Melissa Gilliam1, Shawna D Davis, Amy Berlin, Nikki B Zite. 1. Section of Family Planning, Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL 60637, USA. mgilliam@babies.bsd.uchicago.edu
Abstract
BACKGROUND: This longitudinal, qualitative study explores barriers to postpartum sterilization from the perspective of low-income minority women. We examine women's feelings and attitudes regarding a canceled or postponed procedure over time. STUDY DESIGN: We conducted structured, in-depth baseline interviews with 34 postpartum women with unfulfilled sterilization requests in a university hospital setting. Follow-up phone interviews were conducted at 6 weeks and 6 months postpartum. RESULTS: Reasons for unfulfilled sterilization requests included last-minute misgivings, maternal medical complications, lack of a valid Medicaid consent form, fear of the procedure and provider influence. Sense of autonomy regarding sterilization decision making and ability to obtain interval sterilization or initiate and/or successfully use reversible contraception influenced subsequent attitudes regarding an unfulfilled request. CONCLUSIONS: Sterilization counseling should include comprehensive information regarding the surgical procedure and associated risks and the development of a backup contraceptive plan, with particular emphasis on increasing contraceptive self-efficacy and autonomy in sterilization decision making.
BACKGROUND: This longitudinal, qualitative study explores barriers to postpartum sterilization from the perspective of low-income minority women. We examine women's feelings and attitudes regarding a canceled or postponed procedure over time. STUDY DESIGN: We conducted structured, in-depth baseline interviews with 34 postpartum women with unfulfilled sterilization requests in a university hospital setting. Follow-up phone interviews were conducted at 6 weeks and 6 months postpartum. RESULTS: Reasons for unfulfilled sterilization requests included last-minute misgivings, maternal medical complications, lack of a valid Medicaid consent form, fear of the procedure and provider influence. Sense of autonomy regarding sterilization decision making and ability to obtain interval sterilization or initiate and/or successfully use reversible contraception influenced subsequent attitudes regarding an unfulfilled request. CONCLUSIONS: Sterilization counseling should include comprehensive information regarding the surgical procedure and associated risks and the development of a backup contraceptive plan, with particular emphasis on increasing contraceptive self-efficacy and autonomy in sterilization decision making.
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