Permanent Birth Control Is in Demand in the US—but Hard to Get

All of these reasons for denying sterilization are in direct contradiction to the ACOG’s ethical guidance. However, doctors do not face any repercussions for refusing to perform procedures; the US does not track data on how many sterilization applications will be denied. “So there’s no responsibility, no ability to enforce a consequence,” Hintz says.

Access to the procedure is not equitable throughout society. Echoes of the past picture of sterilization, in which marginalized groups of women were forced to undergo the procedure, including women of color, poor women, and people with disabilities or mental illness, still linger today. Black, Latino, and Indigenous women in the U.S. are up to twice as likely as white women to receive approval for sterilization, while women with public or uninsured health insurance are about 40 percent more likely to receive approval. of possibilities that women with private insurance.

“The bottom line is that the way it is legislated, and the way such subjective assessments can be made, is just a means to perpetuate this very white, rich, fit and cisgender idea of ​​who should have children.” , says Hintz.

An internet corner where those asking for the procedure can find tips and advice is the r / childfree community on Reddit. The subreddit has folders with extensive information on how to request the procedure, a compiled list of doctors who will perform it, and a sterilization folder that members can bring to their doctor with a consent form template and a form to list. the reasons for wanting the procedure. procedure.

In parallel with the increase in requests for permanent forms of birth control, the cancellation of Roe it has already led to an increase in the number of people seeking more lasting but non-permanent birth control, such as intrauterine devices (IUDs). But the very idea that birth control, permanent or not, could replace access to abortion is inherently flawed, says Krystale Littlejohn, an assistant professor of sociology at the University of Oregon, whose work explores race, gender, and reproduction. Although most people who may become pregnant use some form of birth control, one in four women will have an abortion in their lifetime. That’s why the “just tie the pipes” or “just make an IUD” rhetoric that has emerged as a result of Dobbs not useful, he says.

On the one hand, choosing these forms of birth control is not a trivial medical decision: more intense and painful periods and a potentially painful implantation procedure, often without pain relief, are among the possible consequences of obtaining a birth control. GOD. Tubal ligaments require an invasive surgical procedure and, as with any surgical procedure, can cause complications.

In fact, the advice to use birth control can be seen as one more way to control people’s bodies, says Littlejohn. “When it comes to people suggesting that their friends or loved ones take a long-term birth control, I think people think they’re helping other people, but what they’re really doing is invading the their human right to bodily activity. autonomy, “he says. RoeFalling will not only mean that people with uterus are forced to give birth, he says; it is also about forcing them to use longer or permanent forms of birth control action.

A person living in a restrictive part of the United States may now feel compelled to seek long-term contraceptives or to have their tubes tied, which equates to a mandatory birth control. “That’s not the solution right now,” he says. “I think it’s very important that we don’t try to fight reproductive injustice with reproductive coercion.”

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