Essure—Laura Scott Talks to Dr. Carrie Panoff about the Non-surgical Alternative to Tubal Ligation

I was invited by the public relations team representing Essure, a non-surgical, hormone- free permanent birth control procedure, to do a Q&A with Dr. Carrie Panoff, an OB/GYN in Rockland County, New York who has been doing this procedure for four years. Here's a summary our conversation:

Q: What do your patients see as the benefits of this procedure?
A: It's hormone and surgery-free and no recovery time or incision
risk. It's a five or ten minute procedure.

Q: Are any medications offered or recommended for discomfort during or after the procedure?
A: I use Motrin 24 hours before the procedure and Motrin during the procedure.

Q: In your experience has there been any instance where a pregnancy occurred after this procedure?
A: No. Three months after the procedure we perform a test that confirms the blockage.

Q: Which patients are the best candidates for this procedure?
A: Any woman is a candidate.

Q: Do you have any reservations about perform this procedure on a childless woman under the age of 30? If so, how do you handle patients who fall under this category?
A: Patients under 30 years old have a tendency to change their mind so I may give them other options. They have the right to make the decision but I would have to be adequately convinced that have had this decision for a long time and have evaluated all of the options.

Q: Have any of your childless patients changed their mind after having the procedure?
A: No.

To get more information about Essure, visit the FAQ page at http://www.essure.com/what-is-essure/common-questions. Click at the top right-hand side of the page to find doctors who perform this procedure in your area.

Optimism Unwarranted for Past President of the National Organization for Non-Parents

Last month I got this email message from Marie Bernardy, who once served as President of NON/NAOP, one of the first childfree groups in the United States:

Hi Laura -

I was just forwarded an AOL article about your book on childfree couples. My husband and I were members of the National Organization for Non-Parents in the 1970s and 1980s; both of us served as president of the organization. Below is a wikipedia reference, in case you haven't run across it, which gives some details on the history of the "childfree movement."

http://en.wikipedia.org/wiki/Childfree

I had my tubes tied at 23; my husband had a vasectomy at 24. We've been married 35 blissful, childfree years. I feel sad that so much of what we worked for so many years ago (education, acceptance, insurance equity, etc.) is still a problem for so many. Physicians are still reluctant to perform sterilizations, families continue to pressure for grandchildren, friends with kids ostracize those without.

Keep up the good work.

Marie was right. People like her have been working for decades to promote understanding and acceptance for the choice to remain childfree, yet not much has changed. She told me that NON/NAOP shut its doors in 1982, because of lack of funding the “thinking that the concept of being childfree was well entrenched” and that other organizations like Planned Parenthood and ETR would continue to provide materials that would invite people to consider the childfree life as a viable option. Marie now says “We were probably more optimistic than was warranted.”

Choice has its Limits

Recently I was contacted by a journalist who was writing an article on young childfree males who had a vasectomy in their twenties. He asked me if I knew a male in his twenties who had recently signed up for this procedure. I did not.

I knew from my interviews with childfree couples that it is possible to get a vasectomy in your twenties but it isn’t easy. I had heard stories about twenty-something childless by choice men being turned away by doctors who said, "Come back to me when you’ve had a couple of kids."

Hello!? It’s true. You will likely have to doctor shop to get a vasectomy if you are a young childfree man. The same is true if you are a young childless woman seeking a tubal ligation. Some doctors are reluctant to perform a tubal ligation on a woman under twenty-five years old, even if she does have kids. Woman and men have been asked to undergo a year of counseling, write a letter to the child they will never have, and are generally expected to jump through hoops to convince a doctor they are sincere in their desire to remain childfree.

Why is it so hard?

Because there are assumptions, crusty with age, that are operating here:
1) You may think you don’t want children, but you will change your mind (and sue me).
2) You will divorce and your next spouse will want a baby, and you will acquiesce.
3) You’re immature, and you don’t know your own mind.

If you really, really want to be permanently sterilized in your twenties you must find a way to overcome these objections, or wait until you turn thirty. In the meantime, do what many of my particpants in the childless by choice project have done.
1) Double up on birth control (I know, you are already very careful).
2) Discuss your wishes with your partner (it takes two to be this diligent).
3) Do an extensive discernment process. Do you really want to remain childless? Why? When you’ve answered these questions, write a letter to yourself, and print a copy for the doctor and bring it to the initial consultation.

It takes a a good pitch, and a lot of thought, to make this life-altering decision, but if it is what you really, really want to do, remember you can always adopt, foster, or mentor. A life without kids doesn’t necessarily mean a life without kids. (See the previous post).