Goodbye Pill. Hello Sterilization.
Why childless young women are opting for the 'tubal.'
'I want to focus on other things.'
[Editor's note: this is the second of a two part series on being young and sterile by choice. To read the first part, click here].
"I knew I would never want to undo it, so I decided it would be okay to get them cut," says Melissa Day. She's 34 years old and childless, and three years ago had a tubal ligation: what's commonly known as getting your tubes tied.
The procedure prevents the passage of the ovum into the uterus where it can be fertilized by the male's sperm, by closing the fallopian tubes. It's a surgical solution to birth control.
Day's older sister went through a lot trying to get pregnant and have children. Her sister had two miscarriages and is now in the process of adopting an infant. Day was by her side the whole time and it lead her to the conclusion that the trauma isn't worth it. "I don't need to go through that," she says and adds that she's just "not the mommy type anyway."
Before the surgery, Day briefly changed her mind. "I got really nervous for a few days after I told [the doctor] I wanted to have them cut, and I called to change my mind and tell him just clip them." Clipping the tubes instead would mean the procedure would be reversible. "I spoke to the nurse who told me I had to talk to the doctor when I went in to have my surgery, but I was really nervous and totally forgot when I got to the hospital."
She feels more settled about the surgery now. Tugging the waistband of her jersey pants down an inch to display the one-inch scar, she says she knows she made the right choice. "I don't even think about it now," she says simply.
Melanie Sawyer, a 27-year-old law student from Vancouver Island, also chose to have her "tubes tied" instead of using birth control pills or other forms of contraception. "I had a close call," she says. "I missed a couple of [birth control] pills, and by the time I remembered, it was three days after I'd had sex." Sawyer considers herself lucky. "It would have really messed up my plans if I had gotten pregnant again, and I want to really focus on doing other things now." Sawyer now has a stepson, but doesn't want to have children of her own.
No regrets?
They're not alone. Dr. P.J. Mitchell, an obstetric surgeon in Nanaimo B.C., sees "maybe seven or eight women a week" who are considering tubal ligation: women both with and without children. "As many as 90 per cent of them go ahead with the surgery after receiving all the facts," he says. "Little seems to challenge their decisions."
And reliability isn't the only reason women choose sterilization. Christine Franic, a nursing student in Nanaimo, notes that financial considerations may also play a role. Once the surgery is done, "there is no expense, no monthly cost" to birth control. As well, risks associated with the operation are short-term only. "They are primarily to do with the anaesthetic, and within this age group the risk is very low."
Some studies have also claimed to show health benefits associated with tubal ligation. "Preventing or lessening the risks of some diseases, including polycystic ovary syndrome, endometriosis, and a reduction in ovarian and breast cancer risks, can often be a reason for people looking into this surgery," Franic says. But they are likely to be disappointed. "Unfortunately, it's bullshit, but many people will read reports about the correlation between having the surgery and lessening the chances of ovarian cancer and think it's a real option."
Dr. Mitchell agrees.
"There is no hard evidence to suggest that there is a strong correlation between the two ideas," he says. "However, most patients coming in with that idea in mind are already prepared to go ahead with [the surgery] anyway. It simply could have been an added benefit.
"If the patient suffers from a disease like [polycystic ovary syndrome] and is confident that she does not intend on having a child or additional children, the surgery may be the best possible option for them." It's a decision that shouldn't be taken lightly, however. "This surgery should be considered permanent," Dr. Mitchell says. "There are different options for the actual process, but once done you wouldn't want to undo it."
Home by dinnertime
According to the Society of Obstetricians and Gynaecologists of Canada (SOGC), the most common options for the surgery can be accomplished through two processes: laparoscopy or minilaparotomy. According to Dr. Mitchell, laparoscopy is the most common and least invasive. "It's a simple procedure that is done through two tiny incisions: one at the belly button and one low on the abdomen," he says. "It doesn't take a long recovery period and the patient can usually expect to be at home that evening."
Minilaparotomy, or a minilap, is done with a single incision to the abdomen. While the procedure also has a minimal recovery time (about 24 hours), it also requires a larger and more noticeable incision resulting in a bigger scar. Both surgeries allow for options in the way the tubes are sealed. In Canada, three means are available: clips or clamps; rings, which pinch off the tubes in a loop; or coagulation (cauterizing), which is the procedure Melissa Day chose.
Popularity seesaw
While the method used is generally left up to the patients, Dr. Mitchell stresses that medical staff must consider other factors before the surgery date is set. "Most women who come in to consult with a surgeon are pretty prepared already," he says. "But as a medical professional, it's [the surgeon's] job to make sure [the patients] believe what they are saying as well. For example, usually a patient under 30 years is questioned about her reasoning a little bit more than, say, a 45-year-old who has raised three children already."
But the surgery is not withheld unless there are medical reasons to do so. "I had a 21-year-old patient come in who was married and had two children and wanted to go to school and become a professional," Dr. Mitchell remembers. "She had taken some time to consider and we had a consultation that included her husband. In the end they went away with the information and didn't come back for three months. "When they came in again there was more surety and I felt comfortable knowing they had considered their options."
As a birth control choice, the surgery has seesawed in popularity over past decades. Rising use in the early 1960s ended as oral contraceptives became more widely available. More recently, emergency contraception (the "morning-after" pill) has also supplanted its use. But while other methods dominate, tubal ligation is once again being discussed as an option.
"I heard about it from my mother," says Sawyer. "She suggested that it might be something to consider if I really didn't want to have children, which I don't."
Day says she learned about the option in high school. "It was one of those things that I heard about in a health class textbook and really ignored until I realized its impact," she says. "But you talk about these things too, you know. Women talk about this stuff."
She says it just means she has one less thing to worry about.
Stephanie Konefall is a second-year graduate student at Simon Fraser University and a graduate of Malaspina University-College who lives on Vancouver Island and Protection Island, B.C.
A version of this story ran in the Malaspina Incline this summer.
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nightbloom
5 years ago
Comments on "Goodbye Pill. Hello Sterilization."
Interesting series. I don't know why I find the whole issue of young heteros getting sterilized so unsettling. It's their lives, after all. As a side note, although it doesn't figure as a looming factor among the individuals discussed in these articles, I think a lot of 'progressive' young people have internalized the prevailing ideology on demographics (namely, that there's too many people worldwide). I think that's an obscure assumption to base person life-decisions on - demographics are not as predictable as statisticians claim, especially in the just-emerging era of global pandemics. The developed world is underpopulated, yet it is best endowed to raise and cultivate the next generation of global citizen, and overall global population problems will be resolved by far larger systemic forces than individual self-determination. A few more 'indigenous' families in the underpopulated northern and western hemispheres are not going to tip the balance any which way in the long run. There's also so question of values, wherein childrearing is seen is a net negative in the overall ratrace.
G West
5 years ago
Given the way the 'developed world uses resources' the assumption inherent in your thesis above seems at the very least shaky.
However, nightbloom, have no fear - the Christianist right-wing seems to be committed to more than making up for any hypothetical shortfall of little consumers here in the west.
Furthermore, the idea that this is an emerging era of global 'pandemics' seems conjectural as well.
In any case, the article describes a personal decision with almost no impact - hypothetical or otherwise - on the real problems of the modern world. Your phrase, which I have italicized for emphasis, given who and what has gotten us to this pass, is even more open to debate in my view.
nightbloom
5 years ago
Gwest, you continue your tradition of policing my posts while ignoring the article altogether. Very well:
We're getting a lot better. It's the developing world that will pose the biggest environmental risk over the next several generations. You criticism doesn't hold up.
This doesn't hold up either - look at what the scientists are saying. That's the best we have to go on. It's not conjecture at all.
Jeffrey J.
5 years ago
Finally, women are able to exercise complete freedom over their bodies. And more power to them. If men were designed to become pregnant, they would have exercised these steps hundreds of years ago. There is absolutely nothing wrong with women not wanting to have children. There is zero chance that the human race will stop procreating. Great article.
shera
5 years ago
Unlike the first in this series, chronicling a male's fear of impregnating all women within six degrees of him, the woman in question seems better able to express her reasons for sterilization - something more than a desire to f*ck with abandon. No mention of STDs here either, but I suppose that isn't the point.
Booker
5 years ago
What a surprise, the biggest conspiracy theorist is a theologian!
la_bandolina
5 years ago
"Control over our bodies"? Ha ha ha. In my experience of growing up in Nanaimo, I was severely oppressed by the institutions of family and school so that by the time I was a young adult I could 'control' myself by working. Drugs helped too, including contraceptives and pain-killers. I'd like to one day learn about my body's natural rhythms (apparently it generates different hormones at different times, partly so that I can ovulate each month 14 days before my period, apparently I could be having sex for 18 of every 28 days without much risk of pregnancy). Maybe through that I can move on to learn about the rhythms of our greater community and make my contribution gentle and organic rather than "efficient" and "controlled" as I was brainwashed (by myself and others) into doing as a "professional".
Or I could go get my tubes tied and get on with my life as a drone. Sorry for being in a bad mood. Apparently that Nanaimo upbringing didn't give me much security, but they've offered me some anti-depressants at the clinic here in East Van...
DPL
5 years ago
Gosh, the Tyee sure comes up with some stories. Now we know a 30's some woman got her tubes tied and a 20 some guy got snipped. Real important to all of us no doubt. I sort of thought what they do or did is up to them, but since medical resources were involved maybe the folks who aren't into snipping or cutting should get a reduced medical plan reduction. wonder how long the wait lists are for theprocedures mentioned, or if BC medical paid for the jobs?
nightbloom
5 years ago
JeffreyJ, read La_bandolina above.
We're all prey to systems of control to varying degrees. Those who think they're in control are the most hapless prey of all.
Ruby
5 years ago
I would expect that BC Medical paid for it. Why wouldn't they? If they pay for the medical costs of women to give birth, they should pay for the services for women who don't want to.
maestro
5 years ago
Shera : good point re STD's .
STD's were not mentioned much in the TYEE vasectomy article posted a few weeks ago.
ALSO: Hope those young gals that choose these various routes to avoid pregnancy early in life ,( especially with snip,nip and tuck)....don't change their minds later in life ,want to have their own children, and yet necessarily think they can necessarily have children simply with another remedial snip, nip and tuck.
The biological clocks etc. aren't really alterable by surgery. Seen friends and colleagues leave it too late, then either go and adopt babies $30,000 later...or artificially induced means at $10,000 a pop yet no guarantee.
Some also tried later in life and gave up, and probably would have made good parents, too.
G West
5 years ago
I have, nightbloom, looked at what the scientists - a broad range of them - are saying about the 'alleged' threat of global pandemic - perhaps you should too. Sometimes you have to look a little bit behind big pharma you know.
We've gotten better at what?
Consuming no more than 9 - 10 times what the third world citizen does. Spare me. You bear watching!
nightbloom
5 years ago
Gwest - the big environmental disasters of the future are awaiting us in the developing world. No one denies that our rates of consumption are an epic scandal.
It's not big pharma behind what I've been reading, altho your warning is well-taken - government, health policy experts, NGOs and the security sector have all produced some interesting projections.
Davey-boy
5 years ago
Perhaps I missed it, but I see no mention of the extent of this phenomenon.
If there truly is a surge in young men and women taking the permanent plunge so to speak, we have a significant story. But if these stories are not part of an emerging trend, this remains a human interest piece, but nothing more.
G West
5 years ago
It's a nothing story. The people practicing this kind of sterilization at a young age are very self-aware. They like the attention. The suburbs are full of babies - that's the emerging trend.
IAMC
5 years ago
Ruby; we have a right to promote the advancement of the human race. Why are you wishing us all dead?
Human beings can, and have, produced a positive influence for people.
Making the best out of the land, preserving resources are inherent to us.
Relax and try to contribute to the Brave New World.
Ruby
5 years ago
IAMC, what a judgemental thing to say. Of course we all have the right advancement, but suggesting that those of us who support choice for women wish everyone dead is ridiculous.
Avicenna
5 years ago
This made me spit my green tea into the crevices of keyboard
Mon Dieu, warn in advance when you spout out such non sequitors... lest I am left short circuited (not meant to be in reference to tubes being tied).
Fii
5 years ago
Haha... good to see (read) you again, Avicenna.
I agree with Jeffrey. The fact that there are women on this planet who still don't have 100% control and knowledge over their bodies is mind-blowing. Very disappointing... I mean c'mon, all we've accomplished, and yet...?
DPL
5 years ago
are we heqding the right way. I saw a article today that a section of Russia has a very low birht rate. Everyone got the day off and if kids are born 9 months from that date, prizes are given up to a four by four. Maybe our young upwardly mobiles should keep somehting in reserve for later in case of prizes.
RickW
5 years ago
I think a tubal is much better than Plato's idea of killing all the women, then allowing men to live a ife of perfection until the human race all dies off.......
RickW
5 years ago
IAMC:
A right? You wanna prohibit condoms, et al?
Just like Kelowna, "preserving" all the orchard lands by paving them over.....
MetisGirl
5 years ago
Maestro's post highlights the prejudice against women who don't want children. I had my tubes tied when I was 28 (13 years ago) and some people get nasty and lecture me about changing my mind and having a baby. I've never wanted kids-even when I was six I knew I didn't want to get married and have kids-it seems so dull, frankly. Maybe it's because I'm an only child and need space ;-) But a childless woman still seems to cause consternation.
Rhea
5 years ago
Because personal (and temporary) monetary gain such a wonderful reason for people to have kids? What the governments making up these policies to bribe people to breed don't get is that people aren't forgoing kids because they aren't getting an SUV or a one-time cash prize. They're often doing it because they realize that children are extremely expensive in today's society. And I'm not talking about people who go broke to spoil their kids rotten. I'm talking about basic needs, the cost of one parent taking time out of the workforce to care for kids, the lifetime cost of lost wages and the stress and strain kids can put on even the happiest relationships (and the high cost of divorce and single parenthood). Many people in today's world look at that cost and decide it's not worth it. I'm one of them.
Also, do you really want people who don't want children to have them for money? Can you imagine being born to parents who didn't really want kids but felt they "should", and resent them ever after? A friend of mine in high school was. It's not a life I'd wish on anyone. I applaud anyone who feels they're not willing or able to parent, and is responsible enough to avoid accidental kids, whether it's by sterilization, birth control or voodoo. It's their choice, not economy's.
Wanda Spearhead
5 years ago
One thing that your article doesn't discuss and that is a little known possibility ( and a strongly held belief amongst older women who have gone through this) is that tubal ligation causes early onset menopause. I know of two women with children who had their tubes clipped when they were in their early twenties and lived to regret it. At the time it made sense, they were very young and didn't see themselves wanting to have more children, but we change as we get older and the maternal urge is stronger than any rational mind. At about 29 years of age, one friend started yearning for another birth child. She was in a committed relationship with someone who wanted children as well. She is a wonderful mother and yet cannot afford to pay $30,000 - $40,000 to adopt a baby.
To have a reversal is costly and does not gaurantee that fertilization will take place.
Both of the women I refer to are now going through menopause, one is only 35 years old and started noticing symptoms about a year ago. The other woman is 41 years old and has almost completed menopause.
Th older woman is ok with it, but for my younger friend, it is not so easy to start sprouting middle-age momma hairs on your chin and around your nipples
at 34, knowing that the window of opportunity is virtually shut.
Rhea
5 years ago
Wanda, that's sad for your friends, but it doesn't automatically follow that ALL women will have the same experiences they did, nor does it mean that because some women regret this choice, all women should be barred from making it.
It comes down to personal choice on the part of each individual. Some people regret the choices they make, but you cannot dictate to people that nobody should do something because some people regret it.
Wanda Spearhead
5 years ago
Hi Rhea,
Not once did I mention dictating to others. All I wanted to point out was that the article didn't even bring up some of the potential long-term side effects that have been experienced by SOME women.
As it is a right to decide what to do to your body, it should also be a right to make an informed choice.
I would hazard to guess that many more people regret making uninformed choices in their lives.
'nuff said.
Fii
5 years ago
[ think a tubal is much better than Plato's idea of killing all the women, then allowing men to live a ife of perfection until the human race all dies off...]
Isn't that pretty much what is happening? Poor Plato; someone obviously wasn't getting laid...
Mary
5 years ago
What does giving birth have to do with being maternal?
Having never felt the need to procreate I have enjoyed the peace of mind of being clipped for over 10 years. My husband and I foster 2 teen girls, the loves of our lives, and mentor many 20-something young women at work.
There are so many ways to contribute to a healthy society - pick one and do it.
flyingfish
5 years ago
Oh, I"m sure Plato was getting laid. Just not by a woman.