Dear US Physicians: Please Start Honoring Women’s Requests to Be Sterilized
When I first approached my gynecologist at the young age of 23 requesting sterilization, I never dreamed that, nearly 30 years later, I’d be grappling with survivor’s guilt.
Oh, I received the standard stern warnings of, “you’ll regret this when you’re older” from everyone from my aforementioned gynecologist to my parents to the second-great-aunt-twice-removed of every churchgoer I encountered. However, I have never rued having my tubes tied that young. Not once.
The guilt I feel now in the wake of the Supreme Court’s overturning of Roe v. Wade has nothing to do with turning off my reproductive capacity. That, frankly, remains the single-most best decision I ever made. No, I feel horrible because I remain free to enjoy sexual intercourse with my husband or the guy down the street free from fear, while many of my sisters now cannot.
At least without risking death.
That’s why I’m imploring physicians to listen to women because our politicians will not. Stop denying sterilization to women that request it. You now stand on the cusp of history. Will you allow women to have the final say in their reproductive rights?
The Impossible Road to Tubal Ligation
My tubal ligation story is easier than that of so many women. I was fortunately married at the time. This fact becomes important later.
Back in the day, the only reliable options women had for birth control were hormonal solutions and the copper IUD. I first went the hormonal route, trying the birth control pill first — which I took religiously. It failed. I ended up pregnant my sophomore year of college.
After that heartache, I switched to the Depo Provera shot as it had higher overall effectiveness. Unfortunately, that launched me into a severe depression for which I was hospitalized — twice. Despite taking every SSRI in the book, it was only in withdrawing from that drug that the sky began to clear and I started to see a future outside of suicide.
However, I still had the pesky problem of not being ready to be a parent. My then-husband already had a toddler and our young marriage was already on the rocks. I turned to the copper IUD, which had an advertised effectiveness rating of 98.8% at the time.
Guess who the unlucky 1.2% was?
In frustration, I went to my mom’s gynecologist, who referred me to Planned Parenthood for an abortion. He was pro-life and refused to do it himself. He also denied me a tubal ligation the first time I requested it.
“You’ll regret it when you’re older.” It may be a lifetime ago, but I can still remember his patronizing tone, his utter surety that a woman who couldn’t become a mother had no future at all, no reason to exist. Having recently fought my way back from wanting to die every moment of every day, I resented that implication. Strongly.
I got downright Machiavellian at that point, and I have zero regrets. I informed him that I had tried every form of birth control available to date, and they had all failed me. I also informed him that I was not about to stop doing my “marital duty” by my husband (that’s where the I was married part comes in). Therefore, Mr. Smug and Judgey could either grant my tubal ligation request or see me back in his office the following month for another referral to Planned Parenthood for yet another abortion because nothing he would say would make me ready to be a parent.
In the end, he granted my request. I will never know why, and frankly, I don’t care. He shouldn’t have had any say in the decision, anyway.
However, my story is unique. I can barely go on social media even today without seeing a flurry of stories from women who had to fight much harder to get sterilized.
Some of them, like me, were married. Some of them already had children.
That fact wasn’t enough to convince their doctors.
They were met with a firm “no,” not because they weren’t candidates for the procedure. They were denied this basic choice simply because someone outside of them decided that their only human worth was to be a mother. Otherwise, they were disposable vessels — their thoughts, feelings, emotions, future hopes, and dreams — none of that mattered. Only their physician’s adherence to patriarchal ideals that continue endangering female lives even today.
Especially today.
The Dilemma Women Face
Imagine if you risked your life every time you had sex. That scenario is no longer a hypothetical for millions of women in states with trigger laws. Those who could die as a result of unplanned pregnancy now face more restrictions on their freedom than many prisoners.
Multiple conditions make it unsafe for a woman to carry a pregnancy to term. For example, high blood pressure, diabetes, obesity, asthma, heart and lung disorders, and autoimmune conditions can all make pregnancy treacherous.
What’s even more shocking is more than half the population has such a medical condition, regardless of whether they know it. The millions of uninsured and underinsured adults often remain blissfully ignorant until something serious goes wrong — like an unplanned pregnancy.
By the time they reach the ER, it may be too late.
Even those who seek care could die while waiting. Already, trigger laws in several states have led to unnecessary treatment delays where the hospital had to obtain legal approval before treating women with ectopic pregnancies, leaving them at risk of fallopian tube rupture and death. Not to mention, permanently impaired fertility if they do survive.
That’s right — overturning Roe v. Wade could rob women of the chance to ever have a family, all through no fault of their own.
Ectopic pregnancy isn’t the only thing that can go wrong. Laws that ban abortions after a specified time frame could force women to carry non-viable pregnancies to term. Doing so significantly increases their chances of developing sepsis and dying. Even if they don’t, they have to suffer the pain of carrying a dead fetus to term, only to deliver it in the grimmest fashion ever.
These scenarios can happen to non-disabled women, too. However, disabled women face inordinate risks. They’re also in increased danger of further damaging their health beyond repair.
For example, up to 10% of women develop gestational diabetes during pregnancy. Fully half of these women go on to develop the Type 2 form of the disease. This condition significantly increases future heart and kidney disease risks and may require the woman to take medication for the rest of her life. If she’s already overburdened by high healthcare costs, she may go without needed treatment — resulting in tragedy. If the individual already had a pre-existing but previously undetected heart condition, it could push her over the edge into a heart attack or failure.
Physicians Should Lead the Way in Supporting Reproductive Healthcare Choice
Physicians stand at a crossroads in supporting women’s health. It doesn’t matter what your personal abortion views are if you wear a white coat and carry a stethoscope. You can prevent unnecessary female death without ever performing a single D&C.
How? Simply honor a woman’s request for sterilization. Do it without further questioning. Do it without the obligatory lecture about how she will regret it when she’s older. I’m living proof that many women consider this decision the best, most liberating thing they could do, particularly in light of current events.
Please don’t wait until they have a reason. The reality of healthcare in the United States is that many people can’t afford to go to endless appointments to get a diagnosis. It can take eight years to receive confirmation of endometriosis — a common condition that one out of every ten women has. The money a woman saves for a tubal ligation may represent her one chance at ending the nightmare of unwanted pregnancy.
Physicians understand this. They also comprehend science. They know the many benefits of healthy sexual activity. Certainly, they wouldn’t stand in the way of a woman who merely wants to reap these perks with her spouse or partner without the fear of dying as a result.
Trust me — the fear of unwanted pregnancy puts a serious damper on relationships.
A woman’s desire to never procreate should be sufficient reason to tie her tubes. If she’s over the age of 18, she is an adult who should be treated as such. Let’s not forget that the United States follows a for-profit healthcare system. Theoretically, a woman requesting a tubal ligation should be met with the same respect as someone making an appointment for LASIK vision surgery — you pays your price, you gets your service without any proselytizing.
Physicians, Please Honor Women’s Requests for Sterilization
Please, physicians, I implore you. Women are terrified. Disabled women are even more frightened.
Not all women will be desperate enough to trade their procreation ability for the freedom to have sexual relations free from fear. However, some will.
I am a case in point. I made the same decision many years ago, and it was the best choice I ever made in my life. My only regret is having to be downright Machiavellian to get my request for sterilization granted — but once it was, I experienced genuine reproductive freedom for the first time.
You have the power to grant other women the same, all without performing a single abortion. The next time a woman shows up in your office requesting her tubes tied — please say yes.
