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    Sterilization Surprisingly Popular, Even Among Single Women


    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.

    Overall, sterilization rates were lowest among women with the highest levels of education. Bumpass says these women are more likely to talk to their doctors about family planning goals, and to be married to better-educated men who are willing to undergo vasectomies. He says many less-educated men are squeamish about having a vasectomy or think it will interfere with their sexual performance, leaving their wives or girlfriends to find a permanent birth control solution on their own.

    "Sterilization is wonderful for the well-counseled, mature woman who has decided to no longer have children," says Lee P. Shulman, MD, who was not involved in either study.

    But Shulman, who is a professor of obstetrics, gynecology, and molecular genetics and director of the division of reproductive genetics at the University of Illinois at Chicago, says women should not be pressured to chose sterilization because their doctors don't tell them about other options, or because their insurance covers surgical sterilization but not other methods of birth control.

    "Many of them are not able to obtain effective reversible contraception ... it's either condom use or over-the-counter methods that, although they have some benefits, are associated with very high pregnancy rates," Shulman says. "If you're a poor woman and you're faced with using a condom or your partner refuses to use a condom ... sterilization, for many women, unfortunately becomes the contraception of choice."

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