Contraception debate in Alberta highlights concerns about maternal substance use

Paula Simons has just written an interesting piece for the Edmonton Journal called Alberta should fund safe, reliable birth control (October 11, 2011).

The article discusses funding debates about a permanent birth control procedure called hysteroscopic sterilization. The procedure uses a device called Essure – tiny springs which are placed inside a woman’s Fallopian tubes. Over a period of three months, the body responds by creating tissue around the inserts which blocks the tubes and makes a woman infertile. The procedure is considered a non-surgical alternative to tubal ligation.

While sterilization procedures are a wonderful thing for many women, especially women who have had children and are certain they do not want to have more, sterilization procedures always seem to lead to paternalistic discussions of how this procedure might make sense for “certain groups of women.” As Simons says in the article, sterilization is often described as a “good option for women who have high-risk lifestyles, some of whom don’t manage conventional birth control well, have multiple abortions, and don’t have regular access to a family physician or gynecologist. ”

Women with serious addictions issues often get thrown into this category of “high risk lifestyles.” Sometimes, it seems like sterilization is the preferred solution to addressing maternal substance use rather than the underlying roots of addiction and providing appropriate treatment and care.

Simons comments:

“Hysteroscopic sterilization isn’t the answer for every woman or couple. It is irreversible. No woman, including a woman wrestling with mental health issues or addictions, should undergo such a procedure under social duress. While the procedure could reduce the number of unwanted pregnancies, and, potentially, the incidence of babies born with fetal alcohol syndrome and other brain damage caused by substance abuse, it offers women no protection against sexually transmitted diseases.

See an earlier post Project Prevention: Paying women with addictions to get sterilized (April 27, 2011)  for more on sterilization and women with addictions.

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