Meet the woman, 28, who opted for NHS-funded sterilisation operation

Sterilised at 28: Why one woman, who is in a loving relationship, has no children and works in a school, opted for a childless future while still in her prime

  • Rebekah Hall, 28, insisted on getting permanently sterilised at a young age 
  • She underwent treatment and went under the knife on an NHS-funded operation
  • Nearly 13,000 women opted for the same treatment between years of 2018-2019

Many young women see the end of their 20s as a time to take stock. 

If they are childless, they may begin to hear the tick of a biological clock as their thoughts turn to marriage and a settled family life surrounded by children.

But Rebekah Hall, 28, simply can’t imagine anything worse. ‘Sometimes when I am out with my mother and sister, they will stop to coo over a newborn in a pram.

‘But I have absolutely no interest in babies. I don’t want to look at them or pick them up. And I certainly don’t want to have one of my own. I never will.’

This may sound cold, but Rebekah is defiant. 

Motherhood is not for her. And so certain is she of her position that, last year, she took the drastic step of being permanently sterilised — in an operation carried out by the NHS.

‘I feel liberated now that the risk of getting pregnant by accident has been removed completely,’ she says.

‘It’s like a dark cloud that has hung over me since I was a teenager has been lifted. It’s wonderful.’

Yet sterilisation is mired in controversy, with many questioning the wisdom of performing the procedure on young women who may live to regret the decision.

According to the most recent figures published by NHS Digital, nearly 13,000 women had the operation in the years 2018-2019. Of those, 2,000 were aged just 25-29 — although many of those already had children.

Motherhood is not for school cook Rebekah Hall, 28, (above). And so certain is she of her position that, last year, she took the drastic step of being permanently sterilised – in an operation carried out by the NHS

Guidelines from the Faculty of Sexual and Reproductive Healthcare (FSRH) suggest that regret after the operation is a major problem in younger patients. 

Dr Sarah Gatiss says: ‘Research has found regret is particularly common if women are sterilised before the age of 30, if they are childless, or if there is conflict between a woman and her partner. Additionally, the NHS does not routinely offer reversal operations in case a woman regrets a sterilisation.’

There are several ways a woman can be sterilised. The surgeon can apply clips or rings on the fallopian tubes to block them, or the tubes themselves can be tied, cut and a small piece removed.

If these methods don’t work, the tubes may be completely removed in an operation called bilateral salpingectomy, which is permanent and irreversible.

But despite medics’ doubts, there is a growing movement among some younger childless women who are certain they will never change their minds and want to be sterilised.

Rebekah, who works as a school cook, is one of them. Before her operation — a clip sterilisation — she fought for over a decade to, as she puts it, ‘take control of her own body’.

The decision was purely personal. ‘I’ve never once felt maternal. Friends at school would talk about getting married, being a bride and having a family, and I never understood it.’

Before her operation — a clip sterilisation — she fought for over a decade to, as she puts it, ‘take control of her own body’. Pictured: Rebekah Hall as a baby

Nothing in Rebekah’s conventional family upbringing — her mother was a nurse while her father worked as a paramedic — would easily explain this choice.

She recalls growing up in a happy home with lots of children coming in and out. ‘I have one sister, who is four years younger, and we had lots of family friends that we classed as cousins because we were so close.’

Yet from very early on, she knew she didn’t want something similar.

‘I never enjoyed playing with dolls or playing “families” like my sister. My mum and dad noticed, but they never really commented on it. They’ve always just wanted me to be happy.’

In an age when parenthood is marked by increasingly extravagant celebrations — from a lavish baby shower to themed, no-expense spared parties for a child’s first birthday — Rebekah is decidedly unusual. 

She rejects the growing sentimentality that surrounds having children, saying it simply never interested her.

‘It’s not just the idea of childbirth and pregnancy I don’t like,’ she says. ‘The responsibility of bringing up another human being is huge and I knew I never wanted it. I value my freedom too much to give it up. Is that so very wrong?’

Rebekah feels the decision should be hers alone. 

Yet others point out the cost to the NHS — having the operation privately would have cost about £3,000 – although other contraception methods might add up to a larger bill for the health service over time.

And concerned doctors also emphasise the inevitable impact of such a choice on those around her.

Rebekah claims that was never a problem. ‘My family never once tried to sway me or say: “You’ll change your mind.” They have always been fully behind me, and so has my partner Sean, who’s 30.

‘We’ve never had to have a “big conversation” about it, because we’ve always known each other’s feelings. 

‘Don’t get me wrong, we are delighted when friends announce their own pregnancies, and Sean and I love being Auntie and Uncle, but we can never imagine having children of our own.

Rebekah feels the decision should be hers alone. Yet others point out the cost to the NHS — having the operation privately would have cost about £3,000 – although other contraception methods might add up to a larger bill for the health service over time. And concerned doctors also emphasise the inevitable impact of such a choice on those around her

‘My mother-in-law has mentioned this means Sean’s name ends with him because he’s an only child — but it’s only ever said in a light-hearted way. My own parents happily refer to my cats as “the grandchildren”.’

The fact that Rebekah works at a school has confused some friends.

‘They find it odd that I work around children, but just because I don’t want my own, doesn’t mean that I can’t care for other people’s.’

Rebekah feels it was a friend’s accidental pregnancy when they were teenagers that solidified her own aversion to motherhood.

‘I actually felt something close to disgust that a baby could take over my body, grow inside me and then force me to give birth,’ she says. ‘The idea terrified me.’

Such was her fear that shortly after her friend’s baby was born, Rebekah, then 17, approached her GP for the first time about being sterilised.

‘He didn’t take me seriously at all. He said: “You’re too young, you’ll change your mind” and wouldn’t even refer me to a consultant. I left feeling so despondent but also so angry. It really lit a fire in me. I knew I would never want children. So why was no one listening to what I wanted?’

As she was not even old enough to vote or buy alcohol, some will say the doctor’s reservations were justified. 

And they might point out that there are other effective, long-lasting ways to prevent pregnancy, such as the hormonal implant or the coil.

But after going on the Pill at 19, Rebekah felt unhappy about what she saw as pumping her body full of synthetic hormones. 

Guidelines from the Faculty of Sexual and Reproductive Healthcare (FSRH) suggest that regret after the sterilisation operation is a major problem in younger patients. [File image]

She felt determined to fight to be sterilised — and never have to worry about pregnancy again.

She is, perhaps, fortunate in her partner. ‘Sean and I have known each other since nursery school, so he’s always known my feelings about having a baby and, luckily, he feels the same,’ she says. ‘I recognise that many men do want children at some point, but he says he really doesn’t.’

And if Sean has a change of heart? Rebekah says she has considered that possibility. ‘He knows that if he ever changed his mind, it wouldn’t be with me,’ she insists.

She has been utterly convinced, since that first doctor’s visit, that this is the right course for her. Each rejection only made her more determined.

‘By the age of 20, I’d made it my mission to get this operation. At every GP appointment — whether it was for a cough or contraception — I’d ask about sterilisation and, each time, they’d give me a flat “No”.

‘Of course, I was young and I can understand why doctors might be hesitant to refer young women for sterilisation. It is not an operation that can be reversed easily — or with much success — and they don’t want to be sued.

‘But surely, with the correct psychological tests and statements from family, partner or friends, they should take women more seriously. I was always happy to sign a disclaimer saying it was my decision and wouldn’t sue. It angers me that women can’t have autonomy over their bodies.’

But Rebekah, who says she was never offered counselling for her decision, simply kept meeting with refusals from GPs to refer her to a consultant. So she decided the time had come to take more direct action.

‘I asked for written statements from my mum, dad, aunt, boyfriend, sister and best friend, who all agreed I’d never had any inkling of maternal feelings. I sent them to three consultants — two NHS and one private.

‘I was even considering taking out a loan for the operation to be done privately. One of them never even replied but the first to reply was a male NHS consultant who asked me to visit him.

‘I took my mother and my partner to the appointment, for back-up. Despite us all saying I was happy to go ahead, he said it was “an age thing” and insisted I would change my mind. Again, I was so angry. How could these people make medical decisions for me when I knew my own body?’

By 2020, Rebekah says she was verging on depression, feeling she was being denied control of her future.

Still on the Pill and not wanting the hassle of other forms of contraception such as condoms, she despaired of anything being done. 

While there is no absolute age threshold on sterilisation for men or women, according to the NHS most doctors are unlikely to support such a decision unless patients are over 30 — and parents already.

‘Sean could see how upset I was and asked what else we could do to take away this risk,’ she says. ‘What is frustrating is that it would probably be much easier for him, as a man, to have a vasectomy than it would for me to have my tubes tied. He did offer.’

But Rebekah was reluctant to put her partner through an operation for her sake. And, remarkably, she had decided that only having the procedure herself would mean she was completely free from her worries about becoming pregnant.

‘I told him I was going to get this operation, whatever it took.’

While there is no absolute age threshold on sterilisation for men or women, according to the NHS most doctors are unlikely to support such a decision unless patients are over 30 – and parents already.

The third NHS consultant Rebekah had contacted replied to her letter and, as it turned out, she happened to be a parent at the school where Rebekah works. They chatted informally about her feelings beforehand and had a proper consultation in early 2020.

‘This was the first female doctor I’d spoken to about it and, finally, I felt like I was really being listened to,’ she says. 

‘I am not sure men understand as much and perhaps my treatment was sexist. I don’t know. But I always felt that if Sean had been asking for a vasectomy, he wouldn’t have been turned away so many times. I fully explained my feelings and, in turn, she explained all the implications of surgery.

‘It is 99 per cent effective and she was willing to do it on the NHS but if I did change my mind and I wanted it reversed — which could only have a small chance of success — then I would have to get it done privately and it would cost thousands. 

‘But I knew I wasn’t going to change my mind and by the second consultation in March 2020, I was signing a waiver form.’

Last April, Rebekah went into the Royal Hallamshire Hospital, Sheffield, where she had keyhole surgery under anaesthetic.

‘Because of Covid regulations I had to go into hospital on my own, but I was so ready for it that I really wasn’t that nervous,’ she says. ‘I was just going to lie back, be put to sleep and it would all be over.

‘The surgeon made three small incisions in my belly button and lower abdomen. My fallopian tubes had clips put on them and that was it — I was sterilised. 

‘Waking up in the recovery room I was so groggy but remember saying “Have you done it?” and when the nurses said: “Yes, it’s all done”, I burst into tears of relief.

‘It felt like I’d been given the freedom to live my life as I choose.’

She was home with Sean the following day and, after two weeks off to recover, she was back at work.

Today, Rebekah has absolutely no regrets. ‘My best friend has just announced she is pregnant and we couldn’t be more thrilled for her. Meanwhile, I’m free to tootle along with my life and do as I please without the worry of contraception or getting pregnant.

‘I have Sean, my cats Elara and Corvus, and two fish tanks — I’m happier than ever.’

‘My periods have settled back to normal after coming off the Pill and I feel calmer and happier.

‘I’m still furious that it takes a woman nearly a decade for medical professionals to listen to her. Some women won’t have the strength for the fight I undertook and I’m really grateful to have had the support of my friends and family.

‘I was desperate at times and it really shouldn’t have to be that way for any woman.’

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