What to Expect When You Never Wanted to Expect Kids: Getting a Bilateral Salpingectomy

If you or someone you love is considering this procedure for sterilization purposes, this is my firsthand experience in finding a doctor and the recovery process!

In July 2022, I finally got my tubes yeeted as a form of permanent birth control. I was discharged from the hospital on my 37th birthday.

Now before I dive into the whole experience, I need to state upfront that I had some unexpected complications.

HOWEVER, they were pretty rare so this shouldn’t scare you from seeking this procedure if you really need it. As always, you should speak to the surgeon and any other relevant healthcare providers about your individual concerns since I can only vouch for myself here.

But I’ll start with saying that that there’s entire articles about how hard it is to find a doctor who will do this on a single woman with no kids. I wrote one because it took me 16 years to find one. How did the tide finally turn?

A friend from Twitter.

She used to live in Oakland and referred me to the doctor who did her bilateral salpingectomy at a younger age and said he didn’t give her the “bingo card” treatment. She said that the Bay Area and SoCal both overall had a more permissive attitude towards sterilization procedures than the shockingly conservative northeast from whence I came, and I should give him a call if I couldn’t find a local provider.

You read that right. My request was denied for 16 years in New York Fucking City of all places. While it’s good there’s pro-choice laws on the books in New York, New Jersey, and Connecticut, don’t underestimate how conservative “blue havens” are on the ground level.

Once I was done with various major life things after my relocation to California, I looked up the doctor my friend recommended and saw I could easily make the trip up to the Bay.

I did the calculus on it: I could contact god knows how many practices in and near Los Angeles, running the risk of having to treat it like another full-time job just like I did 10 years ago when my time was running out on my father’s excellent medical insurance and I was BEGGING to just get this one and done instead of settling for an IUD. Spending untold lost billable hours, time I could be working on games, my lizard art, and other ventures, not to mention countless co-pays since this is America.

Or, I could bite the bullet on lodging and associated expenses to come up to the Bay Area for a week to do the clearance exam, stupid 72-hour wait mandated by my insurance, and the actual surgery plus a few days of downtime. Since I knew for sure this doctor would actually do it.

While I did find some providers in LA on the list I named below, I still dropped $1,500 on a hotel for the week because the logistics worked better with a friend who didn’t live very far from my hotel and the hospital and could help me with recovery. I ended up dropping another $950 for a last-minute booking to get three more nights at the hotel when I ended up spending three nights at the hospital I did not expect, and was in no state to get packed up again and make that 12-hour train Amtrak schlep between Emeryville and LA. (It’s beautiful, you get to see so much of California, and far less stressful than flying, but it’s literally twice as long as it’d take to drive.)

This doctor’s manner also put me at ease, which as a multiply marginalized woman with a great deal of medical trauma is something I do NOT say lightly. Plus, who wouldn’t want to be at a decent hotel chain where everything is brought to your room after you’ve been told to be on bedrest a few days?

So, if you’re looking for a doctor who will do this — or any sterilization procedure, or something more major like hysterectomy if you’re in need but keep getting “bingo’d” — start with your childfree friends!

I say childfree specifically, because even people who’ve already had kids can and will encounter roadblocks to voluntary sterilization. If this describes you? Know that overall, you’ll have an easier time than us. A doctor who’s done sterilization procedures on people with no kids will wave you right through.

If your friends and other personal connections can’t recommend anyone who’s feasible for your needs (e.g. insurance, location), your next best bet is the childfree Reddit doctor list.

All the doctors listed on there have been vetted numerous times. However, you would need to dig deeper on your own to find out specifics like what insurance they take. Solo, non-corporate practices like the one I chose tend to be the most flexible about working with insurances, including Medicaid and Medi-Cal. Doctors are listed by US state, and a few international recommendations are included.

According to related discussion on r/childfree, your local Planned Parenthood may be able to help if you are on Medicaid or don’t have insurance at all. Some providers perform tubal ligation, others will do bilateral salpingectomy.

What is a bilateral salpingectomy?

A salpingectomy is the removal of the fallopian tubes through laparoscopic incision. Bilateral means that both of them are being removed. It sounds a lot fancier and more complex than it really is. While you have to go under general anesthesia, the procedure is done in 1–3 small incisions.

And I legit did not find out about this procedure until I was in my mid-thirties. I am now the town crier for spreading the word about it.

Coming of age at the turn of the millennium, I knew of “getting your tubes tied” (tubal ligation) and total hysterectomy (removal of the uterus). The latter which was usually only done in cancer cases, and even then that’s debatable because WHAT IF SOME GUY WANTS TO USE YOU AS A BABY FACTORY.

We must raise awareness of bilateral salpingectomies because they’re not as intense or risky as a hysterectomy, while providing the additional bonuses of greatly minimizing the risk of ovarian cancers and ectopic pregnancy.

The latter which you’re probably aware is now being criminalized in some states because the only way you end those is abortion or death, it cannot be re-implanted no matter what those anti-science natalist freaks in the state house say. We know what their actual goals are here.

And as my doctor told me, if you REALLY did change your mind and decided you wanted to get pregnant, you actually still could with IVF because the procedure doesn’t remove the uterus. My response was “If I wanted to go $30,000 in debt for something I don’t want that’s going to shave off 1–2 years of my life out of the gate, I’d pursue a second Master’s degree. Sticking to my toad and lizard children, thanks.”

So, just in case your options for in-network doctors are limited and you start hearing the “But you might change your mind!!!” crap, bring this point up.

Can a bilateral salpingectomy be safely done on larger patients?

Yes! There is risk of complication, which the case was with me: I lost 1.5 liters of blood and spent one night in the ICU where I got a blood transfusion, then two in a regular hospital room before they let me out. While it wasn’t the sole contributor to the hemorrhage, it did factor in. Apparently, the way that my reproductive organs are shaped meant it was a good thing I was having this surgery or else I would’ve been a maternal mortality statistic if I wanted kids! Well, damn. THAT’s a relief.

I’ve never been small, but it never hampered my ability to swing quality dick which is why I spent so long trying to get this operation. Some of the nurses were also surprised I didn’t have high blood pressure, since they weren’t keen on letting me out of the ICU til it got into a more stable range. (Self-employment and petting amphibians keep my blood pressure low, regular workouts notwithstanding.)

But it can be safely done and the provider shouldn’t take a combative attitude towards you when they up your weight on the consult. And you might have to resume your search if they’re overly dismissive of your concerns. Not someone you want cutting you open.

This dismissiveness stems from a belief held by many OB-GYNs that fat people don’t have sex, and then if they do, they must be infertile so you don’t have to worry about unwanted pregnancy. LOLSOB. I’ve met women who became mothers who were north of both 40 years old and 300 pounds. So no, “fat = sterile” and “your eggs dry up after 39” are both utter fucking myths. Take precautions.

If you’re hesitant to pursue bilateral salpingectomy because of your size and the increased risk of complications, remember that even if you’re in a state that has expanded abortion protection, some clinics have an arbitrary BMI limit. This game of fatphobic Russian Roulette compounds the stress in an already stressful time. If you don’t want to be pregnant again, or ever, this procedure is an excellent option if this is a risk you want to mitigate.

And it’s so, so interesting how fat women who want kids will have all this dehumanizing and eugenics-y shit barked at them by healthcare providers, then it automatically flies out the window if you don’t want kids and becomes all about “But what if you change your mind! What if you meet a man who’s has a major boner for fat alternative women from The Bronx who sound like Robert Lozier after a carton of cigarettes and he wants to make you have his babies, THEN WHAT, you slutty Jewish heathen?!?”

But that’s an essay for a whole other time.

Recovery is 2–3 weeks rather than whatever the doctor and literature tell you, and requires more rest than what you were probably told.

Now, let’s get into the actual recovery. Because this part can really suck and most literature does not prepare you at all for it.

Even if you don’t have complications like I did, it’s not going to be as nice and easy as the way that the intake nurse makes it sound. I was literally told “You’ll be back at brunch in no time” when I showed up at the hospital and did intake. They made it seem as if I’d have the operation, sleep off the anesthesia for a bit, then have my friend take me back to the hotel with some takeout.

The fact that we’re in TWO pandemics at the time of writing aside, the absolute last thing you’re going to want is to sit down at a restaurant for a little while. Because you’re going to shift your weight away from the incision areas for a solid 1–2 weeks, especially in those first couple days post-op, even the most comfortable chair made of marshmallows is going to hurt your ass.

I’m going to tell you right now, that even if you don’t have issues like I did, those three small incisions are still heinous. EVERYTHING downstairs is going to be completely rearranged and it takes at least two weeks for it go back to how it was. I mean…everything. A full bladder feels different and more painful, and you might experience this hellish sensation for 1–2 days post-op where it feels like you have to go but then you can’t.

I chalk this commonly-cited “recovery from salpingectomy or tubal ligation is a snap” line to the fact that women’s pain is routinely minimized. So I’m gonna be straight with you: THOSE INCISIONS HURT LIKE HELL. They will also rule your life for 2–3 weeks.

Depending on how many medications you were given before and after the surgery, you’ll also be leaking random fluids like a shitty old Datsun that got smashed on the Cross Bronx. This happens for a few days and is totally normal, but if anything seems alarming you should notify your doctor. I was told to expect bloody urine, I’ve seen worse on periods. It’s mostly like when you crack an egg and there’s a blood in the albumen.

This is a major abdominal surgery so that means no heavy lifting or bending for about 2 weeks. Think of ways in advance that you can keep things reachable and avoid bending, especially if you live alone — are there tables, shelves, chairs and other things you can use that can minimize painful movement? If you’re getting groceries delivered and can’t risk opening the stitches by bending to get items, will the driver take an extra tip to put them on your table, counter, or other surface so you can easily reach them?

If you’re the type who sleeps on your back, you’re good. If you’re a side sleeper like me or the type who sleeps on your stomach, this is going to suck. If you’ve got a recliner chair or couch, it will make the first few post-op nights far more comfortable than your bed. It took a little over 2 weeks to be able to sleep on my side again, coming up on 3 to sleep on my stomach.

That first week is also going to be spent feeling like furry inflation fanart, so keep your most comfortable pajama pants handy. If you’re recovering at home, go commando: you want to avoid putting unnecessary constraint on the area and that includes garments. I had to explain furry inflation to the surgeon on the follow-up call when I discussed it. (I’m sorry, or you’re welcome, depending on your reaction when you just Googled that.)

Once you stop feeling like some inflation fetish commission on DeviantArt, it’s a MAJOR relief. It will get replaced by this occasional stabbing sensation in your stitches, it’s normal but do pay attention to make sure they’re not rupturing. If you got the plastic dissolvable kind, it’s common for them to get bumpy (I just thought I was turning into a toad). About 2.5 weeks in, the stabbing sensation goes away and YOU CAN PICK THINGS UP OFF THE FLOOR AGAIN and it’s glorious.

You’ll feel normal again in about two weeks, totally out of the woods in three.

Of course, individual timelines will vary depending on your individual health, age, weight, and other factors and any concerns should be discussed with your doctor. But I’m just speaking from my personal experience, since I don’t think most medical literature really tells it as it is.

It’s gonna be two sucky weeks. But it’s going to be worth it to affirm your freedom if this is what you want. Two weeks of feeling your lower half was hit by a Mack truck then stitched together with Rexlace has nothing on what unwanted childbirth will do to your body and life!

I felt relief. So much fucking relief. Vindication after I fought for this for so long.

And that’s how you should feel, as a decision you came to on your own: a partner, family or community member, or healthcare provider should NOT pressure you into taking on a major surgery like this!

As for the psychological aspects of salpingectomy and any other sterilization procedure, I have zero regrets or sadness about this. Rather, my only sadness is that on this particular timeline I wasn’t given better choices on personal or societal levels as far as family, romantic partnership, and stability went. I’m angry I had my childfree stance shot down by natalist providers for years and that the present has become so perilous post-Roe, let alone the frightening reality that these freaks are going to come for both standard and permanent birth control next.

I came to California to start over and fulfill dreams, I knocked out two major things I waited for my entire life in the seven months that I’ve been here at the time of writing. With my dream of being impregnable now fulfilled, it’s time for the third major one: ADOPTING A GIANT LIZARD!