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July 6th 2015

The heartbreak or relief of hysterectomies

KATE Torney clearly remembers the moment she was told her uterus had been removed. She was in Intensive Care following the traumatic birth of her son, when her husband, Paul, delivered the news.

"He told me I had a baby who was very sick, and part of keeping me alive had meant an emergency hysterectomy."

During labour Torney suffered severe eclampsia which led to multiple seizures, organ failure and a post-partum haemorrhage. The doctors performed an emergency hysterectomy after all other methods failed to stop the bleeding. She was 26.

“I felt completely powerless, confused and full of self-pity,” she says, adding that the emotional grief was immediate. “My dreams for a bigger family were wiped out just like that. I burst into tears. It was absolutely devastating.”

In the days afterwards Torney experienced a juxtaposition of emotions, and while her physical recovery took almost six months, the emotional recovery is ongoing. “The daily emotional struggle is hard. I am grateful for my child, yet this is underpinned by a sense of injustice, sorrow and loss.“

While a hysterectomy was the catalyst for suffering in Torney’s case, it can put an end to suffering for others.

Around 30,000 hysterectomies are performed in Australia each year, and less than one per cent of these are emergency procedures. The majority are to treat conditions such as fibroids, endometriosis and uterine prolapse. For many women, a hysterectomy relieves pain and significantly improves quality of life. Jo Thornely is one of these women.

Thornely endured years of fibroid pain, an enlarged uterus and excessive bleeding, which previous treatment had failed to cure. She opted for a hysterectomy at the age of 40.

She knew it would end to her ability to conceive but by that point in her life she had decided that she didn’t want children. “The mental hurdle was much smaller than I thought it would be,” she says. “The positives were just overwhelming. The advantage of not having periods, pain, contraception and milder menopause — it seemed too good not to.”

Thornely’s recovery was fast and she feels liberated and empowered. “Having my uterus removed does not make me feel less of a woman,” she says. “Does having your appendix out make you feel less of a herbivore? Sex is better and it’s saving me lots of money on birth control.”

Dr Elizabeth Farrell AM, Acting Medical Director and Senior Gynaecologist at Jean Hailes for Women’s Health says a hysterectomy can have as much of a physical impact as an emotional one, and a range of emotions surrounding the procedure are common.

The uterus simply provides a sack for the baby and has no hormonal function, says Farrell. But a woman may still have a level of attachment to it.

“The personality of the individual is very important, as are how the symptoms are impacting their quality of life,” Farrell explains. “It’s about what hysterectomy means to a woman; how they see themselves in terms of their femininity and sexuality, what their relationships are like, whether they want children. All those aspects of a woman’s history need to be taken into account when she makes the decision.”

While loss of fertility is one of the drawbacks of a hysterectomy, it is not the only one. With any surgery comes risk and recovery is different for everyone.

“It’s vital for women to be well informed. Women need to understand exactly why it’s (hysterectomy) being recommended, and rule out other options,” says Farrell. “If a woman is not comfortable with a recommendation, she should seek a second opinion.”

This is what Bonnie Blaauw did. For ten years she has fiercely protected her uterus. Suffering from uterine fibroids, at the age of 40 she sought medical advice, and was told a hysterectomy was the best solution.

Blaauw consulted several other doctors but they were all in agreement. Despite this, she rejected the advice and researched alternative remedies. A combination of acupuncture and natural treatment has alleviated her symptoms and she had been able to avoid the procedure.

For Blaauw, the decision to keep her uterus was less about fertility and more about control. Her life was “fulfilled without children” so this didn’t influence her decision. And while some women report feeling a sense of empowerment by having their uterus removed, Bonnie feels empowered by keeping hers.

“It’s my body and my decision,” she explains. “I like being in control and don’t accept that the only solution to a medical problem is to remove an organ.”

For Kate Torney, who is still affected by the sudden removal of her uterus, healing is a slow process. In their quest for another child, she and her husband pursued surrogacy in India but three separate transfers have been unsuccessful and their dream remains elusive.

“The emotion comes in waves. There is little to alleviate the underlying sadness that will always be there. It’s always going to be a heartbreak for me.”

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