A woman's right to sterilisation

[Marinetta]

I've just stumbled across an interesting documentary about the difficulties young women face when trying to get a sterilisation if they do not want any children. It would seem that many doctors are reluctant to carry out the procedure, often using the excuse that the woman is too young to know what she wants, will probably change her mind later and want kids when she's older or will meet a new partner who wants kids and will therefore regret having the operation.

According to the documentary it is extremely difficult for childless women under the age of 30 to get the go ahead for the procedure. It also seemed to suggest that doctors are a lot more willing to perform a vasectomy on a man and there is a lot more information available for the male procedure where women may struggle to find reliable reliable information relating to a sterilisation.

I wouldn't consider myself much of a feminist but it made me quite angry to see that women are being told that they can't do what they want with their bodies and we are expected to want children and those who don't are treated like there is something wrong with them or like they don't know what is best for them.

This is the RCOG guidance on consent.
www.rcog.org.uk/globalassets/documents/guidelines/consent-advice/consent-advice-3-2016.pdf

The NHS pays for contraception. Sterilisation is contraception.

Do young men find it difficult to get vasectomies I wonder?

Yes, they do.

Vasectomy can usually be performed under local anaesthetic and is cheaper and safer than female sterilisation.
The reason doctors resist sterilising young women is that we have all encountered patients who have later changed their minds. It is very difficult to try and reverse a tubal ligation.
Many women in their twenties are adamant they never want kids, only to become broody as their biological clock starts running down.
I include myself in that group. I had an abusive childhood and was certain I would never want to have children myself. I had a career as a hospital doctor, was a radical feminist, and had never felt remotely maternal. But as I passed thirty, I began to wonder vaguely if I would regret not having kids. The feeling grew slowly, until I eventually realised I very definitely DID want them. I had two in my mid thirties, and am grateful I wasn’t offered a sterilisation when younger.
Some PPs may have remained fixed in their choices, but many women do not - and we doctors do not have a crystal ball to predict who will regret it later.

I accept that there are women who may regret their decision to be sterilised but I don't see why it should the the doctor's responsibility to ensure that doesn't happen. As long as the woman is well informed and in a good state of mental health I see no reason for anyone to stop her being sterilised. If she regrets the decision later in life then she has no one to blame but herself.

I doubt there is any doctor out there who would refuse to perform an abortion on the grounds that it is something the woman might regret. There are many women who do infact have an abortion and then deeply wish they hadn't. So if a doctor wouldn't question a woman's decision on abortion why should they question the decision to setrilise?

I agree with babdoc
The reason why is mostly because sterilisation can be very difficult to impossible to reverse and many women do in reality change their minds. It is an extreme option when we have reliable cheap contraception and legal safe abortion access.

Abortions are not really comparable to sterilisation because you can get pregnant again at no cost with no new medical procedure and no high risk of infertility, if you later decide you do want to have a baby.

I accept that there are women who may regret their decision to be sterilised but I don't see why it should the the doctor's responsibility to ensure that doesn't happen.

But in a recent thread about a detransitioner confronting her doctor, people were aghast that the doctor didn't see the major regret and trauma it had caused as her responsibility. I really don't see how you can have it both ways. There are very obvious parallels.

I am sure we all know people who were adamant they were not going to have children, and changed their minds. I know several, and it saddens me to think of the disappointment, even trauma, they may have endured had they chosen early in adulthood to take away that opportunity. I also would not want to be the doctor potentially sued in that circumstance...

I believe that when you ask for an abortion you do have counselling to help you be sure it is the right decision, not something someone else has forced you into etc.

I know a man who wanted a vasectomy after his 2 kids were born and because he was still quite young he really had to argue against questions about what if he split up, what if a child died etc. And that is when a vasectomy is more easily reversed. So in this case I don’t think it is sexist, just more based on evidence that the younger someone is the more likely they are to change their minds about having children.

And it is not the most effective form of contraception anyway for a woman. The mirena coil is. 3 consecutive coils could see you through your fertile years and would be less intrusive than sterilisation.
Is it just that you want the finality psychologically? What made you go for sterilisation?

I just also want to add that I do feel there are some judgemental aspects around female fertility, for example the hoohaa around getting the MAP- no need for it. But in the case of sterilisation I do see why it’s difficult to come by.
I have been sterilised myself but am older and have 3 kids, have had 3 mirenas and still had to answer questions about not trying other things or getting dh to have a vasectomy (he wouldn’t).

A female family member who identifies as male has had a hysterectomy in her 20's recently. I'm bewildered by the double standard.

Most women I know who absolutely never wanted children in their twenties went on to have planned pregnancies in their thirties. It seems that there are a lot of women who change their minds.

I both agree and disagree with you.
I disagree that doctors should sterilise young women, I think they’re right to be cautious in case she later changes her mind.
So they need to be doubly cautious with children then!
The answer is to be more cautious are hormones and puberty blockers, not less cautious with women

Nothing is black and white. I know several women who did change their minds in their thirties. I am one of them. We all change throughout the life cycle.

I’m sure there are women who “just know” they will never want kids, and will never change their minds, but it’s hard for the doctors to distinguish such women from those who may change their minds later on—just as it’s hard to distinguish “true trans people” from those swept up in a trend.