Many women identify sterilisation as their preferred form of contraception. However, their requests to be sterilised are frequently denied by doctors. Given a commitment to ensuring women’s reproductive autonomy, can these denials be justified? To answer this question, I assess the most commonly reported reasons for a denied sterilisation request: that the woman is too young, that she is child-free, that she will later regret her decision, and that it will lower her well-being. I argue that these worries are misplaced (...) and hence insufficient reasons for denying a request. I also argue that even if concern for patient welfare provides doctors with a valid reason to withhold sterilisation, this is overriden by respect for patient autonomy and the importance of enabling women’s reproductive control. Consequently, I suggest that adequately informed, decision-competent women should have their requests for sterilisation agreed to, even if they are young and/or child-free. In addition, I examine the impact of pronatalism on how women’s requests are understood and responded to by doctors. I show that the equation of women with motherhood can make it unjustifiably hard for them to access sterilisation, especially if they are child-free. Consequently, part of ensuring women’s access to sterilisation involves challenging pronatalist beliefs and practices. (shrink)