During the last several decades, Brazil has experienced a rapid fertility decline from 6 births per woman in 1965 to 1.8 births per woman in 2006. Though Brazil lacks a significant and organized family planning program, this fertility decline has been caused in large part by an extremely high rate of female sterilization. Of the 81 percent of women living in union who use birth control, 29 percent are surgically sterilized, placing Brazil at the third highest rate of female sterilization in the world. This research analyzes the sterilization narratives of 10 women from the city of Santo Antonio de Jesus in the northeastern state of Bahia in order to understand their motivations for becoming sterilized and to place their choices in the context of economic class and social relations. In addition, two doctors and one nurse were interviewed in order to understand the influence of medicalization on the choices and experiences of the women. The research found that there is a distinction between the choice that women make to become sterilized and the lived experience of the sterilization procedure. The choice that women make to become sterilized is an empowered and determined decision to create a better life in the face of precarious economic conditions. However, when women enter the medical sphere to realize the surgical procedure, the knowledge asymmetry between doctor and patient leave women alienated from their bodies, especially as they continue to live in fear of becoming pregnant again. The research concludes that the disparity between the choice to become sterilized and the experience of sterilization leave women in a conflicted position in which they have taken control of their lives at the cost of losing control of their bodies