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HASTINGS CENTER REPORT November-December 2013

hwever, stries recunting and jus- tiying childree chice are prmi- nent, and tales  denied sterilizatin ubiquitus. Childree wmen wh seek sterilizatin cite envirnmental sensibilities, ecnmic gals, and a revulsin r the traditinal maternal rles (smetimes in additin t medi- cal reasns indicated abve). one interesting develpment in the childree mvement is the emer- gence  peple wh perceive bilgi- cal children as adding t the impact  ppulatin grwth, resurce cn- sumptin, and envirnmental deg- radatin. o curse, the idea that ppulatin grwth is detrimental t the envirnment is nt new, but the mdern childree, sel-prclaimed “GINKs” (green inclinatins, n kids) take pride in cntributing t the envirnmental mvement by nt leaving an enduring carbn cntribu- tin. GINKs believe “a baby wuld pllute the planet—and that never having a child [is] the mst envirn- mentally riendly thing [ne] can d.”

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on a less altruistic nte, ther childree wmen simply desire nan- cial security and see children as an bstacle t their scal gals. The United States Department  Agriculture has estimated that it will cst slightly ver $300,000 r a middle-class amily t raise ne child t adulthd.

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This des nt include prenatal r birth expenses, the saring cst  cllege tuitin, luxuries like music lessns r sprts, r any medical emergencies. Instead  seeing children as a tax-deductin, sme childree wmen see them as a tax liability. Mney managers wh suggest rging children in rder t retire early have taken this idea t the extreme.

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Any cmbinatin  the abve reasns, in cnjunctin with an antipathy r traditinal emale and mthering rles, can be determining actrs in wanting t avid pregnancy and childbirth r lie via sterilizatin. Since mtherhd is by nature a sex-based rle, scilgists and emi- nists have taken an interest in the rea- sns r embracing and repudiating mtherhd. one brad theme that appears in research that determines whether wmen want children is the cst-t-benet rati. “Childree wmen are less apt t view children as bringing rewards in imprtant lie areas. on the ther hand, [childree wmen and mthers] did nt di- er in their perceptins  the csts r negative aspects  having chil- dren.”

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That is, all wmen studied perceived the “drawbacks”  having children, like time investment, de- creased privacy, and less dispsable incme, but wmen wh had chsen nt t have children were less likely t see the benets  childrearing, like uncnditinal lve, ulllment, and cntributin t sciety. These actrs indicate that a deci- sin nt t have bilgical children is deeply rted in a thughtul analy- sis  the status  sciety and gen- der and that a lie withut children is a respnse t “hegemnic ntins  emininity” and therere a “mre radical rejectin r push away rm mtherhd and its assciatin.”

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Witnessing the cnstant sel-sacri- ce, the lst jb pprtunities, the unequal distributin  childrearing amng the sexes, and the cnstant caretaking that is required t raise a child prvides the lie view that “the nurturing and caring rles assciated with mtherhd are unullling r even repelling. . . . [T]he activi- ties assciated with mtherhd d nt appeal because they represent t much unnecessary hard wrk.”

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Because the values  living withut children are s strngly held in these wmen, they seek the certainty that they will nt have t endure a cm- pulsry pregnancy r have t resrt t an abrtin t maintain their qual- ity  lie, and they may therere re- quest sterilizatin as a permanent and reliable rm  cntraceptin. This is neither a dicult nr a risky request.

Women who request steriliza- tion after other contraception.

Sme peple pint t eective but imper- manent birth cntrl as a plausible alternative t permanent sterilizatin, but temprary cntraceptin is nt sucient r many childree wmen wh seek sterilizatin. In mst cases, wmen wh seek sterilizatin have been n impermanent birth cntrl r many years, but they are dissatis- ed with it r a variety  reasns, including its level  eectiveness

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and ptential cmplicatins such as heavy menstruatin, incnvenience, r intererence with intercurse.

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Intrauterine devices are ten ered in lieu  sterilizatin: “wmen g t amily planning clinics with the intentin  requesting a tubal liga- tin and end up leaving with an in- trauterine device.”

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Hwever, IUDs have many drawbacks as well: they are smetimes expelled, placing them is extremely painul, and they must be replaced every ve t ten years. I a twenty-year-ld wman were t chse the ve-year IUD, she wuld g thrugh ve dierent IUDs in her reprductive lie. Childree wmen are n strang- ers t being ered these alternative rms  cntraceptin when they have decided that they want t be sterilized. Indeed, a gd riend  mine rm cllege—a thirty-ne- year-ld wman with a master’s de- gree—has been denied sterilizatin three times nly t be ered tem- prary cntraceptin. on the third attempt, she was prvided with the ten-year Paragard IUD nly ater “meeting with a physician wh had t perrm a mini psych evaluatin t determine that [she] was  sund mind t have a tubal ligatin in the event that [her] IUD ailed.”

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Her stry is nt unique. W men wh d nt succeed in lcating a dctr t sterilize them “remain deeply, desperately wrried abut unwanted pregnancy,”

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with sme earing that the availability  birth cntrl might be limited in the uture. Fr wmen wh want steril- izatin and culd nt mrally accept an abrtin, unintentinal pregnancy resulting rm cntraceptive ailure wuld be tantamunt t a rced pregnancy.

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