I love living in the UK, for many reasons. One of which is the NHS. I love that I can access medical help when I am financially in difficulties and that I am not dependent upon insurance to be able to seek the help I need. I was diagnosed with Asthma as a child and mental health difficulties in my twenties – I would be a nightmare in terms of pre-existing conditions, but none of that matters on the NHS.
I also love that I can access contraceptives – including hormone based ones as well as condoms/diaphrams – through the NHS free of charge. Family planning is part of the service, free of charge, to anyone who wants it, and while my country might have a national religion, our approach to such matters is completely secular. Over the years I’ve had women tell me that they have encountered difficulties accessing what they want through the NHS though, which if I am honest has always surprised me. Not any more though, because last week it happened to me.
I’m 32. I’ve had hormone trouble since I was a teen (extremely painful periods, dark hair growth on my face, occasional bouts of acne). In my 20s I got fed up of dealing with this and was put on the pill. It was magic, but much like the Borg, my body adapts. So after 5 years on the standard pill, I got switched to another type – one called Dianette. Dianette is great, but fuck me it is strong. It took care of all my issues, but once you have been on it for a set time, the health risks associated with it go up. The max time is supposed to be about 5 years. I was on it for about 7.
After looking at the options and discussing things with Mr Shandy I decided to switch to the implant. I travel a lot for work, so this would be more convenient for me and would still contain a hefty dose of hormones to keep me steady. It will also be a more reliable form of contraceptive. I made an appointment with my practice nurse, who agreed with me. She checked me over and sorted me out with a docs appointment, as only a doctor can insert the implant in our practice. There was a female GP qualified to do the procedure. I decided to go see her.
That appointment was quite possibly the worst experience I have ever had on the NHS, in terms of being bullied into things I didn’t want, denied access to the things I did want and having my wishes and statements about my life totally ignored.
First the GP tried to convince me to use a barrier method instead.
I explained that this is not what I want. I am married, I have been in a monogamous relationship with my husband for seven years now, neither of us has ever had an STI and we are looking to make our sex life more interesting, with less faffing about with barrier methods, which we have used up until now in addition to me being on the pill.
She ignored me and tried again. I stood my ground and told her I was here to discuss the implant.
She went through my case history and suggested I might have PCOS (Polycistic Ovarian Syndrome).
I explained that my regular GP had through this and sent me for blood tests a couple of years ago. They came back negative.
She wasn’t happy with this and started insisting I should have an ultrasound scan.
I became concerned. The nurse hadn’t picked up on this, neither had my regular GP. Was this something to do with the implant.
“Well,” said the GP, “the implant lasts for three years.”
“And you’re 32 now.”
“So if you want to start trying for a family, it can take longer if you have PCOS, so you might want to start now.”
I was floored. At no time had I mentioned wanting to have a family during this appointment. If anything, I was here to PREVENT getting pregnant. Where was this coming from?
I explained that my husband and I have decided that this is not the right time to have a family for us, regardless of our age. And the nurse had explained that I could have the implant removed at any time.
She starts trying to change my mind.
“Oh I know it can be off-putting when other people’s kids cry and scream and they poop and vomit everywhere, but it is different when they’re your own.”
Feeling more than a little insulted, I decided to throw some more details into the mix, although the warning lights were already on for the fact that I had to. This was supposed to be a routine appointment, a check over to confirm the nurse’s findings and a discussion about a date to have the implant inserted. Why was this suddenly so difficult?
So in an attempt to open up to this GP I have never met before, I start talking about some of the details of my life. About the fact that my husband and I both have mental health difficulties. That he’s self employed in a successful but newly established business, where he sometimes works seven days a week to keep up and encourage demand. About how I am on a career high, working for a national company, travelling frequently, staying away overnight. In addition to this I am setting up my own business, working towards establishing myself as a writer and trying to run my own home. This is not the right time for a baby and it would not be fair to bring a child into this chaotic life which we are still trying to make sense of.
What happened next floored me. This woman sits there, looks me dead in the face, pointedly looks at my wedding ring, looks back at me and says:
“And what does your husband have to say about this?”
It wasn’t a comment. It was an accusation.
Not to be outfaced, and primed by my feminist reading in the last eighteen months, I was ready for her.
“My husband is in agreement. And more to the point he supports MY wishes to do as I wish with MY body. Now can I have this implant, or is there a medical reason why you are denying me this?”
“I am just saying you might want to consider starting a family if it is going to be difficult. What it you can’t later?”
“That won’t be a problem.”
“This is just my assessment of your situation.”
I lost my shit. This woman wasn’t listening to my situation. She had just taken one look at me and sized me up as a baby-making machine in waiting.
“Then if we can’t have a baby, we can’t. Not being biological parents will not break our marriage. Having a child at the wrong time might do. This is an informed decision. And your assessment of my situation is flawed. So, can I have the implant?”
“I want to send you for an ultra sound first. If PCOS is identified, you should know about it as quickly as possible. Then you can make…” she looked at me “an *informed* decision.”
By this point I was so angry, I could have slapped her, but I have excellent levels of self control. She fills out the referral, which needs my weight. So she asks me to hop on the scales.
My weight is not dangerous, but I am not a svelte skinny minx. I am a UK size 16 at the height of 5’7, so my BMI is slightly on the high side. She looks triumphant.
“Well I’m glad we checked that,” she says. “It can take longer for your fertility to return to normal if you weight is on the high side. So that’s another factor that might influence your decisions about when to have a family.”
I honestly couldn’t believe what I was hearing.
“If you had listened to what I just said, you would understand that I don’t want to have a family. Not now, possibly not in three years time even.”
She settles back at her desk, looks at me and says
“Well, you might want to lose some weight, regardless. Have you through about improving your diet and exercise?”
I had one last shot at some dignity before I got out of the room.
“Everything I eat is fresh cooked. Lean meat, fresh fruit and veg, homemade sauces with ground spices and herbs. I eat mixed grain bread, fresh yoghurt, very little is fried. I have cut down my alcohol intake and I have never smoked. I swim four times a week, use an exercise bike at home and my holiday activities include camping and walking and canal boating. But then you would know that if you’re thought to ask me rather than make assumptions about me.”
She looked me up and down and said:
“Well … keep it up then. I’m sure you’ll see a change soon.”
I am not a weak person by any means. I buckle under extremes of pressure, but that just makes me human. But it has been a long time since I was made to feel so unimportant, undervalued and inadequate by anyone. I have always had a positive experience of doctors appointments before. I make the effort to be informed, I take notes, I ask pertinent questions, I listen to advice and I don’t have to go with the ‘just ignore it and hope it goes away’ approach that so many of my American friends are forced to adopt by circumstances.
I arrived home feeling extremely low and incredibly angry. How dare anyone, even a health professional, dismiss my input into an evaluation in such a way! I am my own person and I will make decisions about my life as I see fit. I have never been ready to be a mum at any point in my life so far. I am not ready now. I might still not be ready in three years. I fail to see how any of that pales in comparison to the ‘but you might not be able to later’ argument.
We still live in a world where women are assumed to be lacking if they don’t reproduce. This has been my first experience of this, even when I am cared for by a health service which is supposed to respect my choices, my rights and my options.
I am not a child hater. I love children. True – babies make me nervous, because they’re so tiny and fragile, but that’s the case for everyone before they have one of their own and get a bit more practice. I am a teacher, I love being around children, I love seeing them learn, watching them grow and knowing that they’re going to grow up to be awesome human beings. That does not mean that my life is the right fit to be a parent right now. This is not a selfish decision. It is a selfless one. I will not bring a child into a chaotic life and inflict two stressed out, not-completely-financially-stable, sometimes-very-ill, workaholic parents onto it. Into a house which has no spare room, where we are renting rather than paying a mortgage and where our employment and therefore means of support is far from dependable.
My choice to not have a child right now is far from selfish. Bringing one into the middle of this mess under the ‘it’ll all be fine in the end’ banner would be a stupendously bad idea. For me, for my husband and for the child itself. No matter how much love I might have for a child, this will not negate any of those factors.
I might never be in the right state to have children. Thanks to advances in modern medical care and the NHS in particular, this is a choice that I can make, that WE can make for ourselves without having to embrace celibacy, without having to sacrifice the idea of partnership and marriage. We are a strong couple in a brilliant marriage and yes, one day, we might choose to have children, but that will be as much an informed choice as our decision not to have them right now.
And if we never have children…? We will still have a marriage built upon love, upon a range of ideas and dreams, things we want to do, ways we want to grown. Children might fit into that one day. But they are not the be all and the end all, not the sole reason we chose to marry and certainly not the sole reason why we are together.
I chose Incubus’ ‘Drive’ as the Song of the Week, because the lyrics show how easy it is to be led astray be the crowd, by the loud voiced, by someone who thinks they know better. I’ve never been much of one for following the crowd, no matter how loud and large they might be. Not when it comes to my life. Especially not when it comes to another life which I would have a prime responsibility for.
“It’s driven me before
And it seems to have a vague
Haunting mass appeal
But lately I’m
Beginning to decide that I
Should be the one behind the wheel.
Would you choose water over wine?
Hold the wheel and drive…
Whatever tomorrow brings, I’ll be there
With open arms and open eyes, yeah”
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