Tubal sterilization. A prospective long term investigation of 218 sterilized women.

ABSTRACT

The present study is a long-term investigation of 218 consecutively sterilized women in Akershus County, Norway. The operations were performed in 1973-74, when the access to sterilization was regulated by a legislation from 1934. The women were interviewed personally, and a clinical examination was performed before sterilization, at discharge from hospital, three months, one and six years later. At each occasion the participation was about 95%, and only one woman was lost to follow-up. The women in this series lived in stable social conditions, their average age was 33.7, their parity 2.8. They were not socially distinguishable from women of the same age in the county at large, but there were important socially and age related differences within the series. Their contraceptive usage was widespread, but inconsistent. Family planning was the all-dominant motive. Forty per cent of the women had been suggested the sterilization by a doctor, 30% at abortion application. The operations were performed as laparoscopic electrocoagulation of the tubes or as a Pomeroy resection. Five pregnancies were recognized in the study period, four of these in the laparoscopy group. There were few serious complications, but 20% had a diversity of complaints at the three month interview. At six years seven women had complaints attributed to the operation. The large majority of the series was satisfied with the sterilization. Almost half the women would have preferred an even earlier operation, and six years after the sterilization 85% of the women had told friends about it, and 71% of these had directly recommended sterilization to someone. Six years after the sterilization 74% said the operation should be more widespread, 69% believed postoperative regret was uncommon, and the impact on postoperative marital life was mainly positive. However, during the study period, 18% of the women had experienced regret, ambivalence or periodic depression because of their sterilization. The rate of, and reasons for regret varied with time. The rate increased; at six years 6% of the women would have preferred the sterilization undone, and in 10% of the couples at least one of the partners held that view. At one year, the primary reason for regret was a feeling of having been persuaded by the doctor at abortion application. Six years after the sterilization the desire for a child with a new spouse was the principle reason. There was no association between regret and age or parity at operation.(ABSTRACT TRUNCATED AT 400 WORDS)