Puerperal tubal ligation in Cape Town.

Major changes have occurred in the nature of the obstetric population under the care of the Department of Obstetrics and Gynaecology in Cape Town between 1974 and 1978. In the Coloured group, a settled population, these changes were: a decrease in the number of teenage deliveries, a shift from the very young to the older teenage patient, and a decrease in the number of elderly obstetric patients and of grand multiparas. Puerperal sterilization virtually doubled during this period. Similar trends in Black and White patients must be interpreted with caution since the former constitutes a shifting population and the latter are not representative of White obstetric practice in Cape Town. Family planning education and the greater acceptance of voluntary sterilization have contributed to the declining numbers of socially and obstetrically disadvantaged patients.