Tying up those loose ends

Pru Irvine left the ranks of the You-Never-Knows and got sterilised when, after two babies and very little sleep, she decided that enough was enough. She has never looked back

This Woman goes to the doctor and says, "Doctor, doctor, I want to be sterilised." The doctor says "Why?" and the woman replies: "Because I don't want to have any more children." Get it? No, the doctor didn't either. The woman was me, aged 36. I explained that my second baby, who was just under two, didn't sleep more than five hours in 24. That he cried day and night. That he seemed to be the first baby in the world who rejected breast milk and that the stress was killing the whole family. Suddenly, my doctor found a reason to refer me - for counselling.

Sterilisation counselling? Why on earth should I have to be counselled? It's my body and my decision. Well, okay it's my and my husband's decision. According to my GP, there is an unwritten gentleman's agreement in medicine that counselling is called for when women want to take charge of such matters. Apparently, you have to understand that sterilisation is irreversible and you have to be clear about the surgical procedure (basically, keyhole surgery to clip or tie your tubes). I do not remember being warned about any of the physiological repercussions when I had my children. Perhaps that's because we might not have them if we knew what was involved.

When I arrived at the clinic, a large, dead, grey room in the bowels of the hospital, I thought a weaker women would be dispirited by now - something to do with the low slung, yellow strip-lighting. I sat in front of the consultant gynaecologist and braced myself. "Well Mrs Irvine," he said. "I have two questions. Have you discussed it with your partner? ('Cheeky beggar,' I thought.) And do you want to be sterile?" That word "sterile" had a funny effect on me. Somehow, there was a difference between sterilised and being sterile. It made me think for a minute but then I remembered why I was there. It was because I didn't want any more children.

Before our counselling session ended we had a brief conversation about my concern that I might die under the anaesthetic because I was so fat. The consultant didn't smile. I don't think he'd smiled for 20 years. He assured me that although I wasn't that fat, it might be a good idea, he said, to get him to do the operation personally. That way we could be sure. I should tell the booking-in nurse to arrange it for a day when he wasn't on holiday. Well, that settled that. I'd probably pull through.

I already had a few sterile friends and they seemed to be enjoying their freedom. Unknown to me I was about to join the Sterile Sisters - a variation on the Scottish clan system, I think. The rest of my friends fell into the You-Never-Know group. These women have had their children, they don't want any more, but you never know what might happen. So they're still struggling with their caps, popping their pills or hoping their coil won't slip.

But, generally, my friends thought that sterilisation was a good way to break up the school holidays. A few days of rest and relaxation with very little pain. A chance to stare at the walls. As most sterilisations are done laproscopically these days, you only get a day in hospital. I, of course, got two, because I could not wake up from the anaesthetic. I think I just needed the sleep. The other joy of this kind of surgery is that you get only two, tiny, pin-hole scars - one just underneath the bellybutton and the other around the bikini line. I have never seen that one, however, because of the little problem I referred to earlier.

They were right. Hospital was great. I lay on the trolley in my surgical bath hat in a wash of pre-med. The surgeon leaned into my face. "Oh, it's you," he said. "Well are you happy and are you sure?" Two more questions. I was one but not the other. My very first thoughts on opening my eyes were: "Thank God, that's it..." I felt adolescent.

Now, how they do it depends a bit on where you live. For some reason, up here in Scotland it seems to be clips exclusively, but in England and Wales, according to the Family Planning Association, it's cutting and tying, otherwise known as Tubal Ligation. There is a third kind called cauterisation and diathermy - burning and sealing. But we'll not discuss that here.

The number of women being sterilised has remained fairly static. Many prefer their partners to have it done because You-Never-Know and because they have had enough pain and angst having the children already. And you can't get the clips taken off on the NHS.

The latest figures from the 1995 General Household Survey show that of women who choose sterilisation as a form of birth control, the highest percentage - 26 per cent of them - are aged between 45 and 49 and only 15 per cent are in the 35 to 39 age category. Younger than that and the figures drop dramatically. I was surprised. I expected the highest percentage to be in the late thirties, immediately post children, not a decade later when the menopause starts to become a topic of conversation.

Talking of which, there does seem to be some confusion about the after- effects of sterilisation and what it can actually do for you - apart from making you sterile, that is. For example, a number of women I know thought that once you'd been sterilised you stopped having periods. Hallelujah. They're wrong. You still have all that stuff to deal with.

There were also those who wistfully wondered whether such a procedure would bring to an end both their PMS and their monthly, regular-as-clockwork homicidal tendencies. Sadly, they're wrong, too. I have to admit - personally speaking, because I don't want to send the Sterile Sisters into a flat spin - that my PMS got worse. But if you think about it, for whatever reason, you return to your normal cycle and all that went with it in those heady pre-Pill days. For me, sterilisation meant both freedom from contraception and a return to PMS.

Anyway, I was thrilled. That was until my stitches burst three days later. It wasn't dramatic. It was just sore and psychologically uncomfortable. Would you like a hole in the middle of your body, on the outside? Anything could have got in or out, I thought. When I telephoned the hospital for advice in a calm, hysterical sort of way, matron explained that there had been rather a lot to stitch up (cheeky beggar, I thought) and that I shouldn't worry. Phone my GP.

It all resolved itself and to this day, girls, I still maintain the three best things I ever did in my life were to meet my husband, get psychoanalysed and get sterilised. But I'll just let you into a little secret. I 've just gone back onto the contraceptive pill to ease the symptoms of dreadful PMS. There is no justice.

The Family Planning Association runs a confidential helpline, call 0171 837 4044.