Determinant factors affecting the trends of permanent sterilization: a decadal analysis in a tertiary care institute

Abstract

Background: Permanent sterilization is a preferred method of contraception worldwide. In spite of popularization of temporary methods, it is used by 2/3rd of married women using any contraception. It has a low incidence of complications and failure rate and is cost-effective. Various socio-demographic factors play a role in acceptability of this method. It has an important role in controlling the total fertility rate.Methods: A retrospective record based analysis was done in armed forces personnel undergoing permanent sterilization operation over 11 years between 2005-2015 in a tertiary care institute. Analysis of trends in method choices of surgery, and comparison of the variables determining these choices was done. Year wise total fertility rates was calculated and the trend over 11 years was analyzed.Results: Permanent sterilization operations were performed in 2121 couples over the 11 years period. Of total operations, 1823 (85.95% with 95% confidence interval = 84.42, 87.38) were done in females and 298 (14.05% with 95% confidence interval = 12.62, 15.58) in males. Female sterilization acceptance ranged between 71.6% to 91.6% and male sterilization between 8.4%-28.4% with an increasing trend towards male sterilization acceptance over the years. Total fertility rate declined from 2.3 to 2.09 in 11 years.Conclusions: Increase in literacy rate of both the partners can positively impact the male involvement in permanent sterilization and control of TFR. This would help to stabilize India’s population growth. Also, a decline in son preference can be beneficial for decline in fertility rate.

Determinants of female sterilization method uptake among women of reproductive age group in Uganda

“…The findings also partly agree with those of a study in Nigeria on female surgical sterilization which found that more than half of the women who opted for sterilization were aged between 35 to 39 years [ 23 ]. However, the study disagrees with findings of a study done in India where sterilization method uptake and acceptance was at a much younger age (mean age 28.9 years) among women [ 24 ].…”

Non-acceptance of permanent methods of contraception-a threat to small family norm: a cross-sectional study from the Northern state of India

“…17 Bharadwaj et al, depicted highest (more than 80%) acceptance in couples with two children in their decadal analysis of trends of permanent sterilization. 18 But their study was facility based, and the population visiting a health institute may have differential characteristics and may not represent the community; this may explain the difference with present study.…”

“…Religion of the couples was not found to affect the decision of accepting permanent methods of contraception, but in other studies acceptance of contraception was found to be significantly less among the Muslims. 14,18,19 Non-acceptors were significantly higher among the couples living in joint families. This suggests the influence of family in decision making among couples.…”

“…Girdhar et al, too found that more than half of the couples with two male children accepted permanent method, while only 1.2% couples with no male children made that choice. 17,18 This result points towards the fact that inclination of having male child is hindering the choice of limiting family after two children. Pathak et al, in their study, has also concluded male child preference as the major reason for not accepting contraception after two children.…”

“…Although studies conducted by Banerjee B and Bharadwaj et al show that permanent contraceptive methods was opted more by educated females, but in present study, acceptance of permanent method was found to be higher among illiterate women and husbands, however the association was not significant. 14,18 Even though it might seem ironical that acceptance of permanent method was significantly lower among literate couples, but it can be explained by the fact that literacy helps married men and women choose other methods among the basket of approaches for contraception as per their needs. Also, literate couples feel more in control of their sexual life and therefore do not feel the need of undergoing sterilization for limiting their family.…”