Amy notes a puzzling asymmetery in the way doctors approach young women’s reproductive choices. If someone in her early twenties wants help conceiving a child, say via fertility treatments, then the medical profession is only too happy to oblige. Perhaps that’s still on the young side to be having children these days — I’ve no idea what the average is, though I don’t think of myself, at twenty-three, as remotely near ready to be a father — but most doctors would not, I suspect, presume to tell a woman my age that she’s not competent to decide to have a child.
Yet when it comes to the opposite decision — the choice to have a tubal ligation — many doctors apparently won’t even consider approving the procedure for childless women until they’re at least thirty. That decision, as Amy’s doctor puts it, is “too big” to make at such a young age. This despite the fact that other forms of birth control, such as the pill, often have significant undesirable side effects. Others are unreliable enough that many women are understandably hesitant to put full trust in them. If you’re in a relationship in which you’re having sex several times a week for a year or so, sooner or later you’re almost certainly going to have a condom break at least once. It’s surely reasonable to be wary of the risk that little statistic entails.
Of course, sterilization is a rather big decision, and one some people might come to regret. Surely, though, it’s not any more significant or irreversible than the choice to bring a child into the world, and plenty of people make that decision with far less deliberation than I know Amy’s given to her own. Like any medical procedure, there are risks involved — but that’s no less true of the abortion that might have to be performed because a sterilization request was denied. That’s another decision that no doctor will veto because twenty-two is “too young.”
I assume that behind this asymmetry is a value judgment. Wanting to reproduce is “normal” and “reasonable,” while not wanting children is aberrant, bad, a sign that you must not be in touch with your Deep Female Nature, which (didn’t you know?) will sooner or later instruct you to start pumping out babies. Now, far be it from me to deny the existence of biological clocks, but I had thought one of the nice things about twenty-first century civilization was that we are not, thank Darwin, in complete thrall to all of our most basic genetic urges. The triumph of choice and intelligence over biology is, at root, the purpose of all medicine. So why does the medical profession not seem to see anything wrong with letting a women-all-want-to-be-mommies norm trump the wishes of patients?
Update:Wow, readers rock. (I have readers… why does that sound so odd?) Stacy McCain eases my confusion by providing the following data:
According to the National Center for Health Statistics, the median age for first-time U.S. mothers in 1999 was 24.5 years. That’s an increase of 2.5 years since 1972, when the median age at first birth was 22.0 years.
