Whereas I always knew I wanted kids, have have never regretted having them, my middle daughter does not want children and I support her decision 1000%. Her dad otoh not so much. That daughter is an excellent auntie, and she is now parenting her parents, she's not missing anything.

'While I have many reasons for not wanting to get pregnant and wanting to be child-free, at the end of the day, 'I don't want to have kids' is reason enough and should be respected.'

A 24-year-old's tongue-in-cheek sterilization photoshoot after undergoing a sterilization procedure has sparked an important conversation in social media circles. Abby Ramsay went viral on TikTok last month after sharing a compilation of photos taken in a typical pregnancy announcement or gender reveal style. In the video—which has been viewed more than 3.8 million times since being uploaded on February 2—Ramsay approaches a box with "Congratulations" written on the side. With excitement clear on her face, she raises the lid of the box to reveal the paperwork for the sterilization surgery.

@abbysworldsastage I’m excited to take control of my own body. I’m not a baby maker. #childfree #childfreebychoice #sterilization #celebration ♬ abcdefu (angrier) - GAYLE
"If you know me, you know that I decided to live the child-free life since I was at least 16. When I turned 19 I decided to start looking into permanent sterilization. The first OBGYN I brought this up to told me I needed therapy (I was already getting therapy at the time) and told me she would not discuss it with me," Ramsay wrote on Instagram. "Another basically just blamed all my problems on hormones and sent me away with birth control pills, even though I told her multiple times that they made me violently ill. Another said that no one should ever get a surgery they don't absolutely need (even after I brought up plastic surgery and my family history of ovarian cancer which the surgery would also help prevent)."

@abbysworldsastage Reply to @maddy_4224 a common question. #childfreebychoice #childfreetiktok #sterilization ♬ original sound - Abbysworldsastage
"Many of these meetings left me frustrated at the least and traumatized at the most. I was infantilized and not listened to and not taken seriously. I was told I was too young to make such a permanent decision and then told I should have a baby in the same breath as if that was somehow less permanent. Finally, in December I found a doctor who listened to me, and even figured out why I have been in so much pain for years! My surgery is scheduled for February 4th, and I can't describe the relief and excitement and nerves that I feel," she continued. "I know my body, and I know what is right for me, and I want to thank my doctors for recognizing that and working with my needs. We need more doctors like that. Wish me luck in my surgery."

@abbysworldsastage Reply to @zarakayn hope this answers your question! #sterilization #recovery #childfree #surgery #childfreebychoice #bisalp #endometrialablation ♬ original sound - Abbysworldsastage
According to BuzzFeed, Ramsay underwent a combination surgery including a bilateral salpingectomy—in which doctors remove both fallopian tubes—and an endometrial ablation, which removes a layer of the endometrium aka the tissue lining a uterus. She reportedly chose this combination to eliminate her chances of having an unwanted pregnancy and also for the relief endometrial ablations can offer those like her, who experience long, heavy periods that interrupt their daily life. While her bill would have been around $116,000 without insurance, Abby said her total out-of-pocket cost totaled $1,000.

@abbysworldsastage Reply to @aceenargentina hope this helps ur journey! #sterilization #childfreebychoice #bisalp #childfreetiktok ♬ original sound - Abbysworldsastage
Speaking of why doctors she consulted with refused to perform the operation, Abby said: "The main reasonings they gave were age and possibility of regret. One said she didn't believe in performing 'unnecessary surgery' and said she was against things like plastic surgery, too. The third doctor I ever saw basically insinuated that there was something wrong with me for not wanting children and said I needed to go to therapy to get my brain fixed so I could have kids someday. There were times I went home crying. Other times I just wanted to scream. Other times I just felt numb and empty. It was frustrating. My pain and my desires and my goals and my life were all dismissed because of a baby that didn't even exist. A hypothetical person had more control over my future than I did."

@abbysworldsastage Reply to @timotheechalametisyummy hope this helps answer some questions! #sterilization #childfreebychoice #bisalp #surgery #endometrialablation ♬ original sound - Abbysworldsastage
Ramsay revealed she nearly teared up when she finally found a doctor who respected her decision. "All she needed was to listen to me for five minutes before saying alright, and immediately telling me my options, and procedures she thought might be right for me. I almost burst into tears of joy right then and there," she said. "I didn’t know how much I just needed someone to listen to me for once. To believe that maybe I knew myself better than they did. I brought that up to her a little, and to the doctor who ended up doing my surgery—my initial doctor had to get her own surgery and recommended me to her coworker—and both of them basically said, 'You clearly know what you want and have thought about this for a long time.' It was like a breath of fresh air."

@abbysworldsastage Reply to @ar.pxl bug numbers. #childfree #childfreebychoice #sterilization #surgery #femalesterilization ♬ original sound - Abbysworldsastage
Not having to over-explain herself and campaign for a procedure she wanted was the ultimate relief, Ramsay said. "While I have many reasons for not wanting to get pregnant and wanting to be child-free—from genetics to fears and medical concerns—at the end of the day, 'I don’t want to have kids' is reason enough and should be respected," she concluded.