Godecker A L, Thomson E, Bumpass L L
Department of Sociology, University of Wisconsin-Madison, USA.
Fam Plann Perspect. 2001 Jan-Feb;33(1):35-41, 49.
Much of what is known about the choice of sterilization as a contraceptive method is based on data from married women or couples. Because of increasing rates of cohabitation, divorce and repartnering, however, the relationship context in which sterilization decisions are made has changed.
The 1995 National Survey of Family Growth includes the complete birth and union histories of 10,277 white, black and Hispanic women. The distribution of union status and marital history at the time of tubal sterilization was estimated for these three racial and ethnic groups among the 799 women who had had a tubal ligation in 1990-1995 before age 40. Cox proportional hazard regression models were used to estimate the effects of union status and marital history on the risk of tubal sterilization. The analysis controlled for the woman's age, parity, race and ethnicity education, region, experience of an unwanted birth and calendar period.
Among women who obtained a tubal sterilization, most whites (79%) and Hispanics (66%) were married when they had the operation, compared with only 36% of black women. At the time of their sterilization, 46% of black women had never been married. Among all women, regardless of race and ethnicity and net of all controls, the probability of tubal sterilization is about 25% lower for single, never-married women than for cohabiting or married women. Cohabitation does not reduce the likelihood in comparison to marriage, however. Higher rates of tubal sterilization among Hispanic women are accounted for by their higher parity at each age; differences in parity or marriage by race only partially account for the relatively higher rates of tubal sterilization among black women.
Because women currently spend greater proportions of their lives outside of marriage or in less-stable cohabiting partnerships than they did in the past, they are increasingly likely to make the decision to seek sterilization on their own. As a result, the gender gap in contraceptive sterilization will likely increase. The possibility of partnership change is an important consideration in choosing sterilization as a contraceptive method.
关于绝育作为一种避孕方法的选择，目前已知的很多信息都基于已婚女性或夫妻的数据。然而，由于同居、离婚和再婚率的上升，做出绝育决定时的关系背景已经发生了变化。
1995年全国家庭成长调查涵盖了10277名白人、黑人及西班牙裔女性完整的生育和伴侣关系史。在1990 - 1995年40岁之前接受输卵管结扎的799名女性中，估算了这三个种族和族裔群体在进行输卵管绝育时的伴侣关系状态和婚姻史分布情况。使用Cox比例风险回归模型来估算伴侣关系状态和婚姻史对输卵管绝育风险的影响。分析中控制了女性的年龄、生育次数、种族和族裔、教育程度、地区、意外生育经历以及日历时间。
在接受输卵管绝育的女性中，大多数白人（79%）和西班牙裔女性（66%）在手术时已婚，而黑人女性只有36%。在进行绝育时，46%的黑人女性从未结婚。在所有女性中，无论种族和族裔，在排除所有控制因素后，单身、从未结婚的女性进行输卵管绝育的概率比同居或已婚女性低约25%。然而，与婚姻相比，同居并不会降低这种可能性。西班牙裔女性输卵管绝育率较高是因为她们在每个年龄段的生育次数较多；不同种族在生育次数或婚姻状况上的差异只是部分解释了黑人女性输卵管绝育率相对较高的原因。
由于与过去相比，女性目前在非婚状态或不稳定同居关系中度过的生命比例更大，她们越来越有可能独自做出寻求绝育的决定。因此，避孕绝育方面的性别差距可能会加大。在选择绝育作为一种避孕方法时，伴侣关系变化的可能性是一个重要的考虑因素。
