Socio-Economic Trends in Tubal Sterilization Among U.S. Women

Background and Purpose: Tubal sterilization is a popular method of contraception among aged 30-49. It is the second most commonly and frequently used form of contraception, a trend that has remained stable over decades. While there has been research on trends in tubal sterilization and its associations with factors such as race/ethnicity, education, insurance among others, there is limited research on how income influences women’s decision to undergo the procedure. The study aims to fill this gap by providing evidence in support of tubal sterilization trends among women aged 30-49 based on their income while controlling for age, race/ethnicity, insurance coverage, religious affiliation, and educational status.

Methods: We use the 2017-2019 National Survey of Family Growth (NSFG) and use an analytical sample of (N = 6137) women. The dependent variable is whether the respondent underwent tubal sterilization (Yes = 0 and No = 1), regardless of reversal. The independent variable was family income which was recoded into two categories of below median income = 0 and above median income = 1. The control variables were age, race, religion, insurance status and educational status. Race was measured by asking respondents if they identified as Non-white = 0 and White = 1. Religion was measured by asking respondents if they identified as someone with affiliation to Protestantism and who did not (Other Faith = 0 Protestant =1). Insurance status was a recoded into No = 0 and Yes = 1 and educational status was recoded into two categories, No college degree = 0 and College degree = 1. Data was analyzed using a binary logistic regression on SPSS V 28.0.0.

Results: Using the NSFG, we find that below median income is a significant predictor of whether women chose to undergo sterilization. Respondents who had a combined family income less than $60,000 were 35% less likely to choose tubal sterilization. Age was negatively associated wherein women who were in the age group of 30-49 were more likely to undergo the procedure. Race, insurance coverage, religious affiliation, and educational status were found to be significantly associated with the decision to undergo the procedure.

Conclusions and Implications: Our findings are indicative of fact that sterilization remains a prominent method of contraception among women aged 30-49 and there are socio-economic differences in sterilization patterns which are integral to build on research on sterilization among women. The study provides evidence to social work practitioners in the reproductive health field particularly those who are involved in providing family planning and counselling services.