The Many Sides of Deciding To (or To Not) Have Your Tubes Tied At A Young Age

It's a tricky spot for many young women

Updated 09/29/17

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When I was in my early 20s, I asked my doctor if it would be possible to get my tubes tied. She looked at me like I had just asked her to teach my dog Korean. “Why would you want to do that?” she asked me.

“I don’t know,” I said. “I read about it online, and my periods are so painful, and the Pill gives me mood swings, and I don’t want to have kids, so it just seems like it makes sense.” I didn’t know much about tubal ligation, but I knew the basic facts: it was an irreversible procedure that involves cutting, tying, or blocking off a woman’s fallopian tubes, thus preventing fertilization, and is often referred to as a permanent form of birth control.

“You’re way too young to make that kind of decision,” my doctor told me. “Come back to me in 15 years, and in the meantime, I’ll give you another prescription for hormonal birth control.”

At the time, I was a year or two out of liberal arts school, and about as staunchly feminist a white girl as you could get: I had repro rights pins on my bag, gave money to Planned Parenthood, and liberally quoted Jezebel. I couldn’t believe what my doctor was saying to me. Who was she to dictate what I should do with my own body? Who was she to tell me whether or not I wanted to have kids, or that I would later come to regret my decision? I didn’t, and I wouldn’t, and it seemed to me that I should be able to make that choice if I wanted to without my doctor passing judgment.

5 years later, when I was 27, I realized that I’d missed a period and my boobs were surprisingly sore, so I purchased a pregnancy test and peed on a stick in my office bathroom. It came up positive. My decision to continue my pregnancy was not an easy one; at the time, I was drinking too much and working too hard and I was barely equipped to take care of the succulent on my desk, let alone a child. But above all else, in those first few weeks after I realized I was pregnant, I was surprised to find that I was most grateful for one thing: that after years of painful periods and partying and popping Plan B like it was Nerds rope, I had not harmed my ability to conceive a child if I wanted to; because my doctor had not listened to my early-20s protestations, even if I did not want this baby, I had the option to have a baby at another time.

And when I really thought about it, although my pregnancy was fraught with complicated and conflicting emotions, I did really want this baby, a feeling that was cemented shortly after that same doctor delivered my now-8-month-old son.

I think about this all the time when I read stories about women who have chosen to undergo tubal ligations at an early age because they do not want children, such as this Broadly piece by a woman who spent 13 years trying to find a doctor who would perform the procedure to this piece by a 27-year-old who got her tubes tied in her early 20s. These accounts generally follow a typical pattern: a woman who does not want to have children approaches a doctor asking to get her tubes tied, who infantilizes her, talks down to her, questions her decision to lean out of a choice that has for centuries been considered not a choice at all, but a biological necessity.

I want to be clear that I do not think any doctor has the right to judge or dismiss a woman’s decision to have kids, nor do I fall into the camp that having children is the right decision for everyone, or that a woman should have a reason on hand why she doesn’t want to reproduce. It is a personal decision for every woman, full stop, and it is not up to anyone else — let alone a medical professional — to interrogate that.

At the same time, however, I do think that if a doctor pledges an ethical obligation to their patient’s health, then they are ethically obligated to preserve their fertility, at least for a certain period of time. Call that infantilization; call that the medical profession’s legendary distrust of women’s ability to make their own healthcare choices; call it what you will. When I think about how close I came to not being able to have my son, all because my priorities were different in my early 20s than they were in my mid-20s, I am grateful to have been infantilized and condescended to in this manner; I am grateful that I had this decision made for me.

In truth, I understand why these narratives resonate with young, child-free women. Our society has spent so much time shaming women who choose not to have children that being confronted with a narrative that validates that decision is incredibly refreshing. We are so used to demanding why a woman chooses not to have kids — a question that I think most feminists can agree does not need to be asked or answered — that we fail to think about what might happen if a woman changes her mind.

To be fair, we hear very little about what happens if a woman has her tubes tied at a young age and then regrets her decision — even though one can reasonably assume it happens fairly often, just as anyone might regret any life choice they make. That applies doubly if the woman who gets her tubes tied was as young as I was, as Maria Cook, who wrote a piece for Marie Claire about her decision, was. “By the time I turned 20, I had come to accept that these intrusive questions [about not having kids] would always be a part of my life,” Cook writes while explaining why she chose to get tubes tied at such an early age.

While I sympathize with the irritation of being forced to continuously answer questions that no one should be asking to begin with, I would also add: when I was 20, I thought I’d be spending the better part of that decade writing a novel, posting my original music on MySpace, and supplementing my income by working part-time at a video store. Now that two of those things are defunct, I ask you: how can you know anything about how your life will turn out when you’ve just turned 20?

It’s understandable why we do not hear these narratives. It’s the same reason why liberals rarely discuss women who regret their abortions: to do so is politically dicey, a way to potentially undermine women’s autonomy over their own bodies. Perhaps less understandable (or at least much more cynical) is the preponderance of internet content for women who choose not to have children, particularly in corners of the internet where being childfree is framed as a political tool for self-empowerment, rather than a personal choice that varies depending on one’s needs and priorities at a given time in their life.

“TK empowering reasons not to have kids!” one headline shrieks, while another echoes: “5 scientifically proven reasons why not having kids is a great idea!”

As a woman who would’ve clicked the crap out of those posts just 2 years ago, who was 100% sure she didn’t want children, and was still plagued by this uncertainty until she actually held her smiling newborn in her arms while dancing to Earth Wind and Fire, I know that for many, what you want in your early 20s is nothing even close to what you want years later; even if it is, you could be wrong about that as well. I am so grateful that I was wrong, and that my doctor told me that I was wrong (or at the very least, that she left the possibility of my wrongness open).

I am grateful to have had the choice to make a choice later on in my life, and I don’t think that saying so undermines other women’s choices at all.

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