Why 103 women asked for reversal of sterilisation

Abstract

Between 1975 and 1976 103 women requesting sterilisation reversal were interviewed at Hammersmith Hospital. Their average age at sterilisation was 26-7 years; 65 (63-1%) had been sterilised immediately after pregnancy, and many patients had previously used contraception inadequately when they were sterilised. When they had been sterilised 78 (75-7%) patients were unhappily married and remarriage was the chief reason for the request for reversal. Sexual dissatisfaction after sterilisation was common, but there was no obvious increase in menstrual disturbance. Thirty-nine (37-8%) patients had been sterilised by irreversible methods, and in only half the cases sterilised by tubal ligation were conditions technically suitable for reversal surgery. It therefore seems unwise to sterilise women under 30 particularly immediately after pregnancy or if their marriage is in jeopardy.

PIP: 103 22-46 year old women requesting sterilization reversal were interviewed. Only 11 had been over age 30 when sterilized. The mean of term pregnancies had been 3.1; the maximum number of term pregnancies had been 7. There were 65 patients who had been sterilized after their last pregnancy. Pregnancy had been terminated in 37 patients. 3 patients had had 2 abortions and 1 had had 5 abortions. The methods of sterilization had varied, therefore, laparoscopy was often done to assess the feasibility of reversal. About half of those so investigated were regarded as not suitable for reversal surgery. Contraceptive advice given before sterilization had been inadequate in about half the cases. Psychiatrists had advised sterilization in 6 cases and also supported their reversal requests. Unsatisfactory marital relations had been the cause for sterilization in 78 patients. Sexual satisfaction had improved after sterilization in 47 but was less so in 49. The most important reason for reversal request was remarriage in 81 cases. Very careful counseling is recommended before sterilizing young patients, patients with unhappy marriages, or immediately after a pregnancy. An unsatisfactory marriage may be an insufficient reason for sterilization.