Abstract
Discussion Forum (0)
Co-Author(s): Jessica Leigh Tarleton
Background: Postpartum sterilization is performed after close to 10% of all births in the US. Studies at other institutions have shown high rates of unfulfilled sterilization requests with an associated increase in unintended and short-interval pregnancy rates. The aim of this study was to identify risk factors for and barriers to immediate postpartum sterilization completion in our population. Methods: We performed a chart review of all patients who had a vaginal delivery at our institution from January 1, 2017 to December 31, 2017 and had at least one preceding prenatal care visit documenting a desire for immediate postpartum sterilization. Results: Of 132 patients who desired immediate postpartum sterilization, only 38 (28.8%) received the procedure prior to discharge. Of the 94 (71.2%) requests that went unfulfilled, the most common documented reasons for not performing the procedure were maternal body habitus (25), patients changing their mind (19), and mandated federal consent forms not being signed, mature, or available at the time of delivery (14). Only 18 of 72 (25%) patients who desired an interval sterilization surgery received it, with over one third of these patients not attending any postpartum clinic visit. Conclusion: Despite increasing literature supporting the safety and efficiency of immediate postpartum sterilization in patients with higher BMI, obesity remains the biggest barrier for achieving tubal ligation. We suggest interventions that improve provider comfort with postpartum sterilization surgeries in patients with higher BMI, improved individualized prenatal counseling about alternatives to sterilization, and promotion of immediate postpartum long-acting reversible contraceptive methods.
Background: Postpartum sterilization is performed after close to 10% of all births in the US. Studies at other institutions have shown high rates of unfulfilled sterilization requests with an associated increase in unintended and short-interval pregnancy rates. The aim of this study was to identify risk factors for and barriers to immediate postpartum sterilization completion in our population. Methods: We performed a chart review of all patients who had a vaginal delivery at our institution from January 1, 2017 to December 31, 2017 and had at least one preceding prenatal care visit documenting a desire for immediate postpartum sterilization. Results: Of 132 patients who desired immediate postpartum sterilization, only 38 (28.8%) received the procedure prior to discharge. Of the 94 (71.2%) requests that went unfulfilled, the most common documented reasons for not performing the procedure were maternal body habitus (25), patients changing their mind (19), and mandated federal consent forms not being signed, mature, or available at the time of delivery (14). Only 18 of 72 (25%) patients who desired an interval sterilization surgery received it, with over one third of these patients not attending any postpartum clinic visit. Conclusion: Despite increasing literature supporting the safety and efficiency of immediate postpartum sterilization in patients with higher BMI, obesity remains the biggest barrier for achieving tubal ligation. We suggest interventions that improve provider comfort with postpartum sterilization surgeries in patients with higher BMI, improved individualized prenatal counseling about alternatives to sterilization, and promotion of immediate postpartum long-acting reversible contraceptive methods.
Co-Author(s): Jessica Leigh Tarleton
Background: Postpartum sterilization is performed after close to 10% of all births in the US. Studies at other institutions have shown high rates of unfulfilled sterilization requests with an associated increase in unintended and short-interval pregnancy rates. The aim of this study was to identify risk factors for and barriers to immediate postpartum sterilization completion in our population. Methods: We performed a chart review of all patients who had a vaginal delivery at our institution from January 1, 2017 to December 31, 2017 and had at least one preceding prenatal care visit documenting a desire for immediate postpartum sterilization. Results: Of 132 patients who desired immediate postpartum sterilization, only 38 (28.8%) received the procedure prior to discharge. Of the 94 (71.2%) requests that went unfulfilled, the most common documented reasons for not performing the procedure were maternal body habitus (25), patients changing their mind (19), and mandated federal consent forms not being signed, mature, or available at the time of delivery (14). Only 18 of 72 (25%) patients who desired an interval sterilization surgery received it, with over one third of these patients not attending any postpartum clinic visit. Conclusion: Despite increasing literature supporting the safety and efficiency of immediate postpartum sterilization in patients with higher BMI, obesity remains the biggest barrier for achieving tubal ligation. We suggest interventions that improve provider comfort with postpartum sterilization surgeries in patients with higher BMI, improved individualized prenatal counseling about alternatives to sterilization, and promotion of immediate postpartum long-acting reversible contraceptive methods.
Background: Postpartum sterilization is performed after close to 10% of all births in the US. Studies at other institutions have shown high rates of unfulfilled sterilization requests with an associated increase in unintended and short-interval pregnancy rates. The aim of this study was to identify risk factors for and barriers to immediate postpartum sterilization completion in our population. Methods: We performed a chart review of all patients who had a vaginal delivery at our institution from January 1, 2017 to December 31, 2017 and had at least one preceding prenatal care visit documenting a desire for immediate postpartum sterilization. Results: Of 132 patients who desired immediate postpartum sterilization, only 38 (28.8%) received the procedure prior to discharge. Of the 94 (71.2%) requests that went unfulfilled, the most common documented reasons for not performing the procedure were maternal body habitus (25), patients changing their mind (19), and mandated federal consent forms not being signed, mature, or available at the time of delivery (14). Only 18 of 72 (25%) patients who desired an interval sterilization surgery received it, with over one third of these patients not attending any postpartum clinic visit. Conclusion: Despite increasing literature supporting the safety and efficiency of immediate postpartum sterilization in patients with higher BMI, obesity remains the biggest barrier for achieving tubal ligation. We suggest interventions that improve provider comfort with postpartum sterilization surgeries in patients with higher BMI, improved individualized prenatal counseling about alternatives to sterilization, and promotion of immediate postpartum long-acting reversible contraceptive methods.
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