{"title":"Sterilization, Infecundity, and Reproductive Autonomy in Rural, Suburban, and Urban America: Results From a National Survey.","authors":"Shelley Clark, Zoe Levy","doi":"10.1111/psrh.70006","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Rural women are significantly more likely than urban women to be sterilized. This study aims to understand why rural women depend so heavily on this method of fertility control, whether they are more likely than suburban and urban women to desire sterilization reversal, and the impact of female sterilization on rural women's ability to achieve their fertility goals.</p><p><strong>Methods: </strong>Data from 10,081 sexually active women aged 15 to 49, who participated in the National Survey of Family Growth (2015-2019), were analyzed using binary and multinomial logistic regression analyses. Unadjusted and adjusted predicted probabilities were calculated to estimate the prevalence of (1) female sterilization, (2) desire for sterilization reversal or wanting a(nother) child if sterilized, and (3) unwanted infecundity among rural, suburban, and urban women.</p><p><strong>Results: </strong>Rural women (24.2%) are substantially more likely than suburban (15.3%) or urban (13.9%) women to receive tubal ligation. These disparities are not explained by women's demographic, reproductive, religious, and socioeconomic characteristics. Rural women who are sterilized are not more likely than suburban or urban women to desire sterilization reversal or to want to have (more) children. However, because more rural women rely on tubal ligation, a significantly higher fraction of rural women (34.8%) than urban women (23.8%) who want to have a(nother) child are infecund. Roughly, 40% of infecund rural women who wish to conceive had tubal ligation.</p><p><strong>Conclusions: </strong>Limited contraceptive choice undermines rural women's ability to conceive wanted births. These results highlight another important reason for expanded reproductive health care in rural America.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perspectives on Sexual and Reproductive Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/psrh.70006","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DEMOGRAPHY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Rural women are significantly more likely than urban women to be sterilized. This study aims to understand why rural women depend so heavily on this method of fertility control, whether they are more likely than suburban and urban women to desire sterilization reversal, and the impact of female sterilization on rural women's ability to achieve their fertility goals.
Methods: Data from 10,081 sexually active women aged 15 to 49, who participated in the National Survey of Family Growth (2015-2019), were analyzed using binary and multinomial logistic regression analyses. Unadjusted and adjusted predicted probabilities were calculated to estimate the prevalence of (1) female sterilization, (2) desire for sterilization reversal or wanting a(nother) child if sterilized, and (3) unwanted infecundity among rural, suburban, and urban women.
Results: Rural women (24.2%) are substantially more likely than suburban (15.3%) or urban (13.9%) women to receive tubal ligation. These disparities are not explained by women's demographic, reproductive, religious, and socioeconomic characteristics. Rural women who are sterilized are not more likely than suburban or urban women to desire sterilization reversal or to want to have (more) children. However, because more rural women rely on tubal ligation, a significantly higher fraction of rural women (34.8%) than urban women (23.8%) who want to have a(nother) child are infecund. Roughly, 40% of infecund rural women who wish to conceive had tubal ligation.
Conclusions: Limited contraceptive choice undermines rural women's ability to conceive wanted births. These results highlight another important reason for expanded reproductive health care in rural America.
期刊介绍:
Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.