For any person or couple the decision to be sterilized is a major one and feelings need to be explored. For couples where there is a disability the whole issue of fertility and the advisability of pregnancy must be considered. It is important for the doctor to be able to give an informed and nonjudgemental opinion on the advisability in regard to the health of the mother and possible risk and problems during pregnancy, as well as the continuing stresses of coping with a child.
There is a need for realistic assessment without prejudice. Sensitive issues surrounding the question of congenital disability need to be addressed and perhaps a genetic opinion obtained.
A person with a disability knows how it is to grow up and live with the disability. Some will feel that there is no way in which they would bring a child into the world with the risk of their disability recurring, but others will feel that they know, understand and are coping with their own disability, and that the risk is reasonable and acceptable, as they could offer true insight and support if their child had a similar disability. Pressure from doctors based on their views of the disability must be avoided at all costs, since it implies a devaluation of the patient’s life, as if their life is useless and perhaps they should not have been born either.
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