Katie Tonkiss, a 40-year-old senior lecturer in sociology at Aston University in England, has turned to body art after enduring a challenging journey with infertility and miscarriage. She chose to tattoo two small hearts on the inside of her right wrist, which symbolize her connection to the two children she and her husband ultimately adopted. For Tonkiss, the tattoos represent a way to reclaim control over her body. “I felt that this was something I could choose to do after such a long time of having no real choice,” she explains. “It was an expression of celebrating after a lot of self-blame and frustration.”
Tonkiss is part of a growing trend: today, more American women have tattoos than men, with 38 percent of women compared to 27 percent of men, according to the Pew Research Center. Overall, nearly one-third of Americans have at least one tattoo, including 56 percent of women aged 18 to 29 and 53 percent aged 30 to 49.
The rising popularity of tattoos among women reflects changing societal attitudes toward a practice that was once predominantly male. Experts note that many women now choose tattoos as powerful symbols of empowerment, identity, and personal values. Frequently, they use body art to honor someone or cope with trauma. For instance, women who have escaped human trafficking often alter or remove “branding” tattoos as a means of rejecting their past and embracing a new beginning.
Moreover, many women view tattoos as a fun and modern fashion statement. Cindy L. Farley, professor emerita in the nurse-midwifery program at Georgetown University, remarks, “In my mother’s day, the only people who got tattoos were jazz musicians and Navy men, and very few women.”
Moved by her own experience, Tonkiss conducted a study of women navigating the grief and sorrow of infertility, discovering solace and strength through tattoos. “Tattooing offered a reconciliation with the body after often traumatic fertility treatments and the grief of miscarriage,” she states. Women often chose symbols like compasses and phoenixes to represent their journeys through infertility and loss.
Cheri Van Hoover, a retired adjunct professor of midwifery and women’s health at Thomas Jefferson University, emphasizes that tattooing has become part of women’s beauty practices and can be deeply personal. “Just as women change their bodies in less permanent ways to be beautiful, it’s the same with tattoos,” she explains. Women might choose to tattoo over mastectomy scars with images representing life and renewal, or memorialize children who have died, particularly from suicide.
However, experts caution that getting tattoos can pose specific health risks, especially for pregnant women. Allergic reactions and infections, which can also affect men, may occur, and tattoos can complicate pregnancy, childbirth, and breastfeeding. Additionally, if regret sets in, removal can be both difficult and costly.
Tattoos are made by injecting colored inks into the dermis, the second layer of skin, a process that can range from mildly uncomfortable to extremely painful and is often done without topical anesthesia. The inks are not regulated by the Food and Drug Administration (FDA) and can only be removed from the market if they cause problems, often due to contamination or other issues.
The FDA does not regulate tattoo parlors, which fall under state and local health department authority. “A tattoo is an open wound that results from applying multiple jabs with a needle,” Farley explains, noting that this makes it vulnerable to infection, leading to redness, swelling, or more serious complications if bacteria spreads to the bloodstream.
Adam Friedman, professor and chair of dermatology at George Washington University, points out that allergic reactions can occur, particularly with red dye. “The areas in the tattoo that contain the pigment will be swollen, scaly, and very itchy,” he says. Treatment typically involves topical or injected steroids, but these solutions are often only temporary.
For these reasons, experts advise women against getting new tattoos or having them removed while pregnant or breastfeeding. “There are unknown ingredients in the ink that can be absorbed by the body,” Van Hoover warns. “An allergic reaction or infection might require further treatment, and medications could affect the fetus.”
Pregnancy can also alter and stretch the skin, potentially changing the appearance of tattoos, especially on the abdomen. Women are discouraged from getting new tattoos while breastfeeding, as chemicals may enter the body during the removal process. “Anything that gets into the mother’s bloodstream gets into the breast milk,” Van Hoover adds.
Even old tattoos can pose issues. For example, a lower-back tattoo can complicate the administration of an epidural during labor, as passing a needle through the skin with dyes may deposit the pigments into unintended areas. Fortunately, solutions exist, such as placing the epidural needle through an uninked part of the design or selecting a different location on the lower back.
Some individuals, regardless of gender, opt for tattoo removal, a procedure that can cost nearly $700, according to the American Society of Plastic Surgeons, and is typically not covered by insurance. Methods of removal include laser treatments, chemical peels, dermabrasion, and surgical excision, all of which can result in discoloration or scarring.
Despite having studied the potential dangers of tattoos, Van Hoover admires their beauty and does not discourage women from getting them. “I respect the personal narrative of what women are expressing on their bodies,” she states. “I just hope we can find ways to make it as safe as possible.”
For Tonkiss, the significance of her tattoo far outweighs any discomfort or risks. Before getting the tattoo, she and her children would draw little hearts on their wrists to feel connected when apart. “The tattoo was a way to create a permanent connection through an image that meant something to us,” she says.
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