Barriers to Women’s Access to Voluntary Sterilization in Canada

Abstract

Introduction: In Canada, any adult who is aware of the permanent consequences of a tubal ligation is allowed to receive it, yet many doctors refuse to perform the procedure on women, especially those from marginalized communities. The purpose of this report is to investigate and identify some of the barriers that impede Canadian women’s ability to access voluntary sterilization. There is a particular focus on how Canada's history of eugenics and coerced sterilization shapes the current conditions under which women seek and are too often refused access to permanent contraception. Methods: Six qualitative, semi-structured interviews were conducted with scholars and activists in the field of Reproductive Justice (RJ) and reproductive healthcare. The interviews facilitated discussions about reproductive autonomy, patient rights, and patriarchal attitudes in medicine. An RJ framework and thematic analysis were used to uncover systemic barriers from the interview responses. Results: As discovered through the interviews, the most prevalent barriers to access to voluntary sterilization in contemporary Canada include race, class, language, ethnicity, disability, age and parity. An RJ framework identifies historical parallels to these present-day barriers by looking at the historical and colonial forces that disempower intersectional marginalized communities and influence their reproductive decisions today. Discussions: Canada’s eugenics attitudes from the past seep into the current barriers to access faced by women of colour, low-income women, female newcomers, women with disabilities, and young or nulliparous women. The assumption that these women are not capable of deciding the right course of action for their own bodies and thus should not be trusted by healthcare providers in making these decisions is a consistent problem in both time frames. Conclusion: The restrictions and modes of disempowerment placed on variously positioned women in the past come back in a new form that leads to those same groups being doubted and denied reproductive justice in the present. Many of the interviewees believed that increasing diversity in the medical field is necessary to help alleviate the discrepancies in how contraceptive healthcare is given.