We welcome the report appearing in the June edition of the American Journal of Obstetrics and Gynecology that adds voices to ours and that of other commentators calling for revision of the 30-day mandatory sterilization waiting period for recipients of federal health care funding.

The authors suggest that it would be impractical to remove the source of payment discrepancy to address the deontological implication of the 30-day waiting period, because “no local, state, or federal government has the authority to create such a national policy to affect all patients….” However, while not creating a national policy, to protect all of its residents, New York City (NYC) created and maintains such a local policy, which we described in our 2014 publication. NYC’s restrictions–a 30-day waiting period and 180-day expiration of consent form–predate the federal consent form restrictions and have been the rule in NYC since the City Council adopted Local Law No. 37 in April 1977. This NYC legislation regulates male and female sterilization procedures performed at all private and public health facilities in the municipality.

Although we agree with the call of Moaddab et al to revise the federal sterilization consent form restrictions, the authors do not elaborate on the continued need to protect some vulnerable men and women from coerced sterilization. The need certainly persists; in fact, in September 2014, Governor Jerry Brown of California signed SB 1135 into law, which bans forced sterilization of inmates in California prisons. While Moaddab et al call upon obstetricians to invoke health care justice to merely advocate for elimination of the source of payment discrepancy, we have previously suggested that there needs to be expanded access to tubal ligation, while continuing to preserve protection from coercion. We recommended a return to the original federal 3-day waiting period, extending or eliminating the 180-day expiration period and ensuring improved secured electronic access to the signed sterilization consent forms.