The sterilization decision in a U.S. sample.

Miller WB; Shain RN; Pasta DJ
In: Choosing a contraceptive. Method choice in Asia and the United States, edited by Rodolfo A. Bulatao, James A. Palmore and Sandra E. Ward. Boulder, Colorado, Westview Press, 1989. 257-73. (Westview Special Studies in Science, Technology, and Society)

To enhance understanding of how and why couples choose sterilization as their method of contraception, LISREL analyses were performed on 3 groups of US women: 253 women undergoing tubal ligation, 166 women whose husbands were undergoing vasectomy, and 200 women who had completed childbearing but did not plan sterilization within the next 12 months. The analysis revealed significant sociodemographic differences between the women planning male or female sterilization and those not planning sterilization. The women not selecting sterilization were older, better educated, and married to older, better educated husbands. If they were currently employed, they had higher status and better paying jobs. Among the 2 groups planning sterilization, a significantly larger proportion was currently pregnant (42% were planning to combine tubal ligation with delivery). Further, both satisfaction with the current method of contraception and current IUD use disposed women not to plan sterilization. Finally, women whose most recent pregnancy was unintended, who had more recently decided not to have more children, who were not in excellent physical health, or viewed sterilization as a means of reducing marital problems were more likely to choose sterilization. On the other hand, women who were highly involved in religious activities or were anxious about surgery were less likely to plan sterilization. These results suggest that the effects of sociodemographic factors on the sterilization decision are mediated through the action of behavioral and psychological variables. That is, the decision to select sterilization occurs within the context of a woman's evaluation of sterilization versus other classes of contraception: that evaluation is itself made within the context of the woman's childbearing desires and plans; and, finally, these desires and plans are formed within the context of the couple's sociodemographic status.

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