TYING THE KNOT

In the midst of a seemingly never-ending fight for reproductive rights, there is a quiet, less apparent struggle that thousands of women in America face each year: the struggle to get sterilized. Although legal abortions and affordable birth control are reproductive resources that are heartily fought for in the public sphere, they do not provide women with permanent solutions to prevent pregnancy. As a result, women who are seeking a procedure such as tubal ligation (getting tubes tied) or hysterectomy, are left to advocate for themselves and their reproductive future on their own, without much political support from the “pro-choice” movement.

Women who are seeking permanent sterilization are frequently faced with firm opposition from not only their family and friends, but also their healthcare providers. While questions about a patient’s health and safety are to be expected for any surgical procedure, many women experience much more invasive questioning and commentary, including questions about their promiscuity, their husband’s (or even future husband’s) opinion on the matter, and how many children they have and how those children may feel about the decision.  Women seeking tubal ligation or a hysterectomy may also endure claims that they are not truly capable to make such a permanent decision and that they will “change their mind later.” While some apprehension around such a permanent, drastic decision is to be expected from a healthcare professional, their responses to women seeking sterilization beg the age-old question: “Why do we struggle to trust women’s decisions about their own bodies?”

Both men and women, particularly young adults, potentially face resistance when making the decision to become voluntarily sterilized. However, this friction seems to disproportionately affect women, some of whom must travel across state lines or wait multiple years to find a provider who is willing to perform the procedure on them. As a result, it would not be out of place to presume that some of this apprehension towards women seeking sterilization is due to not just the difference in risk and reversibility of the procedures, but also sexism.

Although our society has come a long way in redefining the role of women in society, there is still a strong social expectation for women to have children. When having children is considered the default path for women, it becomes incredibly difficult to prove that you want something different for yourself and your future. Doctors, for fear of being sued by a regretful patient, are inclined to assume that the 20 year-old college student asking to get her tubes tied will change her mind when she’s older and married, or that the 29 year-old mother of one will eventually lament not having another child. While it is true that some patients do, in fact, regret their decision, that does not negate the fact there are countless other women who do not, but still must fight to get it done because they are too young or “have not had enough children yet.”

While it can be difficult to find a way to ensure women’s autonomy over their reproduction while also preventing them from making a permanent decision that they may regret, that does not mean that it is impossible. By being open about your desire to not have children, or just not have any more children, you are already improving the environment for other people who choose not to procreate. Through this open dialogue, it could be that one day choosing not to have children is seen as a normal, respected decision, not a radical act to later regret.