Sterilization is a safe and effective form of permanent birth control used by more than 220 million couples around the world. Despite its prevalence, however, patients seeking sterilization from their doctors often face a surprising number of challenges.
In men, the sterilization process is known as a vasectomy, which involves severing the tubes that carry the supply of sperm to the semen. In women, sterilization involves a procedure called tubal ligation. In this form of permanent birth control, the fallopian tubes are severed – or ligated – preventing eggs produced by the ovaries from traveling through the fallopian tubes to fertilize an egg. Vasectomies and tubal ligations can be reversed in some cases, although success rates vary widely.
A 2018 study found that female sterilization is the No. 1 form of contraception in the U.S., used by nearly 1 in 5 women ages 15 to 49. And a partner’s vasectomy is the fifth leading contraceptive, relied on by 5.6% of women in that age group, after birth control pills, male condoms and intrauterine devices, or IUDs.
I’m a scholar of health communication with expertise in women’s health issues and interactions between patients and doctors. My work explores how patients manage the stigma associated with seeking sterilization and communicate with others about their reproductive decisions. My research also illuminates why patients find talking about sterilization with their doctors so challenging.
Ethical guidelines from the American College of Obstetricians and Gynecologists recommend that doctors should respect a female patient’s wishes as a matter of “reproductive justice” when deciding whether to approve their request for voluntary sterilization. The American Urological Association, on the other hand, does not appear to offer ethical guidelines concerning the provision of vasectomy services for male patients.
Yet research has documented that patients seeking sterilization procedures, especially women, are sometimes told that their doctors will not perform the procedure because of the person’s age, number of children or potential risk of regret, among other factors. Providers may also refuse to perform sterilization procedures for other reasons, including fear of legal culpability, backlash from the medical community or conscientious refusal. The latter means that a doctor cannot be compelled to provide a medical service that goes against their best judgment or personal convictions.
This hesitancy to approve sterilization requests reflects the tension over forced sterilization in the past.
Perceptions of sterilization in the U.S. have been marred by a dark history of eugenics, in which racist ideas about who ought to have children have shaped reproductive policies and doctors’ reproductive counseling. And these views have given rise to the term “voluntary” sterilization, meant to contrast with the “involuntary” – or forced – sterilization of earlier decades.
From the late 1800s until the late 1940s, eugenicist movements sought to preserve racial purity by limiting the breeding of people who were considered “unfit” and promoting the proliferation of those who were white and of European descent, from middle or upper classes and considered able-bodied and of sound mind. Widespread federally funded involuntary sterilizations continued in the U.S. until 1979.
In contrast, women who were poor, disabled, immigrant, Black, Hispanic or Indigenous who sought to have children often faced coercive or forced sterilization, sometimes without their consent or knowledge.
…continued
swipe to next page
For more latest Health News Click Here