[The timing of tubal ligation (Author's transl)]

In spite of medical or mixed medical and social indications, the sterilization by tubal ligation is frequently not carried out or done very late as in sterilization combined with a therapeutic abortion. This is borne out by the review of case histories and consultations of patients who had a sterilization operation other than post-partum, multiparous patients who had no sterilization, multiparous patients who had sterilization post-partum and patients who had an application for therapeutic abortion rejected and patients who had a therapeutic abortion with concomitant sterilization. The medical indications, medical social indications, the duration of the disease, the desire for child bearing, the social conditions and the family conditions were of such nature that in 29-80 percent of the cases under review sterilization could have been carried out at an earlier time. The relatively high incidence of women who presented with indications for sterilization but whose sterilization was delayed shows that more active individual counseling regarding sterilization by the attending physician is desirable. If necessary the physician should raise the question of sterilization and discuss the problem with the patient. This type of counseling would insure that the patient can make an informed decision and would minimize the psychological side effects and after-effects of sterilization.