Hysterectomy w/C-Section

[jamilyn]

Hello Ladies - I'm not sure if this is the right section for this BUT I was wondering if any of you have had a Hysterectomy at your last C-Section and how much it changed everything. I am 25 years old and am 14 weeks pregnant with #3 my Peri has started talking since my pre-pregnancy consult with her about what are plans are when I have my C-Section. If I'll have my tubes tied and for me I would prefer a Hysterectomy over having them tied. I have met 3 people in the last couple weeks who have had them tied and got pregnant about 10 years later with a surprise baby to find out they had grown back together. I am meeting with my Peri on thursday for my next appt and have Hysterectomy on my question list so we can finally figure out everything.
I'd just like some opinions and any stories you might have.

Thanks!!!

[mnmom]

I am really surprised that a hysterectomy would even be mentioned without other health issues going on. Or maybe I missed something? As far as permanent birth control, I did get my tubes tied during my last section. That only took a few minutes more and my ob assured me that they were tied, then cut and burned, then the ends lasered some more. They were not likely to grow back together. I guess I'm not sure, but I would think a hysterectomy would be much more extensive of a surgery, with more affects than just birth control.

I do believe we do have one or two posters who have talked about the possibility, but I also think they have other health issues going on.

Good luck with your decision.

[missgamecock]

I don't believe they will do a csection hysterectomy because you are worried that a tubal will fail. I have seen 4 different drs. Every one of them have told me I need a hysterectomy due to adenomyosis (endometriosis of the uterus), surgically/pathalogically confirmed endometriosis, fibroids, and heavy and painful periods. The first endometriosis specialist I saw did not recommend a csection hysterectomy due to my having partial hellp and severe pe. I have a risk of pp hemmorage as I had hemmoraged after my loss with Peyton. He said that the postpartem/pregnant uterus is full of extra blood volume. That would make me at risk for a hemmorage. HOWEVER, I have had adhesions for no reason. So balancing a csection hysterectomy against bloodloss or adhesions. I would have to have a surgeon and team prepared for it. My pcp, second endometriosis specialist (one that performed my lap in May), my ob, and my peri recommend a csection hysterectomy if I get pregnant. 1) because I have had severe pe/pih/mild pe three times and they don't want anymore babies (well my ob says he'll work with it) 2) endometriosis, adenomyosis, and fibroids. I have several medical conditions that indicate I need a hysterectomy. If they can be prepared for potential bloodloss, then the csection/hysterectomy is ok'd. We knew when I lost Peyton I was high risk for hemmorage and the staff were ready and acted quick when it happened. When I delivered Cate, I was CONSTANTLY being checked by my ob and the nurses for a pp hemmorage and blood loss during delivery and after delivery. They controlled the bleeding well. As I remember my ob saying, you are not going to like me very well after I delivered Cate. You know what, I wasn't liking him to well at that moment.

Anyway, my ob has said if I get pregnant again that he will absolutely do a csection hysterectomy for me. That I have very good reasoning and it was an excellent decision for me. It is a very high risk surgery. In 10 years of practice, he has done only one so far by request (not counting an emergency situation of hemmorage where they have to do a hysterectomy). The other time was because the woman had similar problems as I did. Her baby was breech. She was going to have a csection anyway and she needed a hysterectomy as well and was done with her family. My ob said ok to her. He did that one last year. At least that is what he told me. In fact, my ob got a little excited about the prospect of getting to do one because he never gets to do them. I told him hold on doc, I was just THINKING about if I had another (well I want one more but dh is flipflopping).

It is a pretty rare procedure. It is major surgery and comes with it's own set of complications. I have only considered it due to my medical issues and being done with the childbearing years with the next one. I researched it heavily before I approached my ob about it. It is NOT recommended unless you have very good reasons and medical indications for one.

[jamilyn]

With how severe of PE/Eclampsia I have had in the past and this being my last pregnancy for sure none of my Drs/Peri want me to risk getting pregnant again. My last pregnancy my OB mentioned a Hysterectomy or tubal which ever I felt comfortable with and infact in the operating room before starting confirmed again that I may still want just 1 more and not to do anything. My Peri told me to start thinking of what direction I wanted to go with on our first consult and I was surprised but she said with all my history with how sick I get and this being my last pregnancy I need to make a choice about what she needs to do in the OR... I was thrown back, I knew that questions was coming but its still scary to think about. I know its my last pregnancy and I want to make sure I make the right choice...
Thank you for all the info. I didn't really think it was that much different of a recovery except for it can start early menopause which at 25 doesnt sound good to me. They are rechecking my blood on Thursday since with my last pregnancy I did have a blood clotting disorder but they said I dont have those signs anymore and they can't figure out how it has changed since I did have signs before I got pregnant and Ive been told with those issues I can't be on hormones if I was to have one.
I started researching it a few weeks ago and guess I will keep looking at more on it.
Thanks again ladies.

[love_the_daschies]

O.K. so I am sure you have considered all your options - but may I just throw my opinion in for an IUD? I had one for 5 years and LOVED It - plus it wasn't surgery (surgery scares me though!). If you can't do hormonal methods though I cause you would need a copper one.

My mom did have her tubes tied after y brother when she was 31 - then needed a hysterectomy due to fibroids a few years later. They left in one ovary that didn't have cysts to try and regulate her hormones naturally. Not sure how well taht worked because she was in menopause shortly there after.

Good luck with what you decide and I hope this pregnancy goes smoothly for you!

[missgamecock]

Just to second Jamie, I have an IUD now and I take the BCP. I take both for birth control and to control my endo.

[jamilyn]

I had an IUD put in at my 6 week appt after my last pregnancy and it did do the trick of me not getting pregnant it did cause me to have a lot of cramping and pain for most of the 4 1/2 years I had it in. It was perfect though since they were so worried about me having any kind of hormones. Now my Peri is saying they dont see that being a problem though. Hopefully they can clear it up more on Thursday when I see them.
So far my options have come down to something being added to my C-Section I just never thought id be making a choice like this right now. Thanks for letting me vent and putting your opinions out there, it really helps me look at all my options.

[kara]

I'm a bit shocked that anyone would suggest a medically unecessary hysterectomy for a 25 year old, and permanent birth control for someone so young. You do not have to make a permanent decison because your doctor wants you to, even if you are done having babies. To pressure someone into that is not right. There are many other options, like the IUD (and there are two kinds to choose from - mirena which is hormonal, and the copper iud which has no hormones). The Mirena is deemed to be MORE effective than a tubal - not sure of the stats on the copper iud.

For permanent birth control beyond tubal, there is the Essure procedure, which they can do vaginally, at some point after delivery. They put coils in your fallopian tubes which scar the fallopians until the openings are completely closed. They have a follow-up test to make sure they are 100% closed.

These all sound like much better options than a hysterectomy and potentially early menopause.

If you don't think you should be making a decision like this, then listen to your instinct. There's really no need to make that kind of decision. At the very least, a second opinion seems warranted.

[jamilyn]

I have other Medical problems so I'm not feeling pushed at all, I know they are trying to protect me and im just trying to keep all my options open. I had never heard of the Essure procedure, thank you, I will look into that and bring it up as well on thursday.

[hols537]

I had a tubal with my c/s and it was basically a non-event. I understand that the risks of a tubal regrowing are very low (my OB said she has never had a patient with a pregnancy after a tubal) and that the risks are highest for those having it done early in their childbearing years (highest of a very low chance). I don't know if at 25 you would qualify as early, but that's definitely a question for your OB. My nurse case manager suggested (she said it half jokingly, but made an interesting point) that I ask to have them remove my uterus so I wouldn't require hormones, but wouldn't have the risk of pregnancy or the hassle of monthly periods (she had that done herself, but not for birth control reasons). But, like Kara said, if you have any doubt about doing it or a method, then don't.