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  • Title: Contraceptive attitudes and practice in women choosing sterilization.
    Author: Bledin KD, Cooper JE, Mackenzie S, Brice B.
    Journal: J R Coll Gen Pract; 1984 Nov; 34(268):595-9. PubMed ID: 6502567.
    Abstract:
    Selected results of the 1st, or preoperative, phase of a University of Nottingham study of the psychological effects of female sterilization were presented. The study represents 1 part of a World Health Organization multicenter study. Between March 1979 and Februray 1980, 69 interval sterilization patients at City Hospital and at Women's Hospital and 69 postpartum sterilization patients at City Hospital were interviewed prior to undergoing sterilization. 1 part of the interview focused on the patients' contraceptive attitudes and practices. This paper reports findings based on that portion of the interview only. The women were followed up periodically after sterilization, and the results of that phase of the study were reported elsewhere. All of the patients chosen for inclusion in the study were healthy, multiparous, over 20 years of age, and in stable matital or consensual union. All of the subjects decided to undergo elective sterilization for contraceptive purpose only. Analysis of their contraceptive attitudes and practices prior to sterilization revealed that 98.6% of the women ever used contraception, and almost all of the women were knowledgeable about most methods of contraception. 93% ever used oral contraceptives (OCs), and 50% of the women used OCs as their last method of contraception. The major reasons for discontinuing use of a method were physical side effects and the fear of complications. The interviewees were presented with a list of contraceptive methods and asked to identify those methods which they would avoid using if sterilization was not available. IUDs, the least favored method, would be avoided by 49 of the women. Only 12 of the women would avoid using OCs. Physicians were the major source of information about OCs among women who ever used OCs, while most women who ever used IUDs received information about IUDs from family planning or health workers. The majority of both OC and IUD users were under the supervision of physicians rather than of family planning clinics, and only 3/4 of the IUD and OC users received regular checkups. 69% of the interval patients were satisfied with their last method of contraception. Among the 23% who expressed dissatisfaction, 2 said they feared the longterm effects of OCs, and 9 said that condoms interfered with their sexual satisfaction. 24% reported that their last pregnancy was unplanned, and 11% had undergone an abortion at some point in the past. 98.6% of the women chose sterilization either wholly or partly because they had completed their families. 60.1%, wholly or partly, chose sterilization because it was the safest and most effective contraceptive method available. 18.1% said that concerns about the side effects and longterm effects of OCs entered into their decision to undergo sterilization. The concerns expressed by the interviewees about various contraceptive methods were generally not based on their own experience with these methods but were derived from reading articles on contraception or from conversations with other women.
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