I am a social worker, and I deal with many women who are poor with too many children. Many of my clients are 21 years old with four kids. All of them have stated that they would like to have the tubes tied but are not allowed to. I'm not sure if this is a government issue or a doctor's issue. Most of them are told that they need to be 27 years old, have six children or be married so that their husbands can give them permission to get their tubes tied.

Am I missing something here? This is the way was in the 60s, when I was pregnant. Have we not moved forward since then? Men can get a vasectomy at any age with no children. I find this to be very sexist and unequal. Most of these women have men fathering children everywhere and not paying child support. Yet these women are not free to make their own decisions on how many children they would like to have.  Everyone wants to complain that they have too many children. Yet there are laws to keep them from preventing it. What gives the government or the medical profession the right to choose for a woman how many children she should have and what age she should be able to stop? I am very confused and would appreciate it if someone could explain this to me.

I asked my colleague to investigate further and below is her research. And though it doesn't seem that this isn't something formally enforced, that doesn't mean that people don't want women to believe it's true — especially those who feel that it's a woman's duty is to procreate. I have heard versions of this even from middle class women — or more accurately people just tell them they will "regret it." It's very hard to go against what society feels is the right thing and therefore society will put up many roadblocks. I hope that you can find a way to at least initially educate the women in your community about what their options really are. Unfortunately, healthcare providers and activists have very often heard similar stories about women being denied all sorts of birth controls, including sterilization.  After doing some research online, I couldn't find any notes at all about "formal" restrictions, legal or otherwise.  I called the education department at Planned Parenthood NYC and they said there were no restrictions.  The only thing they noted were restrictions in Medicaid coverage — which I'm guessing may affect the women you work with.  At the site for Our Bodies Ourselves, there is a good chart and explanation about what reproductive services are covered state by state, including tubal ligation/ sterilization.  Still, it seems that most states cover it and I haven't found any evidence that there are formal age or other restrictions.  What I suspect is that individual doctors are arbitrarily inventing their own restrictions based on their opinion of what choice a certain woman should make, regardless of which she would like to make for herself.  This is not uncommon.  I would recommend having the women you see insist on a reference for a specific law if a doctor will not perform sterilization.  If there actually is a law, which I doubt, we would love to know about it as I'm sure the other women you see would.

— Amy