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Dear Amy,

When I was diagnosed with cervical cancer two years ago, getting treatment of any kind in a timely fashion was almost impossible--I went through three doctors before I found one who seemed to care at all about my survival past the next five years.

There was a definite discrepancy in treatments for women of childbearing age and women who had no children versus women who had children already or were post-menopausal. Women of childbearing age, or who had no children (such as myself) are given extremely minimal treatment (loop excision, conization, etc.) compared to women who already have children or   are post-menopausal (who receive hysterectomies and lymph node   excisions,   along with radiation). The reason I was given for this lack of health care was: I might someday wish to have babies, even though my husband has a vasectomy and we have agreed to adopt children if we ever decide we want any.

My last gynecologist referred me to this study http://www.uihealthcare.com/news/news/2004/05/17guidelines.html and a couple of similar studies that showed that treatment of any kind can often mean a difficult pregnancy, require circlage, and possibly end in miscarriage or stillbirth. My response to him was: SO WHAT? I'd rather be alive for the next twenty or thirty years than dead next year!

I've discussed my decision not to bear children with my husband, and he agrees with it, so why should anyone withhold treatment from me for a potentially lethal disease? The only thing I was told is that "you might change your mind."

I find it truly offensive that young women (I was 26 at the time) are not considered able to make such an important decision, even when it involves their own personal life or death. My question is, do you think that this is due to the pro-natalist slant of our culture, that women are only worth their baby-making capacity, or that it is just due to the age-old stereotypes of women being nonintellectual creatures?



Dear Lora --

Yes, I do think that this country in general has a hard time believing that women legitimately don't want children. I was actually just at a conference sponsored by Planned Parenthood and one of the keynote speakers was childless by choice and she talked a lot about those pressures and more importantly the judgment and disbelief. She and others who have written to Ask Amy have also talked about doctors reluctance and down right denial of tying a woman's tubes if she is still of child-bearing age.

I think that as more women make their choices known -- just as other women don't feel a need to be married -- society will begin to change. Perhaps there is a pamphlet to be made and distributed to doctors explaining that this is common.

Good luck and take care,

— Amy

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