Expert Answers: Our doctor won’t let us be sterilised

I’m now 25 and my husband is 26 and we don’t want any more children. We decided that one of us should be sterilised but when we asked our GP, he said we were too young.

There are places you could go to for sterilisation but if you are absolutely sure that this is the right thing for you, go back to your GP.

You are both very young to stop all future possibilities of having any more children, so you need to think carefully about some hard questions.

If you were to divorce (or even die), might one of you want to consider having more children with another partner?

If one or both of your children were to die, might you want to try to have more children?

If, after considering these questions, you are still sure sterilisation is right for you, go back and tell your GP.

Explain that you’ve thought this through and you know it’s what you want.

Tell him you’ve considered these possibilities and are still sure. If he still won’t help you, ask him to refer you for a second opinion; you may find that another doctor would think differently.

Finally, and if you are still determined, contact a private service such as the British Pregnancy Advisory Service.

If you are not quite sure and want an alternative to the contraceptive pill, consider some of the many other long-term options available. Your local family planning clinic will be able to advise you.

Female sterilisation is an effective form of contraception that permanently prevents a woman from being able to get pregnant. The operation usually involves cutting or blocking the fallopian tubes, which carry eggs from the ovaries to the womb. This prevents the eggs from reaching the sperm and becoming fertilised. It can be a fairly minor operation, with many women returning home the same day.

In most cases, female sterilisation is more than 99 per cent effective, and only one in 200 women will become pregnant

Almost any woman can be sterilised. However, sterilisation should only be considered by women who do not want any more children, or do not want children at all. Once you are sterilised, it is very difficult to reverse the process so it is important to consider the other options available. Sterilisation reversal is not usually available on the NHS. Surgeons are more willing to perform sterilisation when women are over 30 years old and have had children, although some younger women who have never had a baby choose it.

Every year, thousands of UK couples choose sterilisation as their method of contraception. It has become increasingly popular since the late 1960s.

PAUL CHARLSON, GP FROM BROUGH

I think you should go to another GP. It is not up to your GP to decide when you are sterilised, he can counsel and advise you but he does not have the right to refuse to refer you. You are married you have two healthy children and definitely do not want any more – it seems a sensible decision to me. It is much better if your husband has a vasectomy as it is easier to do as a short day case with less complication risk. If you wish you can go to a family planning clinic or there are organisations such as Marie Stopes, a private service that charges £375 for a vasectomy but you should be able to obtain one on the NHS. If your GP again refuses write to the PCT as they will advise what to do, you are entitled to a second opinion.

ELAINE DOUGLAS, A CHARTERED PSYCHOLOGIST WHO SPECIALISES IN FAMILY AND CHILD RELATIONSHIPS

I can understand why you wouldn’t want to stay on the pill for an extended period of time. However, the pill is not the only form of contraception and I feel that you should look into other alternatives. Like your GP I do have some concerns about sterilisation at your age, because it is such a radical and usually irreversible step. I would like to put to you some “what if” scenarios which you may find a little upsetting, but I think you need to consider. First of all what if something were to happen to you or your husband and either you or he were left on your own? Not a nice thing to think about, but it could happen. If either of you wanted to form another relationship and met someone who wanted to have children and you were not able to, it could cause problems. I have seen this happen with clients in the past and sometimes it has destroyed a potentially fulfilling relationship. What if you and your husband parted company at some point in the future? This may be an unlikely scenario, but not all relationships stay the course. Although I am sure that this isn’t something you would want to think about or would even dream could happen, situations do change.

CARY COOPER, PROFESSOR OF ORGANISATIONAL PSYCHOLOGY AND HEALTH AT LANCASTER UNIVERSITY

If you feel uncomfortable with your GP’s advice and approach, and don’t want to wait, then you need to get a second opinion. You could either do this through one of the other GPs in your practice, or go to one of the independent pregnancy advice services. A great deal depends on your relationship with your GP, if it is good, you could see him/her and explain your concerns about being on the pill for too long and your firm desire not to have another child. Then ask if he/she would mind if you got a second opinion, from say a consultant with experience in this field. Most GPs will understand your situation and would be sympathetic, if not, then you ought consider if you have the right GP.

DR CAROL BURNISTON, CONSULTANT CLINICAL CHILD PSYCHOLOGIST

It sounds as if you are very certain about your family being complete, however, none of us knows what will happen in the future. I hope that you and your husband stay well and happily married and that your children continue in good health, but sometimes things do not turn out as we had imagined and it sounds as if your doctor is trying to help you to keep your options open and not take steps which you may regret in the future.If you feel strongly that you need an alternative view, you can ask to see another doctor in the same practice or visit you local Contraception and Sexual Health clinic (sometimes called Family Planning clinics). There are lots of different methods of contraception which you could consider if you do not wish to continue taking the pill and the trained staff there will be able to explain them all to you and your husband. It sounds as if the reliability of the method which is uppermost in your minds, but the pros and cons of each method can be discussed in order that you can make the most appropriate choice for you.

OTHER MEANS OF CONTRACEPTION

There are alternatives to female sterilisation.

Vasectomy: this method of sterilisation for men is simpler, less invasive and has a better chance of a successful reversal if you change your mind in the future.

Long-acting reversible methods of contraception, such as contraceptive implants and injections or the intrauterine device (IUD): these may be suitable if you do not want to get pregnant in the next few years, but may want to eventually.

For more information visit www.nhs.co.uk or the Family Planning Association at www.fpa.org.u