Factors associated with family planning and vasectomy discussions: Results from a state-wide health provider survey

INTRODUCTION: Despite the relative advantages of vasectomy over tubal ligation, vasectomy is underutilized in the United States. Increased vasectomy uptake in the population may depend on the ability and willingness of health care providers to reorient men towards the positive aspects of vasectomy. Our study aimed to: 1) describe provider knowledge and attitudes regarding sterilization and 2) identify provider-related factors associated with discussions of family planning and vasectomy. METHODS: A one-time survey was mailed to a statewide sample of health care providers in the fields of internal medicine, family medicine, and obstetrics/gynecology. In addition to providing demographic information, providers reported on sterilization knowledge, patient resistance to vasectomy, and provider experiences discussing family planning. RESULTS: Of the providers who completed surveys (N=67), a greater proportion believed vasectomy to be underutilized (83.9%) compared to tubal ligation (23.9%). The most common reasons that providers felt their patients were disinclined to vasectomy included aversion to surgical procedure, desire for more children, satisfaction with other methods of contraception, and concerns about masculinity and sex life. T-tests revealed that compared to other providers, family medicine providers were more likely to discuss vasectomy (p=.013) and family planning (p<.001) with their male patients. In addition, compared to female providers, male providers were less likely to discuss family planning (p=.002) with their female patients. CONCLUSION: Our data suggest that provider gender (female) and specialization (family medicine) may be related to rates of family planning discussion. Further research may better characterize the provider and patient related factors preventing vasectomy uptake.