title: Hospital variation in postpartum tubal sterilization rates in California and Texas.
abstract: OBJECTIVE
  To estimate variation across hospitals in the rate of postpartum sterilization.
  
  
  METHODS
  All hospitals with deliveries in California and Texas in 2009 were included. Proportion of live singleton deliveries with postpartum sterilization was calculated by hospital, insurance status (Medicaid compared with private insurance), type of delivery, and state.
  
  
  RESULTS
  Within each insurance status in California and Texas, we found wide variations across hospitals in postpartum tubal sterilization rates. This variability was not explained by disparities in hospital cesarean delivery rates. Some, but not all, of this variation was attributable to the absence of sterilizations in Catholic hospitals. Overall, postpartum tubal sterilization rates were higher in Texas than in California (10.2% compared with 6.7%), and this difference was found among both public insurance and private insurance patients. Interval sterilizations were more frequent in California, but the difference was not large enough to offset the difference in postpartum sterilization.
  
  
  CONCLUSIONS
  The variation in postpartum tubal sterilization rates across hospitals is substantial and exists even among hospitals without religious affiliations. Large-scale studies are needed to assess the demand for, and the barriers to, obtaining postpartum sterilization.
  
  
  METHODS
  II.
authors.affiliation: Population Research Center, University of Texas at Austin, Austin, Texas 78712, USA. joe@prc.utexas.edu
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Potter
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Stevenson
authors.forename: Kari
authors.initials: K
authors.lastname: White
authors.forename: Kristine
authors.initials: K
authors.lastname: Hopkins
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
mesh_terms: D002140:California / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D049590:Postpartum Period; D013246:Sterilization, Tubal / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology