Female sterilization is relied on by nearly one in three women aged 35–44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician–gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. The informed consent process for sterilization is crucial and requires shared decision-making between the patient and the health care provider. Counseling should include the specific risks and benefits of the specific surgical approaches. Additionally, women should be counseled on the alternatives to sterilization, including intrauterine contraceptives and subdermal contraceptive implants. Complications, including unplanned pregnancy after successful female sterilization, are rare. The objectives of this Clinical Expert Series are to describe the epidemiology of female sterilization, access to postpartum sterilization, advances in interval sterilization techniques, and clinical considerations in caring for women requesting sterilization.
Women and their physicians should share informed decisions for female sterilization; barriers to sterilization are greatest for women who are dependent on public funding.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Corresponding author: Gretchen S. Stuart, MD, MPHTM, Campus Box 7570, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7570; email: firstname.lastname@example.org.
Financial Disclosure Dr. Stuart receives funding from Femasys and Medicines360 for clinical trials, and she is a consultant for Allergan. The other author did not report any potential conflicts of interest.
Continuing medical education for this article is available at http://links.lww.com/AOG/B39.
Each author has indicated that she has met the journal’s journal's requirements for authorship.