Perinatal Delirium

My husband has a very interesting job. I love to hear the stories of the patients that he encounters. Some stories are sad. Some happy. Some are funny. Some are interesting or intriguing.


And some just really piss me off.


Like today. He's telling me this sad story about a woman who's baby has anencephaly. This baby will die when born. Or he or she will die shortly afterwards. It's a sad story. Definitely one of the sad stories.


But then he tells me that the mother is pregnant with baby number 9. NINE. Babies 1-8 are not with this mother but rather in various stages of CPS involvement. Some are in foster care. Some are with relatives. None of them are with the mother. Then he tells me that this mother just got out of prison and immediately got pregnant. Oh, the plot thickens.


Okay, this pisses me off. What is this woman doing having baby #9? Yes, this pisses me off. But just a little bit.


What really pisses me off is this---


I ask him something like this. "This might sound strange or whatever, but can you, as her doctor, recommend or at least ask if she's interested in sterilization? If she'd be interested in having a tubal while she's there delivering?"


DH: "Oh yeah we can. We do it all the time. We ask. We suggest. But she has to sign the consent within 30 days."


Me: What do you mean by 30 days?

DH: Well, she has to sign the consent for the tubal ligation within 30 days of her expected date of delivery. If she's closer to delivery than that, then apparently, she's not mentally stable or whatever, enough to sign the papers."

Me: WHAT????


DH: It's a federal law. She has to sign the consent papers within 30 days of expected delivery and within no more than 180 days. If she's closer than that, she cannot give consent for the procedure.


Me: ARE YOU FRIGGIN' KIDDING ME?


DH: No. Of course not. Apparently, there's a lot of litigation surrounding cases where a woman who's "too close" to delivery decides that she wants a tubal and then regrets it afterwards.


Me: Okay, I can understand regretting it afterwards, but why the 30 days?


DH: Because, I guess, your hormones are too out of whack or something and you're not considered mentally competent to make that decision.


Me: WHAT? You're not considered mentally competent to sign a legal medical document when you're perinatal?


DH: Don't yell at me. I didn't make the law. I'm just telling you what the law says and what standard medical practice is. You can't give a tubal if the patient asks for it within 30 days of the expected date of delivery.


Me: You've got to be friggin' kidding me! Could I legally sign for a mortgage at 36 weeks pregnant? Yes! Could I sign for a new credit card? Yes! Could I decide to divorce you? Yes! But I can't sign a medical consent form for a tubal ligation?


DH: No.


Do you see where I'm going with this? Do you see why I'm so pissed off? Oh my stars, this has soooooo many levels.


Don't even get me started.