One-year follow-up of women with unfulfilled postpartum sterilization requests

To track outcomes of women in three cohorts-those who requested postpartum tubal ligation and received the procedure (postpartum tubal ligation [PPTL] YES), those who requested postpartum tubal ligation but did not receive the procedure (PPTL NO), and a control group (those who did not request postpartum tubal ligation)-for 1 year postpartum.

This was a record review evaluating women who delivered a liveborn singleton between December 2007 and May 2008 at the University of Texas San Antonio. Those in the case group were monitored until 1 year postdelivery. The primary outcome was pregnancy within 1 year of the index delivery among women in the control group compared with those in the PPTL NO group. Secondary outcomes included birth control requested at obstetric-admission discharge, attendance at a postpartum or other gynecology visit, contraceptive use between delivery and the postpartum visit, and request for contraception at the postpartum visit among the three cohorts.

During the observation period, 429 of 1,460 women requested postpartum tubal ligation; 296 (69%) received the procedure and 133 (31%) did not. Within 1 year of the index delivery, 46.7% of women in the PPTL NO group became pregnant compared with 22.3% of those in the control group (P<.001). Attendance at the postpartum visit was lowest for women in the PPTL YES group (12.8%; P=.004) compared with the similarly low attendance among those in the PPTL NO (18.8%) and control groups (20.3%; P=.73). Women in the PPTL NO group and those in the control group selected similar methods of postpartum contraception at hospital discharge.

Women who did not receive a requested postpartum tubal ligation were more likely to become pregnant within 1 year of delivery than were those in the control group (women not requesting permanent sterilization).

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