Tubal sterilization trends in the United States

Objective: To review the rate, setting, and demographic characteristics of tubal sterilization and its current trend within contraceptive practice in the United States. Design: Review of U.S. health care statistics, NCHS publications, English-language literature searched using MEDLINE and PubMed, and bibliographies of key references. Result(s): Total annual cases of tubal sterilization have declined from 687,000 in 1995 to 643,000 in 2006, despite a 4% population growth. Interval sterilizations decreased by 12%. Postpartum sterilizations remained stable and follow 8%-9% of all live births. Tubal sterilizations remain more common in black and Hispanic women; women with lower income, lower education, and higher parity; and among women living in the South. From 1981 to 1995, inpatient interval sterilizations fully migrated to ambulatory surgery care. Conclusion(s): After two decades of stable rates, there is a recent decline in sterilization. Improved access to a wide range of highly effective reversible contraceptives gives women flexibility when deciding how to manage their reproductive ability. (Fertil Steril (R) 2010; 94: 1-6. (C) 2010 by American Society for Reproductive Medicine.)