How old do you have to be to tie your tubes? Laws and facts

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Tubal ligation, or ligating your tubes, is a form of permanent birth control. We also talk about female sterilization.

Tubal ligation is usually performed as a laparoscopic surgery. Your surgeon will make small incisions in your abdomen to access the fallopian tubes. The tubes are cut and sealed, or closed with clamps or rings. Tubal ligation prevents an egg from entering the uterus, where it could have been fertilized by sperm.

Tubal ligation is designed to permanently eliminate the possibility of pregnancy. For this reason, health professionals sometimes try to dissuade young people with a uterus from having the procedure. However, there is no legal age for tubal ligation.

There is no legal age to have your tubes tied in the United States. However, there may be restrictions on who will pay for the procedure, especially if you are on Medicaid or have health insurance through another federally funded program.

There are also variations on consent in state law. Medicaid requires that a consent form be signed between 30 and 180 days before obtaining the procedure.

In Massachusetts, Medicaid recipients cannot legally sign a tubal ligation consent form if they are under the age of 18. In some states, like Tennessee, California, and others, you must be 21 before you can sign a consent form.

The consent form requirements do not legally preclude your ability to have a tubal ligation. Rather, they eliminate the possibility of Medicaid paying for the procedure.

Most private insurance plans provide coverage for tubal ligation.

Under the Affordable Care Act, any plan purchased through the health insurance market must cover this procedure without charging a co-payment or coinsurance, even if you have not reached your deductible.

Some organizations and institutions that provide employer-based health insurance may offer plans that do not include coverage for birth control methods of any kind, including tubal ligation. To be exempt from this requirement, the organization must certify a religious objection to contraceptive coverage. These organizations include:

  • churches and other places of worship
  • religious non-profit hospitals
  • non-profit religious higher education institutions

No matter what your age, there can be many reasons why you might want to consider this procedure. They include health and economic issues, as well as simply not wanting children or more.

Health problems with pregnancy

Certain health conditions can make a pregnancy dangerous. These include:

If you have any concerns about your health and how pregnancy might affect you, speak to a healthcare professional. In some cases, it may be a good idea to have a tubal ligation. In others, treatments may be available to make pregnancy safer for you.

Genetic concerns

If you or your partner has a genetic condition, or if you have a family history of a specific condition, you might be concerned about passing it on to a child. If so, talk to a healthcare professional. They may recommend carrier testing.

Carrier testing is a genetic test that lets you know if you are a carrier of genes for specific genetic disorders. You can also choose to get pregnant and have your embryos tested for the disease instead. This is called preimplantation genetic testing (PGT). PGTs are types of procedures that can be performed in conjunction with in vitro fertilization (IVF).

Mental Health

Some studies indicate that regret for sterilization, which can lead to depression, occurs in approximately 28 percent people who have a tubal ligation. The time that has elapsed since the procedure took place is noted as a potential cause.

Talk to your doctor about the reasons why you had a tubal ligation. In some cases, it may be better to opt for long-term contraception, such as an intrauterine device (IUD). Of course, it’s up to you to decide what you want to do with your body and your fertility potential.

Keep in mind that situations fluctuate and change over time. The reasons you have today may be different tomorrow.

After giving birth

Some people choose to have a tubal ligation immediately after giving birth. If you are on Medicaid and are currently pregnant, discuss with your doctor when you need to sign a consent form. You can sign 30 to 180 days before having your tubes tied, so it may be a good idea to complete the consent form after your first trimester is over.

If you already have children and are totally convinced that you won’t want more, even if you have a change of partner, tubal ligation may be a good choice for you.

It can also be a good choice if you are completely sure that you never want children under any circumstances.

Tubal ligation is designed to be permanent. If you have any doubts about ever wanting children, this isn’t the right choice for you.

Feel under pressure

Getting a tubal ligation should be your decision alone. If you are under pressure from your parents, partner, friends, or anyone else, this is probably not a good choice for you. If you are in a relationship, you may want to make this decision with your partner. However, the final vote on what to do with your body should always be yours.

If you are transgender

If you and your partner both have wombs, you can assume that your partner will be the one carrying the pregnancy. In some circumstances, you may find that it will be difficult for them to do this, due to medical reasons. In this case, you may want to reconsider your decision to tie your tubes.

If you are transgender and were born with a uterus, you may be considering tubal ligation along with other surgeries or hormone therapy. Keep in mind that trans men get pregnant by choice, without compromising their transition. You may or may not decide that you want the chance to get pregnant later in life.

Try not to let fear of other people’s opinions or concerns about social stigma influence your decision.

If you think a reversal is easy

Don’t let myths about how easy it is to reverse a tubal ligation influence your decision. Despite what you may have heard, tubal ligation reversal cannot always be done and is not always successful. The extent of the damage to your tubes and the time that has passed since the procedure are two factors.

In addition, tubal ligation reversal is expensive and is not covered by insurance. It can also increase your risk of having a dangerous ectopic pregnancy.

If you are 20 years old, your doctor may not take your tubal ligation request seriously. Keep in mind that in most cases, they just come from a place of concern that you will one day regret your decision. Even so, you don’t have to accept their refusal to do the procedure as final.

If your doctor refuses to perform a tubal ligation, you can remind them that the American College of Gynecologists and Obstetricians (ACOG) guidelines state that it is ethically permissible to perform this procedure in young people. ACOG guidelines also state that respect for a woman’s reproductive autonomy should be their guiding factor.

You can also choose to find another doctor who fully respects your decision.

Tubal ligation is a form of permanent sterilization. There is no age requirement for this procedure. However, federally funded health insurance plans, including Medicaid, may not pay for it if you are under 21.

Tubal ligation may or may not be the right choice for you. Regardless of your age, if you think you might want to have children someday, you might be better off using long-term contraception rather than sterilization.

Tubal ligation cannot always be reversed successfully.


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