Docs Tell Mom She’s Too Young for Tubal
At twenty-one, Tarrah Seymour is pregnant with her second child and says she doesn’t want anymore. But doctors have told her she’s too young to decide for herself.
The married Canadian mom has been denied a tubal ligation by her doctors, who say they won’t even consider it until she’s twenty-five.
So much for “our bodies, ourselves.”
This is not a uniquely Canadian problem, as I’ve heard it from several women here in the states. Both women who have kids and don’t - and that includes women closing in on forty.
When they’ve started talking to their OB/GYN about the possibility of shuttering the baby factory for good, there’s either been the outright refusal (limited to the women who are “too young” in their doctor’s minds) or extensive lecturing on what this could mean for them. Because we ladies apparently can’t figure that out for ourselves.
By contrast, my husband’s decision to have a vasectomy (at thirty) was met with the words “OK, we’ll get you a referral to a urologist,” by our general practitioner and very basic questioning by the specialist: “have kids?” Yes. “You know this is extremely hard to reverse and extremely costly?” Yes. “OK, let’s look at the schedule to see when we can do this.”
Perhaps his experience was unique, but the degree of difference between that encountered by a male in my life versus the women I’ve met makes for a disturbing look at the gendered approach to healthcare. Women may be considered “women” rather than girls once we’ve hit eighteen, but we’re still being treated as though we’re little kids.
Take Tarrah Seymour. She and husband Adam Sylvester have their lives mapped out. They’ve both been through the proper training to become police officers Once she’s had their second child (she’s five months along right now), she plans to go to work while Adam stays home with the kids. When they feel the kids are “old enough for daycare,” Adam will follow her into policework. They have plans to save money for a house, put some aside for college.
And they purposely chose early parenthood - this was no accident. Sounds like they’ve got their heads on straight. So why won’t her doctor trust Seymour’s decision about her own life?
He says he’s seen too many women make the choice for sterilization this young. He doesn’t believe it can be made this way. But he’s not her, is he?
I agree that the finality of sterilization calls for extensive education of the process - be it for a male or a female. Perhaps even calling in a counselor (to assess mental health rather than try to talk a patient out of the procedure) is in order - similar to the evaluation required prior to plastic surgery.
And that’s where it should end. Because this isn’t a doctor’s body. It’s that woman’s. Putting some one-size-fits-all requirement on women does not address the variety of situations that the variety of women will end up in.
Like a wife and mom of two who says “I’m done” at twenty-one. Or the young unmarried mom of two from two different fathers who I know - who made a similar request to her doctor because she knows she can just barely support two kids on her own . . . only to be denied for the same reason (and, yes, she ended up pregnant again, with yet a third absentee father). Or, better still, the woman who has known from day one that she never wanted children . . . who will be childless for the rest of her life, no matter how she has to make that happen, but would like to make it a heck of a lot easier (not to mention save money on condoms or save her body from years of hormone pills).
Could it be a mistake? Maybe. But that’s her mistake to make. And it’s up to her to decide if it really was one.
Image/Source: CNEWS
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Tags: C-section, Cesarean, Jeanne Sager, pregnancy, sterilization, tubal ligation, vasectomy, woman's body, women's body, young parent
21 Comments
Sara commented on Jun 15 09 at 10:12 amI have mixed feelings about this. On the one hand I agree that it’s the woman’s body, and it should be her choice. In theory. On the other hand, if you go to infertility message boards, you will see a shocking number of women showing up in cyber-tears as treatment after treatment fails to reverse the effects of an ill-advised tubal ligation or vasectomy. I think that serious counseling should be offered to adults of both sexes seeking this type of procedure to make sure that they’ve really thought through the implications of permanent sterilization.
I had a friend who knew at age 20 (when I met her) that she didn’t want children. Now she’s 40 and never had children. She told me at age 20 that she’d get a tubal ligation in a second if she felt like she could trust the doctor, but thought that any doctor that would permanently sterilize a healthy childless 20-year-old was a quack, and shouldn’t be allowed anywhere near her body with a scalpel.
Mistress_Scorpio commented on Jun 15 09 at 10:27 amThere is clearly bias in many people’s minds about who can make decisions for a woman’s body. It is first, last and ALWAYS the decision of the woman. Her body, her say and her consequences.
Angi commented on Jun 15 09 at 11:11 amIt is her body. If she wants her tubes tied then that should be HER choice. I am almost 33 years old and I had mine done just after having my daughter last March. BEST decision I made…for me.
Hillary commented on Jun 15 09 at 11:18 amHer body. End of story.
Laure commented on Jun 15 09 at 11:42 amI would imagine the doctors’ attitudes comes from lawsuits. People will get sterilized, and then complain years later that their doctor did not give them enough information, and they should have had more counseling.
I hear so often in the news that doctors should have told more women that they would have trouble conceiving if they wait until after they are 35, so I take this to mean that they should be actively telling women to start getting pregnant earlier. I see this as intrusive, but doctors are getting forced into this practice.
If you look at anything that doctors do that might seem strange, it is almost always because of crazy lawsuits.
Twyla commented on Jun 15 09 at 11:48 amAre these same doctors wanting these women to get pregnant and abort? That to me seems riskier emotionally and physically.
My doctor pressed me to have a tubal and it is a procedure I regret. I feel powerless over my body and I felt coerced to make a decision. My doctor told me that after 3 c-sections the risks were too great to have a 4th. I don’t know if his information was correct. I just believed him. I was 25 and he is regarded as an excellent OBGYN so of course his word was like gold, right?
leahsmom commented on Jun 15 09 at 12:50 pmIf a woman makes a medical decision she’ll regret, most of the time, doctors don’t bother to discuss it or counsel her. You want a boob job? Great, we’ll schedule you for one - without counseling, and without denying you, even if you’re 18, and even if years down the line, you may regret it. Pregnancy is risky for some, and can be dangerous and alter your health for life. Most pregnant women aren’t made to justify that decision, or to be told they’re not allowed to get pregnant because they might regret having kids. The only place I know where people are denied treatment in this way is transgender sexual reassignment surgery. Regret isn’t the worst thing that can happen to a person - and accepting that your choices might have consequences you later regret - that’s part of life. Doctors have no right to decide that regret is more important than health and financial security for women, or that they can single-handedly prevent it.
PlumbLucky commented on Jun 15 09 at 1:08 pmLet’s see…I had one friend fight with her doctor, at age 25, to get a tubal, as she “only” had two children, she was “only” 25, and what would she do if one of her children tragically died? (WTF kind of argument is THAT?) She eventually “won” but had to go back in instead of having it done prior to discharge after delivery of her youngest.
Another friend, who at 24, had a three year old and twins…and fought for a tubal. And likewise, had to go back in because they refused at the time.
Or the friend who is so severely ill during both of her pregnancies that she was on bedrest for six to seven months each time, and nearly died during both deliveries - and she had to argue with the doctor then too because she was “too young”.
Give them the information and counseling, then sign a waiver. Last I checked, the Dr. isn’t the one going through pregnancy, labor, delivery, and then raising the little scutters….
PlumbLucky commented on Jun 15 09 at 1:08 pm(And I might add - that was three different hospitals and three completely different medical practices, not the same hospital and not the same doctor.)
Shana commented on Jun 15 09 at 2:15 pmI am sure a lot of this has to do with lawsuits and a mix about societies feelings toward female fertility. There are women out there that decide at twenty that they never want to have children and then they change their minds, but many also never ever want to have kids. Here in New York a man managed to get millions from the MTA, because he got drunk and fell onto the tracks and lost a leg. You may say that that is different than a woman making decisions about their bodies, but in the end they are very much the same as far as lawsuits go. People make decisions that they regret and then they blame someone else and a lot of juiries will go along with that. I think that if a lot of doctor’s felt that they would not have to worry about lawsuits and if tubal ligation was easier to reverse, this would not be an issue at all. But unfortunately the world is not that simple.
I totally agree that this woman should be allowed her sterilization. But I can totally understand why some doctors are reluctant to do it. I have a friend right now that is a year older than me and has told me several times that she does not want kids. Many of our other friends have kids, but for some reason my pregnancy has resulted in questioning whether or not she wants kids. But then again, she never considered sterilization.
Brett Singer commented on Jun 15 09 at 3:04 pmIt’s insane that a doctor is legally allowed to do this. I suppose since it isn’t medically necessary surgery, there’s no legal aspect. But if a doctor ever told me I was too young for a vasectomy, or told my wife she was too young to have her tubes tied, I would lose it.
ChiLaura commented on Jun 15 09 at 9:05 pmThis is really interesting. I actually don’t “support” sterilization except in the most extreme circumstances (like the 7 mos bedrest and almost-death above — yikes!), BUT, I think that it seems weird that it’s so easy to, for example, get an abortion (end a life) but not to prevent one. Weird, right? I’d support mandatory counseling before sterilization (for men and women), but I am much more of the line of “it’s her body” on this one. And maybe it seems heartless, but I guess I think that if a woman wants to reverse it later and can’t, well, too bad. If you give a gift like fertility away, you’ll be lucky to get it back.
ChiLaura commented on Jun 15 09 at 9:07 pmOh, I also know of a friend of a friend who had 4 kids by age 30 and had her tubes tied. Now, a couple years later, she wants it reversed, not even because she actually wants another kid right now, but in case she *might.* Maybe she also has some problems with the permanency of ligation? All of which is to say nothing more than, you never can tell.
Sara commented on Jun 16 09 at 8:35 amI agree that in the end it’s nobody’s choice but the woman’s, and think that age by itself shouldn’t be a factor, but I also think that some doctors are a irresponsible when it comes to the “informed consent” angle of things, especially with vasectomies. Also, it might not only be about lawsuits. For example, a surgeon that both does tubal ligations and reversals of tubal ligations is likely to feel upset when a patient comes to him/her in tears and says that this elective surgery was the worst mistake that they ever made. Maybe that affects their behavior the next time a patient walks into their office wanting a TL. Doctors are people too.
LFH commented on Jun 16 09 at 11:04 amThe same thing happened to me @ 27. Because I had no children, I was refused by 3 different doctors. I am now married & have 1 child whom I love dearly, but that pregnancy was unintended. We were planning for zero, and while our lives would have been very different without our son, we would have been happy under those circumstances as well.
Lulu commented on Jun 17 09 at 2:43 pmNuts. With counseling, let her decide of course. Make her sign some sort of form acknowledging her choice even after being counseled. THis is sort of the opposite of what happened to me. My last pregnancy was really rough and I was hospitalized for a week befire delivering at 30 weeks. Baby and I are ok now, but it was rough. My husband asked both my ob and our family doc about a referral to get a vasectomy and they both balked (my husband is almost 50. We already have 2 kids) they both suggested instead that i get my tubes tied or an iud or go on the pill. It was weird–was it b/c they are both guys and didn’t like the idea of another man getting snipped? It was weird. after this difficult opregnancy and the emergency c-section, the last thing i want is more drugs and or more surgery. My husband is very happy to get a vasectomy to make sure I and our family do not go through the pain and terror of this last pregnancy. It was just so weird that they were discouraging him from getting sterilized but pushing me to do it. I guess maybe it was b/c i f I don;t want to get pregnant, the only way to really ensure that is for me to get sterilized, but still.
beep commented on Jun 19 09 at 1:40 pmOn the other hand, life is long and people often do change their minds about things as they mature. I don’t think 25 is an unreasonable “age of consent” for sterilization procedures–young enough that it will save years of contraception and anxiety, but old enough to have settled into adulthood, tested out adult relationships, had experience managing a household, etc. Of course, whatever guidelines are in place should be similar for men and women, and it shouldn’t be up to individual doctors, but to groups including doctors and consumers, to make the call about what the guidelines should be.
Kat commented on Jul 20 09 at 8:56 pmI have a friend who got her tubes tied at 19. She suffered from a severe genetic disease, and didn’t want to pass it on to any offspring, plus it would have been very risky for her to go through with a pregnancy.
There are certainly situations where a young woman should be allowed to request a procedure like that.
Christina commented on Jul 27 09 at 6:20 pmAs a physician, I would like to raise an additional point: that tubal ligation is not actually the most effective option in preventing further pregnancies. Compared to intrauterine devices (IUDs), tubal ligation is more risky to the woman’s health, more costly and associated with *higher post-procedure fertility rates* than IUDs. Though I heartily agree that there are unfortunately many physicians out there who do not respect women’s wishes and decisions regarding their own fertility, the point was not raised in the article is that tubal ligations are often ineffective, especially in young women in their 20s, with up to a 10-15% lifetime risk of pregnancy following the procedure in this population. I would have counseled the young woman in the article - as I counsel all my patients who desire tubal ligation - that IUD placement is a much more effective and safer option than the surgery. (Of course, if tubal ligation is still the method of birth control she desires, then I’ll perform her tubal ligation - but IUDs, especially in younger women, are *much* more effective and have the added benefit of being completely reversible if she does, in fact, change her mind later on down the road.)
Kate commented on Aug 14 09 at 9:01 pmMy husband and I had always wanted three children. Our first baby when I was 28. Our next son was born when I turned 30. Everyone in our lives encouraged us to stop at two. I was miserable being pregnant. Swollen and sick all the time. And both babies had to be delivered by c-section. Everyone said that we should be happy with our two healthy children. That as teachers, we would be lucky to afford the two we already have. I had my tubes tied when #2 was born. As soon as it was done, I knew it was a mistake. In addition I began having all kinds of hormonal issues. Worse PMS and feeling unbalanced. Many women who get tubals report the same thing. Last summer,when I was 33, I had a tubal reversal. It felt like I had another c-section. Insurance did not pay for anything. It was more than $6 thousand dollars. Within a few months I was pregnant. I was thrilled. Then I miscarried. A couple months later I miscarried again. It has now been a year and I’m not sure if we will continue to try. Too much pain.
All this to say,a women should have the right to choose- but more counseling is needed. I made a mistake. It’s no one’s fault but mine.
Jill commented on Sep 07 09 at 11:22 amI don’t about Canada, but in the USA, I would guess doctors’ reluctance would come from the fera of a malpractice suit. The country’s sue-over-anything mentality is terrible, to the point where doctors are afraid to recommend so much as a cure for hiccups during a check-up. Yes, it should be a woman’s chocie to be sterilized, but what doctor would feel safe doing it and not expect a lawsuit years later for not fully informing her of the facts or some legal-jargon way of unfairly placing some blame on them? Yes, it’s the woman’s responsibiltiy, but the world is full of irresponsible people who, giving free rein to sue ANYBODY at their whim, take full of advantage of it. It’s pathetic, and leads to people who aren’t vindictive or irresponsible or stupid having to work in a system that caters to the vindictive, the irresponsible, and the stupid.
