Contraceptive sterilization among married adults: national data on who chooses vasectomy and tubal sterilization.
ABSTRACT Vasectomy has been found to be a highly cost-effective contraceptive method. For couples, tubal sterilization and vasectomy have the same result, but the two methods are used by different segments of the population.
We conducted an analysis of data from male and female samples of the 2006-2008 National Survey of Family Growth, nationally representative samples of men and women in the United States aged 15-44 years.
Among married men, 13.1% reported vasectomies (95% confidence interval 10.4%-16.3%), compared to 21.1% (17.8%-24.9%) of married women who reported tubal sterilizations. Men with higher education and income had greater prevalence of vasectomy than those less educated, while women with lower education and income had the highest prevalence of tubal sterilization.
Efforts to promote vasectomy use need to understand the reasons behind these differences. Increasing the availability and use of vasectomy will require education about its benefits.
- SourceAvailable from: Vidit Sharma[Show abstract] [Hide abstract]
ABSTRACT: It has been theorized that utilization of permanent contraceptive methods may vary with economic conditions. Here we evaluate the relationship between vasectomy/vasectomy reversal frequencies at several large referral centers with national economic indicators over a period of two recessions spanning 2001 to 2011. An IRB approved retrospective chart review was conducted to identify the number of vasectomies/vasectomy reversals per month at several large referral centers from January 2001 to July 2011. The incidences of these procedures were pooled, correlated with national economic data, and analyzed in a multivariate-linear regression model. There were 4599 vasectomies and 1549 vasectomy reversals performed at our institutions during the study period. The number of vasectomies performed per month was positively correlated to the unemployment rate (r = +0.556, P < 0.001) and personal income per capita (r = +0.276, P = 0.002). The number of vasectomy reversals performed per month was negatively correlated with the unemployment rate (r = -0.399, P < 0.001) and personal income per capita (r = -0.305, P < 0.001). Neither vasectomy nor vasectomy reversal frequencies significantly correlated with the inflation rate or the S&P 500. Regression models confirmed that the unemployment rate explained more of the variance in vasectomy/vasectomy reversal frequencies than other indicators. We noted a correlation between the number of vasectomies/vasectomy reversals performed at our institutions and national economic indicators, with the strongest association with unemployment rate. This points to the importance of financial pressures on family planning decisions.The Journal of urology 01/2014; · 3.75 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Objective: Cross-sectional studies have found that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner’s vasectomy than women with higher incomes and whites. However, studies of pregnant and postpartum women report that racial/ethnic minorities, particularly low-income minority women, face greater barriers in obtaining a sterilization than do whites and those with higher incomes. In this paper, we address this apparent contradiction by examining the likelihood a woman gets a sterilization following each delivery, which removes from the comparison any difference in the number of births she has experienced. Study Design: Using the 2006–2010 National Survey of Family Growth, we fit multivariable-adjusted logistic and Cox regression models to estimate odds ratios and hazard ratios for getting a postpartum or interval sterilization, respectively, according to race/ethnicity and insurance status. Results: Women’s chances of obtaining a sterilization varied by both race/ethnicity and insurance. Among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. Privately insured whites were more likely to rely on vasectomy than African Americans and Latinas, but among women with Medicaid-paid deliveries reliance on vasectomy was low for all racial/ethnic groups. Conclusions: Low-income racial/ethnic minority women are less likely to undergo sterilization following delivery compared to low-income whites and privately insured women of similar parities. This could result from unique barriers to obtaining permanent contraception and could expose women to the risk of future unintended pregnancies. Implications Low-income minorities are less likely to undergo sterilization than low-income whites and privately insured minorities, which may result from barriers to obtaining permanent contraception, and exposes women to unintended pregnancies.Contraception 01/2013; · 3.09 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception.Urologic Clinics of North America 02/2014; 41(1):145-61. · 1.35 Impact Factor