[Tubal ligation by minilaparotomy in the immediate post-partum period after vaginal delivery. A retrospective analysis of 253 cases at the maternity unit of the Yaounde teaching hospital]

During 1985-1989 253 women in Cameroon underwent tubal ligation by minilaparotomy after vaginal delivery at the University Hospital Center in Yaounde. The surgeons used local anesthesia and the Pomeroy method to ligate the tubes. The women tended to be married (94%) not to work outside the home (68%) and to be Catholic (67.2%). The annual tubal ligation rate varied from 3.87% to 4.16%. It was highest among multiparous women aged 35-39 (mean family size = 7.2). The tubal ligation rate among women with less than five living children was 4.7%. It increased markedly once women had at least six children (e.g. 23.3% for 6 30.1% for 7). Four women (1.6%) experienced peri- or post-operative complications (peri-operative hemorrhaging difficulty in operation caused by tubal adhesions resulting in no sterilization at that time compress left in the abdominal cavity and fever). These complications were likely attributable to lack of operating experience among the young physicians in training. 96% of the women left the hospital 48 hours after tubal ligation. The hospital stay was the same as that of women who also delivered vaginally at the same hospital but did not undergo tubal ligation. Five years after tubal ligation only 2% regretted their decision to undergo tubal ligation. In developing countries where the medical infrastructure is still under-developed and medical personnel are undertrained female sterilization by minilaparotomy should be included as a birth limiting method in family planning programs.