[Psychodynamics of the desire for refertilization in women after sexual sterilization]

From October 1979 to April 1982 forty two women with previous tubal ligations presented themselves at the Centre for Obstetrics and Gynaecology in Giessen with a high desire of restoration of their fertility. With questionaires and partly structured interviews these women were evaluated at the Centre for Psychosomatic Medicine in Giessen. The results largely confirm previous findings known in the literature regarding the background of tubal ligations in women with desire for restoration of fertility. Most of the patients (N = 37) had the sterilization performed under conditions which are known to have an adverse prognostic effect such as sterilization for medical indications in ten women, sterilization during a marital crisis in eighteen women, and sterilization in conjunction with a therapeutic abortion, confinement or a gynaecological operation in twenty eight women. The psychodynamics of women with a desire for restoration of fertility show two main groups. First: in twenty five women a sterilization and desire for restoration of fertility are an effort to resolve a specific conflict in their marital relationship inasmuch as a new infant should serve as a bonding function and documentation of the new partnership. Second: in sixteen patients sterilization and desire for refertilization are a symptom of an unresolved conflict of the role as woman and mother. The new infant or the restoration of fertility should eliminate the narcistic deficit suffered by the sterilization or restore the self esteem which suffered a female identity blow by the sterilization. Implications of these findings for the counselling practice are discussed.