Depending on the reason for the surgery the moral implications may vary:
My wife has a serious painfull condition for which the only cure will be a Hysterectomy. Her mother nearly died due to complications relating to this condition, and at just 3 years old my wife had to call an ambulance for her stricken, hemorrhaging mother.
I am resigned to the almost inevitable fact that my wife will probably need this operation, and that it is never reversible.
Shortly before we married she had a temporary treatment to reduce the effects of her condition, but having our first baby reversed the effects of that treatment.
We are hoping to have at least one, and possibly 2 more. As our babies can only be delivered by C-Section, medical advice will be to not even consider a 5th baby. My wife would be over 40 by then as well, again a serious contra-indication to healthy family planning for a woman with my wife’s health problems.
Her condition is diffuse uterine Intramural leiomyomatosis: (a severe and extreme form of multiple fibroids. They *cannot *be individually removed. and mean that she permanently has the look of someone heavily pregnant… When actually pregnant she gets bigger than most people with twins or triplets do.)
We are fully aware that each time she has a baby there is a very real risk to her health and life… St. Gianna Beretta Molla died in childbirth after the removal of just 1 fibroid. My wife has to many to count, and they range in size up to the size of a large Eggplant.
In fact we were told before we married that her case was so bad that it would require a miracle for her to ever conceive, never mind carry a child to term.
When she did get pregnant we were told to expect a premature baby, and a high probability of complications.
We now have 2 very healthy children! both went almost full term before being brought out by C-Section (Lying transverse oblique natural childbirth would have utterly impossible - that’s why C-Sections were invented.)
Luckily medical science is more advanced now and it is very unlikely that my wife and I will need to make the choice made by St. Gianna. Here in the UK our medical costs are covered by nationalised health-care and while I also have private insurance it is rarely needed to supplement what our taxes already pay for.
Sooner or later, either due to emergency complications during pregnancy / delivery or as a planned medical treatment afterwards. It is almost inevitable that my wife will be advised to have a Hysterectomy. We were already advised to consider it as the only full or permanent solution before we got married, and it was only delayed to let us try for that miracle.
principle of double effect
In our case, when a hysterectomy is finally considered the purpose of the operation will not be to sterilise my wife it will be to cure a very painful condition which is causing a wide range of other complications and presenting a serious risk of others or of sudden, catastrophic, life threatening hemorrhage. (Or as an emergency to stop a hemorrhage which has occurred spontaneously or during a C-Section).
For us it would be a very sad event but one which we expect to have to accept at some point in the future. There would be no sin in accepting this medical treatment.
We would remain open to New Life in our marriage, and have already agreed that we will consider and probably apply for possible adoption(s) after that time.
I know my situation is my situation and the O.P. has different circumstances, but I wanted to set out a clear case where medical procedures which cause sterilization is not always an intrinsic evil, even if they are sometimes used with that intent.
Obviously that cannot apply to procedures where a sterilisation is carried out for it’s own sake, simply because medical advice is to not have more children… in that situation we are exhorted to resort to very careful use of NFP techniques to avoid pregnancy, and not to resort to methods like Tubal Ligation.
