title: A qualitative study of barriers to postpartum sterilization and women's attitudes toward unfulfilled sterilization requests.
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.
  
  
  METHODS
  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.
authors: Section of Family Planning, Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL 60637, USA. mgilliam@babies.bsd.uchicago.edu
authors: Melissa
authors: M
authors: Gilliam
authors: Shawna D
authors: SD
authors: Davis
authors: Amy
authors: A
authors: Berlin
authors: Nikki B
authors: NB
authors: Zite
mesh_terms: D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D010358:Patient Participation; D026684:Personal Autonomy; D011181:Postnatal Care; D011204:Poverty Areas; D011247:Pregnancy; D013245:Sterilization, Reproductive / Q000523:psychology* / Q000706:statistics & numerical data*; D013246:Sterilization, Tubal / Q000523:psychology / Q000706:statistics & numerical data*