Change of heart

Six Years After An Operation To Prevent More Pregnancies, Her Husband Wanted Another Baby

On 17 January 2006, Mary, a 35-year-old woman, walked into our clinic with her partner. Her records indicated she had been an old patient at the clinic. Six years before she had undergone closure of both her fallopian tubes in a surgical procedure known as bilateral tubal ligation—commonly known as TL, or in Kiswahili, kufungwa. This means the tubes were cut off near the ovaries to prevent the eggs from reaching the uterus.

After her third child in 2000, Mary sought a permanent method to stop her getting any more children. As is the practice, doctors asked her to come to the hospital with her husband so that both may declare joint consent for the operation, which she did. She reported having undergone several sessions of counselling alone and with him.

Bilateral tubal ligation

After serious thought Mary and her husband had agreed she should undergo the bilateral tubal ligation. But now, Mary said, she wanted a fourth child. She wanted the tubal ligation reversed to enable her to have the child. I presume she had done some research because she told me that she had heard of women who had undergone this permanent method of contraception and had it reversed and even proceeded to get children.

She was sure that there was a chance of successful reversal and even a high probability of conceiving. After all, Mary told me, this is the new millennium; if scientists can clone animals, what about a simple task such as reconnecting tubes?

I first explained to her the guidelines for permanent surgical contraception, emphasising on the permanence of the method. I reminded her that TL was a final family planning solution, done without the intention of a reversal. Additionally, I explained to her the risks associated with attempts to undertake such a reversal, which included ectopic pregnancies. She acknowledged all that but was still adamant about wanting it reversed.

He would marry a second wife to bear him the child!

Further discussion into why she had a change of heart, especially considering the number of years since surgery, revealed that her husband’s wishes were the real reason why she wanted a reversal of the tubal ligation. He was demanding another child from her!

Mary revealed that her husband felt that his economic status had improved and they could take care of another child, unlike six years ago when they were struggling financially.

This had strained their relationship as he had given her an ultimatum to either have the TL reversed or he would marry a second wife to bear him the child!

Mary had no desire to share her husband with another woman; she detested even the thought of it. Mary was therefore ready to do whatever it took to satisfy his wish, hence her desperation to have her fallopian tubes reconnected so she would conceive.

She was ready to face the risks

Further enquiry into her background revealed that Mary was currently a hairdresser with an average income of ten thousand Kenya shillings per month. Her husband was a local jua kali artisan making about fifteen thousand Kenya shillings per month.

They were ready to meet the expenses of the operation, and were well aware that the operation was expensive. Mary emphasised that she was ready to face the risks of having the TL reversed.

I referred her to a gynaecologist at a major hospital in Nairobi to discuss the matter further. I also recommended further counselling sessions to persuade them to maintain their decision not to have more babies. On the other hand in the event they still wanted to proceed with the reversal, the couselling would help them cope with the risks.

Four months later Mary came back to the clinic. She had already undergone an operation to reconnect her fallopian tubes. Mary seemed happy and well prepared for the journey ahead. She was confident that pregnancy was not too far away. This was confirmed by an ectopic pregnancy she had already suffered. She however seemed determined to fight on.

One year down the line Mary’s search for a baby is still on.

END: PG 06/12