Tubal Ligation Please.

I was working last weekend on-call. I had been told by the medical manager that the priority for weekend on-call should be to the ward patients. Conversely, the patients waiting in outpatients were (and always are) lowest priority. Last Saturday was very busy on the wards – sick child fitting on paeds ward, acute psychotic patient hitting staff members on male ward and maternity ward heaving with complicated labours – this resulted in me ending up in OPD at 15:00. By 15:30 I was ravenously hungry so decided to take a 30 minute break for lunch. I went back to OPD and continued seeing patients.

At 17:45, a woman stepped in holding a blanket and asked for a tubal ligation. Although this is a procedure we perform often in theatre, it is not an emergency. Whilst explaining this, a cry came from the blanket. Mum had brought her small baby to her breast. I asked Mum the age of her child. Her response, ‘One day’. She had travelled 3.5 hours to get to the hospital. She had left her house at 5 am to travel to Mosvold to wait over 8 hrs. I had to tell her that we would not do the procedure on a weekend. Mum showed no sign of frustration. In consolation, I ‘offered her’ the floor on paeds ward to sleep. She had her tubal ligation yesterday. I think she will be happier knowing she cannot have a seventh child. To quote one of my favourite people - the mind boggles.

NB. Zulu men would never agree to a vasectomy so it is the women who ask for a tubal ligation (or we offer after child number 5 or so). It is done in a secret way from the father of the children – usually prior to a c-section or the day after normal vaginal delivery. I always feel a bit sorry for the woman.