Poststerilization regret: Findings from the United States collaborative review of sterilization

Objective: To evaluate the cumulative probability of regret after tubal ste rilization, and to identify risk factors for regret that are identifiable b efore sterilization. Methods: We used a prospective, multicenter cohort study to evaluate the cu mulative probability of regret within 14 years after tubal sterilization. P articipants included 11,232 women aged 18-44 years who had tubal sterilizat ions between 1978 and 1987. Actuarial life tables and Cox proportional haza rds models were used to identify those groups at greatest risk of experienc ing regret. Results: The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal sterilization was 20.3% for women ag ed 30 or younger at the time of sterilization and 5.9% for women over age 3 0 at sterilization (adjusted relative risk [RR] 1.9; 95% confidence interva l [CI] 1.6, 2.3). For the former group, the cumulative probability of regre t was similar for women sterilized during the postpartum period (after cesa rean, 20.3%, 95% CI 14.5, 26.0; after vaginal delivery, 23.7%, 95% CI 17.6, 29.8) and for women sterilized within 1 year after the birth of their youn gest child (22.3%, 95% CI 16.4, 28.2). For women aged 30 or younger at ster ilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased (2-3 years, 16.2%, 95% CI 11.4, 21.0 ; 4-7 years, 11.3%, 95% CI 7.8, 14.8; 8 or more years, 8.3%, 95% CI 5.1, 11 .4) and was lowest among women who had no previous births (6.3%, 95% CI 3.1 , 9.4). Conclusion: Although most women expressed no regret after tubal sterilizati on, women 30 years of age and younger at the time of sterilization had an i ncreased probability of expressing regret during follow-up interviews withi n 14 years after the procedure.