Desenho escuro de mãos e útero com laços vermelhos e flores roxas

DF performs two tubal ligations through the SUS per day. Find out how it works

The Federal District public network performed 443 tubal ligations between January and July 2022. This represents an average of 63 procedures per month, the equivalent of two per day. The data are from the Health Department of the DF.

Tubal ligation is a medical sterilization procedure for women who do not want a future pregnancy. This week, President Jair Bolsonaro (PL) sanctioned a bill that ends the requirement for a husband or wife to be authorized to perform tubal ligation or vasectomy procedures. Under the Family Planning Act of 1996, sterilization was contingent on the express consent of both spouses.

The text also reduces from 25 to 21 the minimum age for performing voluntary sterilization in men and women with full civil capacity and allows for surgical sterilization in women during childbirth, subject to medical conditions.

will denied

A 36-year-old resident of Ceilândia who asked not to be identified reported that she had a tubal ligation in August of last year. She had her first child at age 34 and wanted to have the procedure done after giving birth, but the law didn’t allow it.

“I always knew I wanted to have just one child, but the doctor said I was too young. They also claimed that I only had one child, I could regret it”, narrates the administrator.

After the improvement in the Covid-19 pandemic scenario, the DF resident decided to take the first step to perform the tubal ligation. “I went to a private hospital and they gave me a checklist. I had to fill out a form and take it to a notary’s office with my and my husband’s authentication and wait 60 days, which is the time they give for us to think better. But at that time I could get pregnant, I was susceptible,” she says.

The woman did the preoperative exams and waited the necessary time. “After that, the plan authorized it and I operated. It was super peaceful.”

“But it was necessary for my husband to sign too. For me, he would have done it right away at birth and wouldn’t have had to go through all this bureaucracy”, he adds.

Procedure by SUS

In 2021, the DF public network accounted for 964 tubal ligations. In 2020, there were 804.

In the Federal District, the first treatment related to tubal ligation or vasectomy by the Unified Health System (SUS) is carried out at the Basic Health Unit (UBS) of reference, where the patient will participate in lectures and will be oriented on other contraceptive methods, which are reversible. .

Although the Family Planning Law states that “in the validity of a marital partnership, sterilization depends on the express consent of both spouses”, during consultations in the health units of the DF, the procedure for information of marital status is self-declaratory. Therefore, no document proving the marital relationship is required.

If the patient decides to continue with the process, he still has 60 days to give up and choose another alternative. “This is because tubal ligation and vasectomy procedures are considered irreversible, so it is necessary for the patient to be aware of the risks of the method and the consequences, if he regrets his decision”, informs the Secretary of Health.

After the final decision to continue sterilization and complete the 60-day process, the patient is placed in the regulation queue, as it is an elective surgery. Patients classified as at risk or who have a medical indication of urgency are prioritized.

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Changes with the new law

According to Amanda Nunes, researcher and lawyer co-coordinating the Cravinas project (Clinic of Sexual and Reproductive Rights) at the University of Brasília (UnB), currently, for a woman to have a tubal ligation, she must be at least 25 years old or be at least 25 years old. least two children, in addition to the consent of the spouse.

In addition, women cannot perform sterilization during childbirth or abortion, except in cases of proven need. “In this case, the law cites the example of previous cesarean sections. But it (the standard) has a somewhat confusing technical wording, which can generate dubious interpretation”, he considers.

“Now the change reduces the age to 21 years, removes the need for authorization from the spouse and allows the procedure during childbirth and abortion as long as some requirements are met so that the woman’s decision is free”, she explains.

On the other hand, she points out that the minimum age requirement in force in the Family Planning Act has an explanation. According to the researcher, the imposition of an age limit of 25 years for carrying out voluntary sterilization has its origins in the unfolding of the 1991-1993 CPMI, established to investigate the performance of mass sterilization of women in Brazil.

“This process of denouncing compulsory sterilizations of women in the 1990s came along with a demand for health and family planning services for all women. The problem was discussed and they concluded that there was a policy of mass sterilization, especially of black and peripheral women, associated with birth control policies. As a result, came this law. So, these limitations of the norm came to ensure that very young women were not subjected to this compulsory sterilization”, explains the expert.

Now, for her, the updating of the norm at this time “is very important to reduce state control over women’s bodies”. “Women’s decisions about their bodies should be autonomous and not depend on someone else,” says Amanda.

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