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Sterilization Surprisingly Popular, Even Among Single Women


WebMD Health News

May 26, 2000 -- Tubal sterilization, or "getting your tubes tied," is nearly as popular as the birth control pill among all women who want to avoid pregnancy, and is a surprisingly popular choice among young, unmarried women, two new studies show.

The studies, published in the journal Fertility and Sterility, found that 68% of the married women who have finished their families eventually undergo sterilization, as do 12% of women who have never been married. In all, an estimated 11 million U.S. women rely on tubal sterilization to prevent pregnancy.

"The challenge is to understand why so many people choose a surgical procedure when there are so many safe, nonsurgical methods of contraception available," Anne Davis, MD, co-author of one of the articles, tells WebMD. "We definitely have methods that are just as safe and effective that are reversible."

Women considering sterilization should realize that, while in some cases the procedure can be reversed through surgery, resumption of fertility cannot be guaranteed, she says. Those unsure whether they want more children are better off with methods such as the pill or the IUD, says Davis, an assistant professor of clinical obstetrics and gynecology at Columbia University's New York Presbyterian Hospital.

Her study found that although tubal sterilization is safe and effective, it has a higher failure rate than previously thought, meaning a small percentage of women -- from .8% to 2.5%, depending on the method used -- will end up getting pregnant. When sterilized women do get pregnant, they are more likely than unsterilized women to have a tubal, or ectopic, pregnancy, the study found. Such pregnancies, in which the embryo starts to develop in the fallopian tube, are very dangerous.

Davis says the study also shows that about 6% of women who undergo sterilization eventually want to have it reversed. Women who were sterilized in their early 20s were twice as likely as those who were over 30 to regret the procedure, highlighting the need for women to be counseled about all their options and to be mature enough to make a responsible decision about their reproductive futures.

Unmarried women may choose sterilization for a number of reasons, including not having a partner they can rely on to handle the responsibility of contraception, and wanting to prevent any possibility of future pregnancies if they are already raising children alone.

Another researcher, Larry L. Bumpass, PhD, of the University of Wisconsin-Madison, says the rates of tubal sterilization among single and divorced women are "much higher than anyone thought." His study notes that vasectomies for men are much less popular than female sterilization, although vasectomy is safer, less expensive, and equally effective.

Bumpass' study found that black women had the highest rates of permanent female sterilization and black men had the lowest rates of vasectomy. Geographically, the South and Midwest have the highest rates of female sterilization, and the West and Midwest have the highest rates of male sterilization.

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