Frustrated demand for postpartum female sterilization in Brazil.
During the last three decades, Brazilians have relied almost exclusively on two contraceptive methods, the pill and female sterilization, with sterilization use increasing over time. Until a new law was passed in 1997, sterilization was virtually illegal and not covered by either public or private health insurance. It was, however, frequently provided in public and private hospitals in conjunction with a cesarean section. The new law regulating sterilization provided for reimbursement for interval sterilizations by public health insurance, but placed restrictions on availability intended to reduce the use of cesareans. These restrictions included the prohibition of postpartum sterilizations. This paper focuses on women's sterilization intentions during pregnancy and their experiences postpartum. In a prospective study of 1612 pregnant women carried out in four Brazilian cities, there was substantial demand for postpartum sterilization in both the private and public sectors among women who wanted no more children. However, public patients were much less likely to be sterilized than private patients. Thus, the new law may not have reduced inequities in access or, paradoxically, the incentive for unnecessary cesarean sections.
Potter
Joseph E
JE
Population Research Center, University of Texas at Austin, 1800 Main Building, Austin, TX 78712, USA. joe@prc.utexas.edu
Perpétuo
Ignez H O
IH
Berquó
Elza
E
Hopkins
Kristine
K
Leal
Ondina Fachel
OF
de Carvalho Formiga
Maria Célia
MC
Souza
Marta Rovery
MR
D000293:Adolescent; D000328:Adult; D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013246:Sterilization, Tubal / Q000706:statistics & numerical data*