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The number of those under 30 who are being sterilised is increasing every year, and the NHS sterilises more than 40,000 women annually.

Date: 2007-09-21

On a beautiful April morning four years ago, Charlie McCann left her home in Dorset and boarded a train to London.

Arm in arm on the platform with her mother, Frances, they chatted easily, and looked, to all intents and purposes, like any mother and daughter setting out on a day trip to the capital.

But shopping and lunch were far from their minds. Instead, Charlie and Frances were travelling to an NHS hospital where Charlie had an appointment to be sterilised.

The operation was a 30th birthday gift to herself, so certain was she that she would never want children.

Her mother, far from being concerned that her daughter would never provide her with grandchildren, went along to offer her moral support.

"Even as a little girl I knew I never wanted to be a mum," says Charlie. "I didn't really like dolls or playing mummies and daddies with the other kids. I first asked my doctor about sterilisation when I was in my early 20s.

"He virtually laughed me out of the door, telling me I was too young and didn't know my own mind.

"But even at the time it seemed grossly unfair. A 21-year- old woman can claim she knows absolutely that one day she wants to be a mum, and no one questions it. Yet the opposite was true with me, but no one took me seriously."

The NHS refuses the majority of sterilisations to women aged under 30 or women who do not already have children.

Yet it seems Charlie, now 34, single and a merchandiser for a major High Street fashion chain, wasn't alone in her desire to be rendered infertile.

Sexual health organisation Marie Stopes International recently reported a one per cent increase in the number of private sterilisations performed on women under 30 last year, while NHS figures for female sterilisations as a whole rose by a similar amount.

For those who already have children, yearn for them or are unable to conceive, such figures will make unpalatable reading.

Yet for Charlie, her only regret was being told she would have to wait until she was 30 to have the operation free on the NHS because she couldn't afford the £1,200 cost of a private sterilisation.

"My best friend and I still joke about the day when, aged seven, I announced to everyone in the playground: 'I'm never going to get married and have children.'

"The others had been talking about how many babies they wanted when they grew up and what names they'd choose in the way little girls often do, but I didn't want any part in it.

"By the time we were teenagers, the other girls I was friends with all had Saturday night babysitting jobs, while I balked at the idea and settled for a paper round instead. Children just didn't interest me.

"My friends would tell me: 'Never say never.' But I was resolute that I wouldn't ever want to be a mum. It's an intrinsic feeling that is completely different from simply not feeling ready to have children. I know I will never feel differently about this."

Charlie, a business studies graduate, is the middle child of three, raised by her community carer mother after her parents divorced. She enjoyed a happy upbringing, and speaks affectionately of being very close to her mother and siblings.

My parents' separation had absolutely no influence on my decision not to have children," she says.

Astonishingly, it was Charlie who held her elder sister's hand during the birth of her second child five years ago - and she even cut the umbilical chord. But even this incredible experience failed to change her views.

"It was amazing to see my gorgeous niece being born, but what struck me most was that it didn't trigger the slightest hint of broodiness in me," she says.

"I remember standing in the delivery room gazing at the baby and thinking: 'OK, where's my maternal feeling, then?' But it never came, and that moment cemented all those years of knowing that I didn't want kids of my own."

Not surprisingly, Charlie's uncompromising stance has caused problems in most of her relationships. She almost came to a compromise ten years ago with one serious boyfriend, with whom she'd enjoyed a year-long relationship and who had expressed a desire to start a family with her.

"I loved him, so, reluctantly, I said I'd have a child for him in the future, but that he would have to raise it while I went out to work and continued with my life as normal.

"He couldn't accept this as he felt he should be the main earner in the relationship, and I quickly realised I was offering to have a child for the wrong reasons.

"Our relationship ended soon afterwards, which was upsetting, but there was no way forward for us on the family issue.

"He's now married with children and his wife's a journalist, which gives her the flexibility to be the main carer for the kids.

"Since then, I've been unwavering on the matter. Another boyfriend already had a son and said he didn't want more children. He ended our relationship just before I had my sterilisation, but said the operation had nothing to do with it - he just didn't want to be with me any more."

Raised a Roman Catholic, Charlie admits abortion is unthinkable and has always practised safe sex. In fact, her fear of getting pregnant but not being able to go through with a termination was just one more reason for her to be sterilised.

"My older sister is a nurse, and I spoke to her extensively about the pros and cons of being sterilised. But for me, there weren't any downsides.

"People may say I'm na've and wonder how I could possibly know that ten years down the line I won't suddenly want to have children.

"But the same people don't ask women my age who want to have kids if they think they will later regret having them and hanker after their old, child-free life. Elective sterilisation is still such a taboo and people don't seem able to accept it."

Although she had the approval of her GP, because Charlie was young and didn't have any children, she was forced - thanks to NHS standard practice - to attain the go-ahead from two other doctors at the London hospital where she had her operation.

"Mum came over the night before the operation and we talked it through one last time. She didn't try to talk me out of it; we just went over all the reasons why I wanted to be sterilised and why I didn't want children.

"But there wasn't a single doubt in my mind, and for that reason mum supported me wholeheartedly. I wasn't even nervous when we arrived at the hospital the next day."

Tubal occlusion - the medical terminology for female sterilisation - is a 45-minute procedure which takes place under general anaesthetic and involves keyhole surgery to make an incision beneath the navel, into which gas is pumped to inflate the area surrounding the fallopian tubes.

They are then tied, clipped, cut or cauterised to prevent eggs from leaving the tubes and being fertilised. In Charlie's case her tubes were doubled over and secured with a tight ring.

Finally, the gas is released and stitches seal the small incision wound. Though not completely irreversible, attempts to do so can be costly and problematic, with between a 65 and 95 per cent success rate.

But Charlie says she will never consider reversing the procedure.

"I woke up crying from the pain and was given intravenous painkillers, but for six weeks I felt like I had terrible period cramps," Charlie says.

"I was also advised not to have unprotected sex until after my next period in case any eggs had already been released into my womb. Since I was single at the time, that didn't matter.

"But I can honestly say I suffered no emotional consequences from the operation and haven't regretted it for a moment.

"In fact, despite the postoperative pain, I felt as though a huge weight had been lifted from my shoulders."

Charlie has since had one serious relationship lasting 15 months, but admits her elective infertility may have sealed its fate.

"We met on a night out in Weymouth, where I live and fell deeply in love. From the start, I'd told him that I didn't want - and couldn't have - children, and he was sympathetic.

"But during a serious conversation about the future one night over dinner, I told him I'd actually chosen to be infertile, and he was very shocked I'd taken such drastic action. He was pretty angry, too, claiming that I'd lied to him.

"I thought that was a bit strong. Just days later he ended our relationship, blaming the long distance between my home in Dorset and his in Bristol.

"It was incredibly upsetting, but I'm fairly certain that it was my sterilisation that galvanised his decision."

So, why are an increasing number of young, healthy and presumably fertile women choosing to opt for an invasive operation which carries all the risks associated with surgery performed under a general anaesthetic, rather than persevere with conventional methods of contraception?

Charlie has faced opposition not only from men but from her female friends, one of whom still refuses to discuss the operation and another who was deeply offended because she was struggling to conceive at the time.

"Why should I be made to feel that I'm cruel in some way because society can't accept that many women just don't want kids?" she asks. "I don't judge those who choose to have children, so why do they feel they can judge me?"

Justine James, 28, an academic from Kent, was sterilised privately at a Marie Stopes clinic with 'no questions asked' when she was only 21. Seven years later, she is adamant that the decision has never come back to haunt her.

"For me, not wanting kids was like someone being gay or straight - it's inherent and it can't be changed. I don't even like children, I have no interest in them and I don't enjoy being around them, so why would I want any of my own?

"My boyfriend at the time was totally supportive of my decision, and we only broke up several years later when the relationship had run its course.

"I told my current long-term partner before we started dating but he was also supportive as he doesn't want children either. Let's face it, we wouldn't be together if he did, because the relationship would be seriously flawed."

Despite being an only child, Justine says she feels no guilt towards her parents about being sterilised.

"They supported me totally when I told them the week before I had my sterilisation. They just want me to be happy and they can see that I am, so that's all that matters to them."

Sarah McIntyre, 33, a buyer for a jewellery company in London, says she'd have been sterilised at 21 if she'd had the money to afford the private operation. Instead, like Charlie, she had to wait until she was 30 to have it done on the NHS.

"There's a commonly held expectation that when little girls grow up they'll get married and have babies," she says. "But I've known since I was about 12 that I would never have children.

"My parents were childhood sweethearts, married at 17 and had me shortly afterwards, followed in quick succession by my three siblings. We had a very loving upbringing but my mum always said to me: 'Don't make the same mistake I did: live your life first before you have kids.'

Sarah recounts how as "a stupid, naive teenager" she became pregnant after not using a condom with her boyfriend.

"I kept it a secret for ages, so I was five months pregnant when I had an abortion, which meant going through labour," she recalls.

"It was very traumatic, particularly as it happened on a maternity ward where both nurses and happily expectant mothers looked down their noses at me.

"The whole experience strengthened my resolve never to have children, and I even asked my doctor at the time if he could sterilise me - a request which, of course, received short shrift.

"My two sisters and brother all have children, but I came to the conclusion a long time ago that parenthood wasn't for me.

"I also believe that there's a strong ecological argument for not having kids. Why bring more babies into this over-populated world when we are already ruining the planet?

"And why would I want to subject a child to the drugs, knife and gun culture that seems to be rife in our schools?

"My parents are in their early 50s now and were totally supportive, knowing that it's something I had felt strongly about for a long time. My three siblings have one child each and, interestingly, none of them wants any more because they find the kids such hard work.

"I don't feel sad that I'll never have children or hear a child call me mummy. If I'm honest, I find it boring when friends chatter about their kids."

Annily Campbell, author of Childfree And Sterilised, feels strongly that although women are becoming more confident about admitting they don't want children, society is less forthcoming.

"Having children and not having children should be equal choices, yet one has the blessing of society while the other meets with the greatest disapproval you can imagine."

Whether such disapproval is warranted remains to be seen. Let's hope that this so-called sterilisation generation know their own minds as well as they believe they do.

And there doesn't come a time when Charlie McCann rues the day she was sterilised at barely 30 and wishes she could head out, arm in arm with her own daughter, for a day's shopping.

By SADIE NICHOLAS





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