A Qualitative Study of Couples' Sterilization Perspectives

Male sterilization is a highly safe, efficacious, and cost effective form of birth control. Male sterilization has lower rates of complications and lower cost than female sterilization, however female sterilization is more common, particularly in black and Latino populations. This goal of this qualitative study was to investigate factors that shape sterilization decision making among black, Latino, and white women and men. We explored similarities and differences between racial groups on their sterilization perspectives. We conducted in-depth focus groups and individual interviews of self-reported long-term heterosexual couples between the ages of 25 and 55 who have reached their desired family size (n=72). Participants were black, Latino, or white. We found that among all racial/ethnic groups, both women and men reported that woman were responsible for introducing vasectomy into the family planning discussion. However, knowledge regarding sterilization was different between racial/ethnic groups. Among black and Latino participants, female sterilization was reported to be more reversible compared to male sterilization which was considered permanent. Black and Latino male participants also reported a lack of discussion about vasectomy with health care providers. In contrast, white participants reported male and female sterilization to be similarly permanent and some participants reported previous discussions about vasectomy with their health care providers. Routine counseling on vasectomy for any woman with a long-term male partner considering permanent birth control may increase introduction of male sterilization into contraceptive discussions. Vasectomy counseling and misconceptions about the reversibility of female sterilization should be targeted, particularly among blacks and Latinos.