The How-To Childfree Guide On Sterilization: Uterus Edition


Jasmine Sierra is your run-of-the-mill 20something who got fed up with “the man” and quit her bogus office job to give her hand at freelancing. She is currently an Intimacy Coach in training and an emerging spiritual practitioner; in the long term, it is her goal to provide services to individuals who are seeking to reconnect with their sexual and spiritual selves again by providing them the information necessary to transform their inner world. She is the owner of The Sterile Slut, a multi-media blog whose goal it is to show her sexual know-how through the lens of one shy, polyamorous, childfree individual.

So you’ve decided to get sterilized! Congratulations! Whether you came to this decision because it as an easy afterthought, or you labored over making this decision before knowing it was right for you, I’m happy that you’re making a choice that you know will give you peace of mind in the long haul. Now is the best time to do it too — I mean yes, we are still in the middle of a p*ndemic — but odds are, if you’re living in America, you have eyes. You’ve seen who was just appointed as the new Supreme Court Justice. You know that the future of reproductive health is hanging on a string that can be cut at any time.

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Making up your mind about going through with the procedure, however, is not the equivalent of getting it done. And from the start, you know what should be a quick snip under the knife is burdened by politics. Will your doctor respect your bodily autonomy and perform the procedure? If you have insurance through an employer, does that employer honor the ACA (while it’s still in tact) and cover your preferred method of birth control?

The information I’ll be providing in this blog article is not a panacea for the obstacles you might be facing. Instead, what I hope to do is to give you a more comprehensive understanding of what sterilization is, how to increase your chances of finding a provider who will perform the procedure for you, and what you can expect both before and after surgery once approved.

But first, let's have a segway


I made a post back in May about how the Big Name Hospital™ I was working at was awful — this is still very much true, but there were a couple of perks: the health insurance was dope and I just so happened to work two floors beneath the OB/GYN clinic. While I had been ruminating on getting sterilized since I was 20, it wasn’t something I was in a hurry for, not right away. Like you, I had the sense that I was going to struggle with finding a provider who would do it. I also had at that time the Paraguard (Copper) IUD, and though it wasn’t perfect, it was one of the few birth control methods I knew had a near perfect effectiveness rate. At that point I figured I would just wait until the IUD expired in several years and ask for the procedure then.

Then reality hit me when somebody close to me became pregnant.

As somebody with tokophobia (which is the fear of pregnancy and childbirth), it was hard enough to cope with it in passing. Of course there were other people I engaged with with who had gotten pregnant, but they were patients in passing and strangers on the street, or distant friends who I mainly interacted with online. A pronounced belly here and there wasn’t enough to send me into a death spiral. It was knowing that this person and the people around this person were passionate about children and so, would talk about it frequently.

Since it’s in bad taste to piss on somebody’s parade when their march isn’t hurting anybody, I had tried my best to be polite and minimize being around these conversations.

But real life is messier than that. After struggling for a couple of weeks with increased intrusive thoughts, I came to the conclusion that it couldn’t hurt to at least book a consultation to see what happens.

I know having a phobia concerning pregnancy seems odd considering it’s perfectly “natural” and that’s how our species propagates, but I’d just like to point out that snakes, spiders, and the ocean are all also “natural” and phobias against them exist too.

Knowing the OB/GYN office was just a quick skip up the stairs, all I had to do was go up and ask for an appointment. Bam. Then all I had to do was show up to said appointment and, with my long list of reasons stored in the back of my mind as to why I could not and will not have children, recite them until I could convince the provider why they should agree to do the procedure.

Spirits how I lucked out! I was fortunate to have met with a provider who was understanding about my reasoning. Besides a couple of obligatory questions making sure that my choice was my own and that I wouldn’t “regret” it, the date was set. I signed some papers, put in my request for time off, and that was it.

This is not to say that it was that easy on an emotional front. Despite how smoothly everything else had gone, the rhetoric of “what if you change your mind” and “aren’t you too young to be making such a permanent decision?” as echoed by a few naysayers began to haunt me. I know I talked about this before but I think it bears repeating: nothing will fuck you up quite like growing up in a world that tells you your primary function is to reproduce. Escaping what Laura Carroll calls “The Baby Matrix” has been one of the single best things I’ve done with my life, absolutely — I just can’t say it hasn’t been without its share of pain. And if you’re reading this because you want to get sterilized, you know what I’m talking about.

The pain of not being believed.

The pain of feeling like you can’t be trusted to know what you want to do with YOUR body.

The pain of making a decision that, while more acceptable now than it was even 50 years ago, still comes with concern trolling from people whose support you wouldn’t mind having.

Looking back, I am grateful that the opportunity presented itself to me; I would do this procedure again in a heartbeat if it meant ensuring my sterility for the rest of my life. And with any luck, I also hope this blog post will direct you towards you or your loved one’s goal of sterilization, too.


*Note: My advice is based on my experience as an American. Not all tips and suggestions may be applicable depending on your location!

Step One: What You Need Before You Start

Let’s start by debunking an oft heard myth about sterilization: that you must be married and/or have children to get this done. Neither of these things are necessary! All you actually need from a legal standpoint is two things:

  • That you are 21 years of age or older

  • That you are making this decision from a “sane” state of mind (that is, this decision is a conscious choice you’re making)

If your provider insists that you get your spouse’s permission or need to feel out additional paperwork beyond the standard “Consent For Surgery” forms (i.e. forms that suggest you need to see a therapist), FIND ANOTHER DOCTOR. These two conditions are the only conditions that MUST be met in order for you to be approved.

Jasmine Sierra

Jasmine Sierra is your run-of-the-mill 20something who got fed up with “the man” and quit her bogus office job to give her hand at freelancing. She is currently an Intimacy Coach in training and an emerging spiritual practitioner; in the long term, it is her goal to provide services to individuals who are seeking to reconnect with their sexual and spiritual selves again by providing them the information necessary to transform their inner world. She is the owner of The Sterile Slut, a multi-media blog whose goal it is to show her sexual know-how through the lens of one shy, polyamorous, childfree individual.

That was easy, wasn’t it? If only the rest of this process was just like this.

As far as costs go, make sure you’re covered by your insurance if you’re not looking to pay ~$1,500 – $6,000 for the surgery! Most insurances (including Medicaid) will take care of the bulk of the costs associated with the procedure since it is a form of birth control. If you’re not sure, however, contact your insurance company and ask — it’s (usually) billed under the ICD-10 code Z30.2.

Step Two: Types of Sterilization and How to Find a Provider

Alright, you’ve gotten the boring legalese schtick out of the way. Now it’s time to understand what type of sterilization you’re looking for.

The most popular type of sterilization procedure is called a tubal ligation. Tubal ligations are considered one of the most effective forms of birth control there is, with a success rate of >99%. Options for tubal ligation include having your tubes tied with twists, being clipped, or cauterized (burned) somewhere along the fallopian tube so that the egg doesn’t have a chance to travel down into the uterus. If you are comfortable with this method, your provider will go over with you which type of tubal ligation they feel is suitable for you and how it will be done.

A simple diagram showing you the main types of tubal ligation. None are more effective than the other; rather, it will depend on how your provider wants to do the procedure.

The other most common method of sterilization is called a bilateral salpingectomy. Simply put, it’s the process by which both fallopian tubes are completely removed (though your ovaries will stay attached to your uterus via a ligament). Providers are increasingly moving towards this method of sterilization as it is the only 100% foolproof, method of ensuring pregnancy can’t happen. It’s also great because it decreases your chances for ovarian cancer, and compared to tubal ligation, surgery and recovery time is about the same. Its only downside — if you can call it that — is that it is not reversible. And while I’m not suggesting you should base your decision on whether or not it can be undone, it is something to keep in mind if “regret” is a huge concern for you (though by that point I would just advise you stick to an easily reversible form of birth control). As for finding somebody who’s going to do the procedure for you: It’s important to research the available providers in your area once you’ve confirmed your insurance will cover the procedure(1). When I was looking for providers in my hospital who would do the procedure fuss-free, I referred to this amazing guide put together by r/childfree. The list is kept up-to-date by users who have gotten their procedures done at these offices, often providing notes about how the interactions went and what type of sterilization the provider will perform(2). It even lists providers in other countries if you are an international reader looking for resources!

Step Three: Prepare for Your Procedure

Once you’ve picked your provider, had your consultation, and scheduled your dates, it’s time for the big event: surgery! Most of what you need to know will be relayed to you by your provider at the time of your consultation — you know, big stuff like surgery time, what to do the day of, how long it will take to recover, and so on. But I found it helpful during this period to really KNOW what to expect and if I can be doing anything else (besides what my provider instructed) to make this as easy as possible for me. As it turns out, you can! Most sterilizations are performed laparoscopically; the procedure will be done though small incisions in your abdomen so as to minimize the complications of surgery. Because this method often involves pumping the abdomen with gas in order to gain easier access to the uterus, however, a common post-procedure pain is feeling super bloated. This bloating may cause pain to radiate up through your shoulder as it puts pressure on the surrounding nerves. Another common concern is making sure you can pass stool without straining your abdominal muscles since they’ll be a little weak for the first several days. Though your experience under the knife will differ from mine, I’ve put together a short list of items you can cop before the procedure in order to ease the recovery process:

  • Stool softener

  • Gas-x or Beano

  • A pack of sterile gauze pads

  • A mild, antibacterial soap

  • A few days worth of soft foods (i.e. soups, mashed potatoes, etc.)

  • (Optional) A heating pad

Step Four: Celebrate!

Sure, you may be banished from dick, bending down to pick things up, and your favorite pair of jeans for the next couple of weeks as your incisions heal, but remember: you are now officially sterilized! If you are at all like me and feel nothing but dread at the thought of being pregnant, the peace of mind sterilization can bring you is priceless. In the two years since I had this procedure done, I’ve been able to enjoy more spontaneous sex with my partners while not worrying about my hormones being slave to the disruptive processes that birth control can induce. I also haven’t spent my time freaking out about the .08% chance of failure from my IUD since I know no tubes = no chance. When you know, you know. If getting sterilized has been on your mind but you haven’t been sure where to start, I hope this guide starts pointing you in the right direction. The first steps can be daunting, but you will come out on the other side knowing you’ve made a huge leap forward towards living your most authentic life. Good luck!

(1) Note that while this list tends to specify which type of sterilization procedure a physician will perform, it may not mean that it is the ONLY type they do! It never hurts to call and ask the office. (2) Depending on your type of insurance, some require that you see your primary care physician in order to obtain a referral before you can book the procedure. You may have to do some additional research and calling around to find a PCP who will write a referral for you if your current one is not willing. You can also consult with your local Planned Parenthood provider to see if they can’t point you in the right direction.

References & Additional Resources A comprehensive guide by r/childfree on making an informed decision Meet the 20somethings Who Want to be Sterilized The statistics of sterilization UHC guidelines on billing for different sterilization procedures

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