Permanent Birth Control Is in Demand in the US—but Hard to Get

All of these reasons for denying sterilization are in direct contradiction of ACOG’s ethical guidance. Yet doctors face no repercussions for refusing to perform procedures; the US does not track data on how many sterilization requests are denied. “So there’s no accountability—there’s no capacity to enforce a consequence,” Hintz says.

Access to the procedure isn’t equitable across society. Echoes of sterilization’s checkered past—in which marginalized groups of women were forced to undergo the procedure, including women of color, women who were poor, and those living with disabilities or mental illnesses—still linger today. Black, Latina, and Indigenous women in the US are up

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