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Quebec woman claims she’s been denied tubal ligation surgery

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Quebec woman claims she’s been denied tubal ligation surgery
WATCH: A Quebec woman claims that she's being denied sterilization surgery. She says she's visited about 30 doctors and no one will budge. As Global’s Gloria Henriquez reports, some experts say there might be cultural reasons behind the refusal – Jul 18, 2022

Elizabeth Emond, 29, says she’s always known she doesn’t want children.

“I don’t think I would be fit to be a parent. I have a lot of mental health issues and anxiety and I’m really, really ADHD. I don’t say everyone like me shouldn’t have a baby … but in my case, I’m saying I wouldn’t be fit,” Emond explained. “I would gladly adopt before I have a baby, but I don’t want any at all.”

So as soon as she turned 18, she says she asked her doctor about getting her tubes tied.

Tubal ligation is a form of permanent contraception. It consists in tying or cutting a women’s fallopian tubes in order to prevent pregnancy.

But she says her doctor refused because she was too young.

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Over the course of the past 10 years, she claims she has talked to about 30 doctors and all have declined to do the procedure.

“Some doctors say, ‘No, we don’t do that on girls that young’ or some laugh and say, ‘No, we don’t do that.’ … Some recent doctor was even horrified and said, ‘No, I really don’t want to do that, you have to put a sterilet (IUD),’ Emond said.

She says she is discouraged.

Vardit Ravitsky, professor of bioethics at the Université de Montréal, says Emond is not alone.

“Unfortunately and also infuriatingly, it is very common,” Ravitsky said.

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Ravitsky believes it’s common for some clinicians to believe that if they accept the request, they could harm a patient.

“To me, it’s just a reflection, first of all, of gender inequity, because men have no problem accessing a vasectomy upon request,” Ravitsky said. “But beyond gender inequity, it’s really stemming from very strong cultural forces that still in 2022 see a woman who chooses not to have children throughout her life as not normal.”

The Association of Quebec Obstetricians (AOGQ) won’t comment on Emond’s case but in general terms says that should not be happening.

Dr. Dario Garcia, president of the association, says once a healthy patient has been thoroughly informed of what the procedure entails and its risks, as well of available alternatives — and they provide informed consent — doctors shouldn’t refuse treatment.

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“It’s not up to the physician to take that kind of that decision, it’s up to the woman herself; she is the owner of her body, she is entitled over the decisions over her body,” Garcia said. “If that’s happening because of what the physician might think, that shouldn’t happen. It’s not acceptable.”

Garcia says the procedure is not simple and carries risks.

“In the worst-case scenario, you may harm a blood vessel, depending on how big that blood vessel is, you can even die of it,” Garcia said. “Tubal ligation has a failure rate of 0.5 per cent, which means five cases out of 1,000. If we’re talking about an IUD, the chances of getting pregnant are one in 1,000.”

In Quebec, the number of women who have undergone tubal ligation has gone down by almost half in the past 10 years.

According to statistics from the Régie de l’assurance maladie du Québec (RAMQ), Quebec’s health insurance provider, in 2011, 2,647 women underwent the procedure, compared with 1,398 women in 2021.

Most of the women who undergo the procedure are 30 years of age and older.

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In 2021, 1,254 women over 30 years old received tubal ligation surgery compared with 144 women under 30 years old.

The Association of of Quebec Obstetricians says surgeries have gone down because there are more effective and less risky methods of contraception, such as IUDs.

As for Emond, she says all she wants is to have self-determination about her own reproductive system, and she would like for doctors to take her request seriously.

“I don’t think they want to listen to me,” Emond said.

Emond says she is looking to go private so her wishes can be respected.

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