Is Female Sterilization Voluntary in El Salvador?

Abstract

Sexual sterilization has become an increasingly important family planning method in developing countries, and notably so in Latin America, but some controversy has surrounded the practice because of the suggestion that individuals are coerced into undergoing sterilization. With the goal of examining allegations that low-income women in El Salvador are sterilized without their full knowledge or consent in family planning programs financed by the US, researchers interviewed 648 women who had received the operation in one of 7 facilities in El Salvador. In general, women were interviewed 1 month after their operation, by 6 trained female interviewers, with the assurance that the follow-up effort was not in any way connected with the facility performing the operation. An effort to sample approximately the same number of women from each facility was not entirely successful because of access difficulties. Most interviewees had been sterilized at below 30 years of age (average age at sterilization was 28 years), had begun having children in adolescence, and had not received more than a primary education. They had an average of 3.4 children and 1/3 had experienced the death of at least 1 child. The response to the survey indicated that female sterilization in El Salvador is voluntary. Women were shown to be aware of other contraception options. They had found out about sterilization and had become further informed about the method through providers and through communications with other women who had known about the operation at least 3 years before making a decision to submit to it, and many had waited between 1 month and 1 year before/between the decision and the actual operation. Only 1 women claimed to have felt pressured to be sterilized, identifying her mother as the source of the pressure.