I didn’t say I agreed with it. I was just pointing out to Catsix that The Bible is one in which it would disapprove of having “the absolute right to self-determination”.
- I’m not particularly crazy about (mostly) irriversible for birth control, however you should be able to have one if you should want it. But you have a medical condition that seems to justify it.
- I understand that doctors may think you’d regret it, but if you’re 30 and still the “I-wanna-have-kids” gene hasn’t kicked in it won’t.
- There are too many 40 year-old women who pay money to have kids after a life of not wanting them, so maybe the doc’s trying toavoid litigation 10 years down the road.
Having said all of this, a well-written consent form should ease any legal fears.
I was not addressing your part, I was addressing Lamia’s and other’s posts about the procedures being denied to people who already had kids (even apparent medically indicated histerectomy). I was suggesting if that was something that varied by culture, since in some places, female sterilization is more common and apparently less denied and less of a hassle to get than in others.
There are several issues being conflated here.
The first: Should an adult woman have absolute authority to decide she wants to be permanently sterilized? That answer is easy: yes, she should.
The second: Should a physician be required to perform a procedure she/he does not think is in that patient’s best interest? That answer is easy: no, she/he shouldn’t.
The third: Should it be easy for a patient to get a procedure done if that procedure is medically available in general? That answer is easy, too: yes, it should be easy, and the fact that it is not is frustrating, I agree.
I think sterilization should be readily available to all, with a simple process that defines the patient as the one held responsible for the decision and a straightforward consent process that eliminates any physician-side culpability for the physiciand (and I don’t have the sense that litigation is the big concern, anyway).
I understand the annoyance of those of you who don’t think the physician should be making decisions for the patient. When it comes to procedures, though, it is different (like it or not ) and the physician’s judgment is usually based on quite a broad experience with patients that tends to reinforce that judgment. So it is perfectly fair to say that you as an individual, rational woman are suffering from being lumped into your larger cohort.
Consider a (very limited) analogy: Your adult friend or perhaps your adult child may want you to do something for them. You think it over and you decide you are not going to do it because you unilaterally think it is unwise for them to do so. Your experience has been that too many people undertaking that particular decision have regretted it. Your advice to them is to partner with someone else. You may be wrong but that doesn’t mean your motivation is suspect.
In the long run it’s less expensive for someone who never wants kids to pay 2500$ for Essure at 25 and not by 30 years worth of birth control pills at 30$ a month. At 34$ a month (which is what I pay), birth control pills from age 25 to 55, if the price never changes, is 12,240$. More than twice as expensive.
The job of protecting a person from doing something they will regret is supposed to be performed by that person’s parents, and it’s not supposed to continue once that person is an adult.
You do realize this sounds exactly like ‘You don’t know what you want until you are with a man who can help you figure it out.’
Nine years ago I was in a relationship with a man and the topic of marriage and kids came up. He wanted kids. I broke up with him so that he could have them. This decision that I made was not whether or not I want children, it was how to go about ensuring that my unwanting of children was best acheived.
It does not, in any way, depend upon what any man wants. It is, in fact, the first and most immediate deal breaker.
I was once in that situation, the ‘nice man who wants kids’. I never seriously considered having them. It was more of a case where I knew what I had to do, and I ended the relationship.
If my doctor brings up the bible at all they’re fired.
Essured, thank you for bringing some actual numbers (and context for the 20% number) to the thread. I was about ready to scream with all the assumptions without cites going on!
So, Chief Pedant, assuming that the 5-6% regret number (which unfortunately still doesn’t differentiate between, “Oh, well, I suppose maybe kids wouldn’t have been so bad…” and “OMG! Essure RUined my LIFE, WTF was I THINKing?!”), do you think doctors are correct in withholding these procedures as the general rule?
How does the 5-6% regret number compare to the percent of people who regret *having *children, I wonder? Do infertility specialists have any sort of process for determining whether or not the people seeking their procedures are unlikely to regret their decision to have children?
Fact is, you’re going to regret some things in life. Some of the things you do in life that you regret are going to be aided and abetted by other people. I still haven’t heard a good reason to not at the very least establish a screening process to help separate the catsixes from the whimsical.
And please remember that we’re not all calling for legislative action forcing compliance here. I for one would be delighted if the aforementioned Boards simply made a recommendation of specific counseling and/or rubric for appropriateness of the treatment other than Woman => Protect Fertility At All Costs. That’s the sexist part - assuming that all young women who say they don’t will eventually change their minds and want to bear babies (not be parents, but bear babies) when the statistics seem to show that only 5-6% of them do.
Remember when they used to do the same for men with prostate cancer? When they’d do everything they could to remove only part of the prostate, so that his potential fertility would go on, even if it meant that they missed part of the cancer and he died as a result? Yeah, they don’t do that anymore. They don’t value his ability to be a biological parent over his health. Why are they still doing it to women? (And yes, I realize that oncologists are not obstetricians, and “they” is a category broad enough to warrant a tinfoil hat here, but surely the change in one field means that change in another is not impossible or impractical.)
If there is a general rule to be made based upon statistics it would stand to reason that we base it upon the 94-95% who do not regret a decision they made as an adult of sound mind. And by ‘decision’, I hope that all the others in this thread understand that my decision was never whether or not I wanted kids, it was how to go about ensuring that I don’t have any.
I would think that there is a process somewhat better than ‘Come back when you are 35 or 40, married, and have two kids.’ I can understand ‘Go home and think about this for 6 months, and if you are still sure, we will do the procedure.’
It’s not a whim for me. Whims don’t last through twelve years of active searching for a doctor to perform the procedure.
You’re right, somehow the board that oversees gynecologists and obestetricians should be able to come up with a process that they can use to determine that is not some spur of the moment decision I made while drunk and/or high. (Which is exactly how some people become parents.) I think though, whoever said that the fact that these are obstetricians who do these procedures hsa bearing on their willingness to do it was right.
They make a lot more coin off me if I pop out some kids than they do if I get fixed. Also, I can’t imagine they went into obstetrics because they dislike babies, so there is a lot of baggage there. They focus so hard on helping people to reproduce that they are unable to wrap their heads around the idea that fertility is something some of us see as a big problem.
If someone contemplating this decision wants your opinion, they’ll read it in your entrails.
Stands, claps, cheers.
It’s my mother who had the hysterectomy refused when it was medically indicated.
To be clear, she was also refused a tubal ligation (because she might need to ‘replace’ either existing child) even though the same GYN told her she* should not *have more children as my birth had been so difficult.
It was based on the fact that she was young (21) and ‘only had two’ children.
I asked about sterilization in my early 20’s and was told to wait until I was over 30. At 30 I was told to wait until I was 35. At 35 I’d had an unplanned child - none of the doctors have taken any responsibility for her upkeep.
If I’d tried harder I might have found a doctor willing to do the procedure, I know of women in their mid-late 20’s who’ve managed - they were all put through the ringer and told all the same crap that’s gone on here. You’d better believe they don’t regret their decision after having been through so much psychological abuse by the people who’ve take an oath to ‘do no harm’.
While I love my kid unreservedly, acceptance is not the same as choice. Had I not had my child, my life would have been different, there would be drawbacks (and regrets) and advantages to either situation.
I fully support anyone’s right to decide on their own fertility.
I am not an Ob-Gyn myself, but if I were my personal position would be to sterilize everyone who asks that it be done, assuming there was no strong evidence they weren’t a nutcase. I come down overwhelmingly on the side which says the patient should decide, and I don’t really personally care if they regret it or not. My personal opinion would not be different if the number was 50%, I don’t think, as long as the patient was given the information about the high incidence of regret.
I think, as I said in earlier posts, that the principal reason so many Ob-Gyns are reluctant is as much tradition as anything else, along with the various other reasons advanced. In my opinion they are generally well-meaning but wrong. Wrong in their perception of how common regret is, and wrong in the tradition of trying to make the decision for the patient.
Thank you for your answer.
So you believe someone should be offered irreversible sterilization at the age of 18, based on nothing more than “I don’t want kids”?
No. It works both ways. Indeed I imagine it is far more common for "committed childfree’ men to change their mind based on new relationships. In committed relationships priorities change and you start taking your partner’s desires into consideration and making decisions together. Since the majority of people do want children, to have preemptively and unilaterally made this decision could cause problems.
Again, I think this procedure should be available and there should be a clear and reasonable set of guidelines for when it is offered. But I think there are some good reasons why other options should be thoroughly explored first, just like they are for any other surgery that has major lifestyle implications (sex changes, weight loss surgery, etc.)
Why not? They can give birth to an irreversable child based on nothing more than “I just felt like having a kid.”
Or they could have an irreversible child based on being on antibiotics, getting drunk, being lied to about their partner’s fertility, rape, forgetting the pill, condom failure etc etc.
If someone feels strongly enough to get sterilised, why can’t *their *partner take that desire (not to have children) into account? Because it’s more common? So? Globally it’s more common to raise children in abject poverty, but I’ve still cooked dinner for my well dressed and (relatively) affluent child.
What basis (apart from 'I imagine") are you using for the probability of men changing their mind about wanting kids more than women?
I agree that the other partner’s desires are taken into consideration in a good relationship, but everyone has deal breakers. Some things are up for negotiation and some things just aren’t. This usually isn’t a mere preference, where the ‘right guy’ might make me rethink it.* This is a serious non-negotiable issue, where he just isn’t the right guy if he isn’t ok with the fact that I’m sterilised.
*Hypothetically. I’m actually married. But it’s the same thing. If it was an issue, the marriage would’ve ended (after he tried counseling) - the sterilisation would still have gone ahead.
I’m not sure what you mean by a “set of guidelines for when it is offered”. What guidelines are you thinking of? Sterilisation isn’t “offered” to young women. And definitely not “offered” to young childless women. It’s not something that is being pushed onto people and we need to be concerned about restricting how it is “offered” to them - it’s something that a small minority of people are actively seeking and being continually denied.* Mainly through misconceptions and prejudice (in my opinion).
*In general - I got mine done quite easily.
Sure. And once the other options have been tried, or discounted as unsuitable for various reasons, then what? Well, then we’re right where we are now. Unless you think people who are trying to get sterilised aren’t already aware of the most common and effective methods available - they’ve just one day decided to get sterilised?
I won’t ask any SO of mine to share or practice my religion. But I demand that he respect it.
I won’t ask any SO of mine to share my dietary restrictions and will respect his, whether they are for medical reasons or a matter of taste. “My milk and your milk” isn’t a problem. But if he ever makes a derogatory remark about lactose-free milk, he’s out the door so fast there will be a sonic boom.
I’ve never filtered my SOs by income or training. But anybody who started making plans for “when I am rich and you can stop working and raise our kids” never got another date with this engineer (nobody gets through engineering school because of “not knowing what else to do with her time”).
Why would “one absolutely requires bio-kids and the other absolutely doesn’t want them” be a situation where the second one must bend over? It seems like breaking up is very much the most sensible solution.
I can see valid medical reasons for not immediately agreeing to sterilize a person without first knowing their full medical history and assessing their competance to make such a decision. So, my answer to this would be that it depends on the 18 year old. Two hypotheticals… Woman A has a long history with her doctor, is now the age of majority, and has decided to be sterilized due to a serious genetic illness that runs in her family. She should be given this option with little barrier. Woman B has no relationship with the doctor, seems to be mentally distraught and is making the decision after a traumatic personal event. In this case, I would suggest a doctor using his/her discretion to suggest postponing the surgery would be a valid medical assessment. I would not argue that doctors have their medical discretion completely removed. However, at a certain point – like in Catsix’s case – it does get a little ridiculous. This, I think, is where the line between medical discretion and unsupported biases and misunderstanding about women is crossed. Why can’t we have a clear assessment criteria that doctors are trained to follow? And, this criteria should not be “come and see me when you’ve got two kids or hit 35”.
I would never, ever be in a serious long term relationship with someone without them knowing from the onset that I do not want to bear a child. My decision to not bear a child is no more preemptive and unilateral than people who decide they want to have kids and make this a priority in selecting a partner. Would you expect someone to not have a child they have always wanted just because their partner doesn’t want one? I wouldn’t, just as I would expect my partner to not force my hand into bearing a child just to make them happy. I have vetted, and will continue to vet, my partners on how seriously committed they are to biologically reproducing. My decision is very much a fundamental aspect of who I am, and to admit anything other than this would be deceptive and downright manipulative.
It totally doesn’t. But it’s nice to have the option to work it out and choose together. People do some extreme stuff for love. Sure, maybe you won’t. But people do. People move to new countries for love. They change religions. I’ve seen straight guys go gay and gay goes go straight because they fell in love. Who knows what crazy stuff lies in your future? If there are options that aren’t cutting out possibilities, isn’t that a better plan? We already lose so many options and futures every day that passes. It just doesn’t make sense to me to further limit your options in life except under the most dire of circumstances.
Anyway, I gotta bow out on this. I’m said my piece and I gotta admit that I don’t really have strong feelings either way. I’m very child-agnostic and can’t picture abhorring the idea of having kids any more than I can picture seeking it out. My position is not that the current situation is reasonable, just that I can kind of see the rational behind it and I think we need to come up with a better model based on equivalent procedures. I really don’t think that is all that different than what you all are arguing.
That is generally the driving reason behind irreversible sterilization.
You seem to misunderstand the choice I made. I never decided that I don’t want children. I have always known this in the way that I have always known I am straight, and an atheist. I could no more have a relationship with a man who wants kids and is unwilling to bend on that issue than I can with a woman or a religious fundamentalist. What you imagine aside, kids are not something anyone should have because of a compromise.
So then as long as the hypothetical 18 year-old woman remains childfree for a year and still expresses a desire to remain so for the rest of her life, she goes under the knife?
And that’s why I’ve brought it up early in every relationship. Once, I didn’t, and there was considerable pain in ending that one. After that, my childfree stance was front and center. I’d make it clear that if the guy wants kids, or even wants the possibility of kids, he should find someone else.
Choose together? This is not something that is an option for me. It’s no more an option than being straight or an atheist. Nice to have the option? There is nothing nice about the fact that I have spent my entire sexually active life dreading an accidental pregnancy and having an emergency plan in place to get to a doctor for an abortion.
The fundamental disconnect here is that kids/no kids were not two options that I chose from. My entire life I have always just known that I did not want anything to do with having any kids. I just know this.
On the contrary, I believe someone should be given irreversible sterilization at the age of 18 based on nothing less than “I don’t want kids.”