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The most common risk is regret.

One U.S. review involving more than 11,000 women who underwent permanent sterilization in the 1970s and 1980s found that, after 14 years, the cumulative risk of regret was 20 per cent among those who were 30 or younger when they were sterilized, and six per cent for women over age 30 at sterilization.

However, regret was lower in women who had never had a child, compared with women with at least one, suggesting “a woman who is child-free and wishes to remain so is less likely to regret sterilization than a mother who wants no additional children,” the McMaster duo write in the JOGC. “Therefore, declining to refer or provide permanent contraception because of the risk of regret is a decision based on conscience and not evidence.”

(As an aside, they point to another study looking at major life milestones that found the fourth most common major life regret reported by Americans was becoming a parent.)

“I personally have zero worries about the risk of regret,” said a 26-year-old woman scheduled for a tubal ligation later this month at McMaster University Medical Centre. “I actually don’t remember a time when I’ve had a parental instinct (other than with animals),” she said in an email.

The woman, a small business owner in the Niagara Region who asked not to be named, said she has experienced “the typical comments about how I’ll change my mind, and that I’m ‘too young to know what I want.’ I’ve had doctors, all men, simply laugh off the situation and my concerns and tell me I’m not ready to make that decision (even though I have medical issues with my uterus and cervix).”