Contraceptive sterilization by tubal ligation has been authorized since 2001 for all adult women.
"For four, five years, we have had more and more young women asking us for permanent contraception," says Hervé Fernandez, obstetrician-gynecologist at Bicêtre hospital.
In practice, many doctors refuse to perform this operation, especially in young women who do not have children, on the grounds that they might regret it.
As far back as she can remember, Mathilde has never wanted a child.
But the young woman does not support the pill and the IUD badly.
This is why she decides, at 27, to learn about contraceptive sterilization by tubal ligation.
The operation consists of preventing the spermatozoa from accessing the oocyte either by cutting or coagulating the fallopian tube, or by applying a clip to it.
The young woman meets
three gynecologists, she receives three refusals.
She calls fifteen others, always the same answer in the negative.
However, surgery has been authorized since 2001 for any adult who requests it.
Mathilde will take more than seven years to obtain permanent contraception.
“For four or five years, we have had more and more young women asking us for contraceptive sterilizations,” notes Hervé Fernandez, obstetrician-gynecologist at Bicêtre hospital, in the Paris region.
Among the patients who ask him for a tubal ligation, 5% do not have children.
Bertrand de Rochambeau, obstetrician-gynecologist, known for his anti-abortion positions but who regularly performs this operation,
even estimates that a third of patients who request this operation
less than thirty years old.
And to clarify: “And a good number of them have no children.
»
The doctor's conscience clause
Legally, nothing prevents young women called “nulliparous”, that is to say childless, from having recourse to contraceptive sterilization.
The only criteria required: a preliminary interview with a doctor followed by a period of reflection of four months.
At the end of this, the patient must see the professional again and give her informed consent in writing.
The operation can then take place.
"The law allows it so there is no reason not to practice it," insists Hervé Fernandez.
In fact, however, many doctors oppose this contraceptive sterilization of women.
The conscience clause gives them the right to refuse an intervention but in this case, they are required to redirect the patient to another practitioner who will agree to perform it.
An obligation little respected according to the women we interviewed.
Conversely, several of them were given a moral or life lesson, sometimes with a condescending air.
Leïla, who first went through her usual gynecologist, was told “what does your boyfriend think?
when she was single.
She was then entitled to “what does your mother think?
".
The practitioner even swore to her that no one would practice this on a woman her age.
"It's not legal," she assured him.
“All the gynecologists I contacted told me that I was too young to make such a decision,” insists Mathilde.
Several of them assured her that she could change her mind if her future spouse wanted children.
“Whether my companion wants it or not, I don't want it!
“, she protests.
The risk of regret
If some doctors are so hesitant about the idea of sterilizing nulliparous women who ask for it, it is because they are afraid that they will regret it one day.
Florence, 32, who took years to have surgery, has always been aware of this risk.
“But if I regret it, only one person will be unhappy: me.
Whereas if I have a child and I regret it, we will be two unhappy.
»
The argument of age does not convince Bertrand de Rochambeau.
“Who am I to find these women too young?
As long as I have explained the consequences to them, if that's what they want, I do it.
»
Listening that Mathilde regrets not having had.
“For gynecologists, I was not in a position to make such a drastic and important decision.
I told them “I have been looking for a doctor for years to have surgery.”
It's not a fad.
I didn't wake up one morning saying to myself “hey, I'm going to have surgery”.
An argument comes up regularly among women who have had their tubes tied or are trying to do so: why the fact of not wanting a child provokes such a debate when we never question the fact of having one?
If Hervé Fernandez performs tubal ligation in young women who request it, he believes that some may regret it one day.
So in order not to destroy their chances of getting pregnant in the future, he strictly forbids the doctors in his department to remove their tubes and favors placing clips on the tubes.
A reversible technique but not without consequence.
If the woman changes her mind, they will be removed and the tube cut on either side.
Microsurgery will connect the tubes.
“In good hands, the success rate is 50%,” estimates Bertrand de Rochambeau.
PMA also remains a possible option.
“Today the chances for young women to have a child in this way are high.
»
A list of doctors exchanged “under the cloak”
Florence, who went through a friend to find the doctor who operated on her, talks very easily about her permanent contraception around her.
Women often ask her how she managed to find a doctor who agreed to sterilize her.
“Today, we pass the contacts under the coat”.
To spare others the obstacle course they have experienced, young women who have had their tubes tied decide to help those who wish to do the same.
Facebook groups, thread on Twitter, list of gynecologists practicing the operation, all means are good to help each other.
After her disastrous experience with her gynecologist, Leïla inquired and easily managed to find a doctor who agreed to operate on her without making her feel guilty.
“I managed to avoid complex situations with the doctors,” she rejoices.
The proof, therefore, that it can sometimes be simple.
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