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The 120 Rule of Sterilization

September 24, 2008

Yesterday, Christine posted on a piece covering highs and lows of women’s health. It includes access to sterilization in the highs, and describes the “120 rule” by which if a woman’s age multiplied by her number of children was less than 120, she couldn’t choose to be voluntarily sterilized. Coincidentally, I’m currently reading “Reproductive Rights in a Global Context,” and reached a passage yesterday that also describes this 120 rule, which apparently originated out of an ACOG recommendation. That text indicates that even if a woman reached the 120 mark, she still needed the approval of three doctors and a psychiatrist to obtain the procedure. (Note: this is no longer the common practice, in case that wasn’t clear)

Christine notes several problems with the article on highs and lows – one I would add is that the bit on access to sterilization and the 120 rule doesn’t specify that this was a problem of white women. The “lows” list does mention the forced sterilization of black women, although it doesn’t come near to illustrating the scope of that problem. The book I mention above provides some history of these abuses, and I’ll get into that in another post when I write more about the book.

What shocked me about the 120 rule – knowing already that (specific groups of) women (whose childbearing was valued) who sought sterilization often had trouble obtaining it – was realizing that not only would I not currently qualify under the old model, but my own mother would fail the test on the basis of ageXchildren. My mom, who was done childbearing 30 years ago after she had me. Seriously.

7 Comments leave one →
  1. September 24, 2008 8:42 am

    Is this something that is still happening? I got my tubes tied back in 1978, when I was 25, and had to fight to get it done (at a women’s clinic, no less). I had 1 son (age 3) at home, 1 daughter that I had given up for adoption at birth (in 1972), and 2 abortions at the time (birth control of any kind just didn’t seem to work with me). I was single, didn’t want to get married, and sure didn’t want any more children, ever. I still had to fight to get a tubal ligation because “what if you get married and your husband wants kids”. Yeah, right, I don’t ever want any more kids, so I’m going to marry someone who does want kids…..NOT. Good thing I did get my tubes tied, since I didn’t get married until I was 53. Even now, I wouldn’t qualify under that 120 rule (2 kids times 54 doesn’t equal 120….damn). If birth control (other than vasectomies and tubal ligations) doesn’t work for a woman, and she doesn’t want kids, is she supposed to spend her life until/after menopause celibate? Yeah, right, I can see that happening. Why does everyone thing that every woman out there just has to have kids? Some women are not meant to be mothers (mine was one of them) and forcing them to risk having children they don’t want does a disservice to the women and to any children they have (can we say abuse/neglect?).

  2. September 24, 2008 8:50 am

    Vesta, no, I don’t think it’s still happening – not specifically using the 120 rule, anyway – although I have heard of women having to jump through many hoops to get this done. I thought it was a piece of history worth knowing, though, and was startled to realize how much of a woman’s life that rule could effect, especially if she only had 1-2 children.

  3. earlgreyrooibos permalink
    September 24, 2008 10:00 am

    Wow . . . that’s depressing. I did the math on my own mom, who is somewhere in her 50’s and has two kids, and she doesn’t even meet the “120” rule . . . and she quit having kids 21 years ago! How on earth did people ever come up with the number 120 to begin with? Seems pretty arbitrary to me . . .

    Of course, I would never qualify under that model, unless I lived to be 120, but at that point I’d have gone through menopause anyway . . .

  4. September 24, 2008 12:45 pm

    Wow, so the minimum is basically having three children during your reproductive years, eh? What if you’re 40, have had two children, and would like to use sterilization to avoid a moderate-risk pregnancy in your later reproductive years?

    Overall, it’s kind of a silly rule.

  5. MomTFH permalink
    September 26, 2008 1:44 pm

    That is such an interesting concept. I have never heard of the 120 rule before. I wouldn’t qualify, and I think a 35 year old woman with two children should have a pretty clear idea whether or not she wants more kids. Do I really need two more to be sure?

  6. horrorshowjack permalink
    September 27, 2008 8:02 pm

    What a stupid rule, I’m glad that went away as a formal guideline.

    @Vesta: I’m on a lot of childfree boards and communities on-line, and it is incredibly hard to get sterilized unless you’ve bred. Still not easy unless there is a high enough number of children that the doctor concludes you’re entitled to be done. It’s not uncommon for women who want tubal ligation or Essure to have to go to multiple ob/gyn to find one who will do the procedure, frequently with balks along the way. I wouldn’t say it’s much easier for men, if at all, since the cutoff to get a vasectomy covered seems to be 2 kids, or 30+ with one.

    I agree with you, it shouldn’t be hard to have voluntary sterilization performed. Some people shouldn’t be parents, and if they are self-aware enough to figure that out themselves there is no good reason to avoid the possibility.

    Sorry if inappropriate to post here since I’m a guy, but the right to never have children is near and dear to me.


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