Female sterilisation: is it what women really want or are alternative contraceptive methods acceptable?

An initial audit was conducted in 2001 to monitor all women referred for female sterilisation. This re-audit in 2003 set out to investigate those women who initially chose alternative reversible contraception and ascertain whether they were still using that method or if they or their partner had requested sterilisation.

A telephone survey of general practitioners was conducted, 2 years after an initial sterilisation counselling appointment, of those women who initially had chosen alternative, reversible forms of contraception.

Information regarding current contraception was obtained for 44 (85%) of the cohort of 52 women. Three women and five of their partners (15.4%) had been sterilised in the intervening 2 years. Two women had undergone hysterectomy for gynaecological reasons. Thirty-four (65.4%) women were using reversible contraceptive methods and 31 (59.6%) were still using the same contraceptive method chosen at the sterilisation counselling appointment. Information was not available for eight (15.4%) women.

Female sterilisation counselling within a contraception and sexual health service successfully offers a full range of contraceptive alternatives. This small audit indicates that at least two-thirds of women who choose one of these alternatives will still be using this method 2 years later. Although the number of women in this audit is small, we suggest that this change in service delivery has contributed to a decline in female sterilisation within the district and has led to an increased use of effective, reversible hormonal contraception within the community and hospital services.