Exploring Factors in the Decision to Choose Sterilization vs Alternatives in Rural El Salvador

Miriam L. Cremer, MD, MPH; Erica Holland, BA; Maritza Monterroza, MA; Sonia Duran, MPH; Rameet Singh, MD, MPH; Heather Terbell, MD; Alison Edelman, MD, MPH


Medscape J Med. 2008;10(8):183 

In This Article


Context: To explore the factors that influence rural Salvadoran women to undergo tubal sterilization versus opting for alternative methods of family planning.
Evidence Acquisition: A moderator fluent in English and Spanish conducted eleven 90-minute focus groups consisting of 5-10 women each. Eligible women in the municipality of San Pedro Perulapan, El Salvador, were identified and recruited by local health workers. Participant demographics and information about family planning decisions were collected through detailed notes and tape-recorded sessions. The tapes were transcribed verbatim, and all data were analyzed using grounded theory procedures to identify common themes.
Evidence Synthesis: Eighty women aged 24-45 years who had previously been sterilized participated in the study. Three major themes influenced a woman's decision to undergo sterilization instead of opting for alternative forms of family planning: (1) availability: tubal sterilization is readily available, (2) fears about side effects of other methods: these women associated negative side effects with other forms of family planning, (3) effectiveness: the women in these focus groups thought sterilization was more effective than other forms of family planning.
Conclusions: This study shows that there is a lack of information, and misinformation, about other effective methods of contraception, especially the intrauterine device and oral contraceptives. Reproductive health education projects, especially those providing services in locations similar to rural El Salvador, should focus on providing accurate information about all forms of contraception, including tubal sterilization.

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