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Contraceptive Sterilization

Key Highlights

  • Well over 20 percent of couples in 20 countries use sterilization to preclude future childbearing, making the medical procedure the number one method of contraception worldwide. In eleven of these countries, including the United States, sterilization prevalence ranges from one third to almost one half of all couples in their reproductive years.
  • Sterilization protects approximately 222 million women and men of reproductive age from unintended pregnancies. 180 million women have elected tubal ligation while nearly 43 million men have chosen vasectomy to safely limit family size.
  • Puerto Rico, the Republic of Korea, China, Canada, and Brazil show the highest prevalence of sterilization around the world, ranging from 49 percent down to 43 percent.
  • Other high-ranking countries include the Dominican Republic (41%), the United States (39%), El Salvador (32%), the United Kingdom (32%), and India (30%).
  • China and India, which contain over 1/3 of the world's population, account for 75 percent of the world's total number of sterilization users.
  • Numbers of women choosing sterilization each year are highest in Latin America and the Caribbean and lowest in Eastern Europe, North Africa, and the Middle East.
  • Many regional sterilization trends observed in 1985 remain similar in 2002. Asia, Latin America, and parts of North America and Western Europe still show high and in many cases growing sterilization prevalence, with the largest increases recorded in Brazil and the Dominican Republic. In these countries, and in Colombia, Mexico, and Nicaragua, prevalence has increased by at least eight percentage points within a 10-year period.
  • In Japan, sterilization rates declined by about six percent over an 8-year period. Explanations for the decline include restrictive policies, high rates of both abortion and condom use, and an aging population.
  • In countries with high prevalence, women average 30 years of age when electing the procedure.
  • In many parts of Asia, Latin America and the Caribbean, about half of all sterilized women have three to four children. In China and the United States, half have two or fewer children. In Africa, more than half have five or more children.
  • In Asia and sub-Saharan Africa, most sterilization users reside in rural areas. In Latin America and the Caribbean, North Africa, and North America, most users live in urban settings.
  • Female sterilization is one of the safest operative procedures, with complications occurring in fewer than 1 percent of all clients.
  • Among women living in 19 developing countries, more than 50 percent of women using female sterilization never used any other modern contraceptive.
  • Male sterilization rates are highest in parts of Western Europe, in North America, and in Asia.
  • Vasectomy does not appear to have any significant long-term negative physical or mental health effects on men. Well-designed epidemiological studies have consistently shown the procedure to be associated with no elevated risks of heart disease, testicular or prostate cancer of immune complex disorders.
  • For female sterlization users, there is no evidence of post sterilization syndrome (alteration in menstrual cycles or length in menstrual pain).
  • Sterilization users frequently cite finances or family size as the reason for seeking sterilization, though problems with other contraceptive methods, health and medical factors, and method failure are also attributed as widespread reasons for choosing permanent contraception.
  • 20 out of 28 countries that restricted sterilization in 1985 have now made access easier by removing barriers to the service.
  • Twenty-five countries require the consent of a spouse, parent, guardian, physician, or committee before some sterilization procedures are performed. Twenty-four countries require that men and women are of a certain age or have a certain number of children prior to sterilization.

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