Women's Fight For Their Reproductive Health Rights

In today’s world, there are a lot of reasons not to have a child. There are those of us who are not mentally ready, financially ready, or just don’t feel responsible enough to take care of anything besides a goldfish. There are many options to prevent a child such as contraception, abortion, and even medical procedures.

Being from California, I feel more educated about all of my options to avoid pregnancy and choices to take if I do happen to become pregnant and do not wish to keep the child. As a woman that is open to having a child in the future, I am content with my options currently. But there are other men and women that are beyond confident in their choices to not want a child. It may be thought that we are equal because all men and women have the same opportunity to get the procedure, but there is not as easy for a woman to get her tubes tied than it is for a man to get a vasectomy. No one bats an eyelash when a man says that he does not want to be a part in making a child. Why should it be any different for a woman?

On August 26th in the year 1920, women gained the right to vote. “The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of sex” had been added to the constitution (DuBois, chapter 8) and women could not have been happier at the time. With such a big victory for women, it was hard to realize that there were still larger issues at hand that were not being addressed in such a large way as the right to vote had.

The right to vote for women was a big win and was the start of more fights for equality in all areas of life. Margaret Sanger is a famous feminist and nurse. Sanger may be considered the mother of birth control. Sanger fought her entire life to get women the right to use birth control and at the very least to be educated about it. As a nurse, she helped many women in her time that had made the attempt to do a self-induced abortion because there was not a lot of education in the realm of contraception. In the 1910’s she began her journey to help women, mostly immigrants with multiple children already, deal with their unwanted pregnancies (DuBois, chapter 7).

This was the beginning of women more widely gaining access and knowledge to contraception. Sanger had been fighting an uphill battle though. Since many white women that had more money than the immigrant women, it was more difficult to get funding or public approval. However, the Comstock Act, a law passed in 1873 that deemed it obscene to spread birth control through mail or across state lines, made it difficult for Sanger to spread word or educate those farther away (DuBois, chapter 7). In 1916, Sanger managed to open the first American birth control clinic. Shortly after was arrested for it. With the opening of her birth control clinic, the diaphragm, a cup that can be inserted into the vagina and used with spermicide to prevent sperm from reaching the egg, became more popular.

However, the diaphragm was only available with a prescription. Because of Sanger, birth control became more respectable and widely accepted in the 1920s (DuBois, chapter 7). Thanks to Sanger, women in the United States now have access to more forms of birth control such as the pill, arm implant, IUDs, and shots. With women typically being the ones to prevent pregnancy from happening, since they are the ones that become pregnant, women are the ones to take action when it comes to things like taking a form of birth control. Only more recently has it become more socially popular for a man to take action with a vasectomy.

A vasectomy is a permanent form of contraception for men. A vasectomy is the cutting or blocking of the vas deferens, the tube that carries sperm from the testicles to the penis. The first vasectomy was performed on a dog in the year 1823 (Leavesley). Although the practice had not been used widely before, it became popular during the second world war. In the second world war, a vasectomy was seen more as a way of male birth control than it was years before as a way to study atrophy of the prostate (Leavesley). The process of a vasectomy is simple. It requires two incisions in the scrotum to access the vas deferens.

The vas deferens is then cut, cauterized, and stitched or glued. It is common that the man goes home the same day as the procedure. Recovery time is less than a week. The procedure does not even require the man to be put to sleep. A simple local anesthetic is used to numb the scrotum. There is also a “no scalpel vasectomy” which requires puncturing a hole in the scrotum, pulling out the vas deferens, snipping, and gluing it (How Is a Vasectomy Done?). On average, there are 354,000 vasectomies a year and the average cost is between zero to one thousand dollars depending on how much your insurance may cover (Stacey). If necessary, the procedure can be reversed. Similarly, there is a procedure for women called tubal ligation, better known as “getting your tubes tied”.

Tubal ligation is a very similar process to a vasectomy. The fallopian tubes in a woman are what carry the egg to the uterus each month to be fertilized with sperm. Much like the vas deferens in a male, the fallopian tubes in a female are cut and cauterized in order to prevent pregnancy. According to Mayo Clinic, the procedure is most easily done after a cesarean section birth. However, it can also be performed after vaginal birth and as its own procedure independently from a birth (Tubal Ligation). Although the procedure is more likely to fail the younger you are and the before process of getting one is difficult, it is more popular than getting a vasectomy. Annually, there are two hundred thousand more tubal ligations than there are vasectomies in the United States (Bartz and Greenberg). An article on Prostate.net states that a tubal ligation can cost ten thousand dollars if you have no help from your insurance (Reacher).

It is a wonder why there are so many more tubal ligations done per year than vasectomies. Not only is the procedure more physically invasive, the work you must do beforehand is much more difficult. For a woman to get a tubal ligation and have it be covered by Medicaid, she must be at least twenty-one years of age, mentally competent, and at one point even needed consent from her partner/spouse to get it done (Sterilization as a Family Planning Method). To get the sterilization, a woman must get it done thirty days after she initially requested the procedure, but before one hundred and eighty days have passed (Garcia). The same source states that there are even seventeen states where a provider can refuse service to perform a tubal ligation. Funny enough, all a man has to do to get a vasectomy is sign a consent form.

Many women across the United States have many issues with trying to find a provider to do their tubal ligation. In 2012, a woman named Monica Trombley explained the struggles she faced while attempting to get sterilized:

“I got a tubal at 26 years old and had to fight to get one despite a) living in NYC, b) being married to a man as adamantly child-free as me, c) working in not one but two fields that are well-known for being unfriendly to kids (law and entertainment). The paternalistic treatment of doctors telling me they were going to “talk me out of it” still ticks me off. But what really took the cake was one doctor who outright lied to us about his willingness to respect my reproductive rights and our right to make decisions for our own family. He ended up changing his mind about doing the surgery and I found a specialist in Manhattan to do it after deciding I was going to lie about the circumstances for getting one.” (Garcia)

From Trombley’s quote we can see that she was scheduled to have a sterilization done, but was later rejected by her provider even though he had previously agreed to do so. It is crazy to think that in such a forward thinking and liberal state like New York, a woman of age and all other requirements would be denied a tubal ligation even though it was previously agreed to.

While many states are willing to cover the cost and typically will not reject your request through an institution, some states such as Ohio and Oregon think otherwise. Ohio and Oregon will not cover the procedure whether it is post-partum or general at any other time. While it may be up the practitioner whether or not to do the sterilization, the ethics committee of the American Congress of Obstetricians and Gynecologists encourages practitioners that ethically, they are allowed to perform a requested sterilization in childless and young women that do not wish to have kids at all.

The committee stats that “A request for sterilization in a young woman without children should not automatically trigger a mental health consultation” which is very important to note (Garcia). Just because a young woman does not wish to have children does not mean that there is something wrong with her. Practitioners may wish to avoid performing sterilizations that a woman may regret later in life, but the most they can do is educate their patients in the effects and close to irreversibility of the procedure. While a tubal ligation can be reversed, the likelihood of it working goes down after the woman turns thirty-five (Tubal Ligation Reversal).

The easier ability for a man to get a vasectomy dates back to the double standard that men are allowed to be sexual creatures. It is expected for men to help make many children. However, women were supposedly put here to reproduce. In the sense that a woman needed the consent of her spouse in order to get sterilized is similar to the colonial times of the 1600s when the idea of feme covert was around. The idea of feme covert was that a woman had no legal identity. The woman did not have control over her own property, children, not even her own body (DuBois, chapter 2).

For centuries following, men had a sense of superiority over women. Women have been seen as inferior and not able to make big decisions for quite some time. Luckily, in the 1970s the case Ponter vs Ponter declared that needing a spouse’s consent to be sterilized is unconstitutional. But unfortunately, the Supreme Court has never ruled on the issue so nothing is set in stone (The Fight for Reproductive Rights). When Sanger finally helped get women access to birth control in the 1920s, women took back some of their reproductive rights. Griswold vs Connecticut in 1965 also helped women gain more of their own rights back. With Griswold vs Connecticut, the selling of contraceptives was made legal (Dubois, Documents). Eisenstadt vs Baird in 1972 made it so unmarried couples could have access to contraceptives as well.

The case of Roe vs Wade made it legal for women to get an abortion. It is ridiculous that a case like this was required to happen. It was caused by many women seeking black-market abortions because many states prohibited abortions in clinics (The Fight for Reproductive Rights). These black-market abortions resulted in death a good majority of the time. But here we are, almost half way through 2019 and it somewhat feels as though not a lot has changed. Sure, women can now legally use all forms of contraception whether it be a procedure to get an IUD or something more permanent such as a tubal ligation. Abortion, while it may not be completely socially acceptable still, is legal in every state. Roe vs Wade made it so every state has at least one abortion clinic.

According to a source that states the abortion laws of all states, some states, such as Alabama, have more restrictive laws around abortion like it cannot be done after twenty weeks, requires a mandatory counseling service, and will only be covered by insurance if the pregnancy is a danger to the mother’s health or a result of rape or incest. California on the other hand is much less restrictive in their laws. California will cover abortion costs no matter what the justification of it is. In Iowa an abortion cannot be performed after the mother is six weeks pregnant (Edwards et al). While changing abortion laws is a step in the right direction, we need to look at all aspects of women’s reproductive rights.

A woman on Facebook named Deonna Minix posted to her page. She said that a man joked to her that he would “get his tube tied at age eighteen and never look back.” To his surprise, she responded that “you must be twenty-five, married, and have at least one son and one daughter, and your husband must agree.” Which may have been somewhat of a stretch because you do not really have to be twenty-five, and do not have to have children.

However, it feels as though those are the laws because of the way some practitioners may refuse you if they do not think you fit their requirements to be sterilized. Minix closes the post with her male friend saying “I could walk in right now and get a vasectomy though” to which she replies “that’s because men are in control of their bodies.” (Garcia). Over the last few decades we have made so many technological advances in terms of making vasectomies and tubal ligations easier, safer, more effect, and even somewhat more cost efficient than they used to be (Bartz and Greenberg). Most health insurance providers are willing to cover some to all of the cost it may take to cover the sterilization.

Of course, a woman’s procedure may be more expensive because it is more tedious, invasive, and typically requires more anesthetic. That is to be expected because the reproductive system is not half outside the body like it is for men. However, we need to make an effort to have the before process and aftermath of getting a vasectomy more equal to the process of getting a vasectomy is for a man. In order for this process to be equal for men and women, we need to stop assuming that a woman is going to change her mind.

Doctors worry that they may be sued in the chance than a woman changes her mind and regrets getting the tubal ligation done. We should just have women sign some paperwork prior to the procedure saying that they will not sue them due to regretting a decision. What is important in the process of being sterilized is education. Doctors need to educate their patients, whether male or female, and let them know the permanent effects of being sterilized and that the chance of a reversal working is not always one hundred percent.

The choice to be sterilized should not be up to a doctor. Unless the procedure is life threatening to the patient, it should not be up to the doctor. We are not there yet but we could be. The most important thing for people to do is be active in our political world. While it may be tedious to read all these bills and acts while voting, you should. It might not seem like it at times, but the government does listen to citizens when we collectively try to change something that matters.