Female sterilization by tubal ligation: a re-appraisal of factors influencing decision making in a tropical setting

Abstract

Female sterilization by tubal ligation is the most commonly used method of fertility regulation. However, in some lesser-developed countries like Nigeria, it has not been accepted as a popular method of contraception. To assess the pattern of female sterilization and determine factors that may influence its acceptability. A retrospective study of 102 cases of tubal ligation (TL) performed between January 1999 and December 2004. Of the 102 patients/clients, 60 (58.8%) had TL at caesarean section, 28 (27.5%) had TL with repair of ruptured uterus and 14 (13.7%) clients had TL alone on request. In the reproductive age group, the rate of TL increased with age. In the group that had TL at caesarean section, the highest incidence of TL (65%) was recorded against parity 4. However, in the groups that had TL with repair of ruptured uterus and TL alone, the highest proportion of TL was recorded against parity 6, with rates of 46.3 and 57.1%, respectively. The rates of TL increased with the level of literacy. In the group that had TL alone, 92.9% of the clients were in a monogamous union. On the contrary, 89.3% of patients that had TL with repair of uterine rupture were in a polygamous union. There was relative distribution of patients/clients amongst the two religions and five ethnic grouping. In 55 of the 102 patients/clients, the indication for TL was completion of family size, though 41 of the 55 patients had TL at caesarean section. Demand for TL alone was low. A greater percentage of the patients had TL in conjunction with another surgical procedure.