Sterilization Main U.S. Contraception Means -Study

Tue May 02 18:53:00 2000 EDT
& WASHINGTON (Reuters) - Sterilization has become the number one form of contraception in the United States, surpassing even the Pill in popularity, researchers said on Tuesday.

They said 11 million women, or 18 percent, rely on either their partner's vasectomy or their own sterilization -- a figure that surprised them. Even more surprising, they reported in the journal Fertility and Sterility -- a third of these women are not married.

That compares to about 10 percent of women who say they currently use the birth control pill.

"What factors have led to this dramatic increase?" Dr. Carolyn Westhoff and Dr. Anne Davis of Columbia University in New York asked in their report. "The direct medical factors include increased safety of anesthesia and surgery."

They also said women had been worried about the health effects of the Pill.

In a second report in the same journal, Larry Bumpass and colleagues at the University of Wisconsin said they found that one-third of all recent tubal sterilizations were performed on unmarried women. "Sterilization while unmarried is remarkably common among all race or ethnic groups," the Wisconsin team wrote in their report.

They were also surprised to find that women are opting to have their tubes tied rather than relying on their partner's vasectomy, even though vasectomy is cheaper, quicker and safer.

They said perhaps women liked having control over the decision. As for unmarried women choosing to be sterilized, they noted that a third of all births now occur outside marriage in the United States, in part because women are delaying marriage.

"Hence, as a consequence of these life course changes, many women have had all the children they feel they want or can support before ever being married," they wrote.

The researchers used a large national survey, the National Survey of Family Growth, which was conducted by the National Center for Health Statistics. Nearly 11,000 women aged 15 to 44 were interviewed at length for the survey.

Six percent of women who had their tubes tied or blocked eventually asked about having it reversed. A second study found that between one and three per 1,000 men request a reversal of vasectomy, a rate of less than one percent.

"Contraceptive sterilization is a safe and effective method of birth control, but we do need better and less costly reversal methods," Dr. Jeffrey Chang, president of the American Society for Reproductive Medicine, said in a statement.

"Although technology has improved the chances for successfully reversing a vasectomy or tubal sterilization, contraceptive sterilization is not designed for those planning to have a child in the future, or for those uncertain about whether or not they plan to have children."

In an unrelated study published on Tuesday, the American College of Obstetricians and Gynecologists (ACOG) said it found huge numbers of women did use the Pill.

Ten percent of the 750 women aged 18 or over surveyed by Gallup for ACOG said they currently used the pill and 59 percent said they had used it in the past.

"We found a dramatic plunge in women's fears about the pill's safety, compared to polls we conducted in 1985 and 1993," Dr. Ralph Hale, executive vice president of ACOG, said in a statement.

He said in 1985, 76 percent of women surveyed said they believed there were "substantial health risks" associated with the birth control pill. But this year's survey found that only 41 percent felt that way.

Older versions of the Pill increased the risk of blood clots but newer formulations do not. Taking the Pill can also reduce the risk of ovarian and uterine cancer.

The Alan Guttmacher Institute, which researches family issues, says 60 million U.S. women are aged 15 to 44, considered the childbearing years.

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