Changing trends in demographic variables and techniques in female sterilization practices in a tertiary-care referral center over four decades

Abstract

Background: Female sterilization is one of the commonest methods of contraception opted by married couple in India. This study was conducted to know the changing trends of demographic profile of these women over the years. Objective: To study the demographic variables of couples undergoing tubectomy, different tubectomy techniques, and how they have changed over four decades in a tertiary-care referral center. Materials and Methods: One year of each decade (1986, 1996, 2006, and 2012) was chosen for the purpose of analysis. Records of couples having undergone tubectomy in these years were analyzed. Main outcome measures included were age and education of the couple, religion, number of children, and couples without male children undergoing tubectomy. Tubectomy techniques studied included laparoscopic versus postpartum/interval/with cesarean section (Pomeroy’s technique). Sterilization following medical termination of pregnancy was also noted. Numbers of couples opting for vasectomy in the same 4 years were documented. Results: A total of 4,303 women represented these four decades. Literacy rates of couples have improved as the decades passed by. The majority of women belonging to present decade undergoing tubectomy have ≤2 children (89.9% in 2012 as against 30.9% in 1986). The number of couples with only two female children has increased from 45.5% in 1986 to 87.7% in 2012. The number of couples without male children has shown a rising trend (7.8% in 1986 to 23.5 in 2012). Laparoscopic sterilization was a predominant mode of tubectomy till 2006. There was a drastic reduction in number of women undergoing laparoscopic sterilization in 2012 with a rise in concurrent sterilization rates. The number of vasectomies continues to remain low. Conclusion: A positive trend with a decrease in the number of children and, more notably, the number of male children at the time of sterilization was observed. Acceptance of permanent method among couples having only female children is a welcome trend.