Why the Roadblocks to Sterilization?

tubes tiedIn addition to the recent talk about sterilization and regret, an article in this month's edition of Vogue takes a very good angle on the topic of sterilization. The title of the article is: "Q: Just how hard can it be to avoid getting pregnant? A: Much harder than you'd think." When it comes to sterilization, to that answer many childfree would say, "Indeed!" The verbiage in the subtitle is what really gets it right:

"Pamela Paul considers a brewing under-the-radar issue: The Right Not to Have Children."

This is at the heart of the issue of doctors refusing to perform sterilization procedures of men and women of any adult age. Take the example of 27 year old Erin Iwamoto-Galusha described in the article. She wanted a "low maintenance, long-term" birth control solution and she asked her gynecologist for a tubal ligation - the most common form of female sterilization. She explained her "deep rooted desire not to have children" and that her husband felt the same way. This gyno refused to do the procedure.

For 5 years Erin looked for a doc that would perform the procedure. Docs said things like, "You're too young to make a decision like that," and "That is what I thought at your age." One asked her to write and essay about why she did not want children. That reminded me of my own situation. In my late 20s, I went to my gyno and asked for information on a tubal. Just wanting the information my gyno asked me to write and essay why I thought I did not want to have children, then he would discuss the procedure and whether he would do it. What did I do? Found another gyno! Ultimately, however, my husband got a vasectomy instead (easier!).

Think of the flipside - As Paul points out in her article, unfortunately it is difficult to imagine a doc putting up "roadblocks to a third round of IVF." If it is about not having children-it's oooh no you don't. If it is about making babies it's another thing.

Why do docs create roadblocks to sterilization? Here's three reasons -

-Religious beliefs or moral preferences. OK I can go with this, barely. In this case, what is appropriate is to refer the woman to a doc who does not have this issue.

-Liability concerns - getting sued if she changes her mind in the future. This can so easily be avoided with full documented disclosure at the time of the procedure, not to mention the fact that the percentage of women who change their minds is very low (and we need to know more about those who do - are they more likely to already be mothers? Childless? Childfree who change their mind? On this last one I would bet money the answer is no).

-Pronatalist beliefs (like but surely not limited to - all women will want a kid one day, or something must be wrong with you if you don't want a child) that make docs conclude they know the women better than they know themselves.

The outcome of the roadblocks?Vanessa Cullins of Planned Parenthood Federation of America sums it up by saying that denying "access to tubal ligation is another form of reproductive injustice.

Erin is the wiser of any doc who refuses the procedure - simply put, she says, "Grown men and women should have control over their own health and bodies."

In the larger picture, violating women's rights to have no children is part of the continued prejudicial context - driven by pronatalism - that prevents full reproductive freedom inour society.

What do you think it will take for the answer in the title of Paul's article to be "A: Not as hard as it used to be?"

Laura Carroll

Author of The Baby Matrix and Families of Two

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