L.A.-resident Ilana (who asked that her last name be withheld), never wanted kids, "even thinking back to when I was a kid," the 29-year-old, who recently had a tubal ligation, tells Yahoo Life.
She shares that she values her career "very much, and I know for a fact I can't do both." But more than that, Ilana says, "I also just....don't want to be pregnant. When I tell people this, sometimes they get confused or uncomfortable because I'm a woman in my late 20s and they just assume that's the next step for me. I would much prefer having a childfree household and my dog. I'm happy this way."
Ilana had a tubal ligation, aka female sterilization, procedure earlier this month — a permanent and highly-effective form of birth control in which the fallopian tubes are cut, tied or blocked, according to the Mayo Clinic, or in some cases removed entirely (called a salpingectomy). Ilana is far from alone. Many women across the country are either looking into or are getting tubal ligation to prevent pregnancy, in the wake of Roe v. Wade being overturned.
Female sterilization is already the most common contraceptive method used, with 18.6% of women aged 15 to 49 relying on it to prevent pregnancy, according to the Centers for Disease Control and Prevention. However, since the Supreme Court ruling, the number of women searching for information on tubal ligation has exponentially soared.
How Roe is influencing tubal ligations
Ilana shares that Roe being overturned was "absolutely" a factor in moving forward with getting an appointment for the procedure. "The leaked documents are what triggered me to make a consultation," she says. "I've been thinking about this procedure for a few years but kept putting it off. I thought my health care options as a woman were pretty open in this day and age, but I'm quickly learning that things can change at any moment."
Like Ilana, 31-year-old Christa Philippeaux tells Yahoo Life that she never wanted to have kids. "It's just not something I desire," the L.A. resident says. "It's incredibly annoying when people used to tell me that I would magically change my mind as I got older or that I'll regret it when I'm old because I wouldn't have anyone to take care of me. I think that's an awful reason to have children — for the sole fact that I could end up lonely. I've even been called selfish but honestly, nothing is more selfish than having children for the pure fact of not being lonely when I'm elderly."
She adds: "Motherhood is absolutely not for me."
Since Roe was overturned, Philippeaux says that she's become "fearful" of an unintended pregnancy. "I was always a little worried that one day I would become pregnant but always knew I would immediately get an abortion," she shares. Despite living in California where abortion care is legal, Philippeaux says, "Now that it's forbidden for a lot of women, I'm afraid that one day it would become my reality. I would grow so depressed if I were forced into motherhood."
The obstacles to tubal ligation
Getting a doctor to agree to perform a tubal ligation, however, can be challenging for some. There are countless stories online of women sharing that they were rebuffed by their physicians after asking for the procedure — many of them hearing similar refrains from doctors: "What if you change your mind and decide you want children?" and "What if you meet someone who wants kids?"
TikToker Olivia Downs, who is 22 and lives in Mass., went viral after she posted on her TikTok in June that her doctor denied her request to get her tubes tied. In the video, she shared, "I never want children." Downs said her doctor told her the procedure is permanent and that she might "meet Mr. Right" and change her mind.
Philippeaux has struggled to get a tubal ligation as well. She says she spoke with three different doctors over the years about having the procedure, but still hasn't found a provider willing to do it. "I simply do not want to jump through hoops to get my tubes tied," she says. "They're my tubes! I shouldn't have to beg for it! I'm angry about it because it is absolutely ridiculous."
While Philippeaux admits she should "push" for a tubal ligation again, she says, "I'm just so tired of rejection." She shares that her husband doesn't want to have kids either, but says he is "super against me having a tubal ligation because it's 'a big procedure,'" adding: "But if I could get it tomorrow I would!"
One Twitter user, a mom who lives in Seattle, recently shared that she was also refused a tubal ligation because of her age and was told by the doctor, "What if my husband wants more kids?"
I asked for a tubal ligation after my daughter was born and I was told I was too young and they only are willing to perform it for women who have multiple kids or are in their late 30’s because “what if my husband wants more kids?” I live in Seattle… it’s a problem everywhere.
— MommaKay425 (@mommakay425) July 20, 2022
Along with a woman's age, marital status and whether or not she's had children already, some doctors point to the fact that sterilization is permanent when dismissing patients. But that's exactly why those women are choosing it. "Fewer than 1 in 100 women get pregnant within one year of having this type of surgery," Dr. Nicolle Mitchell, an ob-gyn with Keck Medicine of USC, tells Yahoo Life. "Medical literature is also revealing that removing fallopian tubes may help reduce a patient's risk of ovarian cancer, as ovarian cancer cells stem from the ends of the fallopian tubes. So this procedure is offered with prophylactic benefit as well."
Women know tubal ligation is considered permanent when we ask for it. That’s why we ask for it. We don’t need to be denied medical care because of hypotheticals we’ve already considered.
— Selemux (@Selemux) July 22, 2022
I feel that! I am childfree and I want to avoid abortions at all costs, but getting a tubal ligation was unnecessarily difficult. I ended up getting the procedure, but there was SUCH a heavy undertone of "This is permanent and you will regret it one day". As I don't know myself..
— Mermaid Sanne (@MermaidsLullaby) July 27, 2022
But why do some doctors push back in the first place? "In many areas of the country and world, there is a history of coerced or forced sterilizations performed on women," says Mitchell. "Thus, much effort has been made to help prevent patients undergoing unwanted sterilization."
Another reason is that "other providers cite studies where patients under 30 years old have higher regret later in life after sterilization," notes Mitchell.
Dr. Jessica Kiley, chief of general obstetrics and gynecology at Northwestern Medicine, previously told Yahoo Life that it's possible female sterilization may be less effective if performed at younger ages. "Since the likelihood of failure continues over time — we call this the 'cumulative' failure rate — younger individuals have a higher likelihood of failure in their lifetimes," she said.
Tubal ligation, while safe, also carries more risks than vasectomy. "Vasectomy can be performed in an outpatient setting versus tubal sterilization that usually requires general anesthesia in an operating room," explains Mitchell, who notes that tubal sterilization is typically covered by insurance. "Blood loss, recovery and overall risks are less with vasectomy when compared to tubal sterilization. Important to note, vasectomy requires two to four months of birth control until semen is completely free from sperm; tubal sterilization is immediately effective."
However, adds Mitchell, "sterilization should be a decision made between a patient and provider, free of bias and judgment."
Why access is important
For Philippeaux, being dismissed by multiple doctors and feeling like she has to "fight" to get a tubal ligation is frustrating. "Women shouldn't have to beg to do anything with their bodies," she says. "It's ludicrous! They don't want us to have abortions, well then make this procedure more accessible." She adds: "Parenthood simply is not the best option for some people."
Ilana agrees, saying: "I think women — and other groups who have uteruses and can bear children — absolutely deserve this access whenever they want it and wherever they want it. Nobody knows what you want more than you, and it's an incredibly personal decision. Denying access to this kind of care is abuse, to put it bluntly. We deserve choices about what happens to us."
After having her tubal ligation, Ilana shares that she feels "amazing." While the recovery is "a bit uncomfortable," she says that’s countered by a sense of "comfort and huge relief in the fact that I will never become pregnant — 100% worth the temporary discomfort."
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