They do not or no longer wish to have children. Each year in France, between 40 and 50,000 women resort to voluntary sterilization, a contraceptive method definitive. Since 2001, this act has been legal and open to all adult women, without age or maternity restrictions, on condition that they express their choice orally and in writing, and that they have a reflection period of four months. “Before 2001, female sterilization was prohibited, it was even assimilated to voluntary mutilation and therefore criminally reprehensible.“recalls Doctor Pierre Panel, head of the gynecological and obstetrical surgery department at the Center Hospitalier de Versailles. Sterilization was only carried out on medical justification, if the woman’s health could be endangered by a pregnancy. “This provision dispossessed the woman of her choice, which is still anchored in people’s minds: some patients tell me that they did not know if they had “the right or not” “explains Doctor Panel.
Ligation or implants to cut off the sperm
Sterilization can be carried out by two different techniques. In both cases, the goal is the same: to “cut” the path that sperm usually take to access the ovaries to make fertilization impossible. The first and oldest technique is tubal ligation fallopian, located between the ovaries and the uterus. It is performed under general anesthesia and externally by means of a laparoscopy. The second method is the Essure® technique. “The advantage of the Essure® method is its great simplicity: it is generally done without anesthesia.“explains Doctor Panel. It consists of placing implants in each tube, by natural means (vagina and uterus). These small devices covered with a polyethylene filament, will generate a process of healing of the tubes which will become blocked in three months. . A check-up will then allow the doctor to check the success of the operation. Sterilization, whatever the technique used, is reimbursed by social security like any medical procedure. It is performed by a gynecological surgeon at hospital.In the case of the Essure® method without general anesthesia, the procedure lasts a few minutes, as in the case of insertion of an IUD. The patient will be able to leave the hospital one hour after the procedure.
To note : female voluntary sterilization will not affect sex life, nor on the menstrual cycles of the woman who used it.
Prevent the risk of regret
Whoever says definitive can sometimes say regret. As a precaution, a woman who wishes to have voluntary sterilization should make two appointments, four months apart, with the same person (usually the surgeon). “Obviously, we check that the expectations of the patients are consistent with what the gesture entails. It is well explained that the procedure is irreversible, that the use of in vitro fertilization (IVF) will not always work, and that the repair of a ligature only works once in two.“underlines Doctor Panel. This is why the doctor will always offer an alternative if he sees any hesitation. In France, women who have recourse to an act of sterilization are often” old “(between 35 and 47 years old).”At 25, you have 15 to change your mind. But as my patients point out to me, when you have a child at 25, it’s also irremediable. And at over 40, the risk of regretting is lower“remarks Doctor Panel. The latter was specifically interested in the question of regret in a study conducted with Professor Hervé Fernandez, gynecological surgeon at Hôpital Bicêtre, between 2006 and 2010 and published in 2014 in the journal European Journal of Obstetrics and Gynecology and Reproductive Biology : only 0.3% of patients followed requested an act of repair or IVF. To refine these results, in particular to take into account women who would have had regrets without going through with this type of process, Doctor Panel is currently carrying out a study on 2,600 women with telephone follow-up. “This work will make it possible to have a long-term vision of the post-sterilization experience.“says Doctor Panel.
Sterilization, an “obstacle course”?
Between the decision-making process and the actual act of sterilization, several months pass. “Compared to other European countries, the process is long and therefore sometimes assimilated to an obstacle course.“laments Doctor Panel. In addition,”even if relatively few gynecologists refuse to perform this procedure, some doctors are still poorly informed and therefore do not necessarily quickly refer their patients to obstetric surgery services“In addition, nulliparous women, that is to say women who have never had children, who express a desire for sterilization are sometimes badly received by doctors.”Voluntary nulliparas, of the “childfree” movement [littéralement “libre d’enfant”, signifiant “sans enfant par choix”] often have a hard time finding someone who accepts their choice and can therefore come from afar to receive sterilization“. However, the decision to give birth or not belongs only to the woman, and is part of the right to dispose of her body.Abortion (IVG), could female voluntary sterilization soon respond to the slogan “my body, my choice, my right”?
And you, what do you think of voluntary female sterilization? Comment on the forum!
Source: interview with Doctor Pierre Panel, head of the gynecological and obstetrical surgery department at the Versailles hospital center.
>> To read also:
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Contraception: 15% of American women opt for sterilization
The IUD, is it for me?
Contraception, a women’s affair
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