No sterilization after all.

Postpartum sterilization is convenient and safe; yet, nearly half of women who requested it while receiving prenatal care at a Chicago hospital in 2002-2003 did not have the operation. (1) In analyses controlling for demographic, prenatal and intrapartum factors, the odds that women who requested postpartum sterilization obtained it were significantly reduced among 21-25-year-olds (the youngest group included-odds ratio, 0.6), blacks (0.7), women who made the request during their second trimester (0.5) and women who delivered vaginally (0.2). So, what happens to change the plan? The analysts speculate that whereas some women change their minds, characteristics of the health care system (e.g., Medicaid restrictions or delays in the procedure if surgical resources are needed for more urgent operations) may deter others. "Clearly," the analysts remark, "it will be important to determine which women who did not get their surgery still wanted it." Moreover, they stress that because many women who ask for postpartum sterilization will not get it, all those who request the operation should receive counseling about reversible contraception.

(1.) Zite N, Wuellner S and Gilliam M, Failure to obtain desired postpartum sterilization: risk and predictors, Obstetrics & Gynecology, 2005, 105(4): 794-799.

FYI is compiled and written by Dore Hollander, executive editor of Perspectives on Sexual and Reproductive Health.