The Decision For Sterilization

THE DECISION FOR STERILIZATION

The decision for sterilization is an important one and the patient should be fully informed about the procedure and its risks, effectiveness, and long-term implications (Box 25.1). Components of presterilization counseling should include:

·  Permanent nature of the procedure

·  Alternative methods available, including male sterilization

·  Reasons for choosing sterilization

·  Screening for risk indicators for regret

·  Details of the procedure, including risks and benefits

·  The possibility of failure, including ectopic pregnancy

·  The need to use condoms for protection against sexu-ally transmitted diseases, including HIV

·  Completion of informed consent process

·  Local regulations regarding interval from time of con-sent to procedure 

Despite careful counseling, approximately 10% to 15% of patients who undergo sterilization subsequently report regret, although only 1% actually request reversal of the procedure

Box 25.1

Risk Indicators for Regret About Decision for Sterilization

Age younger than 25 years at the time of sterilization Less access to, information about, or support for other contraceptive method use

Incomplete or inadequate information about the procedure

Making the decision under pressure from a spouse or because of medical indications