Updated: Jan 22, 2022
If you have landed on this site, I am so sure it must have come across your mind that:
You are so done having babies and do not want to get pregnant anymore.
You cant seem to find the right fit on the best birth control method to use.
You are unsure what Tubal Ligation entails as it sounds scary.
Many of you have dm me on my Instagram Account @letsaskmama asking how it went, the costing and whether its permissible or not. So I hope my sharing here would equip you with the right knowledge and help you make the correct decision. Its a little flashback journey on the different birth control methods I've tried, the side effects and how miserably it failed me that Tubal Ligation became the best decision I've made.
I fully understand that birth control whether its permanent or temporary is a very sensitive topic to discuss among our community. Before I took this step, I've actually asked many learned teachers, Ustazahs and Ustaz on whether it is permissible for me to do this. And due to my condition, it definitely is. I will fully elaborate more later, read on and you will learn why.
What I am sharing here is more or less my medical journey with my gynae. I followed her lead and advices before attempting any type of birth control methods. So please, do not quote me and assume what is applicable to me, will be applicable to you. Please seek expert knowledge and follow your body. My side effects may not be the same as yours. What did not work for me, might work for you. So once again, I implore you to work together with your gynae for the best solution for you.
1st Three Pregnancies
I got married December 2010. One of the most happiest day of my life. A month later, got preggy with my 1st born. Shock, surprised, ready or not my 1st born came in September. It truly was unplanned and we actually left it to fate. We didn't wanna plan and see or wait for the right time. We were ok with letting HIM decide. It is normal procedure for gynae to ask if we have any plans on birth control during our 6 week post natal visit. I've given birth 5 times, each time she will ask me the same qn. I feel like its a protocol of some sort? I'm not really sure but that was what happened.
So after my 1st born, we decided not to get on any Birth Control (from here on referred to as BC) and planned to use the normal traditional method. Initially it was going well cause my 2nd born came about 18months later. So there is a 2 year gap between the two of them. As my 1st baby breastfeeding journey was abrupt and many times rudely discouraged (a story for another post), I was determined to fully breastfeed my 2nd baby. For me, whenever I fully breastfeed my babies, my menses will be of no show till the day I wean them off. So lo and behold, it was hard to predict or know if I'm pregnant or not.
At the same time, I have developed an allergy to latex. My skin could not come in contact with any sort of latex or plastic materials. I couldn't even safely put on a plaster or band aid if I were to get an injection or got hurt. Once applied, my skin will burn and rashes will occur almost immediately. Just imagine feeling that down there.. *CRINGE*
So I only found out about my third pregnancy when I had a bout of stomach aches and couldn't hold in any food. Went to the GP for normal checks and when the doc was prescribing me meds, he asked if I was pregnant and I said I'm unsure. Did a quick test and TADA.. Positive.. And that's not all.. Went for my gynae check up to see if all's ok.. Turned out I'm actually 6 months along.. Baby is coming in 3 months time.. I didn't have a full bump or showing any.. I was working 3 shifts during that time with long hours, I didn't realize I had a baby on the way. Age gap between the 2 was 1 year.
So after Mr Mamat Handsome came along.. Then again I had the BC talk with my gynae for the third time. And this time round, I was seriously considering and said yes to Implanon. That's when all HELL BROKE LOOSE!
What is Implanon NXT?
It is a contraceptive implant that is made of flexible plastic stick, 4cm long. The implant slowly releases a hormone, progestogen, into the body. It will be inserted in the inner upper part of your non primary arm. It sits just nicely under the skin. You cant see it but if you run your fingers around the area, you can feel the stick. The gynae can insert it for you during normal routine check up. You do not need any special room or procedures for it. Its a very straight forward typical insertion into the skin similar to an injection. It doesn't hurt so bad and you will have to change it every few years to keep it working. It typically costs about a few hundreds.
You can google on the typical side effect warnings on the treatment. I would rather share on the side effects that this treatment gave me.
I PUT ON A WHOPPING 10KG!! I felt and look like the cow in this picture.
All the hard work I put into losing the pregnancy weight all came back. Clothes were not fitting well. I was eating almost non stop and couldn't satiate my hunger at all. I constantly needed heavy meals. I could easily finish a few packs of chicken rice at one go which was unlike me. Heavy me = Lazy me. I could no longer function well and run the family routines. I couldn't think straight. My thoughts were constantly hazy.
If I'm happy, I will feel very very ecstatic, over the moon. If I'm sad, ill cry as if someone dear passed away. If I'm angry, I RAGE!!! Many times I almost get into severe trouble cause I couldn't control my temper at all. The children were worst hit. I was very very short tempered and the scolding and yelling they got were really unkind. I became a monster. I got the Implanon almost immediately after my 3rd one was born. And when he started crying, I almost wanted to throw him aside or hurt him. I wasn't proud of that time.
My normal monthly routine would last for about 7 days, and moderate volume. However with the Implanon, it will last between 14 to 20 days. And in very heavy amounts with clots. There were days where I had to use the baby diaper so that I don't soil myself. I couldn't really function well cause I was more or less constantly menstruating.
With all these happening, I decided its enough and got it removed. The removal procedure was also simple. Gynae had to use a small little device and remove it in her clinic. Was not so painful either. It only took 1 month for me to lose about 5kg of the weight I've gained. It was a fast drop. Lost all 10kg in 2 months. My mood regulated once again and I was back to being myself. I finally felt normal. My period went back to my normal cycle. Implanon NXT was definitely not for me. I would not even wish for it on my worst enemy. That's how bad it was. So once again, gynae asked me if I'd like to try any other BC methods and we had decided at that time we wanted a 4th and with God's Blessings, we got another.
Agggaaaaainnn.. at the 6 weeks check up, gynae asked me again. Which BC method I would like to try. So the Implanon had really cause trauma and phobia on me. I was so scared to even try anything. Gynae told me that IUD is similar to Implanon. Since I am so sensitive to hormonal treatments, she is unsure of what's best for me to try. So I bid her farewell and told her let me think about it and get back to her. So as per normal, I went for my yearly check up with her and she kept reminding me on what I wanna do.
2 years went on well.. I thought I'm safe and all's good. And I was still recovering from all the stress that had happened and then BAMMMM!! Hit with another pregnancy, (Yes, my gynae did tell me that I'm highly fertile LOL). This pregnancy though hit me the hardest. I went into depression for close to 5months. I wasn't accepting the baby. I didn't want it. I was dreading the whole 1st trimester and early 2nd trimester. When I saw the positive, I was crying uncontrollably and almost collapsed. Le Cha had to sit me down and calm me. Each check up with the gynae made me end up in tears. I didn't wanna see any scans or celebrate any growth milestones. I was telling my gynae I am not feeling the connection with this baby. She placed me on high alert. The timing was all wrong at that time. We were in the midst of shifting, my brother in law was getting married on my EDD date. I hit rock bottom.
This was when I truly realized, I am done with having kids. For those of you who are close to me will know that I have very difficult pregnancies but very easy labors. I was hospitalized regularly, had many many blackouts and fainting spells. I had to put chairs all around the house like the kitchen for me to sit and cook and in the toilet for my showers, just incase I wanna collapse, I can quickly sit down before it happens. I've fainted at lift landings while sending the elder 3 to school several times and neighbors would help me home.
My gynae than advised me to consider ligation. We both knew after this, I cant sustain another pregnancy. My body will not be able to handle it with all the different complications I was facing and will face even more if it were to happen again.
So at this point I started to ask around. I was unsure if permanent birth control is permissible in Islam. I remembered learning that we are allowed to plan and what not but didn't come across on any rulings on it being permanent.
A quick read on this site, you can learn about the different rulings based on fatwas.
In summary, I have learned it is not permissible unless it is an emergency or a pregnancy again may cause further harm to the mother. Do note that my gynae is a Muslim lady too. Should she do this for me and its not permissible, she will be answerable too right. In Malay we refer to it as 'bersubahat'. My intention of having the ligation is not due to the worry that I cant sustain the children or if we do not have enough to provide for them. But instead, it is for my health sake as I need to be fit to provide for my children. Thus, with that, I am confident I can proceed with the tubal ligation. So after delivery this lil princess, we went ahead as planned. She turned out to be the light of my life. My Little Curly Fries.
What is Tubal Ligation?
Tubal ligation — also known as having your tubes tied or tubal sterilization — is a type of permanent birth control. During tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy.
I chose the tied method. So right now I have 2 clips holding it closed. Looking very much like this.
Typically if you had a C-Section delivery for your last baby, your gynae can do it for you immediately after delivering your child. Again, please discuss with your gynae and don't take my word for it.
I had normal delivery and 2 options were given to me.
Immediately after delivery, I will be wheeled into the operating theater and get it done. My recovery will happen concurrently with postpartum healing.
Wait for a few weeks, come back and get the procedure done during Day Surgery.
I chose the later. Reason being, as advised by my gynae, the clips will sit better if I wait for the swelling in my womb to reduce. It would let some healing happen first and it will be clearer for her to work on. I can just focus at one thing at a time.
Since I went the private route at KKH, I paid about $2000 cash and some deductions through Medisave. I apologize but I do not remember the actual amount. If you chose the subsidized route, the cost would be much lesser than this. An approximate of about $1000.
Complications of Tubal Ligation
Bleeding from the site of the wound
Damage to the pelvic organs
Pain at the incision site
Pregnancy due to improper ligation of the Fallopian tubes
Thankfully, I suffered none of the above and things went well.
Benefits of Tubal Ligation
Tubal ligation is effective in 99% of cases, hence, it is very rare for things to go wrong.
You no longer need to constantly remember to take the pill or schedule appointments to replace your Implanon or IUD. Life becomes much easier.
There is a reduced chance of developing ovarian cancers in the future and does not escalate breast cancers. In addition, the side effects of Tubal Ligation are not as severe as other methods which includes heavy or irregular periods, mood swings, weight changes and the likes of what I've experienced with Implanon.
I booked an early slot in the morning and checked into the Day Surgery Suite at KKH. Went through the normal routine of changing, weighing and registration. Waited patiently for my name to be called, walked into the theater and about 1 hour plus later, it was done. I was put under general anesthesia. I chose to get my Pap Smear done at the same time. It was a key hole procedure. I had 2 holes at my side and 1 through my belly button.
Upon waking up, we were allowed to rest in an observation ward for about an hour before being allowed to go home. I saw some ladies standing up and walking about within 30 minutes of surgery. Me on the other hand had a reaction towards the GA so I was vomiting a lot. Was weakened by that and had to stay in a little bit longer. The longer you stay, additional surcharge applies. Once I felt steady, Le Cha brought me home. Upon discharge, they gave me a card that states I have clip implants in me. I have to show this card whenever I need to get any MRI done as its magnetic and can impose danger.
I had my parents watch the littlest one while the elder four was at my in laws place during the surgery. So I had to take care of the newborn only. I couldn't do any heavy lifting at all. I felt quite sore around the belly area and was very bloated thanks to the gas they pumped in. My left shoulder hurts too. The key hole sites were rather bloody and I just had to do regular dressings until it dries up. It was not too bad. Total recovery took about 3 weeks and I was back to normal. Initial menstruation post surgery was quite bad for about close to 6 months though. It didn't seem to clot up and I was bleeding through. I was put on medications to help lessen the bleeding. After awhile, it regulated and I was back to my normal cycle and all is good. I do not have any major cramps, no mood swings, no drastic weight gain, no other side effects at all.
NADDAAA!! ZILCHHH!! Happiest I've ever been. Knowing that I can never get pregnant again is so liberating. To the point that when I see other babies, yes I love that little child, but nope.. Mama is DONE! I can put all these behind me safely. I can now focus on raising my five little Amanah to the best they can be and they get the Mama they proper deserve. I am much healthier and all the health complications I've had in the past is no longer an issue.
Before you decide if this is for you, sit and discuss with your spouse. Make sure both of you are on the same page. So in future, no one blames the other cause this procedure is almost irreversible. It can be done however the chance of getting pregnant again will be significantly reduced after reversing it. If you feel that being pregnant again is going to make you very depressed and your health is at stake, then go for it. However, in my opinion do not do this if your reason is based on worry about sustenance or if you feel right now you cant afford children so you wanna do it. This will have a higher chance of regret. You wont know in what way rezeki or sustenance will come your way. Weigh your pros and cons, your reasoning well and take the best decision for you.
If you need further clarifications, don't hesitate to dm me on my Instagram @letskaskmama. I am always a beep away. Would love to hear from you. Show me some love by hitting the heart button below so I know you enjoy this content.