Understanding Sterilization Regret in the United States: The Role of Relationship Context

• Author: Mieke C. W. Eeckhaut,Megan M. Sweeney
• Published date: 01 October 2018
• Date: 01 October 2018
• DOI: http://doi.org/10.1111/jomf.12500

M C. W. E University of Delaware

M M. S University of California, Los Angeles∗

Understanding Sterilization Regret in the United

States: The Role of Relationship Context

Although one fourth of sterilized reproductive-

aged women in the United States express a

desire to have their sterilization procedures

reversed, the pathways leading to sterilization

regret remain insufciently understood. Partic-

ularly little is known about how cohabitation

affects the likelihood of sterilization regret. This

study used data from the 2006 to 2010 National

Survey of Family Growth to investigate how

relationship context shapes women’s risk of

sterilization regret. Our ndings point to higher

levels of regret among women who were cohab-

iting, rather than married or single at the time

of sterilization. Experiencing poststerilization

union dissolution or poststerilization union

formation was also associated with an elevated

risk of regret. Together, poststerilization union

instability and selected background character-

istics largely explained elevated levels of regret

observed among women who were cohabiting at

the time of sterilization. An association between

regret and poststerilization union instability

persisted, however, even when socioeconomic

Department of Sociology and Criminal Justice, University

of Delaware, 309 Smith Hall, 18 Amstel Ave.,Newark, DE

19716 (eeckhaut@udel.edu)

∗Department of Sociology & California Center for

Population Research, University of California, Los

Angeles, 202 Haines Hall, 375 Portola Plaza, Los Angeles,

CA 90095.

Key Words: cohabitation, fertility, health disparities, rela-

tionship dissolution, reproductive health.

and reproductive background factors were

controlled.

In the contemporary United States, one in

four women using contraception relies on

female sterilization, making it the second most

prevalent method of contraception (Daniels,

Daugherty, & Jones, 2014). Because of its per-

manent character—reversal surgery is invasive,

expensive, and not necessarily successful—

sterilization is often thought of as a method

used only by married partners. Yet steriliza-

tion has long been common among unmarried

women (Bumpass, Thomson, & Godecker,

2000), with cohabiting women as likely as

rst-married women to become sterilized in the

contemporary United States (Eeckhaut, 2015).

Although contraceptive sterilization has

improved the lives of many women and their

families, a surprisingly large share of women

express regret regarding having become steril-

ized. In 2002, nearly one in four women with

unreversed tubal ligations expressed a desire to

have their sterilizations reversed (Borrero et al.,

2008). Nationally representative studies indicate

that being age 30 or younger at sterilization is

a key risk factor for desiring a reversal (Borrero

et al., 2008; Grady et al., 2013; Henshaw &

Singh, 1986). Although the results vary across

studies, other sociodemographic and reproduc-

tive correlates of sterilization regret include low

parity (Schrefer, McQuillan, Greil, & Johnson,

2015), early childbearing (Grady et al., 2013),

a history of unintended pregnancy (Grady et al.,

Journal of Marriage and Family 80 (October 2018): 1259–1270 1259

DOI:10.1111/jomf.12500