The Decision For Sterilization
THE DECISION FOR STERILIZATION
The decision for sterilization is an important one and the patient should be fully informed about the procedure and its risks, effectiveness, and long-term implications (Box 25.1). Components of presterilization counseling should include:
· Permanent nature of the procedure
· Alternative methods available, including male sterilization
· Reasons for choosing sterilization
· Screening for risk indicators for regret
· Details of the procedure, including risks and benefits
· The possibility of failure, including ectopic pregnancy
· The need to use condoms for protection against sexu-ally transmitted diseases, including HIV
· Completion of informed consent process
· Local regulations regarding interval from time of con-sent to procedure
Despite careful counseling, approximately 10% to 15% of patients who undergo sterilization subsequently report regret, although only 1% actually request reversal of the procedure
Box 25.1
Risk Indicators for Regret About Decision for Sterilization
Age younger than 25 years at the time of sterilization Less access to, information about, or support for other contraceptive method use
Incomplete or inadequate information about the procedure
Making the decision under pressure from a spouse or because of medical indications
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