The new law regarding tubal ligation could benefit women and increase the number of procedures at Hospital de Mulheire

^{Lian Cruz}

Last Tuesday (8), the House of Representatives approved in a symbolic vote a bill that guarantees the autonomy of women regarding the tubal ligation process, that is, it can be performed without the consent of the husband. The text also reduces the patient’s age from 25 to 21 years. The bill still needs approval by the Federal Senate.

According to the head of Fundação Hospitalar Inácia Pinto dos Santos, who runs Hospital da Mulheire, Gilbert Lucas, the expectations are that with the approval of the law, the number of tubal ligations in the hospital will increase.

Photo: Ne Silva/Accorda Cidad

“In 2021, Da Mulhere Hospital performed 243 tubal ligations and now in 2022, to date, 56 tubal ligations have been performed. So we believe that this year we will beat this demand. It is important to note that tubal ligations, when performed Urgently and urgently at the time of birth, you must comply with all necessary documents of Decree Law No. 9263 on Family Planning issued by the Ministry of Health. Therefore, as an institution, we cannot function without the necessary documents that are in the law. We already have a family planning clinic, and in some cases, We already define this appointment as an elective postpartum.Gilbert Lucas explained that so we have already scheduled it as optional with all the documents coming from the Ministry of Health, from the family planning sector, which is also the specific sector for PAISM, the women’s health program.

She explained that in the case of the Health Department, there are all prenatal monitoring processes in the health unit, where the reports that are issued are documented with the records that are filled in. And all this is sent to the Department of Health, to the PAISM sector.

“There, all these documents are filled out at the request of the technical board of the PAISM program itself, and we, as an urgent and emergency unit, in part of the procedure, implement these documents, as required by the Ministry of Health directly here. Without the documents, we cannot do this Because it is a requirement. Since it is a unit of the SUS, we need to meet all the rules and decrees issued by the Ministry of Health,” he said.

She believes that many women face bureaucracy to do this procedure, as they have to complete all the necessary documents and this takes time.

“It is necessary in some cases, such as pregnant women in the streets, who are in need and do not have prenatal care, we know the number of children, the social issue, and that they need to update this law. It is necessary. Ordinance from 1996. So today we need to update it, so we believe that this update of the law will be beneficial to women and that it may reduce the bureaucracy that has to be done today, implementing this tubal ligation. We know that it is a matter of women’s own interest. We see the cases of women who have six or seven children, and it is a social issue But there are other methods as well, such as IUD placement, intrauterine device as well as subcutaneous IUD, when necessary, and of course condoms are essential, which is very important due to other infectious diseases.”

Obstetrician Andrea Alensar, medical director of Hospital de Mulhere, explained that tubal ligation is a surgical procedure, in which a cut is made in the patient’s tube, and then tied, to prevent the passage of sperm and thus pregnancy. during intercourse.

Photo: personal archive

“Because it is considered a definitive method, in which this closure occurs, some studies show that the rate of regret is high, so I see the main difficulty for those who do this, is to reverse the procedure. The literature shows that for many women for various reasons, such as changing spouses, improving their lives, losing Sometimes a baby and wanting to get pregnant again, this re-canalization is more difficult than reversible methods.There is a reversal, but it does not guarantee success.It is re-canalization of the tube, but depending on where this tube was cut, it may not be successful, And there is still the possibility of fibrosis in that place,” he wondered.

On the other hand, according to the obstetrician, it is a definitive method, since the woman will no longer need to worry about family planning since then.

“Although there is no method that is 100% effective, its failure rate sometimes. In the case of tubal ligation, the index is 0.5, less than 1, that is, there is no half a woman, but we want to show that there is a failure rate in all means Contraception.No side effects.

She explained that according to the current law, Tubal Ligation Law No. 9263 of January 1996, the patient must be over 25 years old or have two children and the spouse must also sign to allow the procedure. The interval between the decision and the implementation of the procedure should be 60 days and it is forbidden to perform it during pregnancy and the puerperium, that is, after an abortion or the puerperium.

For Andrea Alencar, the possibility of changing the law represents an important step towards women’s independence.

With regard to this position of having the man as a factor in the decision to have tubal ligation, this is an important step, which should have been done some time ago. Because a woman should enjoy independence in her own body. Excluding her husband from this decision is correct, because the woman must convey to her partner her desire not to have more children and he must support her, but this is not a determining factor for this to happen. This bill also puts in place a change in age, lowering it from 25 to 21. I especially think that this question of age is serious, because we can consider that the age of 21 is practically a teenager and we have long-acting and reversible contraceptives, which should be the first choice. How would you allow a 21-year-old woman to have a tubal ligation? Reducing the age should be something very deliberate,” he said.

With information from reporter Ni Silva of Acorda Cidade

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