Do Health Insurance and Residence Pattern the Likelihood of Tubal Sterilization among American Women?

Abstract

American women have increasingly opted for tubal sterilization or tubal ligation surgery in recent decades. While research has begun to examine the unequal access to health care in the United States, little research has considered how this may impact whether women opt for a tubal ligation surgery. We first profile women with and without tubal ligations using bivariate analysis of the most recent data available, a nationally representative sample of 7,643 women from the National Survey of Family Growth, Cycle 6 (NSFG, Public use data file, 2002). We then use logistic regression models to examine the relationship between having tubal ligation and two focal variables: (1) type of health insurance (Medicaid compared with private, government or military, and no health insurance), and (2) rural or urban place of residence. We find that women on Medicaid are nearly twice as likely to have had a tubal sterilization compared with women who have private health insurance coverage. Also, women on Medicaid are substantially more likely to have a tubal sterilization than women with government or military insurance and women with no health insurance (26% and 36%, respectively). Further, we find that women living in rural areas are nearly twice as likely to have a tubal sterilization, compared with women in urban or suburban areas, all else being equal.