Contraception and female sterilization
Penfield, A.J.
New York State Journal of Medicine 81(2): 255-258
1981
ISSN/ISBN: 0028-7628 PMID: 6936646 Document Number: 172175
Preferences in methods of contraception and sterilization among the U.S. population are assessed. Oral contraceptives, low-dose, are the leading reversible contraceptive method in the U.S., despite the risk of side effects. The diaphragm, among highly motivated women, is in second place. Sterilization methods are more diverse, but basically double incision laparoscopic tubal coagulation is preferred in the U.S. as an interval technique. Some clinics use the Yoon band and Hulka clip instead of coagulation. The favorite method of sterilization in the East has been the suprapubic mini laparotomy and it is gaining currency in the U.S. now. Contraindications to laparotomy are obesity, fixed uterine retroversion, and suspected adnexal pathology; in most patients who are nonobese, however, suprapubic minilaparotomy with Pomeroy tubal ligation, Yoon banding, or clip application is simpler, safer, and less expensive. And both the laparoscopy and minilaparotomy can be performed under local anesthesia. The IUD is recommended for women who are the least motivated, and is thought inappropriate for using in nulliparous women because of the likelihood of tubal scarring resulting from infection.