News | Study Finds More Unintended Pregnancies After Tubal Ligation Than Expected



News | Study Finds More Unintended Pregnancies After Tubal Ligation Than Expected


A recent University of California, San Francisco study found that tubal sterilization has a higher failure rate than expected. It suggested that women consider other contraceptive methods, such as a contraceptive implant or intrauterine device (IUD).


The study, published in NEJM Evidence, found that 3% to 5% of U.S. women who underwent tubal ligation later had an unintended pregnancy. Researchers suggested that implants or IUDs may be more effective for those who want to avoid pregnancy completely.


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Use and Limitations of Tubal Ligation

Tubal ligation is among the most common contraceptive methods in the United States, particularly among lower-income women and those with chronic conditions. National data show that 65% of women ages 15 to 49 use some form of contraception. More than 21% of women ages 30 to 39 use tubal ligation, rising to 39% among women over 40.


Although tubal ligation is intended to permanently end fertility, pregnancy can still occur. Based on earlier research, the American College of Obstetricians and Gynecologists had advised that pregnancy occurs in fewer than 1% of patients after the procedure.


For the new study, researchers analyzed four independent National Survey of Family Growth datasets collected from 2002 to 2015. More than 31,000 women participated, including 4,184 who reported having undergone tubal ligation.


Findings and Recommendations

Among women who underwent tubal ligation from 2013 to 2015, about 2.9% became pregnant within the first year. Pregnancy after tubal surgery was more likely in younger women.


Patients whose procedures were funded by Medicaid were no more likely to become pregnant than those with private insurance. The proportion reporting Medicaid-funded tubal ligation rose from 18% in 2002 to 36% in 2013–2015.


Dr. Eleanor Bimla Schwarz, chief of the UCSF Division of General Internal Medicine, said an unintended pregnancy can be extremely stressful for women who chose a “permanent” method, and that the situation is unfortunately relatively common.


The findings highlight the importance of understanding and comparing contraceptive effectiveness, particularly for long-acting and permanent methods. Women should discuss their options fully with a healthcare professional to determine the most suitable method.


Source:

Collected online


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