Chandra A
Vital Health Stat 23. 1998 Jun(20):1-33.
This report presents national data on the prevalence of surgical sterilization from 1965 to 1995 among women 15-44 years of age. Data are shown by type of sterilizing operation and demographic characteristics of the women. For the 1995 survey data, reasons for the three most common sterilizing operations (tubal ligation, vasectomy, and hysterectomy) are shown, as well as the desire for reversal among those with potentially reversible operations.
Data are based on nationally representative samples of women 15-44 years of age: the 1965 National Fertility Study (NFS), and the 1973, 1982, 1988, and 1995 cycles of the National Survey of Family Growth (NSFG).
After rising from 16 to 42 percent between 1965 and 1988, the prevalence of surgical sterilization among married women 15-44 years old remained stable at 41 percent in 1995. Age, parity, religious affiliation, and education continued to be strongly associated with overall surgical sterilization levels. Tubal ligation and vasectomy were equally prevalent in the 1965 and 1973 surveys, but since 1962, tubal ligation has been more prevalent than vasectomy.
Several factors contributed to the rise in reliance upon surgical sterilization among women 15-44 years old over the last 3 decades: (a) aging of the post-World War II Baby Boom women (and their partners) through the primary reproductive years; (b) relatively high contraceptive failure rates, particularly among socioeconomically less advantaged women; and (c) higher expectations for contraceptive effectiveness, safety, and convenience. Overall sterilization prevalence may be leveling off among women 15-44 years old, in part due to greater delay of first and subsequent births, thus making sterilization less of a concern while women are in this age range.
本报告呈现了1965年至1995年15至44岁女性中手术绝育流行率的全国数据。数据按绝育手术类型及女性人口特征展示。对于1995年的调查数据，列出了三种最常见绝育手术（输卵管结扎、输精管切除术和子宫切除术）的原因，以及接受可能可逆手术者的复通意愿。
数据基于15至44岁女性具有全国代表性的样本：1965年全国生育研究（NFS），以及1973年、1982年、1988年和1995年全国家庭成长调查（NSFG）周期的数据。
1965年至1988年间，15至44岁已婚女性的手术绝育流行率从16%升至42%，1995年保持稳定在41%。年龄、胎次、宗教信仰和教育程度继续与总体手术绝育水平密切相关。输卵管结扎和输精管切除术在1965年和1973年的调查中同样普遍，但自1962年以来，输卵管结扎比输精管切除术更普遍。
过去三十年里，有几个因素导致15至44岁女性对手术绝育的依赖增加：（a）二战后婴儿潮一代女性（及其伴侣）度过主要生育年龄；（b）避孕失败率相对较高，尤其是在社会经济地位较低的女性中；（c）对避孕有效性、安全性和便利性的期望更高。15至44岁女性的总体绝育流行率可能趋于平稳，部分原因是首次生育和后续生育的延迟增加，因此在这个年龄段女性中，绝育不再那么受关注。
