Do Health Insurance and Residence Pattern the Likelihood of Tubal Sterilization among American Women?

Bass, Loretta E.; Warehime, Mary Nicole

doi:10.1007/s11113-008-9082-9

Cited by 17 publications

(26 citation statements)

References 19 publications

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“…We computed these frequencies by women’s age, parity, educational attainment, race/ethnicity, and whether their delivery was paid by private insurance or Medicaid. All of these variables have been significantly associated with sterilization in previous studies using the NSFG [2,4,5,13]. …”

Section: Methodsmentioning

confidence: 94%

Reconsidering racial/ethnic differences in sterilization in the United States

White

Potter

2014

Contraception

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Objective Cross-sectional studies have found that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner’s vasectomy than women with higher incomes and whites. However, studies of pregnant and postpartum women report that racial/ethnic minorities, particularly low-income minority women, face greater barriers in obtaining a sterilization than do whites and those with higher incomes. In this paper, we address this apparent contradiction by examining the likelihood a woman gets a sterilization following each delivery, which removes from the comparison any difference in the number of births she has experienced. Study Design Using the 2006–2010 National Survey of Family Growth, we fit multivariable-adjusted logistic and Cox regression models to estimate odds ratios and hazard ratios for getting a postpartum or interval sterilization, respectively, according to race/ethnicity and insurance status. Results Women’s chances of obtaining a sterilization varied by both race/ethnicity and insurance. Among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. Privately insured whites were more likely to rely on vasectomy than African Americans and Latinas, but among women with Medicaid-paid deliveries reliance on vasectomy was low for all racial/ethnic groups. Conclusions Low-income racial/ethnic minority women are less likely to undergo sterilization following delivery compared to low-income whites and privately insured women of similar parities. This could result from unique barriers to obtaining permanent contraception and could expose women to the risk of future unintended pregnancies.

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Section: Methodsmentioning

confidence: 94%

Reconsidering racial/ethnic differences in sterilization in the United States

White

Potter

2014

Contraception

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“…In addition to age, other variables that we included in our analysis were women’s parity at the time of delivery, educational attainment, race/ethnicity, and payment source for delivery (i.e., private insurance, Medicaid), which have been associated with use of sterilization in other studies (Bass & Warehime, 2009; Borrero et al, 2007; Bumpass et al, 2000; Lunde, Rankin, Harwood, & Chavez, 2013; White & Potter, 2014). Women’s chances of undergoing sterilization also have been associated with her type of delivery and Body Mass Index (BMI), with women who have a Caesarian section (C-section) being more likely to get the procedure and obese women, particularly those having vaginal deliveries, being less likely to get sterilized (Allen, Desimone, & Boardman, 2013; Whiteman et al, 2012).…”

Section: Methodsmentioning

confidence: 99%

“…One possibility that has led to concern is that higher rates of female sterilization in the South may be due to the persistence of coercive practices targeting low-income and racial/ethnic minority women who are pressured into getting sterilized during labor and delivery, not informed that the procedure is permanent, or told they will not receive public benefits or medical care if they do not agree to be sterilized (Bass & Warehime, 2009; Kluchin, 2009; Schoen, 2005). However, the most recent documented case of women being coerced into sterilization occurred in California, not the South (Center for Investigative Reporting, 2013).…”

Section: Introductionmentioning

confidence: 99%

Geographic Variation in Characteristics of Postpartum Women Using Female Sterilization

White

Potter

Zite

2015

Women's Health Issues

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Background Southern states have higher rates of female sterilization compared to other areas of the United States, and the reasons for this are not well understood. We examined whether low-income and racial/ethnic minority women, who were previous targets of coercive practices, disproportionately report using sterilization in the South. Methods We used data from 12 states participating in the Pregnancy Risk Assessment Monitoring System that collected information on women’s contraceptive method use between 2006–2009. We categorized states according to geographic region: South, Midwest/West and Northeast. Within each region, we computed the percentage of women using sterilization according to their demographic and obstetric characteristics and estimated multivariable-adjusted prevalence ratios to evaluate whether the same characteristics were associated with sterilization use. Findings The percentage of postpartum women using sterilization ranged from 5.0–9.9% in the Northeast, 8.9–10.6% in the Midwest/West and 11.6–22.4% in the South. Women in nearly all sub-groups in Southern states were more likely to use sterilization than women in the Northeast. After multivariable adjustment, there were no significant differences in the prevalence of sterilization for Blacks compared to Whites in the Northeast (0.76 [95% CI: 0.55–1.06]), Midwest/West (0.91 [95%CI: 0.80–1.04]) and South (0.96 [95%CI: 0.85–1.07]). Women with Medicaid-paid deliveries (versus private insurance) had a higher prevalence of sterilization in all regions (p<0.05). Conclusions These findings do not indicate that low-income and racial/ethnic minority women in the South use sterilization at disproportionately higher rates compared to other regions, and suggest that other differences, such as social norms and family planning policies, may contribute to this geographic variation.

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“…Parity at the time of last wanted birth is strongly associated with sterilization (Bumpass et al 2000). Sterilizations are more common for women on Medicaid and for women living in rural areas (Bass and Warehime 2009). …”

Section: Introductionmentioning

confidence: 99%

Surgical sterilization, regret, and race: Contemporary patterns

Shreffler

McQuillan

Greil

et al. 2015

Social Science Research

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Surgical sterilization is a relatively permanent form of contraception that has been disproportionately used by Black, Hispanic, and Native American women in the United States in the past. We use a nationally representative sample of 4,609 women ages 25 to 45 to determine whether sterilization continues to be more common and consequential by race for reproductive-age women. Results indicate that Native American and Black women are more likely to be sterilized than non-Hispanic White women, and Hispanic and Native American women are more likely than non-Hispanic White women to report that their sterilization surgeries prevent them from conceiving children they want. Reasons for sterilization differ significantly by race. These findings suggest that stratified reproduction has not ended in the United States and that the patterns and consequences of sterilization continue to vary by race.

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Do Health Insurance and Residence Pattern the Likelihood of Tubal Sterilization among American Women?

Abstract: U.S., Tubal ligation, Insurance, Rural residence, Health disparity,

Cited by 17 publications

References 19 publications

Reconsidering racial/ethnic differences in sterilization in the United States

Reconsidering racial/ethnic differences in sterilization in the United States

Geographic Variation in Characteristics of Postpartum Women Using Female Sterilization

Surgical sterilization, regret, and race: Contemporary patterns

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