The long-term objective of the proposed study is to better understand the consequences of female sterilization in order to reduce negative sequelae.
The specific aims are to 1) determine if, during the first 5 post-surgical years, women undergoing tubal sterilization (TL) experience, physical (primarily menstrual disturbances and increased rates of hysterectomy) or psychosocial changes different from those experienced by control subjects, i.e. vasectomy wives (VAS) and women not planning sterilization (NPS); 2) identify and characterize these changes; 3) compare patterns of regret experienced by TL and VAS subjects; 4) identify antecedents for changes and regret and construct a screening instrument to identify women at high risk for regret; 5) determine contributions made by husbands to female regret and those made by wives to male regret and 6) identify antecedents to the timing and choice of male or female sterilization among NPS women who subsequently select sterilization. Initial (pre-sterilization) and 2 years of follow-up data were obtained during the original study. The proposed study will 1) continue to follow the same women to identify late-appearing sequelae and determine if trends appearing in the first 2 follow-up years persist or change and 2) obtain data from husbands to better understand their role in the decision-making process and its impact on regret. Attrition in the original study has been very low, has affected all groups equally, and is anticipated to be even lower during the continuation study. A sample of over 600 women and 500 men is anticipated at the study's conclusion. Third- and fourth-year follow-up for female subjects will consist of shortened telephone interviews followed by a full home interview in Year 5. Male partners will be mailed self-administered questionnaires. Data analysis will focus on measuring changes in each group between initial intake and follow-up year(s) and then comparing such changes across groups, using multivariate analyses of variance. Antecedents to change will be determined through multiple regression and multiple classification analyses. Discriminant function analysis will be used to construct the screening instrument. Results of this study will: 1) provide patient and physician with needed information regarding likely physical and psychosocial consequences of sterilization so that informed decisions can be made and 2) help identify women at high risk for regret, and thus in need of special pre-surgical counseling.
