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Ethical Issues in Sterilization of Women

Obstet Gynecol; ePub 2017 Apr; Harris

The American College of Obstetricians and Gynecologists (ACOG) Committee on Ethics has issued a committee opinion that reviews ethical issues related to the sterilization of women and outlines an approach to providing permanent sterilization without a reproductive justice framework that recognizes that all women have a right to pursue and to prevent pregnancy. Among the ACOG recommendations regarding the permanent sterilization of women:

  • Respect for an individual woman’s reproductive autonomy should be the primary concern guiding sterilization provision and policy.
  • Coercive or forcible sterilization practices are unethical and should never be performed.
  • Obstetrician–gynecologists should provide presterilization counseling that includes a discussion of a woman’s reproductive desires and places her wishes at the center of care.
  • In appropriate cases, sterilization of a male partner should be discussed during presterilization patient counseling as an option with fewer risks and greater efficacy than female sterilization.
  • It is ethically permissible to perform a requested sterilization in nulliparous women and young women who do not wish to have children.
  • If individual physicians or institutions will not provide sterilization because of personal religious beliefs or institutional policy, patients must be informed as early as possible and provided with an alternative form of contraception that is acceptable to the patient or be referred elsewhere for care.

Citation:

Sterilization of women: Ethical issues and considerations. Committee Opinion No. 695. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;129:e109–16.