Of Sterilization and Birth Control: A Rant

essure coilToday 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.

About Manda:
Manda is, in no special order, an artist, mama, writer, activist and history geek.


  1. You are so right! What right do physicians have to tell you what you will or won’t regret? I’m a family doctor so I don’t do surgery, and it drives me nuts when I have someone in front of me who’s under 30 and already has 4 kids and I can’t find anyone willing to do a tubal ligation. Fortunately the IUD is a great alternative, INCLUDING for your friend! If any doctor tells anyone that she can’t have an IUD because she hasn’t had a child, because she’s not monogamous, or because she’s had an STI in the remote future, I recommend she find another doctor because we now know that it’s safe in all of those situation.

  2. thenutfantastic says:

    My sister turned 31 this year and has 1 daughter aged 10. She went in earlier this year to get an IUD because her periods are so severe she was hoping an IUD would alleviate some of the pain, stress and flow.

    Her crazy pro-Christian Dr told her that because she wasn’t in a relationship or even married he couldn’t give her one. W.T.F.? You would think the unmarried folks would be the targets for such blasphemy, not the other way around.

    She didn’t stick with that Dr thankfully and got the IUD somewhere else. I have one, too, and LOVE IT! Also fully paid for by my insurance.

  3. Oops remote PAST…

  4. I just blogged about this — my insurance is covering this, and I’m so grateful. But your post is a reminder that there are still people out there making decisions for us without our input. Quite infuriating.


  5. I must be missing something here – why on earth wouldn’t someone be abe to get a IUD because they are not in a monogamous, long-term relationship? Can the piece of plastic tell?

  6. This bears repeating: The birth control pill, Yaz, has been linked to a number of adverse reactions, including strokes and lawsuits are growing over these issues. Here is some good information: http://www.yaz-may-cause-strokes.com/

  7. One reason IUDs are medically recommended only for women in monogamous relationships is because if she contracts an STD, the IUD will facilitate the movement of the infection throughout her body, meaning the disease will damage her body faster than it would without the IUD acting as a bridge. (I am not in the medical profession. I learned this from a professor of human sexual behavior.) I’m sure that some of these doctors are using it as an excuse for their paternalism, but there is a medical reason.

    And actually, IUDs work by altering the lining of the uterus and usually make periods worse. I’m unaware of any sound advice for using IUDs to lessen period symptoms.

  8. Hey Z, I would like to offer a quick clarification about IUD’s–there are two common types/brands found in the US: Paragaurd (which utilized copper to alter the uterine lining and create an inhospitable environment for sperm, eggs, and zygotes), and Mirena (which continually releases hormones, keeping the body from releasing eggs.

    While the copper IUD may not improve period irregularity or other symptoms, the Merina can and often does. Because it is continually releasing hormones into a woman’s system, she will likely have a much lighter period, and in the case of some women, may cease having a period completely while the implant is in place. You can check out this link to Kaiser if you want more information about IUDs in general, or the list of possible benefits of a hormonal IUD–http://www.littleurl.net/e6da4f

  9. I think the issue for doctors is fear of getting sued. If a twenty five year old got sterilized and changed her mind, she could sue the doctor for not impressing upon her enough that the procedure is irreversible. The jury would see a young woman’s tears and award her money even though the doctor did nothing wrong. So doctors have to be extremely cautious. They have to think “how would this look if I were sued” before making every decision.

  10. Read up on Essure all you can. It is having tons of very bad side effects. Read some stories at essureprocedure.net

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