Hispanic Women Need More Information About Long-Term Family Planning.

A new national survey of 274 Hispanic women between the ages of 25 – 49, conducted by International Communications Research (ICR) in February and March 2005,(1) reveals gaps in knowledge about female sterilization, the most widely used family planning method among women ages 35 – 44 and among married and formerly married women in the U.S.(2) The survey reveals that a high percentage of Hispanic women select female sterilization for long-term birth control without being informed of other long-term, reversible options.

“Family is the heart and soul of the Latina community. That is why it is important for women to understand all their family planning options so they can make the choice that is best for them. This survey clearly shows that more education is needed about highly effective and removable long-term contraceptives now available,” said Diana Ramos, M.D., assistant professor, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California. “For instance, nearly 65 percent of Hispanic women surveyed are unaware of a contraceptive option that is as effective as sterilization, yet is easily removed if she wants to have another baby. That alternative is Mirena, which is as effective as sterilization in preventing pregnancy for up to five years– without the permanence or risks of surgery.”

According to the survey, 42 percent of women believe that female sterilization is 100 percent effective in preventing pregnancy,(1a) but it is not (failure rate approximately five pregnancies per 1000 users).(4)

Mirena was the contraceptive choice for Gaby Madrigal, a clinical assistant at the University of Southern California and the mother of a four-year-old child. ”As the mother of a young child, and a full-time clinical assistant, I don’t have time to think about birth control. My doctor recommended Mirena, a long-lasting birth control option that is just as effective as sterilization, said Gaby. “My husband and I have not decided whether later we’ll want more children, but with Mirena, we still have that possibility,” added Gaby.

Reversal of Female Sterilization

While reversal may be possible in some instances, female sterilization is considered to be a permanent method of birth control by the medical community. Reversal requires complicated surgery and future pregnancies cannot be guaranteed. In addition, a number of women may not be able to pursue reversal surgery because they do not have enough of their fallopian tubes left in their reproductive tract as a result of certain sterilization procedures. What’s more, reversal surgery is costly and is not always covered by insurance.(5)

“Many women are not aware that the success rate of reversing sterilization is unpredictable,” said Dr. Ramos. “While women cannot control what life changes may occur over time – pressures of work life and second marriages – they can keep some control of their ability to have children. Because of the finality of the procedure, women who undergo sterilization should assume they are relinquishing that ability.”

The Regret Factor

The fact is nobody can predict what the future may hold – 43 percent of first marriages end in separation or divorce within 15 years, according to the National Center for Health Statistics.(6) While there are approximately 12.3 million women in the U.S. who are divorced, approximately 1.1 million of which are Hispanic,(7) many of them eventually remarry and want to have more children. Remarried women, women in new, committed relationships or women who have delayed having children for other reasons may wish to have children with their new partner. According to a previous survey of the general population(3), one in six women who were sterilized wish, at times, that they had left their options open.(3a) Three-quarters of these women regret their decision because they want to have a baby after all, might want a baby in the future or got remarried and want a baby with their new partner.(3b)

For those women who have undergone sterilization, however, having more children may be a considerable challenge or impossible.

“To reduce the risk of regret, women who are considering sterilization should speak with a healthcare provider for counseling and to learn about alternative long-term contraceptive options,” said Dr. Ramos.

(1a) International Communications Research (ICR) study conducted from February 15-March 2, 2005 including 274 Hispanic and Latino women between the ages of 25 and 49 years in the United States.

(2) Mosher, William D.,Ph.D; Martinez, Gladys M., Ph.D; Chandra, Anjani, Ph.D; Abma, Joyce C., Ph.D; Willson, Stephanie J., Ph.D. Use of Contraception and Use of Family Planning Services in the United States: 1982-2002; Advance Data From Vital and Health Statistics; number 350; December 10, 2004

(3a,b) International Communications Research (ICR) study conducted from January 14-25, 2005 including approximately 400 women between the ages of 25 and 49 years in the United States.

(4)Trussell J. Contraceptive failure in the United States: Contraception 70 (2004) 89-96.

(5) http://www.plannedparenthood.org/pp2/portal/medicalinfo/birthcontrol/pub-tubal-sterilization.xml#1096372855599:-3433870888775950819

(6) National Survey of Family Growth, a nationally representative sample of women age 15 to 44 in 1995. Bramlett, Matthew and William Mosher. “First marriage dissolution, divorce, and remarriage: United States,” Advance Data From Vital and Health Statistics; No.323. Hyattsville MD: National Center for Health Statistics: 2 1

(7) US Census Bureau. Marital Status by Sex, Unmarried-Partner Households, and Grandparents as Caregivers, 2000.