Female sterilization, should its reversibility be promoted?
Contraceptive Technology Update 5(2): 13-16
1984
ISSN/ISBN: 0274-726X PMID: 12265920 Document Number: 401123
Family planning professionals often disagree about whether clinicians should tell patients sterilization is reversible or irreversible. According to Dr. A. Albert Yuzpe, no one should promote the use of sterilization on the basis that it can be reversed. Family planning clinic representatives state that they counsel patients that sterilization is irreversible, yet they also discuss reversibility with them. Any time a couple wants to prolong their reproductive capacity, reversible contraception should be the method of choice. Sterilization is the ideal choice when couples want no increase in their family size. Yuzpe urges clinicians to learn the risks and benefits of all contraceptive methods. The surgical procedure for reversal can take between 2-4 hours and requires expensive surgical instrumentation, such as the operating microscope. Yuzpe suggests that clinicians should keep "in the back of their minds" that the sterilization procedure they select should lend itself to reversal should the patient request it. He therfore advocates using sterilization methods which produce the least amount of tissue or tubal destruction. Yuzpe and colleagues have performed almost 11,000 sterilizations. 1.5-1.8% of patients who had the procedures requested reversal because of the death of a spouse, divorce or marriage breakup, or loss of 1 or more children. Generally, operations to reverse female sterilization procedures are expensive and may not be successful. Yuzpe emphasizes that clinicians should be certain a patient does not decide about sterilization during a difficult pregnancy, a difficult labor, or a difficult delivery. Yuzpe performs no sterilizations within the 1st 6 weeks following delivery. The sterilization regulations of the US Department of Health and Human Services outline specific obligations of counselors in family planning programs regardingprereferral counseling sessions with sterilization candidates. Counselors must abide by the following specific guidelines: answer any questions the individual may have concerning the procedure; provide a copy of the informed consent form to every sterilization candidate; advise the individual that she can withhold or withdraw consent to the procedure any time before the sterilization without affecting the right to future treatment and without loss of any federally funded program benefits; describe alternative methods of family planning and birth control; advise each patient that the sterilization procedure is considered irreversible; and offer a thorough explanation of the sterilization procedure to be preformed.