All of these reasons for refusing sterilization are in direct conflict with ACOG’s ethical guidelines. Yet physicians do not face any consequences for refusing to perform procedures; The United States does not track data on how many sterilization requests are denied. “So there is no accountability – there is no capacity to enforce a consequence,” Hintz says.
Access to the procedure is not fair across society. Echoes off sterilization‘s checkered past – where marginalized groups of women were forced to undergo the procedure, including women of color, women who were poor and those living with disabilities or mental illnesses – still lingers today. Blacks, Latina and Native women in the United States are up to twice just as likely as white women to be approved for sterilization, while women with public or no health insurance are about 40 percent more likely to have the procedure than privately insured women.
“The bottom line is that the way this is legislated around – and the way in which these very subjective kinds of assessments are able to be made – is just a means of perpetuating this very white, wealthy, able-bodied and cis-gendered idea. about who should have children, ”says Hintz.
A corner of the internet where those seeking the procedure can find advice and tips is r / child free community on Reddit. The subreddit has folders with comprehensive information on how to request the procedure, a comprehensive list of doctors who will perform it, and a sterilization pad that members can take to their doctor with a template for the consent form and a form to indicate their reasons for they want the procedure.
Along with increasing requests for permanent forms of contraception, the overthrow of Roe has already triggered one increase in the number of people seeking long-term but non-permanent contraception, such as intrauterine devices (IUDs). But the very idea that contraception – permanently or otherwise – can 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. Despite the fact that majority of people who may become pregnant use some form of contraception, every fourth woman will have an abortion in their lifetime. This is the reason for the rhetoric “just get your pipes tied” or “just get a spiral” that has emerged in the wake of Dobbs is not helpful, she says.
First, choosing these types of contraception is not a trivial medical decision: Heavier, more painful menstruation and a potentially painful implantation procedure – often with no pain relief-are among the possible consequences of getting a spiral. Tubal ligations require invasive surgery and can, as with any surgical procedure, lead to complications.
In fact, the advice to use contraception can be seen as just another form of police control of people’s bodies, Littlejohn says. “When it comes to people proposing that their friends or loved ones get long-term contraception, I think people think they are helping other people, but what they are really doing is violating their human rights to the body. . autonomy, ”she says. Roe‘s fall will not only mean that people with uterus are forced to give birth, she says; it is also about forcing them to use long-term or permanent forms of contraception.
A person living in a restrictive part of the United States may now feel compelled to seek out long-term contraception or have their tubes tied – which is tantamount to mandatory contraception. “That’s not the solution right now,” she says. “I think it’s really important that we do not try to fight reproductive injustice with reproductive coercion.”