For many women who don’t want to have more children, childbirth offers a safe and convenient time for adopting the permanent form of birth control known formally as tubal ligation, and informally as having your tubes tied. For women whose health care is covered by Medicaid, senseless bureaucracy can make this difficult.
A patient we will call Sofia (we aren’t using her real name to protect her privacy) is a perfect example of this issue. She had wanted to have a tubal ligation after she delivered her fourth child in March. The timing was bad: It was the peak of Covid-19 in Massachusetts, where Sofia was having her baby, and staffing and resource limitations meant she was unable to get the procedure as planned. She left the hospital with a plan to reschedule her procedure for later.