Regret, shame, and denials of women's voluntary sterilization

Abstract

Women face extraordinary difficulty in seeking sterilization as physicians routinely deny them the procedure. Physicians defend such denials by citing the possibility of future regret, a well-studied phenomenon in women's sterilization literature. Regret is, however, a problematic emotion upon which to deny reproductive freedom as regret is neither satisfactorily defined and measured, nor is it centered in analogous cases regarding men's decision to undergo sterilization or the decision of women to undergo fertility treatment. Why then is regret such a concern in the voluntary sterilization of women? I argue that regret is centered in women's voluntary sterilization due to pronatalism or expectations that womanhood means motherhood. Women seeking voluntary sterilization are regarded as a deviant identity that rejects what is taken to be their essential role of motherhood and they are thus seen as vulnerable to regret.

Voluntary sterilisation of young childless women: not so fast

“…How hard is it for a YCW in the USA or UK to obtain sterilisation? Or, as it has recently been asked: ‘Why do women seeking voluntary sterilization face such extraordinary difficulties?’4…”

“…So was Erin Iwamoto-Galusha at age 25. Lalonde’s claim that ‘women seeking sterilization in 2017… are… treated as objects of population policy’4 overstates the magnitude of the problem. Voluntary sterilisation of women in the USA has been legal for more than 40 years.…”

“…Like Mertes, McQueen laments purported (anecdotally based) difference of the ease by which men and women sterilisation requests are met and likewise suggests that physicians are guided by anticipated regret. Others, such as Lalonde4 and Richie,5 have recently raised very similar concerns.…”

Update on Permanent Contraception for Women

“…In the 1960s, the "120 rule" was endorsed by the American College of Obstetricians and Gynecologist (ACOG) as a means of assessing a woman's candidacy for permanent contraception [42]. This rule dictated that a woman would be candidate for a permanent contraception procedure if her age multiplied by the number of her children was greater than 120.…”

“…A 1999 study evaluating rates of regret for women younger than 30 years old prior to tubal ligation found significantly increased rates of regret in women younger than 30 years old compared to women older than 30 [43]. Some experts argue that the methodology for assessing regret is flawed and the results often misleading [42,44]. We encourage clinicians to thoroughly assess their own biases about the role of women and motherhood and avoid paternalism by denying nulliparous and women < 30 years of age access to permanent contraception procedures.…”