If someone were to produce data showing that, say, 95 percent of women under 30 who had tubal ligation regret the decision and want the procedure reversed (it can be reversed, can't it?), then the doctors would have stronger ground to stand on. But if no study exists, then the doctors are basing these decisions on their own opinions, not fact. This falls into the realm of bad medicine in my book, not just mere paternalism.

OB/GYNs already face staggering med-mal premiums, I'm sure at least some of these doctors who refuse to perform tubal ligations are envisioning a pissed off former patient squaring off with them in court ten years down the road saying "You should have known that 25 was too young to make that kind of decision!"

Juries can be really unpredictable, and really love to blame doctors for not being psychic.

It's really tough for a man under 30-35 to find a doctor to give him a vasectomy, too. Most doctors just feel that, unless they already have children, it's too hard to tell if they might decide they'd like to later in life. I think there was actually a feature on this on Salon once (with regard to men), but I wouldn't know where to find it.

Here's the Salon.com article, "Is it Hip to Snip?"

http://dir.salon.com/story/mwt/feature/2005/02/07/vasectomy/index.html

"It can be so difficult for child-free men to find an agreeable urologist that the message boards on the No Kidding! site include a section where members who've been sterilized can provide referral info for willing doctors."

Who cares if these women have regrets, that's life first off. I regret not doing and doing many things, but oh well, that's how I learn. But I think it's a paternalistic attitude towards men and women. This we won't steralize you happens to men just as often as it does to women. Just sort of a we know you'll change your mind that happens whenever someone says I don't want kids and the "parents" give you the you'll change your mind or you'll be sorry speech. But doctors just don't seem to like performing that proceudre, my mom had a tubal ligation after her second child (unplanned) and she had to fight with the doctors just for that, even though she already had 2 kids and knew she didn't want anymore.

There are many options for having kids even if you are naturally sterile, so I don't see the reasoning other than just, in my experience, people regret it!

I'm all for people steralizing themselves, that ensures those people will never have an accidental child. If they do choose to find a child some other way, at least it was a choice thought about instead of an oh, whoops, I'm preggers and don't want an abortion.

This happened to me. I knew at age 20 that I did not want a child but over the next few years I could never find a doctor who would do a tubal. At age 27 I married a man who DID want children and although we discussed it, we had not really resolved the issue. When I found myself pregnant at 30 I knew that an abortion would end my marriage and I just wasn't in a place (mentally) where I could face being on my own. Now 17 years later I still regret having had a child. And the marriage ended anyway, when the child was 3 - just as I was beginning to come out of my 3-year postpartum depression.

At any rate, personal story aside, I don't agree that it is a doctor's right or responsibility to make this judgement - it's not a medical decision and I don't see how it's an ethical one either. And how is this any different from our (I feel) justifiable outrage at the idea that abortion should be illegal because we (women) might regret it later?

It is paternalistic.

Maybe no so much at 20, but at 25 women are fully formed adults, capable of weighing pros and cons.

I had a tubal at 24, after MUCH argument with my doctor who insisted I see a shrink who spent the entire visit questioning me what my mother was trying to prove when she went to nursing school when we children were in high school.

At the hospitol, I was in a room with someone younger than me getting an abortion. In fact, the whole ward consisted of young white women getting abortions and young immigrant women giving birth.

But I was the one singled out by every nurse (it seems) to be lectured on how I would regret my decision, and how it was a shame, and did my mom know, and curiously, being told that I will experience very painful periods if I was sterilised without having had children first!

I have never regreted the decision. Did I ever wonder what a child I produced would have looked like? Yes. But that is not regret. I have wonderful children through friends and family that I have been involved with while they matured. Never had a mentrual problem, never had to deal with the expence of birth control and the contant medical monitoring getting a prescription filled requires. I have never worried "am I pregnant" since my early 20's.

For me - and it was a highly thought out individual decision - it was a good move.

Doctors should inquire into the reasons and talk with the patient, but ultimately should respect the decision. After all - if that same patient wants to be on birth control for the next 30 years - the doctor would honour that decision, right?

Remember that less than fifty years ago, women were often denied birth control from their doctor, if said doctor "determined" that the woman would be using it for "immoral" purposes. If we're talking about keeping the law off women's bodies, we need to be doing it totally, not going halfsies like we have been since the modern medical era.

This is true not just for reproductive issues, but for all medicine - take the power away from the establishment (HMOs, the government, etc.), and let the patient, under the counsel of an impartial physician without an agenda of their own, weigh his or her own risks and benefits from particular treatments. Wouldn't that be a refreshing alternative to paternal pats on the head, or variations on "this is what's good for you - I know, I've got a medical degree"?