Surgical sterilization in the United States: prevalence and characteristics, 1965-95

Abstract

Objectives: This report presents national data on the prevalence of surgical sterilization from 1965 to 1995 among women 15-44 years of age. Data are shown by type of sterilizing operation and demographic characteristics of the women. For the 1995 survey data, reasons for the three most common sterilizing operations (tubal ligation, vasectomy, and hysterectomy) are shown, as well as the desire for reversal among those with potentially reversible operations.

Methods: Data are based on nationally representative samples of women 15-44 years of age: the 1965 National Fertility Study (NFS), and the 1973, 1982, 1988, and 1995 cycles of the National Survey of Family Growth (NSFG).

Results: After rising from 16 to 42 percent between 1965 and 1988, the prevalence of surgical sterilization among married women 15-44 years old remained stable at 41 percent in 1995. Age, parity, religious affiliation, and education continued to be strongly associated with overall surgical sterilization levels. Tubal ligation and vasectomy were equally prevalent in the 1965 and 1973 surveys, but since 1962, tubal ligation has been more prevalent than vasectomy.

Conclusions: Several factors contributed to the rise in reliance upon surgical sterilization among women 15-44 years old over the last 3 decades: (a) aging of the post-World War II Baby Boom women (and their partners) through the primary reproductive years; (b) relatively high contraceptive failure rates, particularly among socioeconomically less advantaged women; and (c) higher expectations for contraceptive effectiveness, safety, and convenience. Overall sterilization prevalence may be leveling off among women 15-44 years old, in part due to greater delay of first and subsequent births, thus making sterilization less of a concern while women are in this age range.