Permanent contraception in the childfree population: An exploratory study

This study aimed to describe the childfree population seeking permanent contraception, identify barriers to receiving care, and characterize the incidence of regret.

We conducted a cross-sectional survey of people in the United States, aged 18 years and older, without biological children, and who are seeking or have previously sought a permanent contraception procedure. Participants completed an online REDCap survey distributed over social media platforms, including Reddit, TikTok, and Facebook.

A total of 400 respondents completed the survey, of whom 151 (38%) underwent a permanent contraception procedure, 44 (11%) had found a doctor to perform a procedure but not yet undergone it, 32 (8%) had been unable to find a doctor to do the procedure, 83 (21%) were seeking a doctor, and 90 (22%) had not yet sought a doctor. Respondents were predominantly White (88%), identified as women (83%), and were diverse in sexual orientation (heterosexual 42%, bisexual 41%). Reasons for seeking permanent contraception included not wanting children (96%), fear of pregnancy/childbirth (70%), the current state of the world (68%), environmental reasons (59%), and medical reasons (32%). Barriers to care included cost of the procedure (30%) and inability to find a doctor who would perform the procedure (42%). Of the 151 respondents who had undergone a permanent contraception procedure, 70 (46%) asked more than one doctor for the procedure. Of those with permanent contraception, 97% answered "yes" to "Do you think sterilization as a permanent method of birth control was a good choice for you?"

Childfree individuals have a variety of reasons for seeking sterilization and may be at a lower risk of regret than reported in the literature for parous people with permanent contraception.

Clinicians should be aware of the barriers to permanent contraception for patients who do not desire to have children. Providing patient-centered, individualized care to patients seeking permanent contraception can ensure that patients do not face unnecessary barriers to care and feel heard and empowered to enact their reproductive preferences.