'I just had sterilisation surgery. I didn't expect all the opinions.'

I spent six years and thousands of dollars on the IVF rollercoaster so it’s safe to say no one would have picked sterilisation surgery to be on my 2024 bingo card.

But last month I paid several thousand more to have both my fallopian tubes removed which will prevent me from ever falling pregnant naturally.

The technical name is: bilateral salpingectomy via operative laparoscopy. Keyhole surgery to remove both fallopian tubes. The ovaries, which produce essential hormones, stay intact.

Watch: How to be a woman. Post continues after video.

Recovery has been moderately painful, but I was prepared for that. What I wasn’t prepared for was everybody's strong opinions.

I’ll get to that. First a bit of backstory. How did I end up here?

I met my husband in university. We dated for eight years and I probably had six periods in that time. Sounds ideal if you’re young, fun and dating. Less fun when you’ve been married for two years and are desperate to get pregnant. So off to the IVF clinic we went.

IVF was tough, getting pregnant became my part-time job (on top of my full-time job), my only hobby and at times completely consumed me. But this story has a happy ending. Three of them. Thanks to the magic of science and a dedicated team of IVF doctors, nurses and geneticists, we have three beautiful daughters. I have everything I ever dreamed of and I feel grateful every single day because I know so many people still dream.

Why the surgery?

For all its downsides, IVF forces you to be very considered about what you want. From the beginning, we wanted three children. No more. We literally ran the numbers and worked up a budget that factored in IVF costs and the cost of raising children. Three is our max if we want to continue in our chosen fields of work, live in the city and (weirdly important to both of us) drive a “normal” car.

Hannah with her husband and their three kids. Image: Supplied.

After the birth of our third in 2022 I became obsessed with the idea of accidentally falling pregnant. And by obsessed I mean petrified. To make matters worse, everyone around me would constantly joke that it would happen too. Turns out that stories like "My sister/cousin/aunt/best friend’s dog-sitter’s aunt did IVF for 10 years then got pregnant without trying" can be just as unhelpful after IVF as when you’re going through it. 

We’re lucky to live in a country with lots of contraception options, and (relatively efficient) access to the morning-after pill and abortions. But all of these options require an ongoing mental load. After years of "could I be pregnant" taking up valuable brain space I wanted a full stop on my fertility story.

And things probably should have ended there. They haven’t. 

Everyone has thoughts. 

It started minutes before I went in for the procedure. Laying in a bed outside the operating theatre, cannula in my arm, wearing the surgical gown but no undies (which makes you feel so much more vulnerable), the surprisingly loud voice of a staff member wafted out to me.

"It’s a brutal procedure. Wouldn’t be my choice of contraception."

No worries, not asking you to have it done. 

Post surgery I’ve had very few questions but lots of statements. Overwhelmingly, emphatic declarations of…

"YOUR HUSBAND SHOULD HAVE HAD A VASECTOMY!"

"I made my partner have a vasectomy!!"

"It’s only FAIR for the man to get a vasectomy, you carried the baby!!"

These comments are no doubt well-meaning but leave me feeling frustrated.

Health decisions aren’t about fairness. They’re about what’s best for the patient. (Take note those who say it’s only fair for Princess Kate to update the taxpayer public on her abdominal surgery).

If you asked me why, I’d tell you everything I’ve explained above.

If you asked, I’d tell you it’s for my mental health.

If you asked, I’d also tell you that since having the surgery I’ve learnt that many ovarian cancers start, not in ovaries, but instead in the fallopian tubes attached to them (Australian Gynaecological Cancer Foundation).

Listen to The Quicky where we talk about the mental load of going through IVF. Post continues below.

Ovarian cancer is the leading cause of death from gynae cancer in Australia and has been called a "silent killer" because it typically causes few early symptoms and is usually not discovered until it has spread around the pelvis and abdomen. The 5-year survival for ovarian cancer is still only 48%.

The research is still evolving, and no one is suggesting we should all go and have preventative surgery. However, this should be the start of a conversation about women’s bodies. 

Simplifying it to a scorecard about fairness is a wasted opportunity.

Feature image: Supplied.