Esterilização cirúrgica feminina no Brasil, 2000 a 2006: aderência à lei de planejamento familiar e demanda frustrada¹

Caetano, André Junqueira

doi:10.1590/s0102-30982014000200005

Cited by 52 publications

(26 citation statements)

References 8 publications

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“…The attempt of dissociating sterilization from caesarian section has not yet succeeded among the general female population, even twenty years after the approval of the family planning law, as shown by recent studies [13;15;17]. In this sense, our study adds further challenges to both national and local health authorities.…”

Section: Final Remarksmentioning

confidence: 80%

“…Several studies have argued whether part of this decline is due to a decrease in demand for sterilization or to the requirements imposed by the Family Planning Law between 1996 and 2000 to obtain the procedure [15;33]. In the case of WLHIV, it is also possible to assume that this decrease contains an additional element: it may be related to the advent of ART and the success of the most effective antiretroviral regimens for prophylactic prevention of mother-to-child transmission [23].…”

Section: Discussionmentioning

confidence: 99%

“…Considering results from previous studies [15;16;30;32], the following independent variables were used to analyze the prevalence and the risk of obtaining female sterilization among WLHIV and WNLHIV: schooling at the time of the interview (incomplete elementary school and lower, complete elementary school and higher), race/color (brown “parda”, black “preta”, white “branca”), and parity at last delivery (1–2, 3+).…”

Section: Methodsmentioning

confidence: 99%

“…Female sterilization rates fell among married and cohabiting women between 15–44 years of age, from 38.5% in 1996 to 25.9% in 2006, while vasectomies increased from 2.8 to 5.1% [15–16]. The prevalence of hormonal oral contraceptive experienced a small increase, from 23.1% to 27.4%, and the use of condoms increased significantly during the period, from 4.6 in 1996 to 13% in 2006.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the legal impediments established by the law, female sterilization is still carried out in conjunction with caesarean section, which has remained the most prevalent childbirth method [17]. The procedure is more prevalent among women in older cohorts, with parity higher than two, with less schooling and among black women [13;15–16]. Women with less schooling tend to be sterilized without having used another contraceptive method and without reaching the ideal number of children [16].…”

Section: Introductionmentioning

confidence: 99%

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Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil

2016

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BackgroundIn many countries, young women of reproductive age have been especially affected by the HIV epidemic, which have fostered research to better understand how HIV infection influences and shapes women´s fertility and reproductive and sexual decisions. In Brazil, few studies have focused on the impact of the HIV epidemic on contraceptive choices among women living with HIV (WLHIV).ObjectiveThis study evaluates the impact HIV infection may have in the access to female sterilization in Brazil, using a time-to-event analysis.MethodsA cross-sectional quantitative study (GENIH study) was conducted between February 2013 and April 2014 in the city of São Paulo, comparing two probabilistic samples of 975 WLHIV and 1,003 women not living with HIV (WNLHIV) aged 18 to 49. Sexual and reproductive data was collected retrospectively in order to reconstruct women's reproductive trajectories. Given the objectives of this study, the analysis was restricted to women with parity one or more and, in case of WLHIV, to those sterilized after HIV diagnosis and not infected through vertical transmission. The final sample analysis included 683 WNLHIV and 690 WLHIV. A series of multivariable-adjusted Cox models estimated the probability of being sterilized after HIV diagnosis, compared with WNLHIV. Models were adjusted for schooling, race/color, and stratified by parity at last delivery (1–2, 3+). Hazard ratios were calculated for female sterilization, and separately for interval and postpartum procedures (performed in conjunction with caesarean section or immediately after vaginal delivery). Additionally, information regarding unmet demand for female sterilization was also explored.FindingsNo statistical difference in the overall risk of sterilization between WLHIV and WNLHIV in the two parity-related groups is observed: HR = 0.88 (0.54–1.43) and 0.94 (0.69–1.29), respectively, among women with 1–2 children and those with three and more. However, significant differences regarding the impact of HIV infection at sterilization are observed depending on the timing and the type of sterilization procedure. The probability of obtaining an interval sterilization is significantly lower for WLHIV compared to those not living with HIV. The reverse occurs regarding postpartum sterilization. Although sterilization is mainly performed in conjunction with caesarean section in Brazil, it is evident that caesarean sections are not the sole factor increasing the risk of sterilization among WLHIV.ConclusionThe results indicate barriers in the access to services offering interval sterilization for WLHIV and certain facilitation in obtaining the procedure in conjunction with caesarean section. Health policy makers at local and national levels should promote institutional changes in order to facilitate access to interval sterilization and to confront the sensitive discussion of WLHIV’s eligibility for postpartum sterilization. It is also urgent to increase access to a wider range of contraceptive methods for WLHIV and promote dual method protection stra...

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Section: Final Remarksmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil

2016

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Factors Associated with Female Sterilization in Brazil

Amaral

Potter

2020

The Springer Series on Demographic Methods and Population Analysis

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This study aims to investigate factors associated with female sterilization in Brazil. The analysis is innovative because it adds the time of exposure to the risk of sterilization into survival models. The models control for postpartum duration, age at delivery, parity at delivery, type of delivery, place of delivery, region of residence at the time of interview, color/race, and years of schooling at the time of interview. The main contribution of this analysis is to comprehend the effects of different birth intervals (postpartum duration) on the risk of a woman getting sterilized. Data is from the 2006 Brazilian National Survey on Demography and Health of Children and Women (PNDS). The strongest probability that sterilization might occur was observed among women who gave birth at private hospitals and received support from health insurance companies at childbirth. Female sterilization is also executed in combination with childbirth and cesarean section. The findings suggest that years of schooling do not predict the risk of sterilization. The higher chances of getting sterilized among black women are specific to the public sector at higher-order postpartum duration (interval sterilization).

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Concordance between intention to use and current use of contraceptives among six-month postpartum women in Brazil: The role of unplanned pregnancy

2018

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Esterilização cirúrgica feminina no Brasil, 2000 a 2006: aderência à lei de planejamento familiar e demanda frustrada¹

Cited by 52 publications

References 8 publications

Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil

Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study, Brazil

Factors Associated with Female Sterilization in Brazil

Concordance between intention to use and current use of contraceptives among six-month postpartum women in Brazil: The role of unplanned pregnancy

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