Status: 08/28/2022 10:58 a.m
Saskia Rieger has long been sure that she does not want children. But her gynecologist didn’t want to write a referral for a sterilization. Why surgery in young women is controversial.
By Siri Warrlich, SWR Stuttgart
An August evening in Winnenden near Stuttgart: Saskia Rieger is sitting at the dining table with her boyfriend Sascha Somiesky, leafing through a photo album. Corfu, September 2021. Rieger in the sunset, Somiesky on a cliff. Travel and photography are two passions shared by the couple. Rieger is 28 years old, Somiesky 36. They’ve already been to Calabria and Zurich this year, and a road trip through Morocco is planned for the fall.
“Travel plays a really big role for me,” says Rieger. “I don’t want to lose my freedom and flexibility in the long term.” Her job in sales at a management consultancy is also important to Rieger. “I don’t think I could work full-time with a child,” says Rieger, listing the commitments she associates with children: getting the kids ready for school, lunch, homework, doctor’s appointments, driving the kids around, dinner.
Pill, copper chain – tried many things
Saskia Rieger doesn’t want to live like that. She has known for years that she does not want children. Rieger took the pill, later she had a copper chain. Until a few years ago, the YouTube algorithm suggested her a video about female sterilization. Even then, Rieger thought that this could also be a good way for her. Later, at 27, that still hadn’t changed. “And that’s why it was quite logical for me that sterilization is the only right option for me,” says Rieger.
She found a hospital near her that does the sterilization. To do this, she needed a referral from her gynecologist, Rieger recalls.
“Huge lecture” at the doctor
“But when I came to the gynecologist’s practice, there was a huge lecture,” says Rieger. In the reception area, the doctor told her that “no sensible doctor would sterilize me at that age.” She was asked to leave the practice and not to come back with her request. “I felt totally patronized. Why can’t I say as an adult in my late 20s that I don’t want children? When I say I’m pregnant at the same age, everyone congratulates me – even though it’s also a decision for life is,” says Rieger.
The “Self-determined sterile” association advises those affected
According to the “Self-determined sterile” association, Saskia Rieger is not alone in this experience. You often hear that gynecologists initially refuse to sterilize young women, says Susanne Rau from Leipzig on the phone. Rau had himself spayed at the age of 28. Together with others, she founded the association three years ago.
“Self-determined sterile” offers a map of Germany with doctors who perform sterilizations online. “But there are also practices that do it but don’t want to be registered,” says Rau. She suspects fear of image damage behind it – for example, if the practices also offer fertility treatments.
The Federal Association of Gynecologists takes the position that sterilization should only be carried out under the age of 30 if there are medical reasons. “If, for example, there is an illness that would become significantly worse during pregnancy, if childbirth would pose a significant risk, or if the mother has given birth several times and sterilization is expressly desired, sterilization is conceivable as a final measure,” writes the association on request.
Study of Regret After Sterilization
The concern is that women might regret the move later. During sterilization, a woman’s fallopian tubes are closed or partially removed. There is no guarantee that the procedure can be reversed – and attempting it will always require another, complex operation.
The Federal Association of Gynecologists refers to a study from the USA from 1998. More than 11,000 sterilized women were interviewed. As a result, about one in five women who were under the age of 30 when they were sterilized later regretted the decision. However, the results also show that women who had not had children before sterilization had the lowest risk of regret. In this group, about six percent later regretted the sterilization.
Marion Janke knows the topic. She heads the Profamilia counseling center in Stuttgart. “It’s unreasonable when women have to go through five or seven addresses before they find someone to sterilize them,” says Janke. “It’s not okay that women are being made so difficult.”
Rieger feels relieved
At the same time, Janke also understands doctors who have concerns. “Whether someone wants children or not can change over time,” says Janke. Alternative long-term contraceptive methods such as the hormonal spiral have improved greatly in recent years. If a doctor has provided comprehensive information and advice, the decision must ultimately be left to the woman, says Janke. In terms of numbers, the topic at Profamilia in Stuttgart is a niche topic. Fewer than five women a year report because they can’t find a doctor to sterilize them.
Saskias Rieger’s sterilization is now more than a year ago. Another gynecology practice finally gave her the referral. She’s not afraid of one day regretting the decision. Since the operation she has felt relieved. “Whenever I was asked if I wanted children, it was said: ‘That will come,'” says Rieger. “Now I can say, ‘No. I had an extra operation for that. I’m sterile now.’ It gives the whole thing a different expression.”