Pregnancy and Elective Surgery Elective surgery and unplanned pregnancy is not a good combination. Dr. Jewell requires that all women who have the potential to become pregnant be tested at the time of their preoperative visit to rule out pregnancy. The only exceptions to this would be individuals who have permanent birth control such as hysterectomy or tubal ligation (tubes tied), a partner who has undergone a vasectomy, and individuals whe have gone through menopause. Women who have the potential to become pregnant advised to find suitable forms of birth control before surgery and after that are reliable and safe, versus having unprotected sex and risking an unplanned pregnancy, Condoms and over the counter vaginal foam contraceptives are not considered reliable forms of birth control, Please check the boxes below: o | currently use for birth control o | don’tuse any birth control al cannot became pregnant because 5 Thave had a tubal ligation (tubes tied) o Thave had a hysterectomy © My partner has had a vasectomy o [have gone through menopause