I would rather a doctor really lay it on the line what I could be facing, the consequences of what it is I want done, and bring up possible changes in my life. Now, I'd be pissed if, after I was informed of all of that and still wanted it done, he refused, but I can't fault a doctor for A) giving me all the information I need, even if I don't want it or B) having an internal struggle with it.

All the important information like what if your kids die in a fire and you need to replace them? What if your current relationship falls apart and the new man needs his own sprog?

No, I can't go there. This isn't "this is a big decision, so you should be sure you've considered the alternatives," this comes off way more as "little girl, let me explain your foolishness."

Also, where he mentions that "regret rates" are twice as high among younger women - funny how he leaves out that it's in the neighborhood of 4 v. 2 percent.

Early twenties on her third child? Sounds like birthcontrol and she are unmixy things. He doesn't mention this as a very good reason to want a tubal ligation.

I don't want a doctor who is going to try to " talk me into" anything. From a doctor, I want the facts, options, variable and leave the damned decision to me. If I regret it? It's my own damned fault.

That's only one thing that bugs me, there are more. But I'm rather inarticulate.

edit: points at what they said.

The title of the article, "Beyond Medicine, a Doctor’s Urge to Save a Patient From Herself" doesn't help, either.

It would seem to me that the decision to avoid more children so that one can give the best care to the children one already has is pretty freakin' sound and responsible.

it makes children sound so...replacable and unimportant as individuals.

The way I read it wasn't that children are replaceable - they certainly aren't - but personally, if GODS FORBID something happened to Emeline or any other children, I would want to have more.

As for the vasectomy question, I would *like* to think that doctors make the same sort of case, but I believe that vasectomies are easier to reverse than tubal li(ta)gation. I know (not from personal experience) that they are easier to perform.

Yeah, I think I'm going to go with "obnoxious paternalistic bastard", myself.

I think its also easier to work around a vasectomy... freeze some sperm as a back-up before you do it.

Let me ask this question: If the doctor who wrote the article was a woman - same exact everything - would it still come off that way?

I think if a mother loses THREE children in a fire or some other horrible accident, the tubal ligation isn't going to be her biggest source of regret. Also, last time I checked, the procedure wouldn't prevent her adopting children should she feel the need to replace the deceased ones immediately as if they were family pets.

Aimee, you're not alone. Even if this short column doesn't seem terribly well-evidenced, there has to be a point at which a doctor who sees something all the time should advise her patients about it. If I had a client who wanted to do something, and I knew it was riskier than the alternative and frequently regretted, I'd be reluctant to do it.