At the age of 26, Holly Brockwell asked her doctors about sterilization. She had always known she didn't want children, and for people like her, sterilization seemed like a worry-free method of contraception. Like many young women who ask their doctors about this permanent form of birth control, however, she was told, repeatedly, that she was "too young" to go through with it. It was only this week, after a "four-year battle" with the UK's public heath care system, the National Health Service (NHS), that she was finally able to do so.
According to Obstetrics & Gynecology, female or male sterilization is the most common method of contraception in the United States, with about 700,000 women undergoing the procedure—commonly known as "getting your tubes tied," or tubal ligation—each year. About half of these sterilizations take place within 48 hours of giving birth; however, young women are increasingly interested in sterilization before they ever get pregnant, affirming that they know they will never want children. These women are often discouraged, or flat out refused, by physicians, who say they are too young to make this decision. Unlike male sterilization, tubal ligation is permanent, and one day these women may want kids and regret what they had done in their youth.
Brockwell finally underwent sterilization on Sunday. "I feel sore and tired but very, very happy to have finally got the operation after all this time," she said in an interview with Broadly. "I have no regrets at all." Brockwell explains that sterilization is an important option for women's health. "It's vitally important that we listen to women asking for sterilization," she says.
According to Brockwell, the medical establishment's resistance to sterilizing women is a result of sexism. "Many, many people have suggested that I shouldn't have sex if I'm not intending to reproduce, which is an opinion so old that I can see the cobwebs," she told the Independent. "Yes, the men's operation is cheaper and more reversible, but that's no excuse for the judgmental comments women receive when they ask about sterilization."
If a woman is able to make the permanent choice to conceive from the age of 16, then we shouldn't be telling her at 25 she's not old enough to know her own mind.
While Brockwell acknowledges that sterilization won't be right for all women who say they don't want children, she thinks doctors' widespread refusal to talk about the procedure with patients is patronizing and harmful. "Refusing to even discuss it—which was my experience—is damaging and can cause women to not speak up again for a procedure that might be best for them," Brockwell told me. "We don't take women who don't want children seriously."
Kelly Blanchard, the president of the international nonprofit organization Ibis Reproductive Health, agrees with Brockwell's point. "It is important for women and all people to have access to the full range of contraceptive options so they can find the one that works best for them, their lives, and their families," she said in an interview with Broadly. "For women who are finished having children or do not want any children, sterilization can be an excellent option."
Other than the potential sexism at play, age is an obvious facet of the medical establishment's resistance. Brockwell was 26 when she first asked her doctor to sterilize her, well over the legal age of adulthood.
"Age isn't a factor as far as I'm concerned," she said. "If a woman is able to make the permanent choice to conceive from the age of 16, then we shouldn't be telling her at 25 she's not old enough to know her own mind. It's about the woman, not the birth year."
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Blanchard agrees that women are entitled to be informed about their breadth of options in reproductive health care, to be able to speak openly with a provider, and to find the option that best serves them. "It is impossible to have an age cut-off [for sterilization] since women/people have different lives and circumstances," Blanchard said. "Each woman/person should be able to access the method that works for her/them."
For Brockwell, and countless other women who want to be sterilized, the "other options" for birth control do not suffice. Brockwell says that the iconic pill is not right for everyone, despite being the second-most popular method of contraception. "Many women suffer from long-term side effects and put themselves at unnecessary risk [by taking the pill]," Brockwell said, adding that reversible methods of birth control are fine for those who want them, but unnecessary for others. "If [women] plan to never have children, like me, they don't need the option of reversible contraception."
"For women who know they never want a child and for whom alternative contraception causes problems, or for people whose lives are impacted by the constant fear of falling pregnant, we should take requests for sterilization seriously and work with them to ascertain if it's the right choice," Brockwell continued. "Men don't have to fight for vasectomies."