Young, Childless and Opting for Sterilization

"I knew I would never want to undo it, so I decided it would be okay to get them cut," says Melissa Day. She's 34 years old and childless, and three years ago had a tubal ligation: what's commonly known as getting your tubes tied.

The procedure prevents the passage of the ovum into the uterus where it can be fertilized by the male's sperm, by closing the fallopian tubes. It's a surgical solution to birth control.

Day's older sister went through a lot trying to get pregnant and have children. Her sister had two miscarriages and is now in the process of adopting an infant. Day was by her side the whole time and it lead her to the conclusion that the trauma isn't worth it. "I don't need to go through that," she says and adds that she's just "not the mommy type anyway."

Before the surgery, Day briefly changed her mind. "I got really nervous for a few days after I told [the doctor] I wanted to have them cut, and I called to change my mind and tell him just clip them." Clipping the tubes instead would mean the procedure would be reversible. "I spoke to the nurse who told me I had to talk to the doctor when I went in to have my surgery, but I was really nervous and totally forgot when I got to the hospital."

She feels more settled about the surgery now. Tugging the waistband of her jersey pants down an inch to display the one-inch scar, she says she knows she made the right choice. "I don't even think about it now," she says simply.

Melanie Sawyer, a 27-year-old law student from Vancouver Island, also chose to have her "tubes tied" instead of using birth control pills or other forms of contraception. "I had a close call," she says. "I missed a couple of [birth control] pills, and by the time I remembered, it was three days after I'd had sex." Sawyer considers herself lucky. "It would have really messed up my plans if I had gotten pregnant again, and I want to really focus on doing other things now." Sawyer now has a stepson, but doesn't want to have children of her own. Word on the Street - Vancouver: September 24th

No regrets?

They're not alone. Dr. P.J. Mitchell, an obstetric surgeon in Nanaimo B.C., sees "maybe seven or eight women a week" who are considering tubal ligation: women both with and without children. "As many as 90 per cent of them go ahead with the surgery after receiving all the facts," he says. "Little seems to challenge their decisions."

And reliability isn't the only reason women choose sterilization. Christine Franic, a nursing student in Nanaimo, notes that financial considerations may also play a role. Once the surgery is done, "there is no expense, no monthly cost" to birth control. As well, risks associated with the operation are short-term only. "They are primarily to do with the anaesthetic, and within this age group the risk is very low."

Some studies have also claimed to show health benefits associated with tubal ligation. "Preventing or lessening the risks of some diseases, including polycystic ovary syndrome, endometriosis, and a reduction in ovarian and breast cancer risks, can often be a reason for people looking into this surgery," Franic says. But they are likely to be disappointed. "Unfortunately, it's bullshit, but many people will read reports about the correlation between having the surgery and lessening the chances of ovarian cancer and think it's a real option."

Dr. Mitchell agrees.

"There is no hard evidence to suggest that there is a strong correlation between the two ideas," he says. "However, most patients coming in with that idea in mind are already prepared to go ahead with [the surgery] anyway. It simply could have been an added benefit.

"If the patient suffers from a disease like [polycystic ovary syndrome] and is confident that she does not intend on having a child or additional children, the surgery may be the best possible option for them." It's a decision that shouldn't be taken lightly, however. "This surgery should be considered permanent," Dr. Mitchell says. "There are different options for the actual process, but once done you wouldn't want to undo it."