Gendered Divisions of Fertility Work: Socioeconomic Predictors of Female Versus Male Sterilization

Domestic labor researchers have examined a multitude of duties disproportionately performed by women, yet the responsibility associated with navigating a couple's fertility-fertility work-has been overlooked. Using data from the 2006-2010 National Survey of Family Growth (N = 1,415), the author examined how racial and socioeconomic factors affect the division of contraceptive fertility work among married and cohabiting women who rely on either their partners' vasectomies or their own sterilizations. Drawing theoretical connections between fertility work and housework, resource- and gender-based perspectives were used to assess whether women's or their partners' characteristics are stronger predictors of sterilization type, and whether women's absolute or relative education level has a greater impact. Findings suggest that White and socioeconomically privileged women are more likely to have vasectomized partners than disadvantaged women. Male partners' characteristics were more closely associated with sterilization type than women's characteristics, lending greater support for the gender-based hypotheses.Key Words: division of labor, fertility work, gender, housework, marriage, sterilization.Domestic labor researchers have examined a multitude of duties disproportionately initiated and performed by women, yet the labor and responsibility associated with navigating a couple's fertility - fertility work - has been largely overlooked. Like other forms of domestic labor, the time, attention, stress, and physical burden associated with avoiding pregnancy lies primarily on the shoulders of women. For example, only 15% of married and cohabiting couples in the United States rely on vasectomy for contraception, compared to 40% who rely on female sterilization (National Center for Health Statistics, 2010). Although the fertility work related to sterilization involves less time and attention than other forms of contraception, it deserves investigation because it requires physical labor by the party who undergoes the procedure, most often the woman. Most forms of female sterilization are more invasive, costlier, more difficult to reverse, and associated with greater health risks than male procedures, especially with the advent of nonscalpel vasectomy techniques (Dassow & Bennett, 2006). Unlike vasectomies, tubal ligations are performed inside the abdominal cavity, often under general anesthesia. Mortality is more common for female surgical procedures, as are complications, such as infection, injury to surrounding organs, and ectopic pregnancy (Beckmann et al., 2010). Recently approved tubal occlusion procedures, such as Essure and Adiana, can be performed under local anesthesia, thereby avoiding incisions and the serious side effects of general anesthesia related to surgical tubal ligation. Though rare, these transcervical procedures are associated with embedding, ectopic pregnancy (Palmer & Greenberg, 2009), and side effects of hysteroscopy, including uterine perforation, infection, and hemorrhage (Lentz, Katz, Lobo, & Gersenson, 2012). Sterilization also requires emotional labor (Hochschild, 1983). Groat, Neal, and Wicks (1990) illustrated that the decision to sterilize can elicit anxiety about changing one's mind, concerns about decreased interest in sex, fears that one's sexual identity might be incomplete, and worries about spousal infidelity. At the same time, sterilization can relieve the anxiety of potential unwanted pregnancies and, as a result, increase the frequency and enjoyment of sex (Groat et al.). Though either spouse may feel regret when one is sterilized, the one who undergoes the procedure faces the anxiety about a postoperative body, identity, and future. That partner accepts "some degree of individual sacrifice" for the couple in that contraception and unwanted pregnancy will no longer be worries for either partner (Groat et al., p. 256). As with other forms of domestic labor, fertility work is not equally distributed among women. …