Jo Carden has always known she doesn’t want children.
The 26-year-old had considered sterilization in recent years but had not taken any steps. Then came the Supreme Court ruling overturning Roe v. Wade, and she started spending her evenings searching online for surgeons who conduct the procedure on young people.
“I was afraid that it would be hard to find a doctor to perform a tubal ligation, as I am a young, single female in a red, conservative state,” said Carden, who lives in Irving, Texas.
She made numerous calls to gynecologists’ offices, only to find many were booked for the next few months. She finally found a consultation appointment, and is looking forward to getting the process started.
“Where I live, and in many of the surrounding states, the trigger laws in place have no exceptions, even for rape,” Carden said, referring to state laws prohibiting abortion that were set to take effect with the overturning of Roe v. Wade.
“Because of that,” she added, “I decided the best decision for me would be to control the things I can and have my tubes tied.”
Carden is not alone. Since the Supreme Court ruled that Americans no longer have a federal constitutional right to an abortion, several gynecologists tell CNN they’ve seen an increase in people requesting tubal ligation – a surgical procedure more commonly known as having one’s tubes tied.
The decision to get sterilized can raise personal and ethical questions, and for some people, it’s not an easy one. But women, non-binary and transgender people who have made up their minds not to have children say it’s a choice they want to feel free to pursue without pushback.
Some doctors turn down young people looking to be sterilized
The procedure, which involves surgically severing or sealing the fallopian tubes to prevent future pregnancies, is not easily reversible.
Research has found that a small proportion of women – between 1% and 26%, depending on different studies – regret the decision later in life, according to the Centers for Disease Control and Prevention.
Sterilization is a common form of contraception among married couples, but only about 4% of women in their 20s get their tubes tied, the CDC says. Women who were young when they were sterilized reported higher rates of regret.
Because of that, doctors sometimes turn down young people seeking sterilization.
DeAndra Childress, 33, told CNN she has tried several times to get her tubes tied. But she said four different doctors refused to perform the procedure on the grounds that she may regret the decision later in life.
“I was told I was too young, no kids, not married, may get married later, and I should wait til I have a husband,” she said. “All methods to control my body. It infuriates me.”
Now, the medical technologist from Spring, Texas, is more determined than ever to not have children in a post-Roe v. Wade world. She’s discovered a list, circulating on social media, with the names of doctors who perform the procedure on young women, and is researching the ones closest to her. She plans to schedule an appointment soon.
“I am hoping that with this change, the doctors will be more open to doing these procedures for unwed, non-parent women,” Childress said of the Supreme Court’s ruling.
“I have been on the fence about children for years, but I decided to not have them until I was sure about it so I don’t ruin a child’s life,” she said. “Roe v. Wade feels like an ultimate slap to the face for women, and it is completely about control.”
Requests for sterilization have gone up in recent weeks, doctors say
A vocal movement of young women and non-binary people are outspoken on social media about turning to sterilization as their preferred birth control method. There’s also a group of doctors who’re using platforms such as TikTok and Instagram to answer questions on sterilization and educate people about issues related to reproductive health care.
After the Roe v Wade reversal, an obstetrician in Rochester, New York, shared a list of more than 1,000 doctors nationwide who provide sterilization services regardless of patients’ age and marital status. The OB-GYN, Dr. Franziska Haydanek, said she’s noticed an increased interest in sterilization recently among her 173,000 followers on TikTok.
When Haydanek does tubal ligation, she requires her patients to be at least 21 if they’re using Medicaid and to undergo counseling on the effects of female sterilization. These include the fact that it’s irreversible, meaning a patient cannot get pregnant again without IVF, she says.
She also ensures each patient understands the risks of surgery and knows there are reversible options such as intrauterine devices, she said. Intrauterine devices – or IUDs – can last for years, depending on the type.
“No states require you to have children before a tubal sterilization,” Haydanek said. “The age requirement (being at least 21) is only if you have government-assisted health insurance. Otherwise it’s all up to the doctor’s discretion, which is why many young patients have a hard time finding a doctor to honor their wishes.”
Dr. Charisse Loder, a gynecologist and assistant professor in the Department of Obstetrics and Gynecology at Michigan Medicine, also offers sterilization surgery. She recommends removing the fallopian tubes, rather than getting tubes tied, because she says it lowers the risk of ovarian cancer later in life.
“Previously, I would see about one person per week to discuss sterilization, and this week I have six people scheduled for consultations,” Loder said earlier this month. “In the last two weeks, patients have told me they are worried about their access to birth control, they are not sure they will have the option to have a sterilization procedure in the future, and they are terrified about becoming pregnant without reproductive choice.”
Many of her patients told her they decided some time ago that they wanted the sterilization procedure, but put it off until the Roe v. Wade ruling, Loder said.
“Before surgery, all of my patients tell me that they are sure of their decision and they confirm that it is the best plan for them,” she said. “And I feel it is my duty as a physician to respect my patient’s autonomy to make this decision, as long as there is not significant risk of harm.”
One Florida resident threw a party after getting their tubes tied
Isa Ruiz has always known children are not part of their plan.
But the 22-year-old Orlando communications specialist, who identifies by she/they pronouns, did not think much about it until associate justice Amy Coney Barrett started serving in the Supreme Court in fall 2020.
“It (overturning Roe v. Wade) is something that we’ve all been worried about since 2016, maybe even longer,” Ruiz said. The appointment of Barrett, a conservative, to the high court “filled me with a lot of urgency and certainty in my decision to get sterilized.”
Ruiz said she had tried to find a reliable contraceptive, but had negative reactions to hormonal birth control and the copper IUD.
“I quickly realized neither of those methods were viable options for me,” they said. “As someone who has never wanted to conceive at all, it was ridiculous for me to be putting both myself and my body through so much trauma for a temporary solution when a permanent solution would better suit my needs.”
In April of 2021, Ruiz got their tubes tied at age 21. They marked the milestone with a party attended by a few close friends and documented on TikTok. Decorations included inflated condoms as balloons and pink swimming pool noodles tied into knots like fallopian tubes.
“My pièce de résistance however, was by far my cake,” she said. “I ordered a cake, claiming it was for my friend’s elopement, that said ‘congrats on tying the knot!’ Ruiz then altered the message to say, “congrats on tying the knots!”
Now Ruiz is on a mission to educate others who are interested in the procedure.
Ruiz helped friend and fellow Orlando resident Alie Wagner find resources and get her tubes tied in January after months of rejections by doctors.
Wagner, 26, has hereditary health issues that she’s concerned would make pregnancy risky and potentially be inherited by any biological children. Ruiz recommended a doctor who did a tubal ligation without doubting her decision.
“Unfortunately, he was not the first doctor I’ve talked to about my choice to get my tubes tied, but he was the first that didn’t question me or try to convince me that I shouldn’t do it or that I would change my mind in the future,” Wagner said.
“One of my doctors in the past went so far as to say that I should have children because I would have such cute ginger babies since I have red hair. As if having a cute baby is enough of a reason to change my mind about not wanting a biological child.”
Both Ruiz and Wagner said their partners have been supportive of their decisions.
Now that Roe v. Wade has been overturned, Wagner, Ruiz, Childress and Carden all said they feel more convinced they made the right choice. And they’re still attending abortion rights protests.