Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 27;20(1):23.
doi: 10.1186/s12978-023-01572-5.

Does socioeconomic factors and healthcare coverage affect postpartum sterilization uptake in an urban, tertiary hospital?

Sutira Uaamnuichai  1 , Phanupong Phutrakool  2 , Nareerat Thammasitchai  3 , Sarochinee Sathitloetsakun  4 , Somsook Santibenchakul  5 , Unnop Jaisamrarn  4
Affiliations

Does socioeconomic factors and healthcare coverage affect postpartum sterilization uptake in an urban, tertiary hospital?

Sutira Uaamnuichai et al. Reprod Health. .

Abstract

Background: Postpartum sterilization in Thailand has relatively few barriers compared to other countries. The procedure is covered by some healthcare plans, and paid out-of-pocket for others. We aim to determine if healthcare coverage and other socioeconomic factors affect the rate of postpartum sterilization in an urban, tertiary hospital.

Methods: We conducted a secondary analysis of data from a retrospective cohort of 4482 postpartum women who delivered at our hospital. Multivariable logistic regression was conducted to determine if sterilization reimbursement affects immediate postpartum sterilization rate.

Results: Overall immediate postpartum sterilization rate was 17.8%. Route of delivery and parity were similar in those who were reimbursed and those who were not. Women aged over 25 were more likely to have a healthcare plan that does not cover postpartum sterilization. Women whose healthcare plan reimbursed the procedure trended towards postpartum sterilization when compared to women who were not (aOR 1.05, 95% CI 0.86-1.28, p-value = 0.632). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.87; 95% CI 4.77-7.24, p-value = < 0.001). Women aged 40-44 years were 2.70 times as likely to choose sterilization than those aged 20-24 years (aOR = 2.70; 95% CI 1.61-4.53, p-value < 0.001).

Conclusions: Healthcare coverage of the procedure was not associated with increased postpartum sterilization in our setting.

Keywords: Contraceptives; Female sterilization; Health coverage; Postpartum sterilization.

Plain language summary

Postpartum sterilization is an effective and popular method of contraception. In our hospital, postpartum sterilization is easily accessible compared to other countries where there are barriers such as mandatory waiting time, limited operating rooms and anesthesiologists. We examine factors that affect sterilization rates and found that older women and women with more children were more likely to choose postpartum sterilization. We also found that women who delivered by cesarean section were more likely to choose sterilization. Interestingly, whether the woman’s healthcare plan covers postpartum sterilization does not affect the likelihood of sterilization.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

References

    1. Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J. The risk of pregnancy after tubal sterilization: findings from the U.S. collaborative review of sterilization. Am J Obstet Gynecol. 1996;174(4):1161–1170. doi: 10.1016/S0002-9378(96)70658-0. - DOI - PubMed
    1. Department of Economic and Social Affairs. Contraceptive use by method 2019: data booklet. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.... Accessed 1 Nov 2022.
    1. Singh P, Singh KK, Singh P. Factors explaining the dominion status of female sterilization in India over the past two decades (1992–2016): a multilevel study. PLoS ONE. 2021;16(3):e0246530. doi: 10.1371/journal.pone.0246530. - DOI - PMC - PubMed
    1. Foley O, Janiak E, Dutton C. Women's decision making for postpartum sterilization: does the Medicaid waiting period add value? Contraception. 2018;98(4):312–316. doi: 10.1016/j.contraception.2018.07.004. - DOI - PubMed
    1. Borrero S, Abebe K, Dehlendorf C, et al. Racial variation in tubal sterilization rates: role of patient-level factors. Fertil Steril. 2011;95(1):17–22. doi: 10.1016/j.fertnstert.2010.05.031. - DOI - PMC - PubMed