Background Postpartum sterilization in Thailand has relatively few barriers compared to other countries. The procedure is covered by some healthcare plans, and paid out-of-pocket for others. We aim to determine if healthcare coverage and other socioeconomic factors affect the rate of postpartum sterilization in an urban, tertiary hospital. Methods We conducted a secondary analysis of data from a retrospective cohort of 4482 postpartum women who delivered at our hospital. Multivariable logistic regression was conducted to determine if sterilization reimbursement affects immediate postpartum sterilization rate. Results Overall immediate postpartum sterilization rate was 17.8%. Route of delivery and parity were similar in those who were reimbursed and those who were not. Women aged over 25 were more likely to have a healthcare plan that does not cover postpartum sterilization. Women whose healthcare plan reimbursed the procedure trended towards postpartum sterilization when compared to women who were not (aOR 1.05, 95% CI 0.86–1.28, p-value = 0.632). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.87; 95% CI 4.77–7.24, p-value = < 0.001). Women aged 40–44 years were 2.70 times as likely to choose sterilization than those aged 20–24 years (aOR = 2.70; 95% CI 1.61–4.53, p-value < 0.001). Conclusions Healthcare coverage of the procedure was not associated with increased postpartum sterilization in our setting.

Background Postpartum sterilization in Thailand has relatively few barriers and is partially covered by different healthcare plans. We aim to determine if healthcare plans or other demographic factors affect sterilization rate in a tertiary urban hospital. Methods We conducted a secondary analysis of a cohort of 4,482 postpartum women from previous data comparing contraception during and before the COVID-19 pandemic. Results Overall immediate postpartum sterilization rate was 17.8%. Those whose healthcare covered the procedure trended toward postpartum sterilization (OR = 1.11; 95%CI = 0.94–1.31). Women aged 40–44 years were 8.53 times as likely to choose sterilization than those aged 20–24 years (aOR = 2.74; 95%CI = 1.63–4.60). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.78; 95%CI = 4.69–7.12). Women having their second or third child were more likely to undergo postpartum sterilization than those having their first child. Conclusions In conclusion, we found that age, parity, and route of delivery were associated with higher sterilization rates. Healthcare coverage was not associated with increased immediate postpartum sterilization in our setting.