When I was younger, I always thought of motherhood in the abstract. There would only be one baby, for I surely did not want to manage more than that. I was curious to see in which funny ways my genetics would mix with another person’s. Would this kid have my temperament? My blue eyes? Also, I knew my parents would want a grandchild, and I knew that society would expect me to do what women have done since the dawn of human existence. I would raise this child, make sure its basic needs were met, then send it off to college at the age of 18 and be done with my parental responsibilities forever.
I was not yet 18 before I realized that life didn’t work like that. At this time, I also became fully aware that I had a choice. I did not owe it to anyone to become a mother against my will. It would be a disservice to any potential child to bring it into this world when my motivations were clearly lacking. At this point, I made the decision that I would not have children. This was done with little fanfare at the time; I just came to this conclusion and went about my life.
I was 20 the first time I asked to be permanently sterilized. I knew my chances of getting someone to say yes were nil, but I figured I would start putting it out into the universe then. I did not want to spend the rest of my fertile years on hormonal birth control and constantly panicking that one small misstep could end in pregnancy.
I asked many doctors over the following 7 years and got many variations of no until September of 2015. I made the appointment and went it with my typical skepticism. My doctor walked in the room, and I braced myself. I gave my perfected, memorized spiel and then waited for yet another no. Imagine my shock when he told me that my reasoning was sound and that he felt that it was perfectly acceptable to help a woman like me in my quest for permanent birth control.
We immediately began discussing options. I could get Essure, a coil that induces fibrosis and blocks the fallopian tubes. I immediately discounted this, as I have heard of way too many serious complications resulting from the surgery. I could also go for a standard tubal ligation, a procedure that would involve clamping the fallopian tubes, but that did not seem to have the permanency that I was looking for. He then offered a new-to-me option – a laparoscopic bilateral salpingectomy, which is the removal of the fallopian tubes. This would bring my chances of being unable to conceive naturally to very-nearly 100%. Studies have also shown that there may be a correlation between this procedure and reducing the risk of ovarian cancer, since it is believed that many forms of the cancer originate in the fallopian tubes. My mind was made up pretty quickly; I wanted the salpingectomy. We discussed pre-op appointments and counseling, set a surgery date, and officially got the ball rolling.
This is my journey through the process of getting sterilized as a childless, single, 27-year-old woman. It will not be completely comprehensive, but in an effort to be an open book and be honest about the procedure I will do my best to cover as much as possible.
Okay, so I get the “Why?” question a lot. It can be both, “Why did you decide on the drastic measure of permanent sterilization?” and “Why don’t you want kids?” I will do my best to tackle both of them here.
Why did you decide on the drastic measure of permanent sterilization?
I decided to start seeking sterilization options when I was 20. I realized that I had another 25-35 years of being fertile. That is potentially decades of hormonal birth control, stress about ensuring that all birth control is being used correctly, and the panic that would come along with an unwanted pregnancy. I knew, with as much certainty as anyone can really know anything, that I was not ever interested in being pregnant, so I knew that a permanent procedure was the best option for me.
When I first started working on this blog post, Barack Obama was president. Because of his Affordable Care Act, I was able to get back on my parents’ health insurance after a few, traumatizing years of being uninsured. My birth control was free. After turning 26, I spent another year uninsured (because, despite the good intentions, the Marketplace insurance that it matched me with was not feasible on my meager salary) before finally getting a full time job with benefits. During my first round of not having insurance, my hormonal birth control pills were about $40 a month. That is $480 a year.
Now Donald Trump is president, and the administration is tripping over themselves in a rush to repeal the ACA. They voted down the amendment that kept full contraception coverage, and they have repeatedly spoken against amendments that require businesses to cover birth control. Along with this, they are working overtime to make abortion laws so restrictive that, combined with making birth control inaccessible to so many, will result in countless unplanned and unwanted pregnancies.
All of this is to say that I am eternally grateful to the doctor who took me seriously before the government misguidedly stripped away my ability to completely control my reproductive rights.
Why don’t you want kids?
I understand why people are curious, but I admit to struggling with this question. It sometimes comes across as accusatory – almost as if the person asking is trying to parse out what is wrong with me since I am so fervently rejecting the very thing that, in the eyes of many, represents my womanhood.
To answer, there are a lot of reasons that I do not want children. I am accustomed to a lifestyle that does not work well with children. I float through life, taking solo trips to London and allowing spontaneity to pull me in all sorts of directions. I am unwilling to share my time, energy, money, and food with a child. Is that selfish? Maybe. For those who call me selfish (and plenty have!), then I should think they would be pleased that I chose to not procreate, for who thinks an innately selfish person makes a good parent? I acknowledge my need to live my life entirely for me, and in doing so I understand that having children would be terrible for all involved.
Another huge reason is my nearly phobic dislike of pregnancy. I have struggled with all sorts of medical issues my entire life, including a long battle with obesity, and I cannot imagine giving my entire body over to growing a human. Everything about the process, from the start to the bloody finish, is completely unappealing to me.
Without delving into personal family history, I can also say with certainty that my choice to not genetically contribute to the world is not without merit.
What if you regret permanent sterilization?
I try to keep my sarcasm tamped down with this question. I just imagine a 27-year-old woman in her hospital bed, having just given birth. As she cradles her new infant and marvels at what she created, a friend or family member nervously approaches the bed. “But what if you regret it? You’ve had it now, so it’s permanent!”
Maybe the two are not comparable, but that is the feeling I get when I hear this question. This was not something I took lightly. Over the seven years I spent actively fighting for this procedure, I looked at the facts and figures, as well as doing major soul-searching. What I gathered from the studies is that the largest group of women who regret the procedure were the ones who did not go wholeheartedly into it (for example, those who were pressured by a spouse). I did this completely, fully, and absolutely on my own. I was not pressured. I was not threatened. There is not a single person on Earth who had any say in this other than me and the doctor who agreed to perform the procedure. I even kept my entire family in the dark for a year after the procedure was done for fear that I was going to be pressured out of having it done.
Now, to actually answer the question. If I were to hypothetically suddenly want children, there are two options. The more likely one for me would be adoption or fostering. If I were to wake up over my pregnancy phobia and decide that I absolutely needed a biological child, IVF is still an option for me. All of my parts are there (excepting the dearly departed fallopian tubes), and I would just need medical intervention at this point to achieve pregnancy.
What if your future husband –
Yeah, I am going to stop you right there. First off, I do not live my life counting down the seconds until some man comes along and pays the dowry to take me away from my father. I may never be married. I may marry a man. I may marry a woman. I may marry multiple people and go through some messy divorces and awkward rebounds. Who knows? What I do know is that this is not a negotiable point. I do not want children. I do not want to marry someone who brings children to the relationship. And I absolutely will not be pressured, forced, or tricked into motherhood. If that is not acceptable to a future partner, then we were never meant to be.
Do you hate kids?
Nope. I don’t always understand kids, and I often feel as though I don’t have the patience for kids, but I do not feel some sort of blanket hatred or anger towards children. There is a movement of women who consider themselves childfree, and often it turns a bit mean. They make fun of women who have children (with terminology like ‘moo’ for the mother and ‘crotchdropping’ for the child), but that is not who I am. What is most important to me is reproductive freedom for women. It seems a bit backwards and counterproductive for me to look for acceptance for my lifestyle choices while simultaneously tearing down other women. There are plenty of children who have a place in my life, and I love them. I also love turning them over to a responsible adult when I’ve had enough.
Does it bother you when people question your decision?
No, not really. I acknowledge that my choice to get sterilized is more drastic than what most women choose to do. I also acknowledge that I am bucking societal norms, so questions and a lack of understanding are to be expected. I can even face some of the more harsh criticisms without it bothering me too much. I have heard it all. I’ve been told that I made a stupid decision. I’ve been told that I did it so that I could ‘freely whore around without consequences’ (to which my response was, “…do you even understand how the transmission of diseases worse than motherhood works?”). Mostly, I get people who are absolutely convinced that I will rue the day I chose this. I’ve responded with everything that I have already written (and more), but at the end of the day, there is nothing I can do to explain myself to those who are unwilling to see things from my perspective. *shrug*
Did it hurt? What was the procedure like?
Let’s start at the beginning. I had to be evaluated (basically, interviewed about my reasons and intentions) to determine if I was a good candidate for sterilization. Once that was decided, I was given my options. Like I said earlier, I chose the bilateral salpingectomy. There was a mandatory 30-day waiting period since I was young and did not already have children. I was asked multiple times if I was fully informed on the fact that this procedure would make me unable to conceive naturally. I was given ample opportunity to change my mind.
On the day of the procedure, I had to be driven about 45 minutes away to a hospital in a neighboring county. The hospital that my doctor was based out of is Catholic and would not allow the procedure in their facility. I was prepped for surgery, including another talk with the doctor ensuring that, yes, I still most definitely wanted this. I was put under general anesthesia, and less than an hour later, I was awake and preparing to leave.
I had three small incisions – two in my lower abdomen and one near my navel. The procedure was laparoscopic, and my fallopian tubes were removed.
Pain was pretty minimal. I had some soreness in my shoulder from CO2 travelling up there. I also had pain similar to intense period cramps and about a week of soreness in my abdomen. I was given a prescription for Percoset. I did use it for a couple of days, but it was easy to wean myself off.
I will say that I did not exactly follow the instructions to take it easy. Because I was hiding this from my family, they were completely unaware that I’d had surgery and I stupidly went about life as normal. I had the surgery on a Thursday. That Friday, I went to Busch Gardens. On Saturday, I drove from Richmond to Virginia Beach and spent the whole day out and about. Overextending myself led to prolonged soreness that could have probably been avoided had I just been upfront with my family and given myself time to heal without bustling around for the weekend. Regardless of my poor decision on that front, I was completely back to normal in about a week and a half. As of writing this, it has been over a year and a half. The incision scars are barely visible, my periods are normal (more normal than before the surgery, actually), and there have been no bad side effects.
How much did it cost?
I am very, VERY lucky to have had excellent health insurance at the time of getting the procedure. Also, I had an incredible doctor. I don’t know what magic he was able to work with the insurance company, but I only paid copays for the entire thing. Most people do not get off as lightly as I did money-wise, so I would not use my experience as the norm.
That pretty much covers most of what I’ve been asked. I could talk about this for hours, so I welcome any questions that haven’t been addressed, and I will do my best to answer them.
Whatever reproductive choices you make in life, I hope you are able to go into it with the support of your friends, family, and doctors.