Female sterilization - a follow-up report

A retrospective study of 1204 patients who made use of a free sterilization service is reported. Over the 1976-1978 period 3265 sterilizations were performed as part of the free sterilization service offered by the Department of Health at King George V Hospital Durban and the Natal Provincial Administration at Addington Hospital Durban South Africa. An attempt was made to follow up all patients with contactable addresses by utilizing a questionnaire. Information was sought concerning age at sterilization total number of pregnancies number of live births and of children still alive method of contraception used before surgery menstrual history time taken to resume normal activity after surgery attitudes of both the woman and her husband towards the operation subsequent pelvic surgery and subsequent pregnancy. A postal survey was conducted among the white patients; the Indian patients were interviewed by a family planning adviser. Questionnaires were completed for 1032 Indians and 172 whites. The largest number of women in both population groups was in the age range 31-35 years. The mean family size of those accepting sterilization was 4.05 for Indians and 2.89 for whites. The great majority of women chose sterilization primarily because they were satisfied with their family size. Only 5.7% of the Indian women and 1.7% of the white women gave economic reasons as the main factor determining the choice of sterilization. 7% of the Indian and 2% of the white women were sterilized within a year of the last confinement; 47% of the Indians and 36% of the whites had not given birth for over 6 years. 90% of the white women and 96% of the Indian women were satisfied with the operation and the level of satisfaction was uniformly high. Most women were able to resume normal activity within 1 week of surgery. The total number of pregnancies at the time of the inquiry was 6. Hysterectomy subsequent to sterilization had been performed on 12 Indian women and 2 white women a dilatation and curettage on 13 Indians and 6 whites and a laparotomy for removal of a cyst in 1 white woman. 3 women had undergone religation 2 had had operations on the cervix and 5 others unspecified minor procedures. Minor and major operative procedures numbered 44 (4%). Patients who had used the estrogen-progesterone pill were more likely to report an increase in menstrual loss after sterilization than patients using nonhormonal contraceptive methods.