As I sat down in the exam room in a new gynecologist’s office, I prepared to have my blood pressure taken and to answer a few simple questions: When was my last period, how often do I drink alcohol, when was my past pap? Instead, the nurse looked at me incredulously and said, “You’re here for a tubal consult? Really?! …She’s not going to do it, you know.”

I bit back my irritation , gave the nurse a big smile, and calmly replied, “I’d prefer to let the doctor make that decision. Do you need me to take my hoodie off to take my blood pressure?” I’d expected a bit of a struggle during this appointment, but it surprised me that it came so early, and from the nurse. However, her remark was not completely off-base. Here I was, ready to talk to a doctor about getting a tubal ligation, at 23 and with no children. Many doctors will not even consider doing a tubal on a woman unless she is over 30 and/or already has children; they worry that she will one day change her mind. Yet my husband and I had known for months that this was what we wanted.

I wrote a post on a website site last fall about my struggles with bipolar disorder and the realization that though I had thought I wanted to have one biological child before adopting children, that it was not in my or my family’s best interest ( Since then, I have more than come to terms with that decision. In fact, turning my attention to a future of adopted children truly feels like coming home. Growing up and into womanhood, I always felt strongly about adopting children–I knew that it was important to me to give homes to children already in this world, rather than creating new ones. Making the decision once and for all to not have biological children simply feels right, feels perfect to me. I am actually happy that I went through that trying time last year, because it forced me to get back to my core values.

After making this decision once and for all, my husband and I talked extensively about our birth control options. We knew I needed to get off hormonal birth control, since my bipolar meds reduce their effectiveness (and can seriously harm a fetus if I do get pregnant, which I covered in my other post). I thought about getting an IUD and for a host of reasons decided against it. So we were down to surgical sterilization. We determined I should be the one to have the procedure done, primarily because I have better insurance than he does and it would be fully covered. We decided to sit with this decision for several months to make sure it continued to feel right.

Fast forward to present day, with little old me sitting in that doctor’s exam room, waiting to fight for what I wanted. The discussion with the gynecologist went mostly as I expected–we talked about all my options, she asked me why I wanted the procedure, she tried to direct me to other options. Then the discussion took a turn I didn’t expect. I was happily chatting away about why it was important to me to adopt and she interrupts me, saying, “You know those kids in foster care aren’t your responsibility, don’t you?”

I could only stare at her blankly; I was so surprised at what she had just said. She continued, “Do you know any families who have adopted? I wish I could introduce you to my friends. They adopted three children from Russia and it tore their family apart. I wouldn’t recommend adoption to ANYONE after seeing what it did to them.” After some deep cleansing breaths I simply told her that yes, it IS my responsibility to give permanent homes to children in foster care, that I knew I wouldn’t change my mind about the surgery. I then asked if she would do the procedure or if I needed to find someone else. She said she would do it.

I left without saying much else to her, but this is what I wanted to say: My children are out there somewhere right now. They are about to be born, or they are babies, or they are small children. I can feel them in my soul and I can honestly say I want them and love them already. What does the decision to have a tubal ligation mean to me? It is a promise to those children that I will choose them over any biological urge I might feel to procreate. It is a promise that they will have a forever home with people who love them, that the spot they are to occupy in my family won’t be taken by a biological child, that they won’t grow up neglected or abused or unwanted. I know this choice may seem extreme and a lot of people–like my doctor–won’t completely understand it. For most people, it seems counterintuitive to get a tubal done as a family planning measure BEFORE having children. For me, though, putting this plan into action has made me feel more like an expectant mother than I’ve ever felt before. And really, once the children are here, who will care about how my husband and I got them, or the choices we made along the way to ensure things went according to plan? All anyone will see is a family, just as beautiful and loving as anyone else’s.