On Sterilization and Future Regret

Laura Carroll, Childfree Choice

A recent Slate article by Bryan Lowder, titled “Sterilize Me, Please: Why Is It So Difficult For Women to Get Their Tied?” gets at one of the most frustrating experiences for many childfree women who want to choose permanent birth control. I can’t tell you how many emails I have received from childfree women who were having a hard time finding a doctor who was unwilling to do a sterilization procedure, whether it be a tubal ligation, essure or adiana. All too often docs say the women will regret it down the road. But do they? Here are some numbers.

According to a  Collaborative Review of Sterilization (CREST) study:

–There is a 12.7 percent probability that a woman will express regret within 14 years of sterilization.

–For women under the age of 30 at the time of the procedure, there is a 20.3 percent probability that they would “eventually want to take it all back” (compared to only 5.9 percent of older women).

The study does indicate that there are certainly other factors that can predict regret, including “partner/doctor pressure and disagreement among partners about the procedure.”

But overall, the CREST research shows that for women, sterilization at a young age is the strongest predictor of regret.  The “trend” supposedly also holds true for young men getting vasectomies.

My initial reaction to these numbers was – this is not what I hear from childfree men and women of all ages who have gone through a sterilization procedure.  Childfree men and women who want to opt for this birth control method are very sure about not ever wanting children and don’t change their minds about this.

There are studies that support this – like a report that appeared in the journal Obstetrics and Gynecology. The study found that only about 7 percent of women experienced regret within five years after their own sterilization, and only about 6 percent of women regretted their husband’s vasectomy.

What do you see out there – do people, especially those under 30 who undergo a sterilization procedure end up regretting it? Do you have a story to tell?

Regret or not, many women feel they experience discrimination, but the docs don’t see it that way. They seem to regard it “as protection against future emotional pain.”

As Lowder says, this rightly “raises the question of whether a medical professional has any business worrying about a patient’s hypothetical future feelings in the first place”…Is the physician who performed the ligation on a 24-year-old responsible for her potential 35-year-old heartache?

I say no.  She is of adult age and should be left to make her own decisions about her own life. You?

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14 thoughts on “On Sterilization and Future Regret

  1. I never wanted children, even as a teen. I would have loved to have had my tubes tied back then, but of course no doctor would do that. I also had endometriosis and had terrible cramps and wanted a hysterectomy since I knew I would not want to use any of that equipment so why go through all the pain every month? (I’ve since learned about the hormone issues so I’m glad that didn’t happen.) Finally in my mid 40s I was able to get my tubes tied after documenting spotting, etc., for a year. No one could have been happier than me, and my sex life continues to improve. I think that, even though I was on continuous birth control, somewhere in my subconscious I wasn’t allowing myself to fully enjoy sex because there was still that small chance of conception. It’s a shame that I had to wait till 44 to finally be “fixed”!

  2. I was voluntarily sterilized last year at the age of 36 and I have absolutely no regrets. I first asked my pediatrician if I could have a hysterectomy at age 12 (I just knew it meant you couldn’t have babies), so this is something I had been thinking about for a long time. A doctor refused to even discuss it with me when I was 25, and again when I was 30. My current doctor was not too keen on the idea at first, but after asking her about it several times, she finally accepted that I was serious and was not going to change my mind. In all cases though, I felt like the doctors, both male and female, were very patronizing about it. If I am asking for a safe and legal medical procedure, the doctor should not question my motives or my ability to understand the consequences of the procedure. As a 36 year old, highly educated professional woman, I knew what the consequences were and that it was exactly what I wanted, but I knew the same at age 30, age 25, and probably even at age 12. Granted, 12 is probably too young to make such a decision, but once a woman reaches the age of majority, she should be taken seriously about such things and not treated like a child.

  3. “Is the physician who performed the ligation on a 24-year-old responsible for her potential 35-year-old heartache?”

    I say no as well. They are no more responsible than plastic surgeons are when a former (adult) patient regrets getting breast or cheek implants. Although I really do feel for the small percentage of men and women who regret this choice, there are other options, such as adoption or fostering, for those who want the experience of parenthood. Not being able to have a biological child is far from the end of the world, and we need to stop treating it as though it’s a tragedy.

  4. Do doctors ever ask IVF patients if they will have any “regrets” about their life-changing and irreversible decision to have children?

  5. It would be interesting to see the percentage of doctors on either side of this discussion – those who refuse to discuss it as an option depending on age range, and those that trust their patients to decide for themselves. My partner wishes he had done it sooner.

    1. Everything I read and hear is that most, even by far most docs, are reluctant for those who want it at younger ages. If the woman is already a mother maybe less so. Also would be interesting to see if there are differences in what docs think and do re men and women. Easier for men to get vasec when they are younger for example?

  6. I also agree that the physician who performs the surgery is not responsible for what the patient may want years later. Looking at the complements of the statistics, nearly 90% of women DON’T regret their sterilization within 14 years — nearly 80% of those under 30 at the time and nearly 95% of those 30+ at the time. In other words, in most cases the doctor has no cause for concern. Why should those supermajorities of women have to pay the price for the small numbers who do change their minds?

    I would also be interested in knowing how many children the women in the study had — what is the rate of regret for childfree women in contrast with women who might have liked to have more children? I have a relative who conceded to a tubal ligation after her fifth child, and she speaks of it with great sorrow. I, on the other hand, am still gleeful about my tubal (and my childfreedom) all these years later.

    1. I.Am.Free–I too would like to see research that breaks out regret e.g., childfree women and those who have children and don’t think they want any more, and those like you describe – they do it but with sorrow or similar emotion. Feelings do change over time and it would be interesting to track that over time.

      I am doing this with a group of childfree women over a period of 10 years. It is not a study about regret, but designed to track their childfree status over the course of a decade to learn more about how feelings change…or remain the same, and everything in between!

  7. Part of the issue for doctors and patient regret is the legal liabilities hanging over their heads. Anything medical having anything to do with pregnancy or fertility or birth is a huge lightning rod in terms of medical malpractice, even when the patient really has no grounds for complaint. If there’s a jury out there that may get to hear how you, the evil doctor, sterilized someone who now wants a baby, the trial lawyers see lots of dollar signs in their eyes, and the clinic’s business planners see the possibility of total destruction. You will never see a doctor sued for refusing to sterilize someone, but you will see doctors sued for any and every kind of “bad outcome.” You’ll see obstetricians sued just for the fact that a baby was born with birth defects, even if the doctor did everything right. The system generally bends over backwards to give women babies if and when they want them, on demand, hell or high water.

    I don’t understand why a thick legal waiver isn’t enough. Why can’t the doctors just cover their butts with paper like everyone else does? If the patient wants a tubal ligation, make the patient sign something that says she fully understands the risks and takes all responsibility for the outcome and if she regrets it later she won’t sue the doctor.

    I tend to think that even if 99% of the people experience regret after doing it, if they made the decision with all the facts available and made the decision willingly (and were adults), then that doesn’t mean it was the wrong decision. It doesn’t mean that no one should be allowed to make that decision ever again.

    What are we now, a society that is deathly afraid of doing something regrettable, so we have to avoid regret at all costs?

    1. Excellent! Now we just need bigger studies beyond a handful of childfree…I am giving one a whirl. I am in year 3 of a longitudinal study of 40 childfree women (who were in their 20s at the beginning). I am interviewing them once a year for a decade to track their lives and childfree choice.

  8. Laura, whenever I post on abortion debate boards, there’s usually some anti-choice poster (or more than one) who make the false claim that it is “easy” for those who don’t want children to obtain a tubal ligation or vasectomy. I’d love to see more CF folks on this type of forum telling them that these claims ARE false, based on their personal experience.

    If you know of forums that discuss this topic, where both parents AND childfree folks are both on the pro-choice side, please let me know. I’d love to “explore new horizons.” 🙂

    1. Boy is messaging that it is easy for the childfree to do sterilization inaccurate! I have not run across site (s) where parents and childfree are talking trouble with sterilization….but that does not mean they aren’t out there! Have your run across stories where docs give mothers a hard time for wanting a tubal? My hunch is some would give them the same thing as the childfree – the regret talk – if they had not had say 2+ kids already. I bet You would be that mom of one wanting sterilization would get grief from docs, yes?

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