Sterilization for family planning in a Third World country
Reichert, J.A.; Nagel, L.W.; Solberg, N.S.
Minnesota Medicine 80(7): 27-30
1997
ISSN/ISBN: 0026-556X PMID: 9242025 Document Number: 268678
During an 8-day visit to Jalapa, Nicaragua, in 1996, a Short-Term Volunteers in Mission team from Minnesota, US, performed 107 outpatient laparoscopic sterilizations and 14 vasectomies in this remote town near the Honduran border. Standard medical procedures were modified to adapt to the inadequate medical facilities and large patient load. The mean age of female sterilization acceptors was 28.92 years; they had an average of 4.4 living children. 75% lived in or near the town and walked a total of 1 hour or less to and from the hospital; another 20% walked an average of 4 hours round trip. Because of the women's need to walk home after the procedure, local anesthesia (1% lidocaine) was administered in conjunction with oral ibuprofen. More than 75% of acceptors experienced mild or no intraoperative pain and were sent home right after the procedure; 20% reported moderate pain and 3% severe pain, but in all cases the pain dissipated within 10-45 minutes. The length of time from admission to discharge averaged 45 minutes (range, 25-75 minutes). Civil war, overpopulation, and severe poverty limit the ability of government-sponsored programs to deliver family planning services consistently. Thus, sterilization is an ideal method of fertility control for appropriate candidates.