Trends and Disparities in Postpartum Sterilization after Cesarean Section, 2000 through 2008

Area of Science:

• Reproductive Health
• Health Disparities
• Surgical Outcomes

Background:

• Tubal sterilization patterns are influenced by various patient and hospital characteristics.
• Limited research exists on factors affecting postpartum tubal sterilizations performed after cesarean sections (C-sections).

Purpose of the Study:

• To examine variations in the prevalence of postpartum tubal sterilizations after C-sections between 2000 and 2008.
• To identify patient-level and system-level factors associated with these sterilizations.

Main Methods:

• Utilized data from the National Hospital Discharge Survey.
• Estimated odds ratios for patient (race, marital status, age) and system (hospital size, type, region) factors.
• Analyzed likelihood of tubal sterilization post-C-section.

Main Results:

• Medicaid disproportionately covered postpartum tubal sterilizations after C-section.
• Increased likelihood of sterilization observed for Black women, older women, and non-single women.
• Higher rates in proprietary/government hospitals, smaller facilities, and the Southern US.

Conclusions:

• Black women and those with Medicaid coverage were significantly more likely to undergo postpartum tubal sterilization after C-section.
• Hospital characteristics and geographic region were significant predictors.
• Findings suggest tubal sterilization is a disparity issue influenced by multiple factors, requiring further study of patient, provider, and system roles.