Obstetrician–gynecologists’ counseling regarding postpartum sterilization
Kavita Shah Arora,1 Neko Castleberry,2 Jay Schulkin2,3 1Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; 2Research Department, The American College of Obstetricians and Gynecologists, Washington, DC, USA; 3Department of Obstet...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-08-01
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| Series: | International Journal of Women's Health |
| Subjects: | |
| Online Access: | https://www.dovepress.com/obstetrician-gynecologists-counseling-regarding-postpartum-sterilizati-peer-reviewed-article-IJWH |
| _version_ | 1819298511991078912 |
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| author | Arora KS Castleberry N Schulkin J |
| author_facet | Arora KS Castleberry N Schulkin J |
| author_sort | Arora KS |
| collection | DOAJ |
| description | Kavita Shah Arora,1 Neko Castleberry,2 Jay Schulkin2,3 1Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; 2Research Department, The American College of Obstetricians and Gynecologists, Washington, DC, USA; 3Department of Obstetrics and Gynecology, University of Washington, School of Medicine, Seattle, WA, USA Introduction: Obstetrician–gynecologists (ob-gyns) play a prominent role in counseling patients regarding sterilization, offering alternative contraception, fulfilling sterilization requests, and referring patients if unable to provide the service due to a personal moral belief. Therefore, we sought to better characterize the counseling practices of ob-gyns with respect to postpartum sterilization. Materials and methods: This is a prospective, electronic survey-based study of 1,000 ob-gyn members of the American College of Obstetricians and Gynecologists, half of whom are members of the Collaborative Ambulatory Research Network. Results: A total of 188 of 957 surveyed physicians (19.6%) opened and responded to the survey, after accounting for exclusions. Age (31.9%), body mass index (28.7%), and medical history (27.1%) were the three most frequent reasons for an ob-gyn reported declining to perform sterilization in a patient requesting sterilization. Medical history (36.2%), parity (31.9%), and availability of alternative contraception (27.7%) were the three most frequent reasons that an ob-gyn reported recommending postpartum sterilization in a patient not requesting sterilization. Conclusion: Our study has identified both medical and nonmedical factors that impact ob-gyns likelihood to recommend either toward or against postpartum sterilization. Nonmedical factors included clinical logistical issues such as availability of the operating room as well as considerations of a patient’s age, parity, gestational age at delivery, and whether the husband was in agreement. Physicians should be cautious of inappropriately blending medical decision-making with paternalistic counseling. Keywords: postpartum sterilization, contraception, counseling, patient–physician relationship, bias |
| first_indexed | 2024-12-24T05:31:04Z |
| format | Article |
| id | doaj.art-e66a3e351dbf472883f79a5cc2b4eb85 |
| institution | Directory Open Access Journal |
| issn | 1179-1411 |
| language | English |
| last_indexed | 2024-12-24T05:31:04Z |
| publishDate | 2018-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Women's Health |
| spelling | doaj.art-e66a3e351dbf472883f79a5cc2b4eb852022-12-21T17:13:10ZengDove Medical PressInternational Journal of Women's Health1179-14112018-08-01Volume 1042542939822Obstetrician–gynecologists’ counseling regarding postpartum sterilizationArora KSCastleberry NSchulkin JKavita Shah Arora,1 Neko Castleberry,2 Jay Schulkin2,3 1Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA; 2Research Department, The American College of Obstetricians and Gynecologists, Washington, DC, USA; 3Department of Obstetrics and Gynecology, University of Washington, School of Medicine, Seattle, WA, USA Introduction: Obstetrician–gynecologists (ob-gyns) play a prominent role in counseling patients regarding sterilization, offering alternative contraception, fulfilling sterilization requests, and referring patients if unable to provide the service due to a personal moral belief. Therefore, we sought to better characterize the counseling practices of ob-gyns with respect to postpartum sterilization. Materials and methods: This is a prospective, electronic survey-based study of 1,000 ob-gyn members of the American College of Obstetricians and Gynecologists, half of whom are members of the Collaborative Ambulatory Research Network. Results: A total of 188 of 957 surveyed physicians (19.6%) opened and responded to the survey, after accounting for exclusions. Age (31.9%), body mass index (28.7%), and medical history (27.1%) were the three most frequent reasons for an ob-gyn reported declining to perform sterilization in a patient requesting sterilization. Medical history (36.2%), parity (31.9%), and availability of alternative contraception (27.7%) were the three most frequent reasons that an ob-gyn reported recommending postpartum sterilization in a patient not requesting sterilization. Conclusion: Our study has identified both medical and nonmedical factors that impact ob-gyns likelihood to recommend either toward or against postpartum sterilization. Nonmedical factors included clinical logistical issues such as availability of the operating room as well as considerations of a patient’s age, parity, gestational age at delivery, and whether the husband was in agreement. Physicians should be cautious of inappropriately blending medical decision-making with paternalistic counseling. Keywords: postpartum sterilization, contraception, counseling, patient–physician relationship, biashttps://www.dovepress.com/obstetrician-gynecologists-counseling-regarding-postpartum-sterilizati-peer-reviewed-article-IJWHpostpartum sterilizationcontraceptioncounselingpatient-physician relationshipbias |
| spellingShingle | Arora KS Castleberry N Schulkin J Obstetrician–gynecologists’ counseling regarding postpartum sterilization International Journal of Women's Health postpartum sterilization contraception counseling patient-physician relationship bias |
| title | Obstetrician–gynecologists’ counseling regarding postpartum sterilization |
| title_full | Obstetrician–gynecologists’ counseling regarding postpartum sterilization |
| title_fullStr | Obstetrician–gynecologists’ counseling regarding postpartum sterilization |
| title_full_unstemmed | Obstetrician–gynecologists’ counseling regarding postpartum sterilization |
| title_short | Obstetrician–gynecologists’ counseling regarding postpartum sterilization |
| title_sort | obstetrician ndash gynecologists rsquo counseling regarding postpartum sterilization |
| topic | postpartum sterilization contraception counseling patient-physician relationship bias |
| url | https://www.dovepress.com/obstetrician-gynecologists-counseling-regarding-postpartum-sterilizati-peer-reviewed-article-IJWH |
| work_keys_str_mv | AT aroraks obstetricianndashgynecologistsrsquocounselingregardingpostpartumsterilization AT castleberryn obstetricianndashgynecologistsrsquocounselingregardingpostpartumsterilization AT schulkinj obstetricianndashgynecologistsrsquocounselingregardingpostpartumsterilization |