Back in my mother’s day, women were expected to grow up and raise a family.  Nowadays though, modern women view having kids as more of an option.  In fact, more and more often women are choosing to forgo the family experience in exchange for a demanding or prestigious career.  There is no longer a societal stigma for not having children.  It is truly a choice.  Oprah Winfrey, two recently-appointed female Supreme Court Justices, Condolezza Rice, and even our Surgeon General are childless.  While I can say firsthand that it is possible to have both a career and children, I can certainly relate to the ambitious young women out there who want different achievements than those of their mothers’ generation.  While these young women may have decided beyond a doubt that they don’t want children, for some reason, they’re not sharing this information with their OB/GYNs.

Many people see OB/GYNs as physicians who perform annual exams or take care of matters concerning pregnancy.  While these are important parts of our job, they’re not the sole aspects.  We are here to provide support and advice when it comes to a variety of women’s health issues.  Just because you’ve decided not to have kids, doesn’t mean we don’t have anything more to tell you.  In fact, OB/GYNs can give you valuable information concerning your permanent birth control options.  Although so many women are opting out of pregnancy, they continue to use contraception methods that are temporary, not always effective, and sometimes, risky to their health.  With average use, condoms have a failure rate of 17.4 percent and the pill has an 8.7 percent failure rate.  In addition to the pregnancy risk, hormonal birth control increases a woman’s risk for blood clots, strokes and heart attacks.  Yet, those who don’t want kids or those who don’t want any more kids, continue to take the risk.

As stated in my women’s health book, “Inside Information for Women”, the most common form of contraception among couples is sterilization.  While most have heard about invasive procedures like vasectomies and tubal ligations, only 12 percent were aware that other options existed.  Because, in the final analysis, whoever carries the child is the one who is going to be the one most concerned about birth control, it is more usually the female partner rather than her mate who elects sterilization. There is more than one type of sterilization for women though, including sealing fallopian tubes using an instrument with an electrical current, closing them with clips, clamps, or rings.  A new method of sterilization (Essure®) involves inserting spring-like coils into the tubes through the cervix around which tissue grows to block the tubes.  President of AAGL and practicing OB/GYN, Dr. Linda Bradley believes that more women would choose a permanent method if they were simply more educated on the matter.  She cites the insert procedure (Essure®) as being 99.8 percent effective and a lot less invasive than a tubal ligation.  She notes the insert method, for instance, as being a “non-surgical permanent birth control procedure [that] offers women the option of no incisions, no hormones, no general anesthesia and no slowing down to recover.”  It’s a fairly new procedure, just ten years old, but it is gaining in popularity among those who have learned about it.

Wherever you are in your reproductive plans, it’s important to share them with your OB/GYN.  They can give you information you may not have considered, guide you in your decision making, and help you make the healthiest and most informed choice regarding your reproductive health.  The next time you and your loved one debate over who should get that permanent birth control procedure, include your OB/GYN in the conversation.

– Yvonne S. Thornton, M. D., M. P. H.