Female sterilisation: is it what women really want?

OBJECTIVE To audit the effectiveness of a female sterilisation counselling clinic. DESIGN A prospective, observational study of a female sterilisation counselling clinic over a 6-month period to determine the proportions of attenders keeping their appointment, proceeding to sterilisation, and attending for surgery. SETTING A hospital-based, city centre family planning clinic run by permanent, family planning-trained staff. RESULTS A total of 226 women had appointments for female sterilisation counselling and most confirmed attendance. Only 153 (68%) women attended; of those 101 (66%) chose to be sterilised, the remainder choosing reversible contraception. Ninety-three (92%) women went ahead with the sterilisation procedure. Thus only 61% of the original attenders were sterilised; this was only 41% of those referred. CONCLUSIONS The study suggests that many women referred for sterilisation counselling fail to attend. This finding needs to be further explored. For those women who do attend, accurate information and informed counselling is important. Many women are still unaware of highly effective long-term reversible contraception, and following discussion decide against female sterilisation. Services offering counselling for female sterilisation should also be able to provide easy access to a full range of contraceptive methods.