Of Sterilization and Birth Control: A Rant

Today I found out some very exciting personal news: My insurance company will completely cover for me to have the Essure procedure done!

To give a brief overview for those not familiar with Essure, it is a non-invasive sterilization procedure where your gynecologist goes in through your cervix and inserts a small coil into each of your fallopian tubes. Tissue then grows in around the coils, blocking your fallopian tubes completely. Three months after the procedure is done, you go in for an x-ray with contrast confirmation test, which confirms whether or not your fallopian tubes are blocked. If they’re not, you might need the procedure done again; if they are, you’re good to go!

I was especially attracted to Essure for two reasons: Unlike most other birth control, it has no hormones. I very much dislike what hormonal birth control does to me. Unlike a tubal litigation, it has a super short recovery time (according to both Essure’s website and my own gyno, procedure takes about an hour and you’re back to normal in a day). With two small children and a full class schedule, this was a must.

Let me stop right there and acknowledge how extraordinarily lucky I am. According to the Mayo Clinic, without insurance the procedure costs $1,300 – $3,500. We would never be able to afford that if the insurance didn’t cover it (and having been without insurance for several years until recently, I do know how lucky I am to have it right now). Also, I have an awesome doctor. She told me flat out that even having two kids, most doctors would not sterilize a woman under 30.

Which to me, is a little ridiculous. Aren’t our doctors there to facilitate our decision-making process and help us to become better informed about our bodies and our options? The same day my doctor agreed to perform the procedure (but before I knew if it would be covered), a friend of mine was turned down by her doctor for an IUD because she’s “not in a monogamous, long-term relationship.” I guess the doctor just didn’t believe her when she said her boyfriend is loyal, and doesn’t consider an almost year-long, live-in, with-plans-for-the-future relationship long-term enough.

But beyond that, why does the status of her relationship even matter? My friend is 19. She’s taking 19+ credits a semester, works more than 40 hours a week, is planning to transfer into a bachelor program, then grad school. Her boyfriend’s two daughters may soon be coming to live with them. Children are the last thing she needs or wants right now. Even if she were single, why should she be turned down an IUD? She did her research, she weighed her other options, she considered her plans for the future, and she came to the decision that an IUD is right for her. How does her doctor have the right to turn her down?

I can almost understand why doctors refuse sterilization to very young women. Almost. But refusing something a patient wants on the grounds that they might regret it is really just another way of saying that women can’t be trusted to make their own decisions OR accept responsibility for their actions. When a doctor refuses a woman the birth control of her choice on any grounds other than possible negative effects to her health, that doctor is taking away that woman’s ability to think for herself.

Abortion is a very important part of comprehensive reproductive health, and a very vulnerable part. I certainly don’t want to take away from that. But just remember: There are doctors every day that are quietly depriving women of just-as-important reproductive health options.

As an epilogue: My friend isn’t taking it lying down. I’ve given her my doctor’s number, and she’s planning to make an appointment as soon as our semester is over.