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Contraception. 2008 Jan;77(1):44-9. Epub 2007 Nov 26.

A qualitative study of barriers to postpartum sterilization and women's attitudes toward unfulfilled sterilization requests.

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1
Section of Family Planning, Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL 60637, USA. mgilliam@babies.bsd.uchicago.edu

Abstract

BACKGROUND:

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.

STUDY DESIGN:

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.

RESULTS:

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.

CONCLUSIONS:

Sterilization counseling should include comprehensive information regarding the surgical procedure and associated risks and the development of a backup contraceptive plan, with particular emphasis on increasing contraceptive self-efficacy and autonomy in sterilization decision making.

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