Legal medicine aspects of female sterilization: our experience

Abstract

IntroductionThe most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. It may be performed via laparoscopy, mini-laparotomy, or hysteroscopy. Safety, efficacy, short-term complications, long-term complications, and non-contraceptive benefits of sterilization are different for each procedure. Female sterilization has become an important professional liability problem in obstetrics and gynecology.Materials and methodsWe analyzed 6 cases of surgical sterilization that have been the subject of civil proceedings. We review indications, contraindications, and complications associated with each sterilization procedure.ResultsIn our small number of cases, women who have undergone sterilization performed negligently are entitled to recover damages for wrongful conception, negligence, and wrongful birth. We also consider the issue of female sterilization of minors.DiscussionTubal sterilization can be performed with different techniques, chosen in light of the various situations involved, with the goal of reducing as many as possible any failures. Thorough and complete communication of information is of primary importance.ConclusionSterilization is the most widely used birth control method around the world. The procedure is generally safe and highly effective. As reported in the literature, the decision concerning method depends on the setting, the surgeon’s experience, the country’s economic development, and the woman’s preference, but we think that some techniques present a greater risk of failure and expose the surgeon to malpractice litigation.

Liability, risks, and recommendations for ultrasound use in the diagnosis of obstetrics diseases

“…For instance, the interpreting doctor could have missed a fetal abnormality that was visible on the scans. When a patient claims to have an abortion if being aware of the anomalies before giving birth, this is an example of a wrongful birth claim [ [42] , [43] , [44] ]. Experts determine if the doctor's failure to notice the anomaly falls below the accepted level of care [ 45 , 46 ].…”

Health care and contraceptive decision-making autonomy and use of female sterilisation among married women in Malawi

“…Long-term contraceptives which include both long-acting reversible contraceptives (LARCs) and permanent methods such female sterilisation and vasectomy have been cited as the most effective contraceptive methods available to women, men and couples ( 6 ). Female sterilisation is an irreversible contraceptive method that involves surgical procedures, with the most common procedures being postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion ( 7 ). Globally, nearly a quarter (24%) of all women of reproductive age using any contraceptive method(s) rely on female sterilisation.…”