Tubal Ligation and Giving the Game Away

Tubal ligation is an elective surgery to permanently serialize a woman. It is low risk, can be done on an outpatient basis and can be done immediately after childbirth. Its availability recently became a topic on twitter.

The replies to this tweet were full of other women telling of similar events happening to them. This was shocking to me, I had thought this sort of medical paternalism had gone out of fashion decades ago.

Still, these are just anecdotes, I wanted to hear what the actual availability of this procedure was. From the Mayo Clinic:

Before you have a tubal ligation, your health care provider will talk to you about your reasons for wanting sterilization. Together, you'll discuss factors that could make you regret the decision, such as a young age or change in marital status.

That is not great... The Mayo page about the equivalent male procedure, a vasectomy, says nothing about age. Men apparently can go ahead and do it at whenever they want. Men are told to consider how their partner feels, but not some hypothetical future wife.

Part of the problem in America is that so many hospitals are run by religious organizations. The optimal time to get your tubes tied is while you are having a C-section--this way you get two surgeries done at once and have less risk and recovery than having these procedures done separately. However, doctors at Catholic hospitals risk their careers if they follow a patients request to get a tubal ligation while undergoing a C-section.

And yes, like any procedure there is a degree of risk in getting a tubal ligation. Do you know what else is risky? Pregnancy.

On the other end of the spectrum California prisons were illegally sterilizing female inmates. The only reference to forced vasectomies I could find were pieces of satire.

Whether women are refused a tubal ligation or forced to have one, their choice and autonomy is removed. And this is far from the only example of women's health care that has unnecessary restrictions. Under Trump access to contraceptives was rolled back. 36 states currently classify feminine hygiene products as luxury items, which carry commensurate taxes. Women lose out more when their state spitefully refuses to expand Medicaid. And of course there's the big one, abortion. There are so many ways abortion is restricted. One you've probably not considered is telemedicine medication abortion. This is one of the most restricted forms of telemedicine care, despite studies finding it to be as safe as abortion care administered in-person and highly acceptable to patients.

I used to consider myself pro-life. The change in my viewpoint came over years, starting with realizing how many people who called themselves pro-life supported the death penalty. I learned that a lot of the reasoning I had been told was simply lies. At no point did I see myself as trying to control women. Though women having control over their own bodies did not really factor into my consideration.

The idea that being anti-abortion is pro-life starts to break down when you see stories like this:

News like this give the game away. It's clearly not about protecting life when your laws will only result in death. This particularly law was dialed back after an uproar since it was so clearly insane. But there are plenty of other laws that would make a doctor flinch before conducting an abortion. In a medical emergency, health care providers shouldn't have to prove that an abortion is absolutely necessary.

Women shouldn't have to prove that they need an abortion or that they deserve a tubal ligation. Bodily control trumps other alleged concerns in a truly free society.