Husbands and wives from 141 tubal sterilization couples and 162 vasectomy couples were interviewed just prior to sterilization and then again 1 and 2 years later. We conducted linear regression analyses to determine the pre- and poststerilization predictors of poststerilization regret in each of the four gender x method groups (tubal husbands, tubal wives, vasectomy husbands, vasectomy wives). We confirmed a number of hypotheses based on the research literature and our own earlier work. Both individual and couple factors contributed to the development of regret, as did both pre- and poststerilization factors. An important finding was the degree to which regret among the nonsterilized respondents (tubal husbands, vasectomy wives) was affected by pre- and poststerilization interaction with their spouses.
[Show abstract][Hide abstract] ABSTRACT: This thesis examines vasectomy as a gendered practice of (non)reproductive masculinity. Taking the New Zealand context as my domain of focus, I will discuss the socio-cultural meaning of the operation both within Western society, and for individual (heterosexual) men in the ongoing production and reproduction of their identities. This project reports on interview and survey based data, in which a number of New Zealand men made sense of the operation. It is social constructionist in nature, critical realist in orientation and also draws upon poststructuralist feminist theory and critical masculinities theory. This thesis will rely on various forms of quantitative, discourse and thematic analysis to highlight the ways in which men talked about having a vasectomy and its impact on their relationships with their partner, themselves, their own body and others. It will examine the potential use of these in “disrupting and displacing dominant (oppressive) knowledges” (Gavey, 1997, p. 53) and producing inclusive expressions of masculinity, which will have material benefit for women (and men).
[Show abstract][Hide abstract] ABSTRACT: Objectives 1. To produce a list of evidence-based criteria for good quality care relating to female laparoscopic sterilisation. 2. To assess the level of agreement with each criterion among gynaecologists in Scotland. 3. To obtain an overview of current sterilisation practice for comparison with the agreed criteria.
Design 1. Agreement with criteria assessed by questionnaire survey; 2. Overview of current practice obtained by questionnaire survey and by casenote review.
Sample 1. Questionnaire survey: all 132 consultant gynaecologists in NHS practice. 2. casenote review: 988 consecutive women sterilised in 12 representative hospitals.
Results The response rate to the questionnaire survey was 94%. A list of 15 evidence-based criteria was produced, covering patient selection, information and counselling, techniques of tubal occlusion and timing of sterilisation. All 15 suggested criteria gained an overall balance of support among responding gynaecologists. Similar impressions of current practice were gained from the questionnaire survey and from the casenote review. Aspects of practice which measured up well to the agreed criteria included: only 6% of women sterilised were younger than 25 years of age; over 85% of casenotes included clear documentation that women had been counselled regarding failure rate and intended permanency; 88% of sterilisations were performed, or directly supervised by, a gynaecologist of consultant or senior registrar status; and only 2% of sterilisations were undertaken in combination with induced abortion. Aspects of practice which compared poorly with the agreed criteria, and for which recommendations for change have been made, included: only 22% of casenotes mentioned that the option of vasectomy had been discussed; only 30% of gynaecologists indicated that they provide locally produced information leaflets as an adjunct to counselling; four methods of tubal occlusion (including unipolar diathermy) were in use; and there were wide variations among hospitals in the use of day-case care, ranging from 19% to 99%.
Conclusions A list of criteria for good quality care in relation to sterilisation has been validated by agreement among Scottish gynaecologists. Current practice (as assessed by questionnaire survey and casenote review) has been compared with the criteria and some recommendations for change in practice have been made. Following dissemination of these results and recommendations, re-audit will be undertaken in order to identify any changes.
BJOG An International Journal of Obstetrics & Gynaecology 12/1996; 104(1):71 - 77. DOI:10.1111/j.1471-0528.1997.tb10652.x · 3.45 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To recommend further research on vasectomy based on a systematic review of the effectiveness and safety of vasectomy. Design: A systematic MEDLINE review of the literature on the safety and effectiveness of vasectomy between 1964 and 1998. MAIN OUTCOME MEASURE(s): Early failure rates are <1%; however, effectiveness and complications vary with experience of surgeons and surgical technique. Early complications, including hematoma, infection, sperm granulomas, epididymitis-orchitis, and congestive epididymitis, occur in 1%-6% of men undergoing vasectomy. Incidence of epididymal pain is poorly documented. Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient in men with vasectomies. The weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers. CONCLUSION(s): Publications to date continue to support the conclusion that vasectomy is a highly effective form of contraception. Future studies should include evaluations of the long-term effectiveness of vasectomy, evaluating criteria for postvasectomy discontinuation of alternative contraception for use in settings where semen analysis is not practical, and characterizing complications including chronic epididymal pain syndrome.
Fertility and Sterility 05/2000; 73(5):923-36. DOI:10.1016/S0015-0282(00)00482-9 · 4.59 Impact Factor
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