There has been a bit of a hubbub about women’s (and sometimes men’s) requests for sterilization to be granted. Slate has run a series of articles on childfreedom during which the topic emerged, and it has also made this month’s issue of Vogue. In turn, this seems to have prompted some of the bloggers I follow (and now me) to keep the discussion flowing.
By the time I discovered the word “childfree” and found out that there was an entire online community of people seeking relief from the baby-rabies surrounding them, I had already been sterile for a few years. My experience – both the decision and the execution – was so easy that it never occurred to me that other women would have to fight to be sterilized. As I consider my situation, I realize I had several factors going for me (plus a little bit of luck that my small-town doctor was supportive), and I hope that sharing those might assist anyone reading this who is considering a procedure.
Time (and maturity) was on my side. In my early twenties, I brought up sterilization to my first gynecologist. At the time, this woman had known me for only about half an hour, and she could see a lack of confidence in my demeanor. She was very frank that my hesitancy, my age, and her lack of knowing me well made this a non-discussion. I was not ready to put up a fight, and I really did not mind waiting.
In the meantime, I heard people saying things like, “By the time you are 30*, you know for sure,” and, “Once your friends start having kids, you will want them too.” When I reached 30, I had observed enough close friends having children to make me even more certain that it wasn’t for me, and I’d had about 15 years to reflect on why I did not want children and what I did want for my life. I now had a confidence and an ability to articulate myself that a reasonable doctor could not ignore.
*That “magic number” 30 also pops up in some research about which Laura Carroll blogged; in one study, about 20% of women who were sterilized before the age of 30 later regretted the decision, whereas only about 5% of women 30+ expressed regret.
I had “done my homework” and had a plan. When I finally broached the subject with my nurse practitioner, I was able to explain to her in less than 3 minutes why I should be sterilized. I explained that I always knew I didn’t want to bear children and played the “30” card so that she knew this decision had been carefully considered for years and that I had been willing to wait for as long as conventional wisdom demanded. I also shared, with passion and conviction, my commitment to adoption should I ever decide that I wanted to add another person to my family. She listened intently and agreed that whenever I was ready, she would have her office refer me to an M.D. who could perform the surgery.
I anticipated the doctor’s questions and reactions. When I met with the M.D., I was again able to tell the story I had shared with my nurse practitioner. I am sure it also did not hurt that I could tell the M.D. about my advanced degrees, my career, and my marriage too. I know that some people do not appreciate doctors grilling sterilization candidates, but given that this woman had only just met me, it seemed perfectly reasonable that she would want to hear my story – and my ability to anticipate her concerns and articulate my story meant that she had relatively few questions for me. Instead, I felt that she did a great deal of listening. At one point she said, “I wish your husband were here so that I could talk to him too.” My response? “I’ll bring him in from the waiting room!” I know this is also anathema to many who feel like the doctor is asking them to obtain their husband’s permission, but I had anticipated that the doctor might be interested in our family dynamic. Again, she had only just met me. I see it as responsible of her to be sure that I was doing this without pressure and that my husband knew the risks to me. In fact, one of the reasons she stated had to do with risk – she would prefer to know that he was at least willing to have a less-invasive vasectomy (this was when Essure was in its infancy and thus not an option in my little town).
Of course, I jumped in to make it clear that this was about me. If, God forbid, anything ever happened to my husband or, God forbid, I were raped, I wanted to be sure I was taken care of. Though I did not bring this up to the doctor, I was also influenced by the pressure one of my relatives had faced. Her now-ex-husband had a vasectomy when they finished having children, so she was left unprotected in a sense. When she remarried, her childless husband started pushing her to have a baby with him. However, she had clearly already left that stage of her life behind. Her children were older, and she did not want to start over with a baby, especially at her age. Needless to say, things did not end well (though on a positive note, no new lives were destroyed in that tug-of-war).
Lastly, I was able to anticipate a time frame that worked for all of us. I was uncertain how long it might take to schedule a surgery, so I purposely arranged for a consultation in the spring with the intention of surgery in the summer when I would be off work. When the M.D. agreed to the surgery, she added, “I want to give you three more months to think about it, so we’ll schedule the surgery for summer.” I replied, “Perfect!” Waiting periods may raise the hackles of sterilization advocates, but because I had already built that into my plan, I still felt a sense of… I guess… control, that this was exactly what I wanted and I was not just at the whim of the medical establishment or whatever.
I am very healthy. Speaking of risk, I had no health factors that might dissuade the doctor. This made the surgery smooth and successful, and it assisted in a relatively easy recovery.
The only compelling argument I have heard against sterilization is that with the wealth of options available, some of which (i.e., IUD) are more effective than tubal ligation, people should be more resistant to take permanent and potentially dangerous measures. However, my belief is that it is still up to the patient to decide what risks are most acceptable to her. The doctor informs; the patient chooses based on that information.
Seven years and counting, and I still celebrate my sterility every day!
Please feel free to share your experiences in the comments or to offer advice to anyone considering a permanent procedure.