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Maddie
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A mom I know in our h/s group mentioned recently that due to very difficult pregnancies (very painful tubal pregnancy, high blood pressure, gestational diabetes, bedrest for 20 weeks for nearly each of her pregnancies, and other complications) she and her dh are considering not having anymore children. They are afraid her next pregnancy could kill her and are considering a tubal ligation. They believe they are justified in this decision to protect the life of the mother.
My reaction was it is NEVER allowed, but some of the other moms in the group said you could appeal to Rome to get permission? Is that true? Can anyone point me to a reliable source that can offer a clear answer?
Am I wrong? I thought the Church was very clear in the fact that all BC was sinful and not an option? What would be called for? Abstinence?
Thank you so much for listening and for any direction you can offer. 
God bless,
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Dawnie
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No, a tubal would not ever be allowed just to prevent pregnancy for the reason that a pregnancy could be life-threatening. This is covered in Humanae Vitae.
Humanae Vitae wrote:
14. Therefore We base Our words on the first principles of a human and Christian doctrine of marriage when We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children. (14) Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary. (15) |
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A couple in such a situation could use very conservative NFP or they could abstain completely. I guess their course of action would depend on how serious their concerns were.
A woman could have reproductive parts removed if they were cancerous or somehow diseased. In that case, sterilization would be an unintended side effect of the surgery. The purpose of such surgery would be to cure an illness, not to sterilize a person.
Humanae Vitae wrote:
15. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (19) |
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aussieannie
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Maddie, Dawn has posted well on what the Church teaches, I've just given links to also show that from a logic prespective that Tubal Ligation is no easier option, medical wise!
The risks that can occur with all surgeries in general:
• General anesthesia risks
• Risk of infection
• Risk of adhesions
• Risk of bleeding
• Postoperative pain
The risks that can occur specifically with laparoscopic surgery (such as caused by the Veress-needle/Trocar):
• Intestinal perforation (bowel injuries)
• Uterine perforation, abdominal wall emphysema, peritonism, mesosalpinx rupture
• Injury to the major retroperitoneal vessels (injury of a major blood-vessel)
• Perforation of an organ or vessels
• Fallopian tube rupture (tearing of the ovarian tubes)
• Risk of haemorrhages from salpinges on dissected Omentum
The risks relating to the sterilization process (that affecting the fallopian tubes):
• Considered permanent. While reversal is possible in some instances, it is not a guarantee.
• Risk of sterilization failure.
• If sterilization failure occurs then at higher risk of ectopic pregnancy.
• Risk of post-sterilization regret.
• Risk of post tubal syndrome (PTS) (altered ovarian function, menstrual abnormalities)
• Risk of disturbances of menstruation, dyspareunia and altered sexual life.
• Higher risk of subsequent hospital admission for menstrual disorders.
• Increase risk of hysterectomy.
• Risk of ovarian isolation to one or both ovaries (leading to ovarian failure).
Here is a pro-life prespective of it's dangers.
Here is a medical site that says the same thing.
This one is a bit of an eye-opener.
I have personally known of a case where it deeply effected the woman's hormonal balance causing severe emotional problems.
There has been a few cases in the newspapers in Aus of failure rate where women have sued for the costs of raising the child they have had after the procedure...sickening, I know...  But just shows there is no absolute guarantee of no more babies..
I have a friend who is a gyn at a hospital in my city and that hospital had to a few years ago contact every woman who had, had the procedure within the last five years and offer to re-do their tubals as the clips had been recalled as faulty - but interestingly enough, I certain decent percentage of those women didn't want it re-done in the hope they might fall pregnant, the practioners dealing with them were gob-smacked!
And vasectomies are another story in themselves - certainly not safe!!!
Are this couple fully informed/trained in the use of NFP? It is not the poor option that some medical people would like to portray it as. It tops the effectiveness of any contraceptive if the couple are well versed with it - so personally, I think it should not have to call for complete abstinence...
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msclavel
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I personally know many women (some in my family) that have terrible side effects as they entered into menopause as a result of a tubal done when they were young.
It is wrong not merely as a matter of birth control, it is considered mutilating the body.
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Martha
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Well now, one can appeal to Rome for permission for anything. I'd probably keel over in my chair though if she even had a chance of getting it though.
Of course, they certainly are justified to protect the life of the mother in question, but that does not require a tubal. There are other options such as NFP, prevention measures to head off repeating past issues such as hbp, ect... These certainly may not seem like the easiest or quickest methods, but they most certainly offer to protect the health of the mother more than major UNneccessary and unreversable surgery.
At the very least, her life is not in jeapardy NOW and making such a decision out of fear should be avoided. Thus they should take advantage of the above options until they are confident that fear is not the prime motivator. imho.
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Maddie
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After a quick search, this is what I think some of the other mothers are referring to:
It's from Catholic Answers.com
Q: This may sound funny, but can I have my cat neutered? While I was at the animal shelter it dawned on me that I was about to have done to my pet something that would be sinful if I was having it done to myself—sterilization I mean.
A: Directly intended sterilization of a human, whether a vasectomy or tubal ligation, except when performed for strictly therapeutic medical reasons, such as to save a life, is a serious violation of the moral law (Catechism of the Catholic Church 2297). The same does not hold for animals.
So, I went to the Catechism reference:
2297 Kidnapping and hostage taking bring on a reign of terror; by means of threats they subject their victims to intolerable pressures. They are morally wrong. Terrorism threatens, wounds, and kills indiscriminately; it is gravely against justice and charity. Torture which uses physical or moral violence to extract confessions, punish the guilty, frighten opponents, or satisfy hatred is contrary to respect for the person and for human dignity. Except when performed for strictly therapeutic medical reasons, directly intended amputations, mutilations, and sterilizations performed on innocent persons are against the moral law.91
The "except for strictly medical reasons" has me confused. Is it then possible to be sterilized and it not be a sin, but there must be some kind of proof it is necessary?
Forgive me if this is Catholic teaching 101, but I have GOOD Catholic moms telling me one thing and GOOD Catholic moms telling me another. Can anyone help me clarify this?
I really appreciate the responses, they have been so helpful.
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MaryM
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Maddie wrote:
| The "except for strictly medical reasons" has me confused. Is it then possible to be sterilized and it not be a sin, but there must be some kind of proof it is necessary? |
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Like Dawn used in the example above it is permissible as result of action to save a life during treatment. To do so as a "preventative" measure is not permissible in my understanding.
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JodieLyn
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There is a different between "therapeutic medical reasons" and "directly intended sterilizations"
For instance.. there is a possibility with scar tissue on the uterus to have a placenta adhere in such a way that not only can it not fully release but the mother would bleed to death.. the only way to save the mother in this case is by removing the uterus.
The directly intended result is to save the life of the mother and stop the bleeding.
She is of course incapable of having more children at that point.. it was for "therapeutic medical reasons" that she lost her fertility.. it was never "directly intended" that she be sterilized.
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PDyer
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Martha wrote:
| Of course, they certainly are justified to protect the life of the mother in question, but that does not require a tubal. There are other options such as NFP, prevention measures to head off repeating past issues such as hbp, ect... |
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I was able to find these quotes in the Catechism:
CCC 1759 - "An evil action cannot be justified by reference to a good intention" (cf. St. Thomas Aquinas, Dec. praec. 6). The end does not justify the means.
CCC 2399 - (you have to page down quite a bit) The regulation of births represents one of the aspects of responsible fatherhood and motherhood. Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).
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Martha
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PDyer wrote:
| I was able to find these quotes in the Catechism: |
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oh my. I'm sorry for the confusion. I know that.
What I meant by they are justified in wanting to protect the mother, was that THAT may be a valid concern, however it doesn't make a tubal is not a valid need. They are perfectly justified in choosing NFP or other NON-sterilizing methods to protect the mother. 
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PDyer
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Martha wrote:
PDyer wrote:
| I was able to find these quotes in the Catechism: |
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oh my. I'm sorry for the confusion. I know that.
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Oh no no no! ETA I was agreeing with you and I meant to back you up by posting those quotes! I'm sorry if that was unclear and for the confusion!
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Patty
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Martha
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 okay! we're all clear and good now.
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PDyer
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Martha wrote:
okay! we're all clear and good now.
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Phew!
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Patty
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Dawnie
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Maddie,
You might check out Christopher West's book, The Good News About Sex and Marriage. I think he answers your very question there. I'll try to find my copy and look it up later...
When someone has a tubal ligation, they are mutilating their bodies. Think of an amputation...no one in his right mind would amputate a perfectly healthy arm b/c it MIGHT cause him problems in the future. However, if a person's arm was severely infected, or cancerous, or damaged so badly it could not be repaired, then amputation would be medically neccessary in order to treat the person. Does that make more sense?
Dawn
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Maddie
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Thank you, ladies, for walking me through this. You have made it very clear. Last night I discovered an entire chapter dedicated to sterilization in Kimberly Hahn's book "Life Giving Love". Now I guess my question would be is, how to be compassionate and understanding of her fears of another pregnancy. Just saying, "trust in God" seems so flip? Ultimately this is what she must do, but how can I encourage her? Any thoughts would be very helpful.
Thank you!
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Maddie, I know many who have experience with using NFP long term due to grave issues. PM me if you want support with what to say, and I could help you find support for her in her area perhaps?
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Maddie wrote:
| how can I encourage her? Any thoughts would be very helpful. Thank you! |
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Offering a shoulder and a listening ear may be the greatest gift you can give her. My dh and I face a sort-of-similar situation. Different details, but for us we found after the listening ear was in place, the situation led us to lots and lots of reading about how others responded to similar situations, about abandonment to providence in general, and prayer. Would your friend respond positively to being offered suggestions for reading? Without knowing her personally it's hard to make specific suggestions. I feel for her...
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Nina Murphy
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But if one of the spouses is not "cooperative" concerning the use of very conservative NFP? What if, for instance, the partner of a woman with severe reasons to avoid a pregnancy does not see eye to eye on the level of seriousness and pressures the woman either consciously or unconsciously (through moodiness, anger, and other negative effects in the home or on the children)---so therefore, she does not feel "safe" trusting the implementation of NFP? I know those who cite St. Paul saying that spouses do not have "rights" over their own bodies (and that the spouse has certain marital rights) and it would perhaps be leading to sin or dissolution of marital harmony to demand continence?
I don't know if any of you have medical expertise or training in moral theology on some of these more unique circumstances and dilemmas, but if you do, please share your knowledge and experience. I think this definitely needs to be explored and not made light of.
For instance, right now, a good friend of mine is going through just this problem. She has life-threatening pregnancies, requiring removal of the babies early simply to save her own health, but conceives easily (even with nursing and night-sleeping)--- and does not have the kind of marital relationship that is founded on self-sacrifice and that level of Christian maturity that makes extended continence a good thing for the marriage/home life. She absolutely fears another pregnancy doing her in psychologically and physically (and I know her---she is not exaggerating the dangers) but her husband has strong desires, a stressful job, and is frustrated. He would rather talk himself into "everything will be OK" but we need to take care of our immediate needs for intimacy as a couple.
(Now: don't you think this is more common than not? Let's be honest. How many men deal well with this? I have read book after book including the Care and Feeding of Husbands and a book rec. by Steve Wood on What Men Want saying that making yourself available physically to your husband is so crucial to the well-being of a marriage, that is basic.)
How does a Catholic woman deal with this lack of support----especially when everyone in her extended family and medical community is telling her she is truly irresponsible and self-destructive not to protect herself through permanent avoidance of pregnancy.
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LisaR
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Nina Murphy wrote:
But if one of the spouses is not "cooperative" concerning the use of very conservative NFP? What if, for instance, the partner of a woman with severe reasons to avoid a pregnancy does not see eye to eye on the level of seriousness and pressures the woman either consciously or unconsciously (through moodiness, anger, and other negative effects in the home or on the children)---so therefore, she does not feel "safe" trusting the implementation of NFP? I know those who cite St. Paul saying that spouses do not have "rights" over their own bodies (and that the spouse has certain marital rights) and it would perhaps be leading to sin or dissolution of marital harmony to demand continence?
I don't know if any of you have medical expertise or training in moral theology on some of these more unique circumstances and dilemmas, but if you do, please share your knowledge and experience. I think this definitely needs to be explored and not made light of.
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Nina, we see this quite a bit. you are right, it is a very real issue that many face fearfully, painfully, and it can feel very disunifying. sadly we have seen couples (and I'm really talking about the dh here) go from "God can send us as many kids as he wants!" to sterilizations, and only after the fact recognize that the dh had a serious addiction, and when faced with going from unlimited relations to very limited due to serious reasons, the breaking point would be reached and this sad choice would be made, either due to pride about not wanting to admit/seek support, or feeling talked into/pressured by even Priest/well meaning Catholics that in "this circumstance" (health of mother) sterilization would be "ok" , thus seemingly letting the dh "off the hook" about his struggles so to speak. out of time!
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PS, could you pass along to her that she is not alone and that we are praying for her and her marriage? (if you feel appropriate) I am glad that you brought this issue to the discussion here.
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Lisa
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4Real Forums : Tea and Conversation
Topic: Tubal Ever Allowed?
