Talking to your doctor about your tubal ligation

Talking to your doctor is one of the most critical steps in your sterilization journey. As you probably already know, getting the approval for sterilization surgery is not as easy as it should be. This is especially true if you are young and/or childfree. This page can help you to overcome the common objections of doctors when requesting a sterilization procedure.

A quick disclaimer

Doctors generally have your best interest in mind and you should answer their questions honestly. Not being honest with doctors can put your health at risk. The talking advice given on this page is not an encouragement to lie about your situation. It’s more about how to show that you are well-informed and are making this decision with informed consent.

Know about the alternatives to sterilization

One of the main objections that will come up during the appointment is the question, why you are not going for non-permanent contraception. In many countries, doctors have to go over the alternatives by law. Make sure that you know about all common methods of contraception and have your answer ready, why they are not a good choice for you. You probably already know your answers, but it’s good to go over them in preparation for your appointment. You can find a good overview of contraception methods on Planned Parenthood.

A common reason to reject all the hormonal contraceptions is that they mess with various parts of your body and that you made bad experiences with them. You might reject condoms because they have a relatively high failure rate of 13%1.

Know about the sterilization methods

Make sure to read all the pages in our knowledge section before the appointment with your doctor. With this knowledge, you’ll be able to show that you have already put time and effort into understanding the sterilization process and that you know what you are signing up for. Ideally, learn at least a few of the Latin terms. Nothing impresses doctors more than someone knowing medical terms in Latin.

Know about your situation

The biggest worry of your doctor is usually that you might regret your decision later in your life, especially if you are young and childfree. Again, you probably already know exactly why you are sure about your decision, but you should prepare how to communicate your reasons in a few sentences. It’s helpful to show that you already know for a long time that you don’t want any children. It’s also helpful to show what other things in your life you care about, that wouldn’t be possible with children.

Depending on the method, sterilization can greatly reduce your risk of ovarian cancer. If you have a family history for ovarian cancer, you should definitely mention that during your appointment as one of the reasons why you want to get sterilized.

If you are not in a relationship, your doctor might object that “finding the right partner” might make you change your mind. In that case, it’s helpful to mention that not having children is not something you consider negotiable in a relationship and that you wouldn’t enter a serious relationship with anyone who is not on the same page with you. Maybe you even have a history of a past relationship that ended because you don’t want children. Mentioning that can show that your decision to be childfree comes first.

If you are in a heterosexual relationship, your doctor might ask why your partner isn’t getting a vasectomy instead. They might argue that a vasectomy is a much quicker procedure than any female sterilization procedure. Avoid saying that your partner is not sure if they want children. Staying with a partner who is on the fence, might give your doctor the idea, that you are not 100% sure of never wanting children. A better answer to this objection is, that your partner has to make their own decisions over their body and that you don’t want to pressure them into a vasectomy. Another possible reason is, that you are also afraid of pregnancy due to rape.

Making an appointment with your primary doctor

In most countries, the path to sterilization starts with your primary care provider (GP, doctor) or your gynecologist, who has to give you a referral to a dedicated surgeon. You should make a dedicated appointment with your doctor to talk about your decision to seek tubal ligation surgery. This shows that you are serious about your decision. If you just mention it during another appointment, it’s easy for your doctor to shrug it off as a silly idea.

During the appointment

Since you are well-prepared, you’ll be able to explain your reasons to get sterilized During the conversation, you’ll possibly feel offended by some of the objections that question your bodily autonomy. Try to not get defensive and address the objections in a calm and factual manner.

There is a good chance, that your doctor will give you information about alternative contraception types or different sterilization methods, that you already know. Try not to interrupt your doctor to tell them that you already know all this. Ask smart questions and let your doctor draw their own conclusions, that you are well-informed.

The referral to the surgeon

If all goes well, your doctor will give you a referral to a surgeon. Before the actual procedure, you’ll have to make an appointment with the surgeon. You’ll likely have to convince the surgeon as well that the sterilization is the right thing for you. This conversation is pretty much the same as the conversation with your doctor and the same rules apply.

Should you bring your partner to the appointment

If you are in a relationship, you might be wondering if you should attend the appointment together with your partner. This is generally a good idea since it shows that you are in agreement with your decision. Just keep in mind, that becoming sterile is a decision about your body and that you should do the talking with the doctor—while your partner stays in the background. If your partner speaks for you, your doctor might become suspicious that your partner is pressuring you to get sterilized. Since this is an extremely sensitive topic, they might completely stonewall you in that case.

If your partner is not 100% behind your decision to get sterilized, they might end up helping the doctor talking you out of it during the appointment. In this case, you should better attend the appointment on your own.

If you come with your male partner to the apartment, the doctor might suggest a vasectomy for your partner, which is a much simpler procedure with higher chances of reversal. It is good to prepare a good answer for that question. Focus on how the sterilization improves your own life, not your partner’s life.

What if your doctor rejects your wish

No matter how well you prepare and how good your reasons are, your doctor might reject your wish. They might have outdated ideas about women, misguided ethics, or just a bad day. A rejection of a doctor doesn’t mean that you can’t get sterilized. In most countries, it’s relatively easy to change your primary care provider and try it with another doctor.

It might also happen, that multiple doctors reject you. Again, this doesn’t have to mean that your reasons are not good enough or that it’s not possible. It might just mean that the area you live in is prone to misguided ethics. You still have the option to get sterilized in another country with less hassle as a medical tourist. Have a look at our sterilization countries section, for more information about this option.

Notes
  1. Source: https://www.cdc.gov/reproductivehealth/contraception/index.htm