Columns May 9, 2012 at 4:00 am

Unscrew the Pooch



I never understood that. If you're sleeping around and using hormonal birth control to prevent pregnancy (ie. not using condoms), then you're probably going to end up paying LOTS of consequences. Some of them a lot worse than getting pregnant. Most people I know who uses birth control either

a. uses it for health reasons (cramps, etc)
b. are using it in the context of a monogamous relationship.... and sure, if they're not married, I guess it's still probably bad to right wing Christian people (they are a much much less vocal and much smaller minority where I come from) but those folks are not exactly their most hated demographic
I think it is true that there's someone (or, more likely, several someones) out there for everyone... but it's also true that your someone may be in, say, Mozambique--not much help if you're in, say, Toledo...
Ms Cte - I agree, and wonder how a particular divide plays out for the religious set. There are those who require women as gatekeepers who exist primarily to keep men civilized; they fall basically in line with a variation on Pauline reasoning into grudgingly accepting sex in marriage (often limited to a very tiny repertoire), though insisting that the best women never enjoy it or at least never admit to enjoying it. But there are others who embrace the female orgasm as long as it occurs only in the context of exclusive heterosexual matrimony. But in that context almost anything goes, though perhaps with reservations about what would constitute unwifely conduct.

I sometimes marvel that the two factions manage to agree so often as they do, and wonder if maybe the less sex-negative side might be able to be peeled back a trifle from the War on Women.
@113: Ah, but Mydriasis, you're making that mistake again, assuming that you and your friends are representative. I'm talking about the perception of the vast majority, including people for whom the phrase "birth control" or "the pill" is synonymous with "the sexual revolution," itself synonymous with many for "sluts and their slutty, perverted promiscuity."
I never understand couples, gay or straight, who want to have threesomes and are opposed to the following fairly simply options:

Find a similar couple and swap!
Join a swingers' club.
Find a sex club in an urban area.
Pay for an escort or prostitute.
I'll quickly answer some questions.

As far as sperm donation goes:
It is only with a lot of cajoling that my husband has agreed to donate sperm, and only for a couple we know will require him not to parent in any way. He has no wish to be involved with his biological child's life, and really has no wish to have a biological child.

But my friends live in a conservative state, and they are gay so adoption would be a bit harder for them. Helping a family have children is a good thing in this case. Also, my husband has really really good genes (200+ IQ and no genetic diseases. Everyone in his family lives past 100.) I think it would be a shame if he didn't donate. He has no wish to, and is only doing it with great reluctance because I'm making him. We don't know how many children they will want (they feel ambitious now but that might change after their first), and stuff straight from the tap is better than stuff on ice.

As for my health problems:
I'm in a situation where I *do* have other options.

The first is to go back on hormonal birth-control, and stay on a medication that when combined, in my case, causes me excruciating pain. We've tried every type of hormonal birth control known to man. The pain is debilitating.

The second is to try to find an alternative to the medication that combines badly with my birth-control. But I've been on every SAFE medication there is, none of them work, and the combination that sorta-kinda works has caused me to gain massive amounts of weight. Seriously. Since going off my birth-control and back on the first medication I've lost fifty pounds. I have fifty more to go before I'm at the weight I was before this whole mess.

The third option is what I have to live with right now. I'm on the good medicine, and off of hormonal birth-control. I've been bleeding for five months straight. My iron levels are actually fine, so I don't have a "real problem" according to my gynecologist. I do have horrible horrible cramps when I'm off birth-control, though. I'm miserable, and I feel worthless all the time. I'll have a period free week here and there, but then it'll start up again.

The forth option is an ablation. I'd be sterilized, but my risk of an ectopic pregnancy would be higher, and that doesn't get rid of the horrible horrible cramps. I know because two women in my family had one, and they both wound up getting hysterectomies within a year. I'd rather only have to go under once, thank-you.

The fifth option, and the one that EVERYONE knows is the most logical is a partial hysterectomy. I don't want a baby. I don't want a period. I'm okay with having my hormones because I'm only 30, so I'm too young for menopause.

But it's not NECESSARY, because I have other options. And that's the sticking point.

It's humiliating. Two of those doctors were psychiatrists. I've also had to get a note from my husband and my mother.

As for why I haven't gone to any of the other doctors, they've both politely told me that they won't risk bad blood by stealing my doctor's patient. These are the best doctors in my area, and I'm not comfortable with the safety records of anyone else. If she stalls again after this next deadline, I'm going to risk getting mutilated by a hack, though.

I'm worried that my insurance won't cover it if I wait longer--after all, my life isn't threatened. Just my health, happiness, and sanity. I'm worried that my husband and I will slip (We've been abstaining since I went off of birth-control), I'll get pregnant, and be unable to have an abortion.

I feel like I'm being treated like a child. I'm sick of it.

"It is only with a lot of cajoling that my husband has agreed to donate sperm, and only for a couple we know will require him not to parent in any way. He has no wish to be involved with his biological child's life, and really has no wish to have a biological child."

"I think it would be a shame if he didn't donate. He has no wish to, and is only doing it with great reluctance because I'm making him."


Are you serious?

You're forcing your husband to become a biological parent (who will have contact with his biological child who will grow up and wonder who daddy is) even though he doesn't want to? And in the same breath complaining about how your wishes are being ignored?

How you're being treated is horrible and you should be able to get the surgery if you want, I'm all for that if you want it. It's your body. You should control it. Don't you think he should also control his?

I was honestly shocked reading this. Please tell me I missed something.
That was an exaggeration. I say "making" I mean persuading. If you knew my husband you'd know it was impossible to "make" him do anything. And I wouldn't try.

The reason he's willing to do it, is because I've made a case that it's the moral thing to do. Our friends want children, and he thinks they would be great mothers.

Also, they live in a different state than us, and he wouldn't have to have contact with them any more than he wants to. He's said that he'd like to occupy the same space as an "uncle" in their life.

The child will know who his/her biological father is, but as we have a grown friend who was raised in this exact situation (talking to her was how I persuaded my husband to agree to it) we really don't expect the child to want much more from him than the occasional phone call and visit, and Birthday and Christmas presents. That's what she wanted from her biological father. Her moms were enough for her.

If my gynecologist took the same tactic with me that I took with my husband, I'd have no problem. Give me the case. Have me talk to people in my situation who made the choice I want to make and made the opposite choice, etc. Then respect my decision after I've made the choice. That would be reasonable. This. What I'm going through now. This is inhuman.
@118, 120:
First of all, I agree with Mydriasis regarding your husband's sperm donation: if it wasn't his enthusiastic idea, he shouldn't do it. There is no way of knowing what kind of relationship the yet-unconceived child will want with his or her biological father, if he is known to the family; it isn't even a guarantee that the moms will not want more involvement than your husband might want to give. This isn't anonymous sperm donation at a bank; this is a complex intertwined relationship. So your friends are lesbians living in a conservative state; they can still use sperm from a sperm bank, either locally, or, if no such place exists, than they can go take a trip to one. They can advertise for sperm from a man who wants to be a biological father. It's not your place to solve their family problems; it's not your place to "persuade" your husband to do something of this magnitude that he explicitly doesn't want to do.

Second, talk to one of the other doctors again. This isn't like a hairdresser "stealing" a client; your healthcare provider is refusing to do a procedure that she admits is a the best option for your health. The idea of bad blood sounds ridiculous and childish.

Frankly, something sounds off about this whole thing, and I'm not sure that you characterized things accurately. Psychiatrists? Notes from mothers? There's a level of drama that seems unnecessary. The surgery can always be obtained (just as, should you and your husband "slip up" and you get pregnant, an abortion can be obtained)--it just might not be paid for by insurance should it not be deemed necessary. There's a difference between having to pay for "optional" or "voluntary" surgery, and not having a doctor be willing to perform it. It sounds like you're trying to get a doctor to say this is medically necessary so that insurance will cover it and since you have other options, none will. The doctors might be unable to make that call if it isn't true without repercussions. If you want an abortion, you can still have one (assuming you seek it while in the first trimester). You may need to travel across state lines; you may need to endure humiliating and unnecessary "tests" and lectures "informing" you of the fetus' development; you will undoubtedly have to pay for it yourself.

Diane, here's hoping you find a solution that works for you -- and soon. Pain sucks.

Thank you for clarifying! I second Erica's sentiment.

You kind of put what I was feeling into much better words.

I'm going to go a bit out of character and trust that what she's saying is accurate and her husband legitimately came around through a better understanding of the situation than the one that initially led him to say no.

But my gut reaction was more along the lines of what you said.
@DianeLGD: I'm curious what your husband's objections to sperm donation were in the first place.

Second, I'm troubled by the disconnect about what role he is to play in the child's life. First you say, "He has no wish to be involved with his biological child's life," but then later you talk about him being okay with being some sort of "uncle." And after that it's "the occasional phone call and visit, and Birthday and Christmas presents." Sorry, but that sounds like someone is fully expecting to put him on the hook for a relationship with this child -- to me it has the distinct smell of camel's-nose-in-the-tent. He would not be in the wrong to put his foot down and insist that the lot of you (meaning the lesbian couple and you -- and yes, this is starting to sound like a conspiracy of three against one) treat it for all intents and purposes as an anonymous sperm donation, or else forget the whole thing.

If I were in his shoes, my response would be, "I am helping the two of you have the child that you cannot conceive without technical intervention. As such, I am no more that child's father than the doctor who did your in-vitro would be. That child has a perfectly good set of parents: you and you, and not me. I don't want to complicate his life."

Third, I'm not sure of the laws surrounding this, but I don't know whether it is even legally possible to create an agreement where both parties disclaim his paternity when done this way -- meaning that should your lesbian friends find themselves in financial trouble, they could come after your assets for back child support. I recommend you get competent legal advice before embarking on this.
Diane, regarding your medical situation (best to untangle from the sperm donation thing):

I might suggest a conference call with both doctors, where once you have them both on the line, tell them, "Look, I'm in pain here. Your professional deference is all well and good, but it isn't in line with your Hippocratic Oath. You've both established that you respect one another and want to maintain good professional relationships. That's awesome. Now, which one of you is going to do the right thing and treat me, and which one is going to do the right thing by green-lighting the other to treat me?"
There are many reasons to not want to use a sperm bank. Wanting someone you know to be the father of your child is a natural thing. Wanting your child to have the option of a relationship with their biological father is a natural thing. Wanting someone who has agreed ahead of time to donate a kidney, bone marrow, and blood is a natural thing.

I get a lot of grief from all sides about how my husband and I run our marriage. Some think he controls me too much. Some think I control him too much. I think that's a sign that we are doing something right.

But if I were pregnant, he'd try to talk me out of an abortion and into adoption. Because we look out for each-other, and we make our big decisions together. When it's someone else's body the person whose body it is gets to make the final call, but we are always allowed to present a case.

My husband acknowledges that the child might have different expectations from normal. He's got friends who were in open and closed adoptions, and he's made the call. He's decided to roll the dice. My husband never makes a decision without looking at it in the most pessimistic way. We balance each-other out, because I tend to view things too positively.

We did the standard thing that we do when we disagree on a major decision. We decide who would make the call (not an issue here, because the answer was obviously him.), and we gave a time limit to the other person to present a case. I was given a month. I tracked down statistics, facts, and I presented it to him in written form. I did not even discuss it out loud. He e-mailed me with questions, and I did the research and backed my answers with facts and sources--also in e-mail form. We've found this cuts down on drama.

After looking at statistics and talking to our friend, he agreed that the good he'd do outweighed the potential risks.

But I did not want to go into the details of our marriage.

As for my gyno-woes. Of course there are other factors in play here. I've told you all of the relevant ones, and I've told you the complete truth about everything I've stated. Can you name a factor--seriously wrack your brain--that would justify what my doctor is doing to me?

It's possible that the other doctors had different reasons for not wanting to help me. I told you the answer they gave me, though.

Ultimately, it comes down to the fact that they don't trust me to not change my mind. My mother was not asked for a letter. She provided one of her own free will, because she felt like they didn't understand how long I've been child-free (the answer is as long as I could talk.)

And I've asked around. Most women who want to be sterilized have to jump through hoops like this if they are young and child-less. Hell, my Mother-in-law got sterilized in 1990, and they didn't want to do it because she was under 30, even though she had three children. Every doctor I've spoken to about getting my tubes tied before now has pulled that "Wait five years. You'll change your mind!" crap. The problem? After three years I've moved, I have a new doctor, and they want to make me start over again.

Fine. I'll tell you the big factor that makes them unwilling to trust my judgement: The other medication that combines badly with birth-control for me? Zoloft. I'm bi-polar. But I've not been found incompetent, and my psychiatrist (and every psychiatrist who has seen me for the past ten years) believes me when I say that I don't want children, and I won't change my mind. She even made me see two new psychiatrists.

My Gyno's freely admitted to me that she doesn't understand mental-illness, and certainly feels unqualified to treat it. But she's not willing to listen to the people who are.

My husband's argument: If you don't think she's mentally competent to decide she *doesn't* want a baby, why do you think she's mentally competent to take care of one if she has it?

But that falls on deaf ears.

So now that you know way more about my life than I ever intended to share, can you stop judging how my husband and I've seen fit to conduct our marriage? Now you can go on to dismiss everything I say from this day forth because I'm a nutter-butter.
Oh, and he knows about the court cases involved. Our friends do not live in California. They live in a state where sperm-donor contracts have been upheld when challenged. A contract is a must.

He has no problem providing financial assistance. He's already an uncle and he kind of wants to know anyone who shares his DNA. He just doesn't want the kid to live in his house with him. He doesn't want to make the important decisions--that much responsibility frightens the hell out of him. He wants the kid to know that if he/she wants to run away, he's not an option.
And my insurance has stated explicitly--to me, over the phone--that they have already voiced a willingness to pay for my surgery to my doctor.
I'm getting sick of unpacking. I'm not answering any more questions about Sperm donation or my uterus. I'm sorry I brought it up. My mistake.

I don't think you're a nutter butter, and I don't think that your (treated) mental illness has any bearing on your decision - especially if two psychiatrists also vouch for that. Your husband also makes a valid point.

Have you considered an nonhormonal IUD?

I didn't mean to suggest that you were a nutcase; I was commenting on what seemed to me to be a high amount of drama. Leaving aside your husband's decision to be a sperm donor and how it was arrived at, there seem to be two different things going on with the partial hysterectomy.

The first is that you have described a health condition which is affecting every part of your life: you are in pain, medicine isn't adequately addressing your pain, there are serious, deleterious side effects associated with the medication you've been prescribed, you bleed constantly.
The solution that doctors agree would help your condition the most would, as a collateral effect, render you infertile.

The second is that you have repeatedly expressed a desire, apparently independently of the specific health issue, to be sterilized, knowing that you don't want to be a mother.

It would seem that these two situations have a felicitous convergence. Furthermore, you have been given approval for the surgery from your insurance company, which sees the partial hysterectomy as the best medical/surgical solution to your primary problem.

Your mental illness, treated or untreated, should have no bearing on the decision to have the procedure. I can understand a doctor being reluctant to do something as permanent as a hysterectomy purely for reasons of controlling fertility on someone who is young and has had not children, and I don't think it would be unreasonable to ask the woman requesting it as a form of birth control to wait for a while before committing to it.

But that's not the primary reason you want the surgery. This is the best treatment available for your medical problem, and the biggest objection to it is a non-issue as far as you're concerned (even a side-benefit).

I think you need to approach your doctor and the other two again, and take discussions of how long you've known you didn't want to be a mommy off the table, along with discussions of your mental health. If your bi-polar disorder is under control, you are mentally healthy. Enough so as to make informed decisions about your medical care. Keep the discussion focused clearly on how to best treat your painful and debilitating condition, make it clear that you understand and accept the consequences of the best treatment (a partial hysterectomy), and talk about scheduling the procedure. Refuse to turn the conversation into being about what it's not.

Good luck.
IUD's make my cramps worse, and a non-hormonal IUD would not solve my "always-on-my-period" problem.

But I appreciate the help.
Would they be willing to do the surgery if you had your eggs frozen first? (If they're so convinced you'll change your mind)
They don't even need to freeze them. They are leaving my eggs in situo. All they are removing is my uterus.

Haha, blonde moment. I guess my point being, if you did, in theory want to have kids some day (and I believe you when you say you won't!) you could just use a surrogate, no? The surgery doesn't prevent you from having children (there's adoption!) and it doesn't even prevent you from having biological children, if I'm understanding correctly...

Just seems strange to me.
Anyway, best of luck.
@106 Diane---I hope it works out for you. Keep your foot firmly down and continue to assert your needs.

Boy, can I ever relate to you!! Knowing I would have been a SHITTY mom (think Kathleen Turner in The War of the Roses), I focused on being a kick-ass aunt instead. Ironically, my oldest sister, now a grandmother, keeps asking me parental advice----25 years after rightfully chewing me out about how she was raising my niece and nephew when they were little. I vaguely remember saying something smugly sarcastic, so I most likely deserved her tongue-lashing.
I had to concede her point, having no kids of my own then or now. Because of this, I'll never give advice on parenting or marriage, either. I'm better off single.

Back in my stupid housewife days of being unhappily married, I had to battle my butt off in defending my choice not to have children to my spouse, his family, his friends "who all had kids", his chaplain, his employer, etc., etc. ad nauseum, with the only exceptions being MY parents and closest friends who were supportive of my decision.
Hang in there! I plan to throw a WILDLY INSANE party when I reach menopause!!
I'm gonna cool off my forecasted hot flashes with tee martoonis!!

All the best,
Auntie Grizelda
@101 nocutename: I agree. There is no one "right" way; what works amazingly well for me might not for you. We should all be free to make our own decisions, especially when pursuing our joie de vive.
@137: A tubal ligation will not affect her bleeding. Look up the positions of the fallopian tubes vs the uterus on a diagram. Or, don't give people medical advice if you can't understand female anatomy/pathology.
@DianeLGD: I hope that your doctor starts to listen or that you can find another good quality doc who will. Based on what you've said, it sounds like you're making the most rational decisions possible, but your doctor is too caught up in emotion to be able to provide the best care to you.

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