Childfree? Just Try Getting Sterilized
Britgirl | March 15, 2007 | 12:00 amAn increasing number of women who are childfree by choice are demonstrating their personal commitment to a childfree lifestyle by opting for sterilization. But even though they, as childfree women may have put much thought into their decisions, and/or had painful or less than satisfactory experiences with other forms of contraception, when they approach their GP (in England a GP is short for General Practitioner, which would be Doctor in Canada) for a referral for the procedure they are often met with refusal from the medical profession.
I’ve for long been interested in this subject, however find that, as with most childfree related issues there is very little information in the public domain about women’s experiences with obtaining sterilization and what does exist is hard to find. What I have gleaned from my reading about it and from the occasional women’s posts in childfree forums, is that it is often difficult for childfree women or women who know don’t wish to have children, to have their doctor refer them for the procedure. GPs seem to be more willing to refer a woman for sterilization if she’s had say, four or more children.
International Women’s Day was on March 7th, and Mother’s Day is almost upon us. What better time to bring this subject to the fore. For Mother’s day many childfree women will be gearing up for the outpouring of motherly accolades and the inevitable, intrusive and tiresome “so, when are you going to become a mother/produce kids/grandkids/do your duty/make us happy/make us proud etc…” questions, for which the childfree must have their script ready to defend their choice.
The truth of the matter is that when a childfree woman is seeking sterilization, she should be prepared for a long hard haul. Good luck finding a physician who will do it for her. Many childfree and women intending to be childfree, when approaching their GP or doctor, instead of understanding, are quite likely to presented with one or more of the following:
- A patronising response from their GP and a dismissal of their request based on the GP’s assumption that
- They “will change their minds”
- They are “too young to know what they want”
- That “there might be a handsome young chap out there with whom they’d want to have children with..”
- The woman is “much too young and attractive to be considered for sterilization”
- They need to “go off and have a couple of kids first…”
- They should “abstain from having sex if they don’t want children – sterilization is too final”
- They should come back in a few years – if they still want to do it
- They should take the Pill/or come off the Pill
- They should have counseling before making a final decision (even though the woman has said she is 100% certain this is what she wants.
- Hostility and refusal from the medical profession
This is a very short selection of responses that are likely, clearly indicating that 1) the woman’s decision to seek sterilization is often trivialized, if not outright dismissed, and 2) women seeking sterilization need to approach this almost as if they are going to do battle and prepared to be subjected to ridicule from those who should be looking out for their needs. In the face of often negative and unhelpful responses from much of the medical profession, particularly when an esteemed member of said medical profession is telling you that they, not you know what is best for you, and your future it is very often hard for the woman to remain undeterred in her quest for sterilization. To add insult to injury, the decision to remain childfree is likely to have been made years before.
There are, of course, exceptions to every rule. Which means there are some GPs who will do a referral based solely on their patient’s request and their unbiased evaluation. Finding these exceptions however seems to be the luck of the draw and far from easy. Why should this be?
By and large, the overall response of the medical profession seems to be based on the notion that motherhood is a blessed, assured and inevitable state to which all women aspire. The highest achievement of womanhood is assumed to be the conception of children, joyful pregnancy and radiant motherhood. Pregnancy and motherhood appear to be desirable, natural and ultimately normal. Which means anything outside these “cultural norms” is seen as abnormal. And there is no certainly no option to consider whether to become a mother or not – even though it isn’t a choice many woman will make.
To quote one woman on the irrational nature of doctors refusals:
“If I had gone along to my doctor, aged 30 and said “I want a baby but nothing seems to be happening”, he would never have said to me “Are you old enough to know what you’re doing? Do you realize it is irreversible?” They never bother to check out why people want to have babies because it’s considered normal, but they consider it odd that I don’t want any…”
So, in addition to having to confront an overwhelmingly pro-natal society, women who do not want children and who, for their own reasons wish to use sterilization as their chosen method of ensuring they remain childfree (particularly given that alternative contraception can fail spectacularly) have to also confront established medical opinion.
The established medical opinion in this area seems to be that woman still do not have the right to control their reproductive choices or their fertility.
Technorati Tags: childfree, sterilization, women, contraception
well i am going to go with my fiancee, wife when that happens, and sit with her and i am good with arguments, and words, i think a double whammy, her saying it, and me countering the objections, it could help.
but yes, if a woman wants to be sterilised, and she has thought about it, then i would say its the b/f husbands duty (if he is also cf) to support HER.
the other side to this, is the pressure by other cf women, and doctors too, that it should be the man who gets a vasectomy, not the woman. in some states in america you have to get permission for tubal from the womans husband, this is in reality an optional thing, you dont have to ask, but some do. it is easier, and better for her to have the tubal that she wants, over here in this country, as the UK is less child friendly in regards to sterilisation.
I found it easy to get my sterilisation aged 21, but then I eschewed the NHS altogether and saved up to go to Marie Stopes who have a policy of not turning anyone down based on age or lack of children alone. As I recall (it was 8 years ago now), all they did because of my age was have an extra 10 minutes ‘counselling’ where they asked me if I was ‘really really sure’ (as opposed to asking everyone else if they were just ‘really sure’, presumably) and got the doctor to make sure he was all right with it (he shrugged his shoulders and said ‘fine with me!’) and I had it done later that week. The BPAS have a similar non-judgemental attitude, I hear.
I have hear horror stories from others who have tried to go down the NHS route, and what you say about all the difficulties it is possible (and unfortunately also probable) for childfree women to encounter is absolutely true. I’ve also heard the odd good story though, of sympathetic GPs and unpatronising gynaecologists, to have some hope that it *is* possible to fight through the rampant pronatalism system and take control of your own body, though of course it shouldn’t be a fight at all.
I’ve often thought I should set up some kind of database of childfree-sympathetic medical professionals around the country that women could consult when seeking sterilisation…
I called my insurance company several years ago to see if they covered sterlization, and they not only informed me they did, but told me the cost, which was very reasonable. I have not done that, and probably won’t, as I’m closer to menopause than I was back then.
The medical profession here in the States is not always keen on sterilization even for women who’ve had a few kids. I overheard a twenty-something women on the train a decade ago complaining because her doctor had turned her down for sterilization. She had four children, and she was a single mom. It was clear from her conversation that she realized she had made a poor choice in being a parent so young, but was trying to make the best of things. She was working towards a degree to make life better for her and her children, and did not want another pregnancy to put her further behind.
It appears that the medical profession has always been slow about responding to women’s health needs to begin with. They claim that they have made progress in doing more research on women’s health. However, the medical world and the large pharmaceutical companies’ best interest in to keep patients on meds and in doctor’s offices. There is money to made on pushing hormone treatments on menopausal women, as there is to keep pregnant women coming in for ultrasounds and endless checkups, before and after the baby arrives. Once a woman is sterilized, that income stream for doctors is cut off.
i am gonna try the nhs route, but marie stops route looks like the next logical step.. so will see, rowan wants hers done first, for her own sake, and i probably will at a later date..
i can totally relate. i kept getting turned down until that magic age of 30. i knew ever since i was a kid, that i never wanted kids. i kept asking since i was 18 and got turned down…and than doctors have the gull to look surprised that i was on the pill from 17-30….well duh!!
than the doctor i was with tried to talk me out of it ….when i turned 30! she kept saying how i didnt have kids and needed to have them…i was hell no! not interested..what part of not interested do you NOT understand here!?
i typed out a top list of reasons why i do not want kids ….and came up with 37 reasons why not. (a list for myself and also made copies, just in case.) i brought that list in for the doctor. she had looked and read awhile and asked if she could make a copy. i said sure. than she okayed the decision! Sheesh!
needless to say my new independence day is Sept 7 2006
YIPPEEE
have courage everyone, if you keep trying and come prepared with a list of reasons…you might be surprised…(keeping fingers crossed for everyone)
Just letting you know, that’s my wife in the last comment. I’m very proud of her and I supported her every step of the way. She did have quite the battle. I felt like going to these doctors myself and saying “What part of ‘I DON’T WANT ANY KIDS!!’ do you not understand!?”
Even her female gynecologist was stubborn as an ox on the issue. Christine had to resort to that list just to make it clear to the gyne that her mind was made up!
I think Hillari hit the nail spot on on why the medical profession is so adamant on their objections to tubals. They say that they’re only looking out for the woman, and I think that is a half-truth. They’re also worried about their financial lifestyle; how much money they can get out of an expectant mother and her insurance company, not to mention the cash flow from all the new kid’s checkups and what not. Tubals, to them, may mean no more cash “mooooom” cow!
Same story here.
Knew at 8 I didn’t want kids, started asking to be sterilized at 18. Was told, no, you are too young to know what you want and wait until after you’re married. When I responded why was it that teenage mothers at 18 weren’t told they were too young to have kids, my Dr looked at me like I had two heads.
Asked every single year, at every single checkup. Always told no. Switched Dr’s. Again was told no.
Married at 25 and my husband and I made a concerted effort to find someone to sterilize one of us. No can do, we were told. You are too young and you will change your mind.
FINALLY, at 32 my husband DEMANDED to be given a vasectomy. The way he phrased it to his Dr was ‘my wife has been on the pill for close to 18 years and I want her to stop taking it’. Then he threatened to sue for discrimination.
Vasectomy was scheduled within 2 weeks.
Case closed.
I do agree that it should not be hard for a woman to get a tubal ligation. But a vasectomy is a much less invasive procedure and one usually has a a pretty quick recovery. Tubal ligation, from what I understand, carries more risk. So for a committed childfree couple, I think that the vasectomy is probably the better choice. Of course, it is a choice and tubal ligation might well be the better option for some people…and if it is, it should be much easier to obtain.
All, thanks for sharing these VERY interesting stories and comments.
mercurior – I didn’t know there was pressure by women on men to have a vascectomy… if there is, it could be as result of the obstacles women face in trying to have the procedure done themselves. But the key point is, to me, that if a woman wants to have sterilization done she should be able to have it done without having to justify herself.
Jack – From what I know about Marie Stopes they would be my first option, knowing about the obstacles that I’d face with the nhs. Unfortunately, having to fight the maze of medical opinion seems to be a given if you go via the NHS or any public health care system. Which, although it’s as well to be aware of it, is a shame. That database of sympathetic GPs is a really good idea. If I knew of any I’d put them up on Like It Is. I think that would be something worth sharing.
Christine 1 – and Kath – thanks very much for sharing your stories- you’re going to relate even more to my next article then
It’s already written, yet to publish as I write this.
37 reasons not to have kids – that’s some list. Good for you. But the lengths you had to go to just to prove to your gynae that you knew what you wanted is just crazy.
As for Kath – kudos for sheer determination. Isn’t it odd – we’re old enough to get married, old enough to HAVE kids by the dozen, way old enough to go to war, old enough to die, but somehow not old enough to be sterilized? Something is very wrong with this picture…
Hillari – I had never thought of that it might have a monetary angle, but thinking about it for doctors in the States this might well be a reason. Coupled with the fact that the medical profession is solidly behind women having kids. In the UK, doctors working in the NHS (National Health Service) get funding for certain types of procedures, which in many cases they can decide how they use it. So you can also get doctors deciding not to spend funds on what they consider “non-essential” surgery.
Christine 2 – That’s my husband’s view. And I agree, of the two, a vascectomy is the less invasive of the two procedures. He’s been more than willing to have a vascectomy for a while now precisely because it is less invasive AND he knows how difficult it could be for me to get a doctor to do a sterilization. We’ve just been slow in getting around to it and if anything it’s me who’s been saying there’s no rush. At least I have the option. But I shudder to think of the lengths I’d have to go to, as a childfree woman to get the procedure done, even though I would stick at it until I succeeded.
Thanks again ALL for such inspiring stories!
see even christine2, says it should be the man “So for a committed childfree couple, I think that the vasectomy is probably the better choice”
for medical reasons she claims and yes there is a slightly higher risk, but why should a man have it done if the woman doesnt want kids too, isnt it her responsibility to control HER own reproduction, rather than relying on the man.
if a man doesnt want kids, imagine the outrage if he says let the woman get it instead of me. but its ok the other way round. we all are responsible for our own reproductive rights, its our bodies, so if you dont want them, you get fixed. regardless of sex.
yes it may be less invasive, but is that any reason to put pressure onto the opposite partner if they really want to be sterile and really want to be childfree
See, I damn near hugged my gyno this last visit. I’m 34. They’ve *never* asked if I was having children or not and I’ve been with her since I was 22. Finally though this year she just looked up and said “Are there children plans?” I said “No, we don’t want children.” She said “Ok, sorry for asking, I just need to know the plans.” For the first time I wasn’t hassled or given any looks. I knew I chose her for the right reasons.
mercurior – Have to say, until you mentioned it here, I had never heard of childfree women pressuring their men to be sterilized. I’ve heard of men offering to be sterilized or simply going ahead and doing it, regardless. I haven’t even heard of the medical profession insisting that the man has the procedure. Which of course isn’t to say it doesn’t happen.
My view – I feel that putting pressure on ANYONE to have any procedure done isn’t right.
I didn’t see that Christine was talking about anyone putting pressure on anyone else to be sterilized. An opinion does not a trend make
I would think in any committed relationship there would be tons of discussion and eventual agreement about who would have the procedure done and why. But besides this – there are at least two examples in these comments where the men are quite willing to have the procedure done – the reasons are above so I won’t repeat them here. Kath’s story is one, mine in terms of my husband’s view is another.
More importantly, this post’s central message is key – it is about women who DO want to get the procedure done and, can’t for whatever reason are turned down sometimes for years. They are refused the ability to control their own reproduction. Meaning it often isn’t a simple question of “if you don’t want them you go and get fixed”… as you say.
Sometimes, the man having the procedure may sometimes be the only way if the couple want to remain childfree. In a committed childfree relationship this is about the couple, and what is best for them not about who “should/should not” do something. I would be surprised, if, in the face of obstacles his partner goes though the man wouldn’t at least volunteer…Kath’s story is inspiring.
But consider this. It’s the woman who’s been taking the contraceptive pill for God knows how many years, her body that runs any risks associated with the pill. And there are risks. Or endures the hassle of other sometimes painful forms of contraception.
It’s the woman who will have the abortion if an unwanted pregnancy accidentally occurs. Or have it adopted if she doesn’t want to abort or keep it. It’s the woman who will take the brunt of the
“scares”. It’s the woman who is refused a tubal ligation by much of the medical profession – even when she desperately wants one. It’s the woman who goes through the humiliating ordeal of being told “she doesn’t really know what she wants,” when she asks to be sterilized. It’s the woman who has to justify her choice to the doctors. And it’s the woman who runs the greatest risk if she DOES get the procedure – things can go far far more wrong with a TL than a vascetomy.
yes exactly, there is a vocal minority, more so on some cf boards, that say its the mans responsibility, to have it done.
its not common, but there is a pressure, i have been told on these boards that *I* should be the one to have a vasectomy, instead of what my fiancee wants.
it may be different because on a lot of cf boards, men are the minority.
i know there are medical risks, i know theres the pressure against them by doctors, and i understand it, dont get me wrong, i am all for people taking charge of their own reproduction, but there is a subtle pressure, on men that they should be the ones.
and it does happen, that men are refused, it is a rarity,
http://www.refugees.bratfree.com/read.php?2,12426,13100#msg-13100
and this one http://www.refugees.bratfree.com/read.php?2,12026,12070#msg-12070
“My husband just had the Big V last week and had to get my permission/signature. We’re in Illinois & apparently it has the highest percentage of malpractice lawsuits, so that could be one reason.
When we asked the doc why he needed my permission he said in so many words that it’s because many wives change their husband’s minds & force their husbands to get a reversal ”
http://www.refugees.bratfree.com/read.php?2,10444,10563#msg-10563
but i still say there is a minority of women, who prefer the man to be snipped, rather than taking charge of themselves.
and todays world of keyhole surgery the risks are minimised, so the dangers are a lot less, so long as you can find a dr willing to do it that is.
Men can be refused, yes, but on the whole it appears they are less likely to be refused than women. Some women do ask for reversals, it is true. but I find that these are women who, not only are NOT committed childfree women, but are women who have had two or more children and suddenly decide they want more, then regret their decision. In my opinion these are completely different from women and their partners who are certain they never wanted and don’t want kids in the first place. And it is unfair for doctors to lump childfree women in with women who’ve had children and want reversals – which is what I feel is happening and compounding the difficulty in childfree women getting the procedure if they want it.
And I think the anecdotal “permission” issue for married couples is where doctors are afraid of having a law suit slapped on them. Looks like it isn’t universal but varies depending on where in the States you live. But it seems to work both ways as they are a couple. Although I think rather than permission the writer may have been referring to “consent.”
as you said, its a very gray area, in some places they mean that consent, which has 2 name spaces on, some doctors, go the extra mile so to speak.
its wrong, for men and women, if a person is committed to not having kids, which may well be shown by a 30 min to an hour session explaining your reasons, and showing u have indeed thought about it, it should weed out the reversal people. then it should help those that really dont want kids, and really want a tubal/vasectomy.
as i said i am going with my rowan, to bypass the what if your husband wants one, i can put my point, just as a backup. and since we run a cf forum board, they have evidence
Quite a lot of discussion which is interesting. But yeah, Britgirl’s right on, I didn’t say it shouldbe be the man. It’s a choice for the couple and if the choice is indeed tubal ligation then it should not be so very hard to organize.
There would need to be a lot of discussion (one hopes!) within the relationship and that discussion would probably include the relative risks to each partner.
I don’t really know if there’s a lot of pressure in some relationships on men getting the procedure. Anecdotally I have not found this to be true in my own limited experience. But I don’t doubt there probably is in some cases as mercurior notes.
It’s not the man’s responsibility alone any more than it’s the woman’s alone. It’s both their responsibility and they both have to come to a mutually agreeable decision.
It’s too bad really that there’s no totally reliable long term birth control method that doesn’t do things to our hormones that could have lasting negative ramifications.
it was the way you said it christine, its just that as a man, i get this all the time, from other childfree, from other people, that she shouldnt get what she wants, that i should have it done instead.
its a near constant pressure, i have been told i am bullying my fiancee into having the tubal, that i should be the one instead. this argument is about choice, my choice, and your choice, people are denying my choice, by implication. if you visit any cf forums, have a look, at how many women want the man to get the snip rather than the woman.
but that last paragraph you put is in essence the argument for some people, i cant have it done because it changes my biochemistry, hormones etc, let a man do it, as it wont affect him as much.
perhaps i am more sensitive to this, non responsibility, being a man, in a group thats predominantly women. if you want it have it, if you dont want it dont have it, its a personal choice, i would say dont push what you want onto you partner (this is the same for males and females)
I am 34 years old and recently asked my doctor for a referral for locations that will provide the sterilization. I was told that it would be challenging to find any doctor who would do the procedure in the States. I know 100% that I have no desire for children. I have created my own list in the past for myself, but it sounds like an excellent idea to present it to my own doctor. I was actually recommended to use the IUD, since I am currently childfree and a tubal ligation is “too permanent”. They said that there is a high percentage of women who are childfree who have the procedure reversed. I know that I don’t ever want children, the reasons why and am disappointed that my thoughts and wishes are not respected. I am currently doing research to find a location outside of The States that will give me the procedure without any hassles. Coming across this website with people who share the same thoughts has been a blessing.
you can fine the mariestopes site, they have a lot of places, in the UK and other places
http://www.mariestopes.org.uk/ they have a number of a place in new jersey that may have more numbers
Hello Mimi! Thanks for stopping by and sharing your experience. You’ll see that from other readers that though they’ve faced challenges with getting the procedure done in the States, some have been fortunate to find a doctor that will do the procedure. However, if you are looking at getting it done outside the US, Marie Stopes is a good place to start, as mercurior has suggested. I know there are also Marie Stopes clinics in countries outside the UK, for example, Australia, Austria and Belgium, and a centre in New Jersey.
All the best – and don’t give up
I’m only 20 so I know that when I start trying for sterilization, I will be met with disapproval. I’m saving up for it and hope for it to be a bit of a present for me. I’m hoping to be accepted to med school and I’m thinking that if I go in as a med student and ask for sterilization, that maybe they will take me a little more seriously.
I find it absolutely offensive that 15 year olds that you usually see on shows like “Jerry Springer” and “Maury” can go pro-create until their uteruses fall out and no one says a damn thing. But god forbid someone actually thinks a decision through and decides to YIKES! have no children. Women’s reproductive rights are swept under the rug if they pertain to having no children. Sick stuff.
I am fortunate to have a 40 year old, childfree, female gyno who would have no problem performing the procedure yet we have not done it. Why? Mostly because surgery, no matter how routine, is still surgery and comes with a certain amount of risk. I have been on an IUD (despite not having the prerequisite pregnancy so many doctors require) for nearly 7 years and love it. We do plan on sterilization someday, but not until one of us has some other need to go under the knife or if the IUD is no longer a viable option. Being in the medical industry we always advise against elective surgery unless all other options have been exercised.
For your doctors who will not insert an IUD because you have yet to have a child, argue that the reason this warning is in place is because of an increase risk in ejecting the device and you are diligent enough to pay attention and willing to take the risk.
I was sterilised earlier this year, and had a very positive experience, which was very unexpected. I asked my gynaecologist for a referral to a surgeon. My gyn listened to me, asked questions, offered an IUD (which I didn’t want), and wrote a referral for me. When I met with the surgeon, he’d read the referral in advance, and when I walked into his office, the first thing he said was, “so you want a sterilisation? No problem, I can do that for you in 8-12 weeks!” I had a long talk with him, weighing up my options (Essure or tubal ligation) and at the end of the appointment, I said, “this has been a pretty surprising afternoon, because I’d expected you to refuse me because of my age [I was 29] and because I don’t have kids.” The surgeon replied, “you’ve obviously given this a lot of thought, and you’re not a little kid, so why would I tell you that you can’t have something you want?”
I was very lucky.