“Lie Fallow” by Jade Wallace

Jade Wallace (they/them) is a legal clinic worker, writer, book reviews editor for the literary arts magazine CAROUSEL, and co-founder of the collaborative writing entity MA|DE. Most recent works include Wallace's debut poetry collection, Love Is A Place But You Cannot Live There (Guernica Editions, April 2023) and MA|DE's fourth chapbook, Expression Follows Grim Harmony (Jackpine Press, August 2023). Keep in touch: jadewallace.ca

A Word from the Author

"Lie Fallow" is an essay detailing how I got a tubal ligation in my late twenties, even though I was the worst kind of candidate in many doctors' eyes: young, unmarried, childless. I wrote "Lie Fallow" as an antidote to the seemingly endless cautionary tales I had read online about how hard, if not impossible, it is for people like me to get permanent birth control. While remaining starkly conscious of, and sympathetic to, the fraught, ongoing struggles for greater reproductive freedom—such as the fights to protect abortion rights in the U.S., to expand access to abortion in Canada, and to prevent coerced sterilization—this is simultaneously a hopeful piece about how reproductive medicine can be done well, but it takes a team of supportive government officials, chealthcare professionals, bosses, even family members, to make that dream real.

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When I wanted to know about tubal ligation, I turned to online magazines, which offered an  impressive collection of horror stories. Grim tales populated by paternalistic gatekeepers  wielding clipboards and impossible checklists. These articles were awkwardly prefaced by twee illustrations of bubblegum pink fallopian tubes, or stock photos of simpering nuclear families. Comments sections were equal parts sympathy and rage. According to these accounts, it was  nearly impossible for a young, unmarried, childless person with a uterus to access permanent  birth control, even in the ostensibly progressive era of the late 2010s.  

But, being young, I was energetically stubborn, so I booked a day off work and left the  city on a coach bus. When I arrived at my parents’ rented house, I sheepishly asked my  mother for a ride to my appointment, the purpose of which I demurely elided, and she kindly  did not ask. We coasted past fields, some lined with fledgling stalks of corn, some thick with  spring grass and grazing cows, some barren and gathering strength. 

I spent another hour in the doctor’s waiting room, skimming glossy magazines full of  anachronistic recipes for strawberry chiffon pie. The appointment itself lasted ten minutes.  “Have you thought about the pill? An IUD? Something temporary?” my doctor asked.  For months, I’d read up on contraceptives: intrauterine devices, birth control pills,  diaphragms, spermicidal gels, vaginal rings, cervical caps, hormone patches, condoms, internal condoms, progestin injections, ovulation calendars, the rhythm method. I’d read, too, about  the erosion of healthcare coverage in the U.S. and how, even in my own province of Ontario,  not all birth control is covered by our universal healthcare. The kinds covered, who can get  them, and the extent to which they are subsidized, are subject to the government’s regulatory  whims. At the legal clinic where I worked, there was fresh evidence every day of the steady rise of low-wage, precarious employment. On the subway, ads announced the television debut  of The Handmaid’s Tale.  

“I’ve thought about them,” I said. “I’d prefer something permanent.”  

“Are you sure?” my doctor asked. 

* 

The summer after kindergarten, we went on a family camping trip. My grandmother asked  me, Did you make any friends? One friend. Do you have a boyfriend? No. What good is a  boyfriend? Do you want to get married someday? Maybe. As long as I can have four horses, two  cats, two dogs, and a big farm. Do you want kids? Never. Then I’d have less time for the horses. 

* 

“I don’t want hormones,” I told my doctor. “I can’t handle the mood swings.” The last time I  was on the pill I was doing my first Master’s degree and spending several nights a week crying on my second boyfriend’s kitchen floor. I didn’t know whether to blame the pill, grad school,  my boyfriend, or myself. When I finished school, moved to another city alone, went off the pill, and started dating women, the crying stopped as if I had turned off a tap. “And no insertions,” I added. “I don’t want to think about pregnancy ever again.”  

He nodded. “Doctors perform vasectomies for men every day. Women shouldn’t be  treated any differently.”  

Woman has never been the word I would pick. If pressed, I use agender or nonbinary. If  no one asks, I don’t volunteer. My gender has always been evasive. Regardless, I left my  doctor’s office feeling more understood that I’d expected, and pleasantly shocked by how  easily I’d gotten a referral to a gynecologist.  

*

At fourteen, I was a pious Catholic schoolgirl who failed to look the part. I wore oversized  men’s clothes, tucked my hair under my hat, and didn’t know what to call myself. Tomboy made the girl who sat next to me stick gum in my hair. Every other girl in class had already  begun to bleed. I had so far escaped that tide sweeping them toward adulthood, but I didn’t  feel left out. Secretly, I was relieved. Lying in bed at night, hands folded, I asked God to spare  me. Fertility is a gift, I said. Give mine to someone who will use it.  

When I found my underwear soaked red one morning, I still prayed. Let it be a  hemorrhage. A fluke. The second time I bled, I gave up praying. I gave up God soon after. 

* 

While I waited to hear from the gynecologist, I talked to other people. My parents were unruffled, as  though they had been expecting it.  

“Your grandmother had a tubal ligation,” my mother said. “At twenty-three. After your  uncle was born.”  

“In the sixties? Didn’t they give her a hard time?” I asked. 

“Not that I heard.” 

 My other older friends told me they had no problem getting tubal ligations decades  ago; meanwhile my younger friends recounted exhausting searches for a compassionate  physician. Why had it seemingly become harder to get a low-risk, highly effective procedure?  Briefly, I wondered if medicine had somehow become more patriarchal. Then I realized the  simple truth: my older friends, like my grandmother, had given birth before getting sterilized.  My younger friends had not yet paid their debt.  

* 

On my friend X’s seventeenth birthday, we walked to the grocery store with two other girls to  get pop and a pregnancy test. 

“Aren’t you on birth control?” one girl asked X. 

“Yeah, but I’m late this month,” X replied. 

“Would you keep it?” another girl asked. 

“Maybe,” X said. “My parents would be so pissed, but I don’t know what they’d do.”  I knew what my father would do—he swore if I ever got pregnant, he’d kick me out of  the house. 

Later that day, we stood useless outside the bathroom door while X struggled. I wrung  my hands, as though the possibility of an impending pregnancy sentence were mine. Finally, X came out smiling. I hoped my fate would never be foretold by such a lowly oracle.  But all of ours would someday, one way or another.  

* 

Meeting the gynecologist required another day off work. I wore a suit so she wouldn’t feel like she was offering life-changing surgery to the teenager I was occasionally mistaken for. In her  office, I avoided the brochure “Storing Your Baby’s Stem Cells,” lest anyone think I was having  latent maternal impulses.  

A med student entered first, asking questions like whether my boyfriend could get a  vasectomy so I wouldn’t need a tubal ligation. No, I thought, because we might not last.  Then the gynecologist came in. 

“Have you considered other forms of birth control?” she asked. 

“Yes, I’ve considered other forms of birth control,” I said.  

“An IUD?” she pressed. 

“I’d really prefer something permanent.” 

“You never want to have children? Tubal ligations are technically reversible but the  success rate is only seventy percent.” 

“Never.”  

“You’ll need general anaesthesia. You could wake up with a colostomy if your bowel is  punctured. Infection could set in up to three days after surgery. You could die.” 

“What’s the chance of any of that happening?”  

“Less than two percent.” 

“I understand.” 

“And you’re sure?”  

* 

One night, my first boyfriend and I were taking the last bus from the university back to his  house, folded into each other. The dim interior lights cast a blue haze over the glassy-eyed  faces of the passengers.  

“I’m not ready to have sex yet,” I whispered suddenly.  

“Oh. Well, that’s okay,” he said. “What do you need to be ready?” 

“Birth control pills are not one hundred percent effective. I’m really terrified of getting  pregnant.” I did not mention that the prospect of an abortion terrified me, too.  “I have condoms. Do you know how small the chances are of getting pregnant if we use both?” 

“Yes. But the fact that there’s a chance at all still worries me.” 

“We can use two condoms.” 

“That makes it less safe!” 

“I know.” 

“I’m sorry.”  

“It’s okay. We can still do other things, right?” he said.  

I nodded, flooded with relief.

We dated for three years after that, and he never once acted resentful or tried to  reform me. We’re still friends now, in the way adults living in different cities generally are,  speaking only a few times a year.  

The night he and his wife had a baby, I was honoured to be among the first people he  called, and I surprised myself with how happy I was for the three of them, even though, at the  same time, I was as certain as ever that it was not a fate I wanted for myself.

* 

I told my boss I needed a week off for surgery.  

“Of course!” He said, looking concerned.  

“I’ll bring a doctor’s note,” I said.  

“Don’t worry about it!”  

How lucky I was. To work for someone who was always kind to me, who offered me an  all-too-rare, permanent position with paid sick leave. To have parents and doctors who  accepted my convictions. To live in a province where the healthcare system covered the costs  of the surgery, in an era when I didn’t need any husband or guardian’s permission. 

* 

One Friday night, my third boyfriend and I were walking down a quiet, residential side street  with our arms around each other, making our way to an art show.  

“I’m considering getting a tubal ligation,” I declared, without segue.  

“Oh. Isn’t that permanent?” 

“Yes.” 

“You’re off the idea of an IUD?”  

“Why get a new IUD every few years when I’m sure I never want children?” 

“Not even with me?” he smiled that smile of plausible deniability I recognized from all  the times he’d said we should get married. 

“I like kids just fine when they belong to someone else. Do you want kids?”  “Maybe. Someday.” He smiled again. “I bet our kids would be cute.”  

“I’m sure.” I thought of my most recent pregnancy test—negative—and resolved never  to mention it to him.  

“I don’t expect you to make a choice based on whether I want kids.”  

“I know. And I wouldn’t.” Still, it felt like I was slamming a door in the face of our  would-be children.  

* 

Surgery was easy. I arrived early the morning of and spent my time in pre-op dozing. In the  operating room, my gynecologist asked how I was feeling.  

“And you’re ready?” she asked. “And you’re sure?” 

“Absolutely,” I said. 

The anesthesiologist arrived to put me under. Anaesthesia ran like icy water into my  vein. Is this how it’s supposed to feel? I wondered, but was knocked out before I could ask.  When I woke, I was alone again. Blearily, I whipped off my blanket. My  abdomen looked more or less the same. No colostomy, no weeping cuts. Deep relief. My  mother found me soon after. She drove me home late that evening, while I lay fully reclined in  the passenger’s seat, mesmerized by stars rushing past the top edge of the window. 

* 

My mother took care of me until my third boyfriend arrived the next afternoon. He stayed for  days and cooked endless meals while I slept on the couch next to my cat who lay warm  against my wounded abdomen. 

Whenever I stood up, my boyfriend would say, What are you doing? I’ll do it for you. I  ran out of ways to say I love you and I’m so glad you’re here and thank you. I wondered if I  would ever have the chance to be as good to him as he was being to me.  (I would not.)  

Before week’s end, I was healed enough to rejoin the living. I felt my gynecologist had  fixed a decades-old, prenatal mistake by sealing up my fallopian tubes and sequestering my  ovaries from the rest of my body. From the world.  

* 

When I was reading those harrowing online accounts of tubal ligation, I began to worry that  all of us who wanted permanent birth control were doomed to wander forever in fruitless  pursuit of our own autonomy. But none of us were wrong for believing we should have first  and final say about our bodies. My doctors gave me an incomparable gift by allowing me to  exercise that agency. They were good doctors, but also perfectly ordinary. Any doctor could be  just as liberating, if they aspired to it.  

I have rewritten this account of my sterilization several times over six years, never  wholly satisfied because I am trying to write for so many people at the same time. But I keep  at it because this conversation is urgent. The U.S., which is a walkable distance from my home  in Canada, is beset by regressive political efforts to reduce access to reproductive care  including abortion.  

I want my account to remind other people seeking permanent birth control that  sometimes, in spite of all that stands in front of them, they will find it. They will find it even if  they are unmarried, unassertive, childless, guileless, queer, meek, disabled, flailing, tender,  timid. 

I want to show bad doctors that some of us spend our entire lives completely sure of  what we need. I want to thank good doctors for their remarkable ability to give us just that.  I want my parents to know that they did everything exactly right.  

I want everyone to see how easy it can be to hold one another up: cook for a loved one when they are sick; give an employee the benefit of the doubt; stand back and let someone become the person they long to be.  

* 

For years, I wondered how I could be happy about a surgery that has been a terror to so many. Like abortion, sterilization has been coerced or withheld as a means of control by states and  medical systems. Used against people like me, and people oppressed in other ways, in an effort to convince us that our bodies are not our own. In 2021, Canada’s Standing Senate Committee  on Human Rights reported that sterilization is still forced upon Indigenous people, and that  ‘preliminary’ evidence suggests people who are disabled, low-income, HIV-positive, Black,  racialized, transgender, intersex, or institutionalized are also vulnerable to forced sterilization.  

These days, I understand that permanent birth control is like sex: you do it in full  awareness of how dreadful it would be if forced upon you. I’m lucky. I asked for my tubal  ligation, would have begged for it, and it feels natural and right. The telos of decades of  reproductive anxiety and gender dysphoria.  

For five years now, I have been a bare field, and I am as satisfied as ever to carry only  myself. My body is reserved for other forms of regeneration. I make art, tend gardens, dream  of horses. A sole scar remains from the surgery: a small ridge on the smooth expanse above my fallow uterus. Sometimes, lying in bed at night, I run my fingers across the scar to remind  myself that no lover, no lineage, no state, no mass of fetal cells, can claim this small space that  is mine.