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Obstetrician-gynecologists' counseling regarding postpartum sterilization
Kavita Shah Arora1, Neko Castleberry2, Jay Schulkin2,3
1Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA, kavita.shah.arora@gmail.com.
International Journal of Women'S Health
|August 28, 2018
Summary
Obstetrician-gynecologists consider patient age, medical history, and parity when counseling on postpartum sterilization. Nonmedical factors also influence decisions, highlighting the need for cautious, patient-centered counseling.
Area of Science:
- Reproductive Health
- Medical Ethics
- Surgical Procedures
Background:
- Obstetrician-gynecologists (ob-gyns) are central to patient counseling on sterilization.
- They offer contraception alternatives and referrals when personal beliefs conflict with patient requests.
- Understanding ob-gyn counseling practices for postpartum sterilization is crucial.
Purpose of the Study:
- To characterize the counseling practices of ob-gyns regarding postpartum sterilization.
- To identify factors influencing recommendations for or against sterilization.
Main Methods:
- Prospective, electronic survey of 1,000 ob-gyn members of the American College of Obstetricians and Gynecologists.
- Half of the surveyed physicians were members of the Collaborative Ambulatory Research Network.
Main Results:
- 19.6% of surveyed physicians responded.
- Top reasons for declining sterilization requests: patient's age, body mass index, and medical history.
- Top reasons for recommending sterilization (when not requested): patient's medical history, parity, and availability of alternative contraception.
Conclusions:
- Medical and nonmedical factors influence ob-gyn recommendations on postpartum sterilization.
- Nonmedical factors include operating room availability and patient demographics (age, parity, gestational age).
- Physicians must avoid paternalistic counseling and ensure decisions are medically sound.