Past topics in the Tubal Reversal Blog include posts and comments about patient care at Chapel Hill Tubal Reversal Center. This topic summarizes important articles about tubal ligation and tubal reversal reported in the news during 2007.

Sterilization is Most Popular Family Planning Method
Approximately 10 million American women use the pill for contraception, while sterilization has been chosen by 15 million men and women.

One In Five Women Regret Decision For Tubal Ligation
One in five women under age 30 who undergo tubal sterilization later regret the procedure, despite the number of children they have.

Is Sterilization the Best Contraception Choice?
Women requesting a tubal ligation should be counseled regarding other long-term, reversible methods of contraception and informed that vasectomy is safer and more effective than tubal ligation.

Tubal Ligation Counseling Issues
Counseling about tubal ligation should include permanence of the method, possibility of future regret, and information about the specific techniques of tubal sterilization.

Relationship Conflict Before Sterilization
Women whose relationship was marked by substantial conflict before they underwent tubal ligation were most likely to regret the decision.

Young Age, Prodding Partner and Sterilization Regret
Young age and a prodding partner are risk factors indicating that a woman undergoing sterilization may later regret her decision.

Tubal Reversal Among Overweight Women
Overweight women’s chances of becoming pregnant after tubal reversal improve when they lose weight.

Dr. Berger’s Comment

These news reports touch on some of the issues patients talk about when they come to Chapel Hill Tubal Reversal Center for tubal sterilization reversal. The popularity of tubal ligation, and the fact that many women regret their decision to have a tubal ligation, are well documented. Young age and marital conflict are risk indicators for subsequent regret. Before performing a tubal ligation, doctors should ensure that the implications of ending childbearing potential are clearly understood and discuss vasectomy as an alternative permanent method of birth control. Women undergoing tubal reversal who are overweight should be aware that losing weight will improve their chances of becoming pregnant again.

At Chapel Hill Tubal Reversal Center, we receive requests 7 days a week, 365 days a year, for information about tubal ligation reversal. These requests come from women who regret having a tubal ligation. A staff member recently asked me how big a problem this is throughout the country. The following is in response to this question.

How Many Women Have Had A Tubal Ligation?

There is no single data source reporting the number of surgical sterilizations performed in the United States. Based on multiple sources of information, it is likely that 650,000 to 700,000 tubal sterilizations are performed each year, and more than 11 million American women have had a sterilization operation. The latest study, conducted in 2002 by the US Department of Health and Human Services, indicates that between one in four to one in five of adult, sexually active women have had a tubal ligation.⁽¹⁾

How Common Is Tubal Ligation Regret?

Many factors can affect a woman’s likelihood to regret sterilization. Among women who had a tubal ligation, risk factors for regret include young age, less education, and a husband or partner who wanted the woman to have a tubal ligation.

In 1999, a study called the Collaborative Review of Sterilization (CREST) found that 20% of women who were sterilized before the age of 30 regretted their decision. Women who were sterilized at a young age had a higher chance of requesting information about reversal, regardless of their number of living children. Also, women who reported conflict with their husbands or partners before tubal sterilization were more than three times as likely to regret their decision and more than five times as likely to request a reversal than women who did not report such conflict. ⁽²⁾

Dr. Berger’s Comment

This statistical information helps give a broader picture to the significance of the issues and comments raised in the previous blog topic - Ethics of Tubal Ligation. Additional comments on this issue are welcome from all readers.

References

1. MMWR Surveillance Summary, “Contraceptive Use — United States and Territories, Behavioral Risk Factor Surveillance System, 2002.
2. Mosher WD, Martinez GM, Chandra A, Abma JC, Wilson SJ. Use of contraception and use of family planning services in the United States: 1982–2002. Hyattsville, MD: US Department of Health and Human Services, National Center for Health Statistics, 2004. Advance Data from Vital and Health: no. 350.