PROGNOSTIC FACTORS FOR PREOPERATIVE CONSULTATION OF WOMEN DESIRING STERILIZATION - FINDINGS OF A RETROSPECTIVE ANALYSIS

In this exploratory study, 37 sterilized women applying for sterilizat ion reversal were questioned thoroughly to establish why they had deci ded to undergo sterilization and why they now wished for it to be reve rsed. Taking an interactive behavioral model as our starting point, we concentrated on the psychosocial circumstances leading to the definit ive decision to be sterilized. A relationship crisis at the time of st erilization was found to be a prognostically unfavorable factor. Furth ermore, 20 of the 37 patients cited new partnerships as their main rea son for seeking reversal. Those who felt pressurized by their gynecolo gist or partner into undergoing sterilization had significantly more p roblems in overcoming the psychological stress accompanying such an op eration than those who, through a series of consultations on contracep tion, had had sufficient time and opportunity to make their own decisi ons. Sterilization performed for medical reasons was found to have par ticularly problematical consequences, especially where the doctor had made the decision largely on his own, failing to give an adequate expl anation for the medical necessity of the operation. Regarding the time chosen for sterilization, the study revealed that the patient's posto perative psychological condition was significantly worse when steriliz ation was carried out immediately after a delivery, after abortion or after Caesarean section, rather than in the interval between pregnanci es. The resulting increase in the incidence of psychosomatic complaint s and depressive states is also confirmed in the literature. The findi ngs of this study offer practical suggestions for improved preoperativ e consultation and should help to determine the course of action to be taken when a patient wishes to be sterilized.