Psychological sequelae to elective sterilisation: a prospective study.

Abstract

Mr. Peter Cooper and others (February 13 p. 461) have reported their experience with elective tubal sterilization. In the early 70s we initiated a prospective study on the psychological evaluation and guidance of electively sterilized couples; at present our elective tubal interval sterilization series numbers several hundred cases. Our results suggest that the entire evaluation including the couples history (personal and social characteristics fertility contraceptive history motivation and indication) provides a basis for reliable prognosis of positive postoperative adjustment. Postoperative interviews have a very important counseling effect as well: they provide support during the working-through period and help the understanding of any alterations of the menstrual pattern. As could be anticipated women sterilized on a completely voluntary basis have less difficulty in assimilating the effects of the operation. Prediction of the reaction is more difficult when the preoperative interview coincides with pregnancy or tubal ligation is combined with a cesarean section. Clinically it is important to keep in mind that the administration of contraceptive depot preparations to women waiting for interval sterilization may induce negative psychological reactions that will become manifest during the postoperative assimilation process. The high response to the call-up for poststerilization evaluation and the high proportion of satisfied individuals constitute evidence of the value of both the selection and follow-up procedures practiced. (full text)