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Indian Journal of Medical Sciences, Vol. 61, No. 6, June, 2007, pp. 359-360 Letter To Editor Poststerilization regret: Findings from India and the United States Jamieson DeniseJ Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia Code Number: ms07060 Related Article: ms07031 Sir, The authors of this article [1] should be commended for addressing such an important topic - poststerilization regret among women in India. Surgical sterilization, which has become the most common method of contraception in the world, [2] is very popular in India. [1] As such, it is critical that the acceptability and satisfaction with the procedure be evaluated, particularly since tubal sterilization is considered a permanent method of contraception and women may later regret their decision. In this study, more than 200 women who had undergone tubal sterilization one year ago were asked 1) if tubal sterilization was a good choice and 2) whether they would again choose tubal sterilization if given another option. Women who answered ′no′ to both questions were considered to have regret. Overall, regret was 9.3%, with 12.3% of women under 30 years of age reporting regret. After adjustment, women who were under 30 years of age were three times more likely to regret their decision compared to older women. By comparison, the United States Collaborative Review of Sterilization (CREST) study, a prospective cohort study of more than 11,000 women conducted in the United States, reported an overall cumulative probability of regret of 3.9, 7.5 and 12.7% at 3, 7 and 14 years respectively, with women under 30 years of age nearly twice as likely to experience regret. [3] The question used to measure poststerilization regret in this study was ′Do you still think tubal sterilization as a permanent method of birth control was a good choice for you?′ A woman who answered ′no′ to this question at any point during follow-up was defined as having regret. It is critical to point out that the cumulative probability of regret did not plateau over the time period but rather continued to increase substantially throughout the long period of follow-up. Furthermore, an analysis of regret among women in CREST whose husbands underwent vasectomy found that the probability of regret was similar to women who underwent tubal sterilization. [2] Although CREST assessed regret differently than the current study, it is noteworthy that the current study documents considerably higher rates of regret compared with CREST. This high probability of regret was observed despite the fact that the study excluded women who might be most likely to experience regret, such as those who lost a child or were divorced or remarried. These findings highlight the importance of presterilization counseling, which should include a discussion of alternative temporary contraceptive options such as intrauterine devices. In addition, the possibility of regret associated with sterilization should be addressed. References
Copyright 2007 - Indian Journal of Medical Sciences |
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