When a mother who has experienced 3 pregnancies complicated by serious hyperemisis gravidarum that required frequent serious medical intervention and medication is told by her doctor that she should not have more children because of the consequences to her health and the outcome for the health of a future baby is recommended to have a tubal ligation - what does the Church say? Is a Priest called to be a part of the conversation with the doctor and woman? As family to a young woman in these circumtances we don't know what to do. This third pregnancy has left her with a stent in a kidney, infusion therapy and repeated hospitalizations with some consequences to her heart as well. She is 24, wants to abide by the Church teachings on contraception/sterilization but we've been told a Priest has no role in helping her with the decision. We don't have much time to deal with this problem because they would like to do a tubal ligation as soon as she delivers the baby which will be withing the next week or so. She's been hospitalized for the last month but now the recommendation for this proceedure is looming and we could use the advice of correct teaching. Thank you very much. CGrangaard

Dear Christine

I forwarded your question to Anthony Dardano, M.D. and following is his response:

Hyperemesis gravidarum is a condition where the "severe vomiting" during the pregnancy causes metabolic disturbances. The complications described here are not that uncommon: renal stent for stone formation, IV infusions to replace lost electrolytes, etc. The case described here has recurred in all pregnancies which is not the norm. Usually, the first pregnancy is the most severely affected. However, with good anti-emetic therapy and IV replacement of fluids, nutrients and electrolytes, the condition is manageable. I have not seen in my 41 years, a deterioration of one's future health due to this condition. Your ObGyn seems to be opting for the easy way out and be done with it. Tubal ligation, or any contraceptive measure for that matter, is forbidden. The principle of double effect does not apply as the primary act is intended to prevent pregnancy making it inherently immoral. That's not to say one may not use NFP along with ovulation predictors (available over the counter) to help one space pregnancies in a manner which is morally acceptable. Taking your priest out of the loop is poor advice. Your confessor has a definite place in helping you arrive at the correct decision. Take the time to consult him. Don't be pressured by the thought you must act by delivery time. Accept the fact now that sterilization is not an option. Pregnancy is almost at term. Use the remaining time to pray for the strength and courage to endure these last few weeks. Post partum, things will revert back to normal and the joy of a new baby quickly erases the memories of the trials this past pregnancy has placed. Live your life as before. If you were to conceive again, it's not a certainty that this condition will repeat. God bless you.

Anthony N Dardano, MD, FACOG, FACS

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