Permanent Birth Control Is in Demand in the US—but Hard to Get

The fall of Wade will have a huge impact on contraceptive trends. Clinics began to report a surge in people requesting tubal ligations in the days after the Supreme Court ruled. One that is very difficult to reverse is the procedure in which the fallopian tubes are blocked.

Doctors are a big roadblock for those requesting the procedure. The American College of Obstetricians and Gynecologists advises respect for an individual woman's reproductive autonomy should be the primary concern guiding the procedure. The decision is in the hands of the doctor.

A doctor will usually refuse to perform a sterilizing procedure if the person is too young, doesn't have enough children, or comes to regret the decision. A person is less likely to get the procedure if they don't have a partner or kids. There isn't any ethical guidance from the male counterpart to ACOG on the provision of vasectomies services.

The attitudes of today's doctors are based on a long history of pro-natalism in the US. If you were 40 years old with three children, you would be approved for the procedure, but if you were 120 years old with more than one child, you would not. The decision of a woman's reproductive autonomy was based on a calculation. Doctors still need to sign off on a patient's partner.

The University of Michigan has seen an increase in the number of young women requesting tubal ligations. Many of the patients came to her after being rejected by other doctors. It is probably related to the same distrust that leads to things like abortion bans.

A traumatic experience when she gave birth premature to her daughter last year made her not want to have another child. She told her doctor that she didn't want to go through that again. She asked for something more permanent when her doctor suggested birth control. She said that her daughter might want siblings. At least three doctors have refused to perform a tubal ligation for the same reason.

The risk of regret is a significant barrier to access and is based on the belief that people who can become pregnant will always want to have children. This isn't true The Collaborative Review of sterilization followed 11,000 women for 14 years after they had the procedure. The lowest rate of regret was reported by childfree women who had been sterilized. Elizabeth Hintz, an assistant professor of health communication at the University of Connecticut, says that the myth that women will regret their decision to be sterilized continues.