CONTEXT: Sterilization is the most commonly used contraceptive in the United States, yet access to this method is limited for some.
METHODS: A 2006–2008 prospective study of low-income pill users in El Paso, Texas, assessed unmet demand for sterilization among 801 women with at least one child. Multivariable logistic regression analysis identified characteristics associated with wanting sterilization. In 2010, at an 18-month follow-up, women who had wanted sterilization were recontacted; 120 semistructured and seven in-depth interviews were conducted to assess motivations for undergoing the procedure and the barriers faced in trying to obtain it.
RESULTS: At baseline, 56% of women wanted no more children; at nine months, 65% wanted no more children, and of these, 72% wanted sterilization. Only five of the women interviewed at 18 months had undergone sterilization; two said their partners had obtained a vasectomy. Women who had not undergone sterilization were still strongly motivated to do so, mainly because they wanted no more children and were concerned about long-term pill use. Among women's reasons for not having undergone sterilization after their last pregnancy were not having signed the Medicaid consent form in time and having been told that they were too young or there was no funding for the procedure.
CONCLUSIONS: Because access to a full range of contraceptive methods is limited for low-income women, researchers and providers should not assume a woman's current method is her method of choice.
Perspectives on Sexual and Reproductive Health, 2012, 44(4):228–235, doi: 10.1363/4422812
Joseph E. Potter is professor of sociology and faculty research associate, and Kristine Hopkins is research assistant professor, both in the Population Research Center, University of Texas, Austin. Kari White is assistant professor, Department of Health Care Organization and Policy, School of Public Health, University of Alabama, Birmingham. At the time this article was written, Sarah McKinnon was a data analyst, Centers for Disease Control and Prevention, Atlanta. Michele G. Shedlin is professor, College of Nursing, New York University. Jon Amastae is professor, Department of Languages and Linguistics, University of Texas, El Paso. Daniel Grossman is vice president for research, Ibis Reproductive Health, Oakland.