A qualitative study of barriers to postpartum sterilization and women's attitudes toward unfulfilled sterilization requests.
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.
Gilliam
Melissa
M
Section of Family Planning, Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL 60637, USA. mgilliam@babies.bsd.uchicago.edu
Davis
Shawna D
SD
Berlin
Amy
A
Zite
Nikki B
NB
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*