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Title: Female contraception over 40.
Author: The ESHRE Capri Workshop Group
Source: Human Reproduction Update. 2009 May 20;
Abstract: BACKGROUND The majority of women 40-49 years of age need an effective method of contraception because the decline in fertility with age is an insufficient protection against unwanted pregnancy. Although pregnancy is less likely after the age of 40 years, the clinical and social consequences of an unexpected pregnancy are potentially detrimental. No contraceptive method is contraindicated by advanced reproductive age alone; thus there is a need to discuss the effectiveness, risks and non-contraceptive benefits of all family planning methods for women in this age group. METHODS MEDLINE searches were done by topic (epidemiology, age and reproduction, sexual function, delayed childbearing and specific contraceptive methods). The topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. RESULTS The decline in fecundity in the fifth decade is insufficient for contraceptive purposes. Thus a family planning method is needed. Sterilization is by far the most common method in several countries. Copper intrauterine devices and hormone intrauterine systems have similar effectiveness, with fewer than 1% failures in the first year of typical use. Special considerations in this age group include the frequency of menstrual irregularity, sexual problems and the possibility of menopausal symptoms, all of which may respond to hormonal methods of contraception. CONCLUSIONS Women should be advised to continue with a contraceptive method until they have reached the menopause with its natural state of sterility.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | MENOPAUSE | FAMILY PLANNING | FEMALE STERILIZATION | BIOLOGICAL AGING | AGE FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Reproduction | Sterilization, Sexual | Physiology | Biology | Population Characteristics
Document Number: 341250

Title: Hysteroscopic female sterilization with Essure in an outpatient setting.
Author: Andersson S; Eriksson S; Mints M
Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(6):743-6.
Abstract: The aim of this study is to evaluate the short and long-term results of hysteroscopic sterilization in an outpatient setting. Sixty-one women underwent hysteroscopic sterilization. At follow-up, all of the women were asked to complete a questionnaire concerning possible pregnancy, bleeding patterns, side-effects, or need for further therapy after sterilization. Technical feasibility, complications, patient satisfaction, and tubal occlusion based on X-ray or ultrasound were measured. Fifty-eight (95%) women were sterilized according to this method. Successful bilateral device placement was achieved in 52 women (85%) during the first attempt and in six (9.8%) during the second. A total of 50 (81.9%) women submitted completed outcome questionnaires. The mean follow-up period was 23 (range 7-67) months. No pregnancies were reported. All questionnaire respondents expressed overall satisfaction with the procedure. To conclude, Essure sterilization is a safe effective method for female sterilization thatis feasible in the outpatient setting.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | CLIENTS | FEMALE STERILIZATION | HYSTEROSCOPY | COMPLICATIONS | SIDE EFFECTS | TUBAL OCCLUSION | SATISFACTION | SAFETY | Developed Countries | Europe, Northern | Europe | Program Activities | Programs | Organization and Administration | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Treatment | Psychological Factors | Behavior | Public Health
Document Number: 341444

Title: Male perceptions on female sterilization: a community-based study in rural central India.
Author: Char A; Saavala M; Kulmala T
Source: International Perspectives on Sexual and Reproductive Health. 2009 Sep;35(3):131-138.
Abstract: CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies.
Spanish Abstract: Contexto: El uso de m�todos anticonceptivos modernos se ha cuadruplicado en India desde los a�os setenta y se ha caracterizado por el predominio de la esterilizaci�n femenina. Ha habido considerables esfuerzos de investigaci�n sobre la elecci�n de la esterilizaci�n femenina que hacen las mujeres, pero existen pocos estudios desde la perspectiva masculina. M�todos: Siete sesiones de grupos focales se condujeron con 58 hombres actualmente casados con mujeres en edades de 15-45 a�os, seguidas por una encuesta transversal aplicada a 793 hombres actualmente casados con mujeres del mismo grupo de edad. Se us� an�lisis bivariado para los datos de la encuesta y an�lisis de contenido para los datos cualitativos. Resultados: Para los hombres, la fuente primaria de informaci�n sobre salud reproductiva fue los medios masivos, aunque ellos expresaron inter�s en obtener informaci�n a trav�s de charlas con gente informada en el tema. Los hombres encuestados entendieron la planificaci�n familiar y la anticoncepci�n como dos temas separados: los hombres percibieron la "planificaci�n familiar" como sin�nimo de esterilizaci�n femenina, mientras que se refirieron a la "anticoncepci�n" como m�todos de espaciamiento, cuyo conocimiento fue limitado. Treinta y cuatro por ciento de los hombres reportaron que sus esposas hab�an sido esterilizadas; 79% de los hombres que no depend�an de alg�n m�todo permanente dijeron que quer�an que sus esposas fueran esterilizadas. En las sesiones de grupo, la mayor�a de los hombres se identific� como el �nico tomador de decisiones en su familia respecto a la salud reproductiva; sin embargo, solamente un tercio de los hombres encuestados se identific� de esa forma. Conclusi�n: Los hombres est�n interesados en obtener informaci�n sobre planificaci�n familiar, pero desconocen las fuentes disponibles que pueden consultar, lo cual limita su capacidad para tomar decisiones informadas sobre planificaci�n familiar. Los prestadores de servicios y planificadores de programas de planificaci�n familiar deben estar conscientes del conocimiento y percepciones de los hombres en relaci�n con la planificaci�n familiar, y realizar las modificaciones apropiadas a sus estrategias de comunicaci�n.
French Abstract: Contexte: La pratique de la contraception moderne a quadrupl� en Inde depuis les ann�es 1970. Elle se caract�rise par une pr�dominance de la st�rilisation f�minine. De nombreuses �tudes ont �t� men�es sur le choix f�minin de la st�rilisation. La perspective masculine n'est en revanche gu�re connue. M�thodes: Sept r�unions de groupe ont �t� organis�es avec 58 hommes mari�s � des femmes de 15 � 45 ans. Une enqu�te transversale a ensuite �t� men�e aupr�s de 793 hommes mari�s � des femmes de la m�me tranche d'�ge. L'analyse bivari�e a �t� utilis�e pour les donn�es d'enqu�te, et l'analyse de contenu pour les donn�es qualitatives. R�sultats: Pour les hommes, les m�dias repr�sentent la principale source d'information sur la sant� g�n�sique. Ils expriment cependant un certain int�r�t � s'informer par discussion aupr�s de sources comp�tentes. Les hommes voient dans la planification familiale et la contraception deux questions distinctes: la �planification familiale� est pour eux synonyme de st�rilisation f�minine, tandis que la �contraception� d�signe les m�thodes d'espacement, au sujet desquelles ils ne sont gu�re inform�s. Trente-quatre pour cent des hommes ont d�clar� que leur femme �tait st�rilis�e; 79% de ceux qui n'avaient pas eu recours � une m�thode permanente ont indiqu� d�sirer que leur femme se fasse st�riliser. Lors des discussions de groupe, la plupart des hommes se sont d�clar�s les seuls d�cideurs de leur famille en mati�re de sant� g�n�sique, par rapport � un tiers seulement des r�pondants � l'enqu�te. Conclusion: Les hommes d�sirent s'informer sur la planification familiale mais ils ignorent les sources d'information disponibles, ce qui entrave leur aptitude � op�rer des choix �clair�s en la mati�re. Les prestataires de services et les planifi- cateurs de programmes de planification familiale doivent �tre sensibles aux connaissances et aux perceptions masculines et ajuster en cons�quence leurs strat�gies de communication.
Language: English
Keywords:
INDIA | RESEARCH REPORT | FOCUS GROUPS | CROSS SECTIONAL ANALYSIS | MEN | CURRENTLY MARRIED | REPRODUCTIVE HEALTH | PERCEPTION | FEMALE STERILIZATION | INFORMATION SOURCES | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Marital Status | Nuptiality | Health | Psychological Factors | Behavior | Sterilization, Sexual | Family Planning | Information
Document Number: 343003

4.
Peer Reviewed

Title: Contraceptive discontinuation and non-use in Santarem, Brazilian Amazon.
Author: D'Antona Ade O; Chelekis JA; D'Antona MF; Siqueira AD
Source: Cadernos De Saude Publica. 2009 Sep;25(9):2021-32.
Abstract: In this paper we discuss the causes of non-adherence to reversible contraceptives, especially hormonal methods, among women in rural Santarem in the Brazilian Amazon. The analysis is based on questionnaires with 398 women and visits to health centers. We consider the motives reported by women who: never used contraception; used some method in the past; and who at the time of the survey were using a different method from the ones they used in the past. The results indicate a rejection of hormonal contraception and a preference for female sterilization, an option possibly influenced by the characteristics of health services in the region. The side effects of hormonal contraceptive use reported by part of the interviewees contribute to a generalized fear of the side effects even among women who have never used such methods. To improve women's health services in the Amazon, we recommend further studies of the relationship between reported side effects and available services and prescriptions, as well as an analysis of women's discourse and perceptions.
Language: English
Keywords:
BRAZIL | RURAL AREAS | RESEARCH REPORT | WOMEN | CONTRACEPTION TERMINATION | CONTRACEPTIVE METHODS CHOSEN | MOTIVATION | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTIVE AGENTS, SIDE EFFECTS | FEAR | FEMALE STERILIZATION | CONDOM USE | CONTRACEPTIVE PREVALENCE | PROGRAM ACCESSIBILITY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Demographic Factors | Contraception | Family Planning | Contraceptive Usage | Psychological Factors | Behavior | Contraceptive Agents | Emotions | Sterilization, Sexual | Risk Reduction Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 342777

Title: Use of oral contraceptives, intrauterine devices and tubal sterilization and cancer risk in a large prospective study, from 1996 to 2006.
Author: Dorjgochoo T; Shu XO; Li HL; Qian HZ; Yang G; Cai H; Gao YT; Zheng W
Source: International Journal of Cancer. 2009;124(10):2442-2449.
Abstract: The association of contraceptive methods, including oral contraceptives (OC), intrauterine devices (IUD) and tubal sterilization (TS), with overall and site-specific cancer were prospectively investigated in a cohort of 66,661 Chinese women in Shanghai, 76.7% of whom used contraception. During a median follow-up time of 7.5 years, 2,250 women were diagnosed with cancer. Ever-use of any contraceptive method was not associated with overall cancer risk [adjusted hazard ratio (HR(adj)) = 1.02, 95% CI, 0.92-1.12]. Use of any contraceptive method was associated with increased risk of rectal cancer (HR(adj) = 1.68, 95% CI, 1.08-2.62) and reduced risk of thyroid cancer (HR(adj) = 0.63, 95% CI, 0.38-1.04). Risk of gallbladder cancer increased with ever use of OC (HR(adj) = 2.38, 95% CI, 1.26-4.49). IUD use was associated with a possible reduced risk of thyroid cancer (HR(adj) = 0.64, 95% CI, 0.38-1.07). Longer duration of IUD use decreased risk for breast, thyroid and lung cancers. Ever having a TS was associated with increased uterine body cancer (HR(adj) = 2.50, 95% CI, 1.47-4.25) and decreased risk of stomach cancer (HR(adj) = 0.59, 95% CI, 0.39-0.91). We did not find any contraceptive method to be related to the risk of ovarian cancer but the analyses were based on few events. Although chance findings are a likely explanation for some of the associations found in our study, these findings suggest that various contraceptive methods or reproductive patterns may play a role in the etiology of cancer. (c) 2008 Wiley-Liss, Inc.
Language: English
Keywords:
UNITED STATES OF AMERICA | CHINA | RESEARCH REPORT | WOMEN | ORAL CONTRACEPTIVES | IUD | NEOPLASMS | FEMALE STERILIZATION | TUBAL LIGATION | Developed Countries | North America | Americas | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Diseases | Sterilization, Sexual
Document Number: 329657

Title: Formulation and Performance Characterization of Radio-Sterilized "Progestin-Only" Microparticles Intended for Contraception.
Author: Puthli S; Vavia P
Source: AAPS PharmSciTech. 2009 Apr 21;
Abstract: The aim of this study was to formulate and characterize a microparticulate system of progestin-only contraceptive. Another objective was to evaluate the effect of gamma radio-sterilization on in vitro and in vivo drug release characteristics. Levonorgestrel (LNG) microspheres were fabricated using poly(lactide-co-glycolide) (PLGA) by a novel solvent evaporation technique. The formulation was optimized for drug/polymer ratio, emulsifier concentration, and process variables like speed of agitation and evaporation method. The drug to polymer ratio of 1:5 gave the optimum encapsulation efficiency. Speed of agitation influenced the spherical shape of the microparticles, lower speeds yielding less spherical particles. The speed did not have a significant influence on the drug payloads. A combination of stabilizers viz. methyl cellulose and poly vinyl alcohol with in-water solvent evaporation technique yielded microparticles without any free drug crystals on the surface. This aspect significantly eliminated the in vitro dissolution "burst effect". The residual solvent content was well within the regulatory limits. The microparticles passed the test for sterility and absence of pyrogens. In vitro dissolution conducted on the product before and after gamma radiation sterilization at 2.5 Mrad indicated no significant difference in the drug release patterns. The drug release followed zero-order kinetics in both static and agitation conditions of dissolution testing. The in vivo studies conducted in rabbits exhibited LNG release up to 1 month duration with drug levels maintained within the effective therapeutic window.
Language: English
Keywords:
INDIA | RESEARCH REPORT | EVALUATION | WOMEN | CONTRACEPTIVE AGENTS, PROGESTIN | ANALYSIS | FEMALE STERILIZATION | LEVONORGESTREL | LABORATORY PROCEDURES | INJECTABLES | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Research Methodology | Sterilization, Sexual | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods
Document Number: 331124

9.
Peer Reviewed

Title: Factors predictive for failure to perform postpartum tubal ligations following vaginal delivery.
Author: Seibel-Seamon J; Visintine JF; Leiby BE; Weinstein L
Source: Journal of Reproductive Medicine. 2009 Mar;54(3):160-4.
Abstract: OBJECTIVE: To identify patients requesting postpartum sterilization and compare those who underwent the procedure with those who did not. STUDY DESIGN: A retrospective study of requested postpartum tubal ligations was completed. Demographics and clinical characteristics were analyzed. We analyzed whether the failure to obtain postpartum sterilization resulted in an interval laparoscopic tubal ligation or future pregnancy. RESULTS: A total of 135 women requested sterilization, but only 56% received the desired procedure. Time of delivery (OR 2.23, CI 1.08-4.58), body mass index (OR 2.38, CI 1.10-5.16) and gravidity (OR 0.80, CI 0.65-0.97) were significant variables that were different between the 2 groups. Of the women who left the hospital postpartum without a sterilization procedure, 44% received an interval laparoscopic tubal ligation and 18% later became pregnant. CONCLUSION: Postpartum tubal ligations are often not performed despite patient request. Additional measures should be undertaken to ensure that patient requests for postpartum tubal ligation are implemented.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLIENTS | POSTPARTUM WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | LAPAROSCOPY | Developed Countries | North America | Americas | Program Activities | Programs | Organization and Administration | Puerperium | Reproduction | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341445

10.

11.

Title: The ACQUIRE Project end of project report to USAID, October 1, 2003 - September 30, 2008.
Author: EngenderHealth. ACQUIRE Project
Source: New York, New York, EngenderHealth, ACQUIRE Project, 2008. [62] p. (USAID Cooperative Agreement No. GPO-A-00-03-00006-00)
Abstract: The ACQUIRE Project -- Access, Quality, Use and Reproductive Health -- was USAID's flagship project for global leadership in FP / RH service delivery, funded from October 2003 to September 2008. EngenderHealth implemented and managed ACQUIRE in partnership with the Adventist Development and Relief Agency International (ADRA), CARE, IntraHealth International, Meridian Group International Inc., and the Society for Women and AIDS in Africa (SWAA). The Project's core mandate was to provide comprehensive programming support for FP / RH facility based services with an emphasis on long-acting and permanent family planning methods (LAPM): intrauterine devices (IUD), implants, female sterilization, and vasectomy. ACQUIRE provided global technical input and support to 22 countries to increase access to, improve the quality of and scale up RH / FP services that yielded impressive gains in LAPM family planning use. (Excerpts)
Language: English
Keywords:
BANGLADESH | DEVELOPING COUNTRIES | SUMMARY REPORT | REPRODUCTIVE HEALTH | FAMILY PLANNING | HEALTH SERVICES | QUALITY OF HEALTH CARE | PERFORMANCE IMPROVEMENT | IUD | FEMALE STERILIZATION | CONTRACEPTIVE IMPLANTS | MALE STERILIZATION | DELIVERY OF HEALTH CARE | NEEDS | Asia, Southern | Asia | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Management | Contraceptive Methods | Contraception | Sterilization, Sexual | Economic Factors
Document Number: 331465

12.

Title: Long-acting and permanent methods.
Author: Family Health International [FHI]
Source: Family Health Research. 2008 Feb;2(1):1-8.
Abstract: In this issue, the authors examin the unrealized potential of long-term contraception to help family planning programs meet the needs of clients and improve public health. Long-acting and permanent methods (LAPMs) of contraception include reversible contraceptive implants and intrauterine devices (also known as intrauterine contraceptive devices, or IUCDs), as well as the permanent methods of vasectomy and female sterilization. LAPMs are the most effective modern methods for preventing unintended pregnancies. Because they are also cost-effective, increases in their use can help sustain family planning programs. But the use of LAPMs is limited in most countries in sub-Saharan Africa. Challenges to LAPM use persist. However, experience from Kenya and other countries suggests that comprehensive efforts to improve service delivery and to educate potential clients can increase use. And research conducted by FHI has identified ways to improve access to LAPM services.
Language: English
Keywords:
KENYA | SUMMARY REPORT | WOMEN | FAMILY PLANNING | CONTRACEPTIVE IMPLANTS | IUD | FEMALE STERILIZATION | VASECTOMY | COST BENEFIT ANALYSIS | FAMILY PLANNING PROGRAMS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Sterilization, Sexual | Male Sterilization | Quantitative Evaluation | Evaluation
Document Number: 341180

13.

Title: Long-acting and permanent methods. LAPMs contribute to family planning programs.
Author: Family Health International [FHI]
Source: Family Health Research. 2008 Feb;2(1):2-3.
Abstract: Long-acting and permanent methods (LAPMs) of contraception remain a relatively small - and sometimes missing - component of national family planning programs in sub-Saharan Africa. These methods can enhance family planning programs in meaningful ways if challenges to their availability, access, and acceptability can be overcome. Key Points of the article are: 1) Providing LAPMs expands contraceptive choice for clients; 2) LAPMs can help countries reach national health goals; and 3) Persistent challenges to LAPM use need to be overcome.
Language: English
Keywords:
AFRICA, SUB SAHARAN | SUMMARY REPORT | CONTRACEPTIVE USAGE | IUD | CONTRACEPTIVE IMPLANTS | FEMALE STERILIZATION | VASECTOMY | CONTRACEPTION CONTINUATION | CONTRACEPTIVE METHOD ACCEPTABILITY | PROGRAM ACCESSIBILITY | PROGRAM SUSTAINABILITY | Africa | Developing Countries | Contraception | Family Planning | Contraceptive Methods | Sterilization, Sexual | Male Sterilization | Program Evaluation | Programs | Organization and Administration
Document Number: 341184

14.

Peer Reviewed

Title: Why are rates of sterilization in decline? A pilot study designed to explore reasons for declining female sterilization in Scotland.
Author: Chen ZE; Glasier A; Warner P
Source: Contraception. 2008 Oct;78(4):309-314.
Abstract: In the last decade, female sterilization had been in decline throughout the UK. It is not clear whether fewer women are requesting sterilization or whether the universal enthusiasm for long-acting reversible methods is leading health professionals to discourage women from being sterilized. Since correct and consistent use of alternative, reversible contraceptive methods depends somewhat on their acceptability, it is important to determine whether women are being refused sterilization or whether they are freely choosing other methods. This study aims to explore whether female sterilization is being widely considered as a contraceptive method, the reasons for choosing or rejecting it, and whether women are being discouraged by health professionals from being sterilized. A self-completed questionnaire survey among 205 women aged 30 to 50 years who felt that their family was complete attending a family planning clinic in Scotland. Of the 203 women included in the study, 151 (74.4%) had heard of femalesterilization, 90 had discussed it with someone (60%) and 87 (58%) had considered it as a contraceptive option. Of the 56 women who consulted their family doctor about sterilization, almost half (27; 48%) were not referred to a hospital and fewer than one (17, 30.4%) in three of them was eventually sterilized or had arrangements in place to get it done. Free-text comments from the women revealed a variety of reasons for not choosing female sterilization and suggested that some women are being deterred from sterilization. The study suggests that some women are being actively encouraged by health professionals to use long-acting reversible contraceptive methods and discouraged from choosing sterilization. However, other women recognize for themselves the wisdom of keeping their fertility options open. (author's)
Language: English
Keywords:
SCOTLAND | RESEARCH REPORT | PILOT PROJECTS | SURVEYS | WOMEN | FEMALE STERILIZATION | CONTRACEPTIVE METHOD ACCEPTABILITY | CONTRACEPTIVE USAGE DETERMINANTS | Developed Countries | United Kingdom | Europe, Western | Europe | Studies | Research Methodology | Sampling Studies | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Contraceptive Usage | Contraception
Document Number: 328081

15.

Title: Exploring factors in the decision to choose sterilization vs alternatives in rural El Salvador.
Author: Cremer ML; Holland E; Monterroza M; Duran S; Singh R
Source: Medscape Journal of Medicine. 2008;10(8):183.
Abstract: CONTEXT: To explore the factors that influence rural Salvadoran women to undergo tubal sterilization versus opting for alternative methods of family planning. EVIDENCE ACQUISITION: A moderator fluent in English and Spanish conducted eleven 90-minute focus groups consisting of 5-10 women each. Eligible women in the municipality of San Pedro Perulapan, El Salvador, were identified and recruited by local health workers. Participant demographics and information about family planning decisions were collected through detailed notes and tape-recorded sessions. The tapes were transcribed verbatim, and all data were analyzed using grounded theory procedures to identify common themes. EVIDENCE SYNTHESIS: Eighty women aged 24-45 years who had previously been sterilized participated in the study. Three major themes influenced a woman's decision to undergo sterilization instead of opting for alternative forms of family planning: (1) availability: tubal sterilization is readily available, (2) fears about side effects of other methods: these women associated negative side effects with other forms of family planning, (3) effectiveness: the women in these focus groups thought sterilization was more effective than other forms of family planning. CONCLUSIONS: This study shows that there is a lack of information, and misinformation, about other effective methods of contraception, especially the intrauterine device and oral contraceptives. Reproductive health education projects, especially those providing services in locations similar to rural El Salvador, should focus on providing accurate information about all forms of contraception, including tubal sterilization.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | FOCUS GROUPS | RURAL POPULATION | WOMEN | TUBAL LIGATION | FEMALE STERILIZATION | CONTRACEPTIVE METHODS | SIGNS AND SYMPTOMS | DECISION MAKING | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Contraception | Diseases | Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 329801

16.

Title: Contraception in women with epilepsy: pharmacokinetic interactions, contraceptive options, and management.
Author: Dutton C; Foldvary-Schaefer N
Source: International Review of Neurobiology. 2008;83:113-34.
Abstract: Contraceptive counseling is a critical component of the management of the female patient with epilepsy because of the increased risk of pregnancy associated with epilepsy and the multitude of interactions between antiepileptic drugs (AEDs) and hormonal contraception. Steroid hormones and many of the AEDs are substrates for the cytochrome P450 enzyme system, in particular, the 3A4 isoenzyme. As a result, concomitant use of hormonal contraceptives and AEDs may pose a risk for unexpected pregnancy, seizures, and drug-related adverse effects. The risk of combined oral contraceptive (COC) failure is slightly increased in the presence of cytochrome P450 3A4 enzyme-inducing AEDs. Several AEDs induce the production of sex hormone binding globulin (SHBG) to which the progestins are tightly bound, resulting in lower concentrations of free progestin that may also lead to COC failure. There is no increase in the risk of COC failure in women taking nonenzyme-inducing AEDs. Oral contraceptives significantly increase the metabolism of lamotrigine, posing a risk of seizures when hormonal agents are initiated and/or toxicity during pill-free weeks. There is no evidence that COCs increase seizures in women with epilepsy. While higher dose COCs are one contraceptive option for women on enzyme-inducing AEDs, a variety of other options are available. Injectable contraception (depot medroxyprogesterone acetate) appears effective with AED use, but the potential for bone mineral density loss is a concern. Intrauterine devices (IUDs) and barrier methods do not rely on hormonal components for contraceptive efficacy, and are therefore appropriate to recommend for use in women using enzyme-inducing medications. This chapter reviews the evidence regarding the pharmacokinetic interaction between AEDs and oral contraceptive hormones, the known or potential interactions with alternative contraceptive methods, and provides practical advice for management of contraceptive needs in reproductive-age women.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | WOMEN | NEUROLOGIC EFFECTS | COUNSELING | CONTRACEPTIVE USAGE | CONTRACEPTIVE SAFETY | PREGNANCY | RISK FACTORS | KNOWLEDGE | ORAL CONTRACEPTIVES | FEMALE STERILIZATION | PRESCRIPTIONS | Developed Countries | North America | Americas | Demographic Factors | Population | Physiology | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Safety | Public Health | Health | Reproduction | Sociocultural Factors | Contraceptive Methods | Sterilization, Sexual | Distributional Activities
Document Number: 329599

17.

Peer Reviewed

Title: A qualitative study of barriers to postpartum sterilization and women's attitudes toward unfulfilled sterilization requests.
Author: Gilliam M; Davis SD; Berlin A; Zite NB
Source: Contraception. 2008 Jan;77(1):44-49.
Abstract: This longitudinal, qualitative study explores barriers to postpartum sterilization from the perspective of low-income minority women. We examine women's feelings and attitudes regarding a canceled or postponed procedure over time. We conducted structured, in-depth baseline interviews with 34 postpartum women with unfulfilled sterilization requests in a university hospital setting. Follow-up phone interviews were conducted at 6 weeks and 6 months postpartum. Reasons for unfulfilled sterilization requests included last-minute misgivings, maternal medical complications, lack of a valid Medicaid consent form, fear of the procedure and provider influence. Sense of autonomy regarding sterilization decision making and ability to obtain interval sterilization or initiate and/or successfully use reversible contraception influenced subsequent attitudes regarding an unfulfilled request. Sterilization counseling should include comprehensive information regarding the surgical procedure and associated risks andthe development of a backup contraceptive plan, with particular emphasis on increasing contraceptive self-efficacy and autonomy in sterilization decision making. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | LONGITUDINAL STUDIES | QUALITATIVE RESEARCH | POSTPARTUM WOMEN | FEMALE STERILIZATION | TUBAL LIGATION | SATISFACTION | CONTRACEPTION | ATTITUDES | POSTPARTUM PROGRAMS | Developed Countries | North America | Americas | Studies | Research Methodology | Puerperium | Reproduction | Sterilization, Sexual | Family Planning | Psychological Factors | Behavior | Family Planning Programs
Document Number: 323058

18.

Peer Reviewed

Title: Intrauterine contraception as an alternative to interval tubal sterilization.
Author: Grimes DA; Mishell DR Jr
Source: Contraception. 2008 Jan;77(1):6-9.
Abstract: In countries where levonorgestrel-releasing IUD use has increased, the incidence of female surgical sterilization procedures has decreased. Will the same inverse relationship appear in the United States, and, if so, what would be the medical implications of such a transition in long-term contraception? A recent UK review compared long-term contraception with IUDs vs. surgical sterilization; here we compare these two approaches from a US perspective. We focus on interval tubal sterilization by laparoscopy or laparotomy and will not consider postpartum sterilization. (excerpt)
Language: English
Keywords:
GLOBAL | UNITED KINGDOM | UNITED STATES OF AMERICA | RESEARCH REPORT | INCIDENCE | COMPARATIVE STUDIES | IUD | LEVONORGESTREL | CONTRACEPTIVE METHODS | TUBAL LIGATION | FEMALE STERILIZATION | CONTRACEPTIVE EFFECTIVENESS | Developed Countries | Europe, Western | Europe | North America | Americas | Measurement | Research Methodology | Studies | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Sterilization, Sexual
Document Number: 323052

19.

Peer Reviewed

Title: Social and logistical barriers to the use of reversible contraception among women in a rural Indian village.
Author: Hall MA; Stephenson RB; Juvekar S
Source: Journal of Health, Population and Nutrition. 2008 Jun;26(2):241-250.
Abstract: 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 modern 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. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | INTERVIEWS | WOMEN | MARRIAGE | CONTRACEPTIVE USAGE DETERMINANTS | CONTRACEPTIVE METHODS CHOSEN | REVERSIBILITY | BELIEFS | KNOWLEDGE SOURCES | FEMALE STERILIZATION | SOCIOCULTURAL FACTORS | Asia, Southern | Asia | Developing Countries | Data Collection | Research Methodology | Demographic Factors | Population | Nuptiality | Contraceptive Usage | Contraception | Family Planning | Culture | Communication | Sterilization, Sexual
Document Number: 327595

20.

Peer Reviewed

Title: Provider advice to women may vary by women's social class and ethnicity.
Author: Hollander D
Source: Perspectives on Sexual and Reproductive Health. 2008 Mar;40(1):54.
Abstract: Low-income black and Latina women surveyed in the Los Angeles area were more likely than middle-class whites to say that during a current or recent pregnancy, a health care professional had advised them to limit their childbearing. In a multivariate analysis of the survey results, ethnicity and social class were the only characteristics associated with the odds that women had received this kind of advice. Low-income Latinas (along with women who had large families and unmarried women) also had elevated odds of saying that their doctor or someone else had discouraged them from having children. The survey sample consisted of 193 low income and 146 middle-class women who were pregnant or had given birth in the previous five years. Women were considered low income if they were on welfare, had health coverage through Medi-Cal (California's Medicaid program) or were uninsured; low income participants were recruited at offices of the Special Supplementary Food Program for Women, Infants and Children. Women were classified as middle-class if they had a college or graduate degree and had health insurance other than Medi-Cal; these women were recruited at a variety of locations in middle-class neighborhoods and through electronic mailing lists. (excerpt)
Language: English
Keywords:
CALIFORNIA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | HISPANICS | WOMEN | SOCIOECONOMIC STATUS | INCOME | SOCIAL CLASS | CONTRACEPTION | FEMALE STERILIZATION | REFERRAL AND CONSULTATION | SOCIAL DISCRIMINATION | RACE RELATIONS | PHYSICIAN-PATIENT RELATIONS | Developed Countries | United States of America | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Family Planning | Sterilization, Sexual | Program Activities | Programs | Organization and Administration | Social Problems | Sociocultural Factors | Political Factors | Interpersonal Relations | Behavior
Document Number: 325190

21.

Peer Reviewed

Title: The cost-effectiveness of long-acting reversible contraceptive methods in the UK: Analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline.
Author: Mavranezouli I
Source: Human Reproduction. 2008;23(6):1338-1345.
Abstract: Long-acting reversible contraceptive (LARC) methods are highly effective in preventing unintended pregnancies. However, their uptake is low in much of the developed world. This study aimed at assessing the cost-effectiveness of LARC methods from the British National Health Service (NHS) perspective. A decision-analytic model was constructed to estimate the relative cost-effectiveness of the copper intrauterine device (IUD), the levonorgestrel intrauterine system (LNG-IUS), the etonogestrel subdermal implant and the depot medroxyprogesterone acetate injection (DMPA). Comparisons with the combined oral contraceptive pill (COC) and female sterilization were also performed. Effectiveness data were derived from a systematic literature review. Costs were based on UK national sources and expert opinion. LARC methods dominated COC (i.e. they were more effective and less costly). Female sterilization dominated LARC methods beyond 5 years of contraceptive protection. DMPA and LNG-IUS were the least cost-effective LARC methods. The incremental cost-effectiveness ratio of implant (most effective LARC method) versus IUD (cheapest LARC method) was pound13 206 per unintended pregnancy averted for 1 year of use and decreased until implant dominated IUD in 15 years. Discontinuation was a key determinant of the cost-effectiveness of LARC methods. LARC methods are cost-effective from the British NHS perspective. Practices improving user satisfaction and continuation of LARC method use should be identified and promoted. (author's)
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | WOMEN | CONTRACEPTIVE METHODS | IUD | COST EFFECTIVENESS | LONGTERM EFFECTS | PREGNANCY, UNWANTED | FEMALE STERILIZATION | Developed Countries | Europe, Western | Europe | Demographic Factors | Population | Contraception | Family Planning | Evaluation Indexes | Quantitative Evaluation | Evaluation | Time Factors | Population Dynamics | Reproductive Behavior | Fertility | Sterilization, Sexual
Document Number: 326850

22.
Title: Overview of contraceptive use in Jos University Teaching Hospital, north central Nigeria.
Author: Mutihir JT; Pam VC
Source: Nigerian Journal of Clinical Practice. 2008 Jun;11(2):139-43.
Abstract: BACKGROUND: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. METHODS: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, 1985-2002. RESULTS: The accepted methods were the intrauterine device (26.1%), oral contraceptive pills (23.5%), female sterilization (21.7%), the Injectable (14.2%), male condom (9.5%), Norplant implants (4.9%) and vasectomy (0.1%). Reversible methods were used by 78.2% and the permanent forms by 21.8%. The women were the acceptors of the methods in 90.5%, while men contributed only 9.5% of the new acceptors. Ten men only had vasectomy over the period of study. CONCLUSION: The Intrauterine device was the leading method of contraception accepted by the women and male vasectomy was the least accepted by men. There is the need for increased male involvement in contraceptive issues.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | ORAL CONTRACEPTIVES | FEMALE STERILIZATION | IUD | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE METHOD ACCEPTABILITY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Contraceptive Methods | Contraception | Family Planning | Sterilization, Sexual
Document Number: 329013

23.
Title: Re: Pregnancy after microinsert sterilization with tubal occlusion confirmed by hysterosalpingogram [letter]
Author: Nichols JE Jr
Source: Obstetrics and Gynecology. 2008 Jul;112(1):185-1866; author reply 186.
Abstract: I read with interest the recent case report by Ory et al that describes an unintended pregnancy in a patient who had undergone the Essure (Conceptus, Inc., Mountain View, CA) procedure and purported confirmation of bilateral tubal occlusion by hysterosalpingography 6 months postprocedure.1 The authors note that this is one of two unintended pregnancies reported in the literature occurring after the microinsert procedure, each of which turned out to be caused by microinsert perforations not recognized at the time of confirmation testing. Critical to evaluating proper microinsert placement for contraception reliance is obtaining a clear picture of the uterine cavity, complete bilateral cornual filling with radiographic dye, and proper anatomical location of both microinserts in the proximal tube with bilateral occlusion (microinsert confirmation test protocol, available at http:// www.microinsert device procedure md. com/). Figure 1 demonstrates an appropriate microinsert procedure confirmation image. A study by Levy et al shows that, of an estimated 50,000 microinsert procedures performed, only 64 pregnancies were reported, none of which were attributed to microinsert failure.3 Most pregnancies (47%) occurred due to patient or physician noncompliance, and 28% were due to misinterpreted microinsert procedure confirmation tests. Ory et al report that at the initial 3-month confirmation test, left tubal patency was seen (image not provided), but repeat testing 3 months later (per manufacturer's protocol) noted bilateral proximal occlusion. However, after careful review of the image provided in the article, it appears that the left microinsert is oriented in an abnormal anatomical position, which is highly suggestive of a microinsert perforation, which was later confirmed at the time of cesarean delivery. This case report demonstrates the importance of having providers experienced with microinsert confirmation testing for interpretation and evaluation of proper microinsert location and tubal occlusion before counseling a patient to rely on microinsert procedure for contraception. Furthermore, the title of this case report is very misleading because it suggests this pregnancy was the result of microinsert failure. In actuality, this is a case report of an unintended pregnancy that occurred as a result of a misinterpreted microinsert confirmation test. (full-text)
Language: English
Keywords:
GLOBAL | UNITED STATES OF AMERICA | CRITIQUE | PREGNANCY, UNPLANNED | FEMALE STERILIZATION | MEDICAL PROCEDURES | EQUIPMENT AND SUPPLIES | SURGICAL ERROR | Developed Countries | North America | Americas | Reproductive Behavior | Fertility | Population Dynamics | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Medicine | Health Services | Delivery of Health Care | Health | Surgery | Treatment
Document Number: 328325

24.

Peer Reviewed

Title: Update on female sterilisation: Report from an international symposium on considerations for assessing long-term failure rates.
Author: O'Brien S; Gupta J; Najia S; Yehia M
Source: Journal of Family Planning and Reproductive Health Care. 2008;34(1):13-18.
Abstract: The 6th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists (RCOG) took place in September 2005 in Cairo, Egypt. During the meeting, a sponsored symposium entitled 'The changing face of female sterilisation: meeting the needs of the 21st century woman' (sponsored by Femcare-Nikomed Ltd, manufacturer of the Filshie clip) provided an overview of the different methods of long-term contraception with a focus on female sterilisation. Here we report the main observations of the symposium, including recommendations for factors that should be considered when assessing the long-term failure rates associated with female sterilisation. Over the past few decades, rapid advances in technology have allowed the development of a number of different contraceptive methods that are available for use today. The choice of contraception is influenced by a number of factors, including age, sexual lifestyle, relationship type, family status and medical history. In addition, as part of the necessary counselling of any family planning programme, it is essential that provision of unbiased accurate information be provided so that women can make informed decisions on long-term contraception. (excerpt)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | CONFERENCES AND CONGRESSES | FEMALE STERILIZATION | LONGTERM EFFECTS | CONTRACEPTION FAILURE | CONTRACEPTIVE EFFECTIVENESS | CONTRACEPTIVE SAFETY | LAPAROSCOPY | HYSTEROSCOPY | Sterilization, Sexual | Family Planning | Time Factors | Population Dynamics | Demographic Factors | Population | Contraceptive Usage | Contraception | Safety | Public Health | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 323462

25.

Peer Reviewed

Title: Sterilization.
Author: Peterson HB
Source: Obstetrics and Gynecology. 2008 Jan;111(1):189-203.
Abstract: Worldwide, sterilization (tubal sterilization and vasectomy) is used by more people than any other method of contraception. All techniques of tubal sterilization in widespread use in the United States have low risks of surgical complications. Although tubal sterilization is highly effective, the risk of pregnancy varies by age and method of occlusion. Pregnancies can occur many years after the procedure, and when they do, the risk of ectopic gestation is high. There is now strong evidence against the existence of a post-tubal ligation syndrome of menstrual abnormalities. Although women who have undergone tubal sterilization are more likely than other women to undergo hysterectomy subsequently, there is no known biologic basis for this relationship. Although sterilization is intended to be permanent, expressions of regret and requests for reversal are not uncommon and are much more likely to occur among women sterilized at young ages. Tubal sterilization has little or no effect on sexual function for most women. Vasectomy is less likely than tubal sterilization to result in serious complications. Minor complications, however, are not uncommon. Vasectomy does not increase the risk of heart disease, and available evidence argues against an increase in the risk of prostate cancer, testicular cancer, or overall mortality. Whether a postvasectomy pain syndrome exists remains controversial. Although the long-term effectiveness of vasectomy is less well-studied than that for tubal sterilization, it seems likely to be at least as effective. Intrauterine devices and progestin implants are long-acting, highly effective alternatives to sterilization. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | STERILIZATION, SEXUAL | FEMALE STERILIZATION | MALE STERILIZATION | TUBAL LIGATION | VASECTOMY | SURGERY | COMPLICATIONS | SIDE EFFECTS | CONTRACEPTIVE USE-EFFECTIVENESS | IUD | CONTRACEPTIVE IMPLANTS | Developed Countries | North America | Americas | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Contraceptive Effectiveness | Contraception | Contraceptive Methods
Document Number: 308606

26.

Peer Reviewed

Title: Prong sign: a simple measure to enhance safety of laparoscopic sterilization.
Author: Puri M; Pasrija S; Trivedi SS
Source: Tropical Doctor. 2008 Apr;38(2):99.
Abstract: Laparoscopic female sterilization is widely practiced and is very safe. However, mesosalpingeal tears and mesosalpingeal haematomas are common complications especially when performed by an inexperienced surgeon. It was found that the observation of a simple 'prong sign' could prevent these complications and possibly reduce failure rates.
Language: English
Keywords:
INDIA | SUMMARY REPORT | FEMALE STERILIZATION | LAPAROSCOPY | SAFETY | GYNECOLOGIC SURGERY | Developing Countries | Asia, Southern | Asia | Sterilization, Sexual | Family Planning | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Urogenital Surgery | Surgery | Treatment
Document Number: 308923

27.

Peer Reviewed

Title: Hysteroscopic sterilisation with Essure: A promising new alternative to tubal ligation?
Author: Sagili H; Divers M
Source: Journal of Family Planning and Reproductive Health Care. 2008 Apr;34(2):99-102.
Abstract: The Essure (Conceptus Inc., San Carlos, CA, USA) contraceptive device consists of a nitinol (nickel/titanium alloy) coiled spring containing polyethylene fibres. It is a dynamic expanding microinsert, placed under hysteroscopic visualisation in the proximal section of the Fallopian tube. The microinsert acts by inducing a tissue reaction that permanently blocks the tube within 3 months. It is recommended that an additional form of contraception be used until correct placement of the device is confirmed by an imaging procedure 3 months after the operation. Intrauterine devices (IUDs) cannot be used during this time period. Essure is becoming increasingly popular as a nonincisional, permanent, birth control device and has been licensed for use in the European Union since 2001. Approximately 501000 procedures have been performed worldwide, of which 141000 have been carried out in Europe. National Institute for Health and Clinical Excellence (NICE) guidance concluded that current evidence on safety appeared adequate, although evidence of the long-term efficacy did not appear adequate for the procedure to be used without special arrangements for consent and for audit or research. (excerpt)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | FEMALE CONTRACEPTION | CONTRACEPTIVE SAFETY | FEMALE STERILIZATION | COMPLICATIONS | COST EFFECTIVENESS | Contraception | Family Planning | Safety | Public Health | Health | Sterilization, Sexual | Diseases | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 325824

28.

Title: Contraceptive security: incomplete without long-acting and permanent methods.
Author: Wickstrom J; Jacobstein R
Source: New York, New York, EngenderHealth, ACQUIRE Project, [2008]. 6 p. (Advocacy Brief No. 4)
Abstract: Contraceptive security-when people have regular, reliable, and equitable access to a choice of contraceptive methods to meet their reproductive health needs-is of vital importance to family planning programs, and thus contraceptive security has properly been getting increased attention in international family planning circles. Yet few contraceptive security activities clearly articulate the requirements for meeting the needs of the four long-acting and permanent methods of family planning (LAPMs)-hormonal implants, IUDs, female sterilization, and vasectomy. LAPMs are not only highly effective-the most effective of all modern methods-they are also widely adopted when they are made available and affordable as options to clients. Indeed, not only is the principle of providing a broad choice of methods in family planning programs universally accepted (United Nations, 1995), but LAPMs will be used on a large scale when providers have the equipment, supplies, and contraceptive products available within a supportive program environment.
Language: English
Keywords:
EGYPT | SUMMARY REPORT | CONTRACEPTIVE SECURITY | CONTRACEPTIVE IMPLANTS | IUD | FEMALE STERILIZATION | VASECTOMY | LOGISTICS | Developing Countries | Africa, North | Africa | Contraceptive Availability | Contraception | Family Planning | Contraceptive Methods | Sterilization, Sexual | Male Sterilization | Management | Organization and Administration
Document Number: 341523

29.

Peer Reviewed

Title: Female sterilization by tubal ligation: a re-appraisal of factors influencing decision making in a tropical setting.
Author: Adesiyun AG
Source: Archives of Gynecology and Obstetrics. 2007 Apr;275(4):241-244.
Abstract: Female sterilization by tubal ligation is the most commonly used method of fertility regulation. However, in some lesser-developed country like Nigeria, it has not been accepted as a popular method of contraception. The objective was 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. (author's)
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | FEMALE STERILIZATION | TUBAL LIGATION | POMEROY METHOD | DECISION MAKING | LITERACY | PARITY | REPRODUCTIVE AGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Sterilization, Sexual | Family Planning | Behavior | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Reproduction
Document Number: 313023

30.

Peer Reviewed

Title: Strong decline in female sterilization rates in Norway after the introduction of a new copayment system: a registry based study.
Author: Bakken IJ; Skjeldestad FE; Schoyen U; Husby MG
Source: BMC Women's Health. 2007 Aug 27;7(1):12.
Abstract: January 1, 2002, copayment for outpatient female sterilization in Norwegian public hospitals increased from 33 euros to 750 euros after a revision of the health care system. The aim of the present study was to investigate the effect of the new copayment system on female sterilization epidemiology. We retrieved data on all female sterilizations 1999-2005 (N=23 1333) from the Norwegian Patient Register, an administrative register to which it is mandatory for all hospitals to report. Sterilizations with diagnostic codes indicative of vaginal delivery, caesarean section, spontaneous abortion, ectopic pregnancy, and termination of pregnancy were analyzed separately. All other sterilizations were defined as "interval sterilization". An abrupt fall in female sterilization was observed after the raise in copayment. Age-adjusted incidence rates dropped from 6.3-6.8 per 1000 women in 1999-2001 to 2.2-2.3 per 1000 women during 2002-2005. Interval sterilizations dropped to 25% of the previous level after the rise in copayment while sterilizations in conjunction with caesarean section and postpartum sterilization remained constant. For many Norwegian women seeking contraception, sterilization is no longer an available alternative. (author's)
Language: English
Keywords:
NORWAY | RESEARCH REPORT | RETROSPECTIVE STUDIES | FEMALE STERILIZATION | NATIONAL HEALTH SERVICES | HEALTH POLICY | ECONOMIC FACTORS | PROGRAM ACCESSIBILITY | CONTRACEPTIVE METHOD ACCEPTABILITY | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Sterilization, Sexual | Family Planning | Health Services | Delivery of Health Care | Health | Policy | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Contraceptive Usage | Contraception
Document Number: 313834


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