tubiligation concerns

Since my daughter had the Gardasil vaccine she has developed autoimmune problems and all forms of birth control create havoc on her body.  She is 16 and pregnant and I am considering having her tubes tied for a safer form of birth control until she gets older and she can have them undone when she's ready for more children.  But I don't know if there would be a better alternative.

[Elaine Brown, MD]

Hi!
A tubal ligation is NOT REVERSIBLE.  Once the tubes are "tied" (actually a segment it removed, then the ends sutured and burned) they cannot be un-tied.  Most doctors would never consider tying tubes in a 16 year old unless she was severely disabled and they had a court order to do so.
Depo Provera is one of the most effective methods for this age group.
IUDs are sometimes used with good results too, the problem is that until the young ladies "settle down" they are at risk for STIs which are problematic when an IUD is in place.
There is also a contraceptive called Implanon which is inserted under the skin and lasts up to 3 years.
It can be very frustrating to be in your situation.  I think if it were my daughter, I would strongly consider the Implanon.
I hope this helps!
Good luck!
Dr B

[moxie_mom]

Thank you for replying to my question.   I did find out that this was out of the question with our doctor and was not reversible.  It's just so frustrating with her having the worse possible side effects to everything we try...thus the pregnancy.  Depo is not an option for us because if she does have a bad reaction then there would be no way to get it out of her body, but I will look into the other contraceptives.  Thank you for your time :)

  

[Beth_Y123]

I thought you might appreciate hearing from someone that has multiple auto-immune diseases and has also struggled with the birth control issue.I have lupus, Raynauds, hypothyroidism, and vitiligo (as far as auto-immunes go anyway) I did an extensive amount of research and found that Depo is quite often the most recommended option for women with autoimmune disease, esp in lupus.Any of the contraceptives involving estrogen are very likely to make the auto-immune conditions worse, so sticking with a method that contains progestins only would be ideal.Although my niece tried Depo immediately following pregnancy and had bleeding problems, I believe that was due to giving it to her while the hormones were still all over the map from pregnancy. So if your daughter did try Depo I would say wait about 6 weeks after the birth to give hormones time to balance back out. A side benefit to Depo is many (and I am one of them) do not have periods at all and have not had one since starting Depo--it's success rate at preventing pregnancy is 99.7% which is actually higher than tubal ligation anyway.While its true that it can't be immediately withdrawn from the system after being tried, it has only a 3 month duration and would be back out of her system if it didn't work for her.As she will have had her uterus stretched by the pregnancy an IUD like Mirena would be an option as well, it also contains progestins only and is also likely to cause a lessening or cessation of periods. But with any progestin containing contraceptive option it would be best to ensure that she receives extra calcium and vitamin D while she is on them as a precaution to preserve her bone mass. There is also a hormone free IUD called Para Guard that is made from copper.I myself am pushing 40 and looking to get off the Depo as I have been on it a lot longer than is recommended due to the fact that finding birth control while having auto-immune conditions is so difficult. I was only about 4 years older than your daughter when I started on the Depo and I'm still on it; I've been allowed to stay on it longer than recommended due to the lack of any better options given my medical background and anything containing estrogen is out. I know it's a difficult situation that your daughter is in and I wish you both the best in finding an option that works best for her, and I hope you may have found my perspective and experience helpful :-)