and fulfilled.