Use Of Female Sterilization Research Articles

Use of Female Sterilization and associated Factors among Women of Reproductive Age in Malawi

Background: Malawi has witnessed an increase in the uptake of female sterilization, making it one of the few countries having a high prevalence of female sterilization on the continent. The factors responsible for the high uptake of female sterilization are not known. Objective: The main objective of this study was to establish the factors associated with the use of female sterilization in Malawi. Methods: In the study, the 2015-16 Malawi Demographic and Health Survey has been used. The chi-square test and multivariate binary logistic regression were used to explore the factors influencing the uptake of female sterilization in the country. Results: Results showed the prevalence of female sterilization to be 18.1% as a method of contraception. Women residing in the Northern Region (OR=1.587, 95% CI=1.276-1.972; p=0.000) and the Central Region (OR=2.387, 95% CI=2.084-2.734; p=0.000), with no education (OR=2.102, 95% CI=1.634-2.703; p=0.000) and primary education (OR=1.488, 95% CI=1.206-1.835; p=0.000), who had not been visited by a field worker in the last twelve months (OR=2.252, 95% CI=1829-2.774; p=0.000) or had not visited a health centre in the last twelve months (OR=1.860, 95% CI=1.634-2.117; p=0.000), had higher odds of being sterilized. While women who were not working (OR=0.771, 95% CI=0.664-0.894; p=0.000), aged 30 years or less (OR=0.104, 95% CI=0.0.79-0.136; p=0.000), poor (OR=0.599, 95% CI=0.510-0.704; p=0.000), having middle wealth status (OR=0.744, 95% CI=0.626-0.883; p=0.000), having no child (OR=0.163, 95% CI=0.119-0.223; p=0.000) or 1-2 children (OR=0.408, 95% CI=0.352-0.473; p=0.000), and not being aware or having heard regarding family planning from television (OR=0.769, 95% CI=0.603-0.981; p=0.000), had lower odds of using female sterilization. Conclusion: According to African standards, the use of female sterilization in Malawi is high. The factors associated with the use of female sterilization include a high level of education, residing in the Central or Northern Region, aging 30 years and above, having been visited by a field worker in the past 12 months, having visited a health facility in the past 12 months, having heard regarding family planning on TV in the past few months, work status, wealth, and children ever born. These factors should be considered when planning future contraceptive strategies to improve the uptake of female sterilization. Family planning programs should also aim at economic empowerment for women.

Does locality have more impact than ethnicity on contraceptive use?

Ethnicity and locality influence contraceptive use and are important in family planning programs. As ethnicity is unmodifiable, the locality may be left to help promote contraceptive use. This study aimed to determine whether locality impacts contraceptive use more than ethnicity. The prevalence ratios of ethnicity (11 categories) and locality (14 regions) for the top three contraceptive methods were estimated from the Nepal Demographic and Health Survey dataset in 2016. The locality had a greater impact on male condom use and injection practices than ethnicity. In contrast, both locality and ethnicity strongly influenced the use of female sterilization; however, ethnicity had a greater impact than locality. Our findings suggest that, depending on the contraceptive method, family planning activities should be adapted to locality and that careful consideration of ethnicity is required for female sterilization.

Delivery at Catholic hospitals and postpartum contraception use, five US states, 2015-2018.

ObjectivesTo evaluate whether the prevalence of postpartum contraceptive use was lower among people who delivered at a Catholic hospital compared to a non‐Catholic hospital.MethodsWe linked 2015–2018 Pregnancy Risk Assessment Monitoring System (PRAMS) survey data from five states to hospital information from the corresponding birth certificate file. People with a live birth self‐reported their use of contraception methods on the PRAMS survey at 2–6 months postpartum, which we coded into two dichotomous (yes vs. no) outcomes for use of female sterilization and highly‐effective contraception (female/male sterilization, intrauterine device, implant, injectable, oral contraception, patch, or ring). We conducted multilevel log‐binomial regression to examine the relationship between birth hospital type and postpartum contraception use adjusting for confounders.ResultsPrevalence of female sterilization for people who delivered at a Catholic hospital was 51% lower than that of their counterparts delivering at a non‐Catholic hospital (adjusted prevalence ratio: 0.49; 95% confidence interval: 0.37–0.65).ConclusionWe found lower use of postpartum female sterilization, but no difference in highly effective contraception overall, for people who delivered at a Catholic hospital compared to a non‐Catholic hospital.

Domestic Violence and Sterilization Skew in India: An Instrumental Variable Analysis.

The objective of this study was to assess the prevalence of domestic violence in ever-married women in India and analyze the relationship between domestic violence and use of female sterilization as contraception. We analyzed data from the National Family Health Survey 2005-2006 (NFHS3). The Domestic Violence Module of the survey included abuse experiences and reproductive health outcomes of ever-married women aged 15 to 49 years (n = 69,704). The main outcome of interest was female sterilization and domestic violence experience was the main independent variable. Covariates in our multivariate regression models were guided by the socioecological model for domestic abuse. We estimated a reference linear probability model for the dichotomous outcome. We also employed an instrumental variables procedure to strengthen causal inference under such potential sources of bias as measurement error in reporting domestic violence and omitted variables. The reference model showed an increase of 2.1 percentage points (p < .001) in the probability of female sterilization associated with exposure to domestic violence. After correcting the estimate for the measurement error and omitted variable bias, we found that domestic violence was associated with an increase in female sterilization by 6.4 percentage points (p < .001), which is 18% higher than the rate of sterilization among non-victims. In conclusion, our findings imply that domestic violence may lead abuse victims to opt for female sterilization as contraception. Domestic violence is a significant obstacle to efficient contraceptive use. Programs directed toward violence prevention should work conjointly with family planning programs in India.

Description and comparison of postpartum use of effective contraception among women with and without diabetes

ObjectiveAs diabetes is increasing among women of reproductive age in the United States, access to effective contraception is important to allow time for optimal glycemic control which may mitigate complications in future pregnancies. This study sought to describe contraceptive use and compare the effectiveness of contraceptive methods among postpartum women with and without diabetes. Study designThis study used data from the Pregnancy Risk Assessment Monitoring System and included women with recent live births during 2012–2015 (N = 93,574). Women were asked about pre-gestational or recent gestational diabetes and their postpartum contraceptive method. Chi-square and multivariate logistic regression analyses were used to compare contraceptive methods between women with and without diabetes. ResultsContraceptive prevalence was similar between women with (82%) and without (83%) diabetes; women with diabetes were more likely to use the most effective methods. This was driven by higher use of female sterilization among women with diabetes (15%) compared to women without diabetes (9%) (p < 0.001). In multivariate analysis, odds of use of female sterilization versus reversible prescription methods was higher among women with diabetes than women without diabetes (adjusted odds ratio 1.29, 95% confidence interval 1.19–1.39). ConclusionsAlthough overall postpartum contraceptive use was high, only 1/3 of women with or without diabetes were using the most effective methods. Furthermore, women with diabetes were more likely to use female sterilization than women without diabetes. It is important all postpartum women, particularly those with high risk pregnancies such as women with diabetes, receive counseling about and access to all contraceptive methods. ImplicationsIt is important for clinicians to counsel women with pregnancies affected by diabetes that reversible contraceptives such as implants and IUDs are as effective as female permanent contraception.

Contraceptive use by disability status: new national estimates from the National Survey of Family Growth

ObjectiveThe objective was to determine population-based estimates of use of contraception among women 15–44 years of age in the United States by disability status. Study designWe examined the relationship between disability status and use of contraception among 7505 women at risk of unintended pregnancy using data from the 2011–2015 National Survey of Family Growth. ResultsAfter examining the full distribution of contraceptive method use by disability status, we found that disability status was significantly associated with differences in three categories of use: female sterilization, the oral contraceptive pill and nonuse of contraception. Multivariate analysis shows that use of female sterilization was higher among women with cognitive disabilities (aOR=1.54, 95% CI=1.12–2.12) and physical disabilities (aOR=1.59, CI=1.08–2.35) than for those without disabilities after controlling for age, parity, race, insurance coverage and experience of unintended births. Use of the pill was less common among women with physical disabilities than for those without disabilities (aOR=0.57, CI=0.40–0.82). Finally, not using a method was more common among women with cognitive disabilities (aOR=1.90, CI=1.36–2.66). ConclusionsSelf-reported cognitive disabilities (“serious difficulty concentrating, remembering or making decisions”), as well as physical disabilities, are significant predictors of contraceptive choices after controlling for several known predictors of use. ImplicationsThe patterns found here suggest that screening for self-reported cognitive and physical disabilities may allow health care providers to tailor counseling and sex education to help women with disabilities prevent unintended pregnancy and reach their family size goals.

Gambaran Perilaku Wanita Dalam Penggunaan Kontrasepsi Strerilisasi Wanita Di Pamulang, Kota Tangerang Selatan

Background: TFR in Indonesia since 2002 stagnanted at 2.6. CPR trends Indonesia are increasing but most short term family planning methods. The use of female sterilization contraception in Indonesia is only 2.3%. The female sterilization in Banten province is ranked lowest in Java. Objective: to obtain a description of the user behaviour of sterilization contraception Methods: The design of this study was a RAP (Rapid Assessment Procedure). The informant were 12 wife EFA who used and did not use female sterilization and 14 key informants. Data collection used in-depth interviews and document review. Data is analyzed with content analysis. Result: Behaviour of contraceptive use of female sterilization in Puskesmas Pamulang working area due to medical indication. Support factors include better knowledge, confidence in contraceptive use, positive attitudes and perception of pregnancy risk. Enabling factors include service availability of services and distance perceptions to contraceptive services do not affect contraceptive use, and the cost is affordable and they have access to good information. Reinforcing factors include husband support and advice from doctors. Conclusion: Behaviour of contraceptive use of female sterilization in Puskesmas Pamulang working area due to medical indication. Supporting factors are knowledge, attitude, perception of pregnancy risk, belief, and husband support. Inhibiting factors are expensive cost perception, lack of access to information and lack of support of health workers (PLKB and Midwife).

Variation in postpartum contraceptive method use: results from the Pregnancy Risk Assessment Monitoring System (PRAMS)

ObjectiveThe National Survey of Family Growth has been a primary data source for trends in US women’s contraceptive use. However, national-level data may mask differences in contraceptive practice resulting from variation in local policies and norms. Study DesignWe used the Pregnancy Risk Assessment Monitoring System, a survey of women who are 2–4 months postpartum. Information on women’s current method was available for 18 reporting areas from 2000 to 2009. Using the two most recent years of data, we computed the weighted proportion of women using specific contraceptive methods according to payment for delivery (Medicaid or private insurance) and examined differences across states. We used log binomial regression to assess trends in method use in 8 areas with consecutive years of data. ResultsAcross states, there was a wide range of use of female sterilization (7.0–22.6%) and long-acting reversible contraception (LARC; 1.9–25.5%). Other methods, like vasectomy and the patch/ring, had a narrower range of use. Women with Medicaid-paid deliveries were more likely to report female sterilization, LARC and injectables as their method compared to women with private insurance. LARC use increased ≥18% per year, while use of injectables and oral contraceptives declined by 2.5–10.6% annually. ConclusionsThe correlation in method-specific prevalence within states suggests shared social and medical norms, while the larger variation across states may reflect both differences in norms and access to contraception for low-income women. Surveys of postpartum women, who are beginning a new segment of contraceptive use, may better capture emerging trends in US contraceptive method mix. ImplicationsThere is considerable variation in contraceptive method use across states, which may result from differences in state policies and funding for family planning services, local medical norms surrounding contraceptive practice, and women’s and couples’ demand or preference for different methods.

Lessons from the Recent Rise in Use of Female Sterilization in Malawi

Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints.

Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia

BackgroundEthiopia is the second most populous country in Sub-Saharan Africa. Total Fertility Rate of Ethiopia is 5.4 children per women, population growth rate is estimated to be 2.7% per year and contraceptive prevalence rate is only 15% while the unmet need for family planning is 34%. Overall awareness of Family Planning methods is high, at 87%. The prevalence of long acting and permanent contraceptive methods (LAPMs) in Tigray region was very low which accounts for 0.1% for implants and no users for intra-uterine contraceptive device (IUCD) and female sterilization. Moreover almost all modern contraceptive use in Ethiopia is dependent on short acting contraceptive methods. The objective of this study was to assess factors associated with utilization of long acting and permanent contraceptive methods (LAPM) among married women of reproductive age group in Mekelle town.MethodsA cross sectional community based survey was conducted from March 9-20, 2011. Multistage sample technique was used to select the participants for the quantitative methods whereas purposive sampling was used for the qualitative part of the study. Binary descriptive statistics and multiple variable regressions were done.ResultsThe study consisted of quantitative and qualitative data. From the quantitative part of the study the response rate of the study was 95.6%. Of the qualitative part two FGDs were conducted for each married women and married men. 64% of the married women heard about LAPMs. More than half (53.6%) of the married women had negative attitude towards practicing of LAPMs. The overall prevalence of LAPMs use was 12.3% however; there were no users for female or male sterilization. The main reason cited by the majority of the married women for not using LAPMs was using another method of contraception 360 (93.3%). Mothers who had high knowledge were 8 times more likely to use LAPMs as compared with those who had low knowledge (AOR = 7.9, 95% CI of (3.1, 18.3). Mothers who had two or more pregnancies were 3 times more likely to use LAPM as compared with those who had one pregnancy (AOR = 2.7, 95% CI of (1.4, 5.1).ConclusionA significant amount of the participants had low knowledge on permanent contraceptive particularly vasectomy. More than half (53.6%) of married women had negative attitude towards practicing of LAMPs. Few of married women use female sterilization and none use of female sterilization and or vasectomy. Positive knowledge of LAMPs, women who had two and above pregnancies and women who do not want to have additional child were significantly associated. Information education communication should focus on alleviating factors hinder from practicing of LAPMs.

Contraception choices in a cohort of HIV+ women in the era of highly active antiretroviral therapy

Background The study was conducted to determine whether increased desire for fertility coupled with increased awareness of reduction in mother-to-child HIV transmission (MTCT) with increased availability and use of highly active antiretroviral therapy (HAART) has been associated with reduction in use of tubal sterilization as a form of contraception among women infected with HIV. Study Design One hundred HIV+ women, 18 to 45 years of age, receiving care at university-affiliated HIV facilities between October 2008 and February 2009, were surveyed about their contraceptive knowledge and practices. We performed descriptive analysis of population characteristics to determine contraception choices and fertility desires following initiation of HAART. Results The study group was composed of women with median age of 35 years, 55% African American, 18% Caucasians, 19% Hispanic and 8% “other”. Most (63%) were single; 36% were married. Contraception choices were condom 61%, injectable contraceptive 7%, pills 6% and only 3% said they used female sterilization. Thirty-four percent of respondents said that their choice of contraception was based primarily on ease of use, 19% said that their choice was primarily based on convenience and only 9% said that their choice was primarily based on provider recommendation. Desire for future childbearing increased to 19% following knowledge that MTCT can be reduced by taking antiretroviral therapy (ARV) and to 22% following initiation of ARV. Conclusions Initiation of ARV and awareness that maternal treatment can reduce MTCT may explain lower use of female sterilization as a form of contraception among a cohort of HIV+ women in the post HAART era.

Social and logistical barriers to the use of reversible contraception among women in a rural Indian village.

Women in a small coastal village in western India were asked to explain their preference for female sterilization over modern reversible contraceptive methods. Married women aged 19+ years were interviewed in six focus groups (n=60) and individually (n=15) regarding contraceptive methods and their use and side-effects. Women publicly denied contraceptive use but privately acknowledged limited use. They obtained contraceptive information from other village women and believed that modem reversible methods and vasectomy have high physical and social risks, and fertility goals could be achieved without their use. Women felt that reversible contraception is undesirable, socially unacceptable, and usually unnecessary, although the achievement of fertility goals is likely due to the use of female sterilization with abortion as a back-up method. Economic migration of village men may also play a role. Although women with high social capital can effectively disseminate correct knowledge, the impact on the uptake of reversible method is uncertain.

Healthcare infrastructure, contraceptive use and infant mortality in Uttar Pradesh, India

This paper analyzes data on approximately 30,000 women from a survey in Uttar Pradesh in 1995 together with the data from surveys of public and private providers of healthcare and family planning services. A framework was developed for analyzing the effects of quality of services on utilization, and for understanding the gradual evolution of the healthcare infrastructure. The empirical results from logistic regressions for use of female sterilization and IUD showed significant effects of quality of services in government and private hospitals, and of socioeconomic variables such as education, caste, and an index of household possessions. Secondly, models for infant mortality of children born in the preceding 3-year period showed significant effects of socioeconomic variables, quality of healthcare services and birth spacing. Lastly, analysis of data at a more aggregated (Primary Sampling Unit) level indicated differential effects of economic development on the quality of services available in the public and private facilities.

Women’s perception of their reproductive health before and after sterilization in rural Maharashtra, India

Few community-based studies in India have investigated the determinants of women’s self-reports of reproductive tract infections and other forms of gynaecological morbidity. One of the most striking findings to emerge from the few that have done so is the strong association between the use of female sterilization, or in some cases the intrauterine device (IUD), and reported or diagnosed gynaecological morbidity.

Contraceptive Practice in the United States, 1982-1988

Use of oral contraceptives by married women declined markedly between 1973 and 1982, but analysis of data from the 1988 National Survey of Family Growth shows that this decline stopped between 1982 and 1988. Reliance on female sterilization continued to increase, however, and it remained the leading method among currently married and formerly married women. Among women of all marital statuses, IUD use dropped by two-thirds between 1982 and 1988, from 2.2 million to 0.7 million women. As the proportion of less-educated, low-income, black and Hispanic contraceptive users choosing the IUD decreased, the proportion relying on female sterilization increased. Among college-educated white women, use of female sterilization did not increase; instead, pill use rose in this group. Condom use increased most sharply among teenagers and rose among never-married white and black women, but the pill was still the leading method by far in these groups, regardless of race. Among never-married black women, reliance on sterilization increased significantly between 1982 and 1988, with female sterilization becoming the second leading method. Use of the diaphragm declined sharply over the same period among never-married white women and among those who intended to have more children, as did use of periodic abstinence (rhythm and natural family planning) and foam.

Thailand's Reproductive Revolution: An Update

A comparison of the results of the 1981 Contraceptive Prevalence Survey with those of a similar survey carried out in 1978-1979 shows that the proportion of currently married Thai women who are practicing contraception has continued to rise and is now approaching 60%. Nearly all segments of Thai society have participated in this increase; rural/urban and educational differentials are modest and even among rural women with fewer than 4 years of education more than half report that they are currently using contraceptives. Important regional differences remain however; southern Thailand particularly lags behind the other regions. Increases in contraceptive prevalence have resulted largely from greater use of female sterilization and to a lesser extent from increased use of injectable contraceptives. The pill remains the method most commonly employed but by 1981 it was only slightly more popular than female sterilization. Pill users represent slightly more than 33% of all women using contraceptives; sterilized women constitute slightly less than 33%. Government outlets of the Ministry of Public Health are by far the most important suppliers of contraceptive services. Fertility rates among currently married women in the year prior to the survey were slightly higher among 1981 respondents than among those interviewed in 1978-1979. However the proportion of respondents reporting that they were currently pregnant declined between surveys; the average length of the interval since a womens last live birth increased. Both of these findings suggest that Thai fertility may have actually declined between surveys and that regional fertility differences are diminishing. The average expected family size has decreased to 3.3 children. Among women married less than 5 years only 2.4 children are wanted. A 2-child family appears to represent a lower limit on any further decline in fertility that might occur in the immediate future. Family size preferences vary with the sex distribution of children already born. (authors modified) (summaries in ENG FRE)