Should I Get My Tubes Tied During My C-section?

Gillian Goddard

3 min Read Gillian Goddard

Gillian Goddard

Should I Get My Tubes Tied During My C-section?

Q&A on risks and benefits

Gillian Goddard

3 min Read

I am preparing for my third (and final) C-section, and my OB has strongly recommended that I consider having my tubes removed “while [they’re] in there,” as it reduces the risk of ovarian cancer. They assured me there is zero hormonal impact from doing this, as the tubes themselves don’t generate hormones. However, they confusingly say the only impact is that I may possibly experience menopause about a year earlier. I’m all about reducing my risk of cancer, and have no need for my tubes, but I’m very concerned about hormonal impacts, especially any increased risk of postpartum depression or anxiety, as I live with some anxiety today and know I’m vulnerable postpartum. I’m also unsure what earlier menopause actually means and what else I should be considering. I don’t know how to think about making this decision and would so appreciate help! 

—Anonymous

If your family is complete and you would prefer permanent contraception, a salpingectomy — the surgical removal of the fallopian tubes — is a great option. If you are already having a C-section and the salpingectomy can be performed at the same time, all the better. You are already having pelvic surgery, and there is minimal added risk and no significant change in recovery when you add a salpingectomy to a routine C-section. And you get the contraceptive benefit as soon as you are ready to return to having sex.

In the past decade or so, there has been growing evidence that in the general population, opportunistic salpingectomy (removing the fallopian tubes during another pelvic or abdominal surgery) reduces the risk for ovarian cancer by as much as 80%. This is because upward of 75% to 85% of ovarian cancers actually start in the fallopian tubes.  

Permanent contraception and reducing your risk for ovarian cancer all in one procedure during a surgery you are going to have anyway — what’s the hitch? Based on the data available to date, there seems to be very little downside. Immediately after the procedure, there appears to be no difference in hormonal function. One observational study showed no difference in age at menopause among women undergoing opportunistic salpingectomy. A large randomized controlled trial looking at this question is ongoing. However, there is virtually no health impact of entering menopause just one year earlier. 

Ultimately, salpingectomy during a C-section is effective permanent contraception and ovarian cancer prevention with little proven downside. I would encourage you to know your state laws around sterilization procedures. In my state of New York, you must sign consent for these procedures at least 30 days prior, so think ahead! 

A model of a uterus in a doctor's office.

Feb 27 2024

8 min read

Contraception for When You’re Done Having Kids

I gave birth to my fourth child when I was 38 years old. My husband and I knew our family Read more

Gillian Goddard
A variety of birth control options.

Mar 01 2024

2 min read

Do I Still Need to Use Birth Control?

I am 49 years old, and I am definitely having symptoms of perimenopause. I am only having periods a few Read more

Gillian Goddard
Illustration of a vasectomy made with construction paper.

2 min read

How Can I Convince My Husband to Get a Vasectomy?

How can I convince my husband to have a vasectomy? Our family is complete, and the stress of a possible Read more

Gillian Goddard
ParentData podcast cover art

Feb 29 2024

16 min read

Birth Control After Kids

Birth Control After Kids With Gillian Goddard

Emily Oster

Instagram

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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy. 

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙

We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy.

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙
...

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster
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How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months. 

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages. 

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords

How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages.

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords
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I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit.

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit. ...

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata
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What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata

What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata
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Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

 #emilyoster #parentdata #childnutrition #babynutrition #foodforkids

Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

#emilyoster #parentdata #childnutrition #babynutrition #foodforkids
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Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata
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Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes

Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes
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Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices. 

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata

Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices.

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata
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Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster
...

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there! 

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there!

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife
...

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens. 

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children. 

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens.

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children.

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata
...

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
...

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks
...

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData! 

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData!

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity
...

Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
...