A tree-bark and its pilgrimage through history.

Tubal sterilization is a highly effective, permanent, andsafe method of contraception. Many women who desirepostpartum sterilization do not obtain the procedure dueto barriers. We performed a retrospective cohort studyexamining patients from a single obstetrics practice whodelivered between 1/1/07 and 6/30/07 at Women and In-fants Hospital in Providence, RI. During the study period,626 women in the practice delivered. Of these subjects,87 (14%) desired postpartum sterilization. Of these 87,45 (51.7%) underwent sterilization as planned. In multi-variable analysis controlling for age, BMI, delivery modeand marital status, older age (OR 2.15, 95% CI 1.12, 4.12,p=0.02)and cesarean delivery (OR 19.65, 95% CI 3.75,103.1, p < 0.001)were associated with completion of post-partum sterilization and being married (OR 0.10, 95% CI0.02, 0.56, p=0.009)and having a higher BMI (OR 0.60, 95%CI 0.39, 0.91, p=0.02)were associated with incompletion.Only half of women who request postpartum sterilizationantenatally end up obtaining the procedure. keywords: postpartum sterilization, barriers, contra-ception, unintended pregnancy introductionTubal sterilization is a highly effective, permanent, and safemethod of contraception. Tubal sterilization is the secondmost common method of contraception used by womenin the United States and the most common among womenover 30 years of age.1 Approximately half of all tubal steril-izations are performed in the immediate postpartum period,following nearly 10% of all births in the United States.2 Post-partum tubal sterilization can be performed during cesareansection or after vaginal delivery through a minilaparotomy.The procedure is convenient for the mother as she is alreadyin the hospital for the delivery. Sterilizations after vaginaldelivery are performed through a small infra-umbilical inci-sion as the enlarged postpartum uterus facilitates access tothe fallopian tubes. The procedure can be performed from r h o d e I s l a n d m e d I c a l j o u r n a lF E B RUA RY 2 0 1 3 32contriButions