‘My husband forbade me to have tubal ligation, even after the 5th pregnancy’

After the fifth child, the elderly caretaker Monica (not her real name), then 32 years old, wanted to have a tubal ligation so she wouldn’t get pregnant again. The risk of dying in childbirth, serious financial problems and changes in the body motivated the decision.

However, citing religious issues, her husband prevented her from having the procedure.

“The old testament says ‘marry and multiply’. Many brothers preached based on this and my husband followed the same thought. He told me that I would not do the tubal ligation and wanted to know why I wanted the procedure. situation as an ‘I’m in charge’ and I was blown away,” she told BBC News Brasil.

Monica had one more child, making a total of three males and three females.

In March, the Chamber of Deputies approved a bill that abolishes the obligation of consent between husband and wife for tubal ligation, in the case of women, and vasectomy, in the case of men.

The text also provides for the permission of tubal ligation during childbirth, to join the two procedures, minimizing sequelae resulting from the surgeries.

The bill also provides for the lowering of the minimum age to undergo the procedure from 25 to 21 years. To become law, it still needs to be approved by the Senate and sanctioned by President Jair Bolsonaro (PL).

If this law had already been passed a few decades ago, Monica, now 43, believes she would have made other choices.

“We live in different times. But if I could look in the mirror, I’d say to myself: ‘Go study and find a profession. You’ll love yourself even more, value yourself’. I wouldn’t have gotten married so soon either. myself,” he said.

Monica says that the couple argued several times because of her husband’s constant refusal to allow the tubal ligation. She recalls that, after many fights, he finally agreed to receive medical attention to have a vasectomy. But, without being able to schedule an appointment with the public health system, the procedure was not performed “and the sixth child came”.

Stopped eating to give milk to children

A resident of a favela in São Paulo, Monica says that the family faced financial difficulties and even “lack food”.

“We went through a lot of financial difficulties. With so many children at home at the time, only my husband, who is a doorman, could work. We had more children and the situation began to tighten. We had to choose: we ate or fed the children,” he said.

At the time, Monica’s husband started working two jobs to supplement his income. Even so, while the favela developed and most residents began to build brick houses, the family continued to live in a wooden shack.

“Imagine not having milk to give our children. We used only donated clothes. The bills were so tight that we ran out of food. Sometimes we went to my sister-in-law’s house to fill the bottle with milk to give to our hungry children”, reminded the caregiver.

After the fourth child, Monica said, the first discussions with her husband began over the idea of ​​having a tubal ligation. He became unemployed and what saved the family from an even more desperate situation of hunger was the income that the eldest son got, after being hired as a clerk at a newsstand.

“He (son) practically supported our house. My husband started to use the car we had to make trailers and I did odd jobs cleaning and taking care of children. I did what I could for my children.”

Today, she says that the family is in a much better situation, with most of the children working.

She believes that the project to perform tubal ligation without her husband’s permission is just one step for the benefit of women.

‘Gateway’

Lílian Leandro, executive director of the Family Planning Institute, said that the difficulty in accessing tubal ligation has a profound impact on the lives of the poorest women.

“This is a gateway to several other problems, such as increased poverty, crime and domestic violence. Teenage pregnancy, for example, makes girls drop out of school. public spending. We have an annual cost of R$ 4.1 billion due to unplanned pregnancy, according to a study published in the National Library of Medicine, in the United States.”

For Lílian, the approval of this bill and the sanction of the president brings advances, but still does not solve the problem of family planning in Brazil.

“We need systematized information and agility in these processes. We received many reports of difficulty in scheduling and even carrying out the procedure. What has to prevail is the will and the right to choose that will define the future of the woman. want to have”, argued Lílian.

Body changes and health problems

In addition to financial and family planning problems, Monica says that the pregnancies also caused several health problems.

“The body feels the changes. With them, health problems arise. After my fourth child, the doctor said I would die if I had another birth. This also had emotional consequences. house, children, husband and church. You are always last because they are the priority”, said the housewife.

She said that after so many pregnancies, she felt her body “fall apart”.

“Organs can’t take it. Everything hurts. It’s a person growing inside you, so it messes with everything, outside and inside”, she says.

Monica said she started to “live” after turning 40, when most of her children reached adulthood. She says she got married at the age of 18, when she was pregnant with her first child. Six years later, she was four. But, at the time, the couple did not even consider having a tubal ligation.

“When we got married, we couldn’t have an operation or use any other method of avoiding children. As we got involved in our church, the Assembly of God, these rules entered my husband’s mind and mine. Only after the sixth child, we got real. But by then it was too late”, he said.

The housewife said that this doctrine of banning definitive contraceptives was overturned, and that today it is followed only by a few people who attend the same church as her.

“But there are still people with that in their heads. They think that women were made to have children and fill the house. Many evangelicals still have this mentality.”

Family planning specialist Lílian Leandro explains that, currently, to be able to perform tubal ligation after a risky delivery, a woman needs a report signed by two doctors to validate that she can die if she has another child.

“They put obstacles in the way and the woman often gives up. Many don’t have money for driving or with whom to leave the child. When they approve, they still ask for a 30-day deadline to perform the procedure. The intention is that the patient has more time to reflect , because it is an irreversible procedure. They say that for a person over 25 years old and at least 2 children”, said Lílian.

She sees this process as a lack of respect for the decision of women, especially the poorest.

“We don’t see cases like this in classes A and B. The difficulties that disadvantaged women have in accessing the Family Planning Law is very great. Women who can afford it go to the hospital and deliver, through the health plan or private network, and they already perform the tubal ligation together with the cesarean when the mother’s clinical indication evolves to this”, he said.

Poorer mothers, on the other hand, she explains, need to return to the SUS queue after childbirth to undergo a new procedure. Lílian says that, many times, they are already pregnant again when the tubal ligation is finally scheduled.

‘I don’t regret’

When commenting on the past and reflecting on whether she would make other decisions if she had the mentality she has today, Monica said that she would like to have only two children.

“I wouldn’t have so many children. The older ones really struggled. As we have this law, either he (husband) would sign to allow the tubal ligation or marry someone else. This happens because of the husbands and society. We live in a sexist world. in which the woman has to give birth and be always available”, he said.

The housewife makes a point of making clear the happiness of having each of her children.

“I don’t regret having my children. They are all I have. Motherhood is the most special moment for a woman. It’s when a person comes out of you, grows wings and flies. But it made me stop studying and in this part I regret it. My children were an impediment in my life. With the conditions we had, I had to stop working to take care of them and let my husband work to try to support them”, she said.

She says she doesn’t want her three daughters to go through the same situation and says she often guides them. The eldest had her first child at the age of 21, in 2021. The mother advises her to have, at most, one more.

“I don’t want to interfere in their lives, but they need to be independent. To be different from me. I want them to study, work and have a profession,” he said.

The deputy author of the project, Carmen Zanotto (Cidadania-SC), said in an interview with BBC News Brasil that she believes in a quick approval of the text in the Senate and in the sanction of President Jair Bolsonaro (PL). She presented this project in 2014 and it has been on hold ever since.

The deputy said that, after approval of the project, the biggest challenges will be to make the population aware of their rights and claim them in the health services – and that the government fulfills them.

“SUS has the capacity to deal with all these cases. It will only be necessary to prioritize the most urgent ones. People need to know and demand their rights.”

Carmen says that this project is a great advance for the lives of these women. “How many ‘Monicas’ like the one you interviewed do we have? These are women who would like to have the right to choose and make decisions. This isn’t birth control. It’s giving everyone the same right.”

*BBC News Brasil chose to hide the identity of the interviewee