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Carolyn Westhoff - One of the best experts on this subject based on the ideXlab platform.
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tubal Sterilization trends in the united states
Fertility and Sterility, 2010Co-Authors: Lolita M Chan, Carolyn WesthoffAbstract:Objective To review the rate, setting, and demographic characteristics of tubal Sterilization and its current trend within contraceptive practice in the United States. Design Review of U.S. health care statistics, NCHS publications, English-language literature searched using MEDLINE and PubMed, and bibliographies of key references. Result(s) Total annual cases of tubal Sterilization have declined from 687,000 in 1995 to 643,000 in 2006, despite a 4% population growth. Interval Sterilizations decreased by 12%. Postpartum Sterilizations remained stable and follow 8%–9% of all live births. Tubal Sterilizations remain more common in black and Hispanic women; women with lower income, lower education, and higher parity; and among women living in the South. From 1981 to 1995, inpatient interval Sterilizations fully migrated to ambulatory surgery care. Conclusion(s) After two decades of stable rates, there is a recent decline in Sterilization. Improved access to a wide range of highly effective reversible contraceptives gives women flexibility when deciding how to manage their reproductive ability.
V. Thieme - One of the best experts on this subject based on the ideXlab platform.
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Gedemütigt, entwürdigt, verstümmelt – die „rassenhygienische Ausmerze“ der Lippen-Kiefer-Gaumenspalten. Studie zur Situation der Betroffenen und zur Position der Ärzte im Dritten Reich
Der MKG-Chirurg, 2012Co-Authors: V. ThiemeAbstract:In the Third Reich a total of 350,000-400,000 persons were compulsory sterilized as a consequence of the Law for Prevention of Genetically Diseased Offspring from July 14, 1933. The list of victims also includes individuals affected with oral clefts. The precise number of these persons sentenced to compulsory Sterilization for eugenic reasons is unknown. In the first part of this study the character of injustice of the Law for Prevention of Genetically Diseased Offspring and its social sequelae for persons with cleft lip and palate are described. By means of a survey of 130 exemplary case records and related court records of Genetic Health Courts from 1934–1940 the concrete policy of eugenic eradication (“Ausmerze”) with regard to victims affected with oral clefts is revealed. The court decisions were hallmarked by arbitrariness, contrariness and inconsistency. In 71 (54.6%) cases Sterilization was carried out or definitively ordered. In 12 (9.2%) additional cases applications for Sterilization were made by state medical officers. The Genetic Health Courts rejected applications for Sterilization in 42 (32.3%) cases. In one case a newborn baby affected with cheilognathopalatoschisis was renounced to the so-called “Reich Committee for Scientific Research of Serious Illness of Hereditary and Endogenetic Origin” for admission to a “Childrens Expert Department”. As a rule inmates in “Childrens Expert Departments” were murdered by euthanasia. Auf der Grundlage des Gesetzes zur Verhütung erbkranken Nachwuchses (GzVeN) vom 14. Juli 1933 wurden im Dritten Reich ca. 350.000 bis 400.000 Menschen zwangssterilisiert. Unter den Opfern befanden sich auch Menschen mit Lippen-Kiefer-Gaumen-Spalten. Die genaue Zahl der betroffenen Spaltträger ist nicht bekannt. Im ersten Teil dieser Studie wird der Unrechtscharakter des GzVeN und dessen soziale Folgen für die Spaltträger dargestellt. Anhand einer exemplarischen Literaturrecherche über 130 Kasuistiken und aktenkundige Verfahren gegen Spaltträger an Erbgesundheits- und Erbgesundheitsobergerichten in den Jahren 1934 bis 1940 wird die konkrete Politik der rassenhygienischen „Ausmerze“ gegenüber dieser Opfergruppe verdeutlicht. In ihren Ergebnissen waren diese Verfahren durch Willkür, Uneinheitlichkeit und Widersprüchlichkeit gekennzeichnet. Bei 71 Verfahren (54,6%) wurde die Sterilisation durchgeführt bzw. angeordnet. In weiteren 12 (9,2%) Fällen lag ein Antrag des Amtsarztes auf Sterilisation vor. In 42 (32,3%) Beschwerdeverfahren wurde die Sterilisation abgelehnt. In einem Fall ist die Meldung eines Neugeborenen an den „Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden“ zur Aufnahme in einer „Kinderfachabteilung“ dokumentiert. Dies hatte in der Regel den Mord im Rahmen der nationalsozialistischen Euthanasie zur Folge.
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Gedemütigt, entwürdigt, verstümmelt: die „rassenhygienische Ausmerze“ der Lippen-Kiefer-Gaumen-Spalten. Studie zur Situation der Betroffenen und zur Position der Ärzte im Dritten Reich
Der MKG-Chirurg, 2012Co-Authors: V. ThiemeAbstract:In the Third Reich a total of 350,000-400,000 persons were compulsory sterilized as a consequence of the Law for Prevention of Genetically Diseased Offspring from July 14, 1933. The list of victims also includes individuals affected with oral clefts. The precise number of these persons sentenced to compulsory Sterilization for eugenic reasons is unknown. In the first part of this study the character of injustice of the Law for Prevention of Genetically Diseased Offspring and its social sequelae for persons with cleft lip and palate are described. By means of a survey of 130 exemplary case records and related court records of Genetic Health Courts from 1934–1940 the concrete policy of eugenic eradication (“Ausmerze”) with regard to victims affected with oral clefts is revealed. The court decisions were hallmarked by arbitrariness, contrariness and inconsistency. In 71 (54.6%) cases Sterilization was carried out or definitively ordered. In 12 (9.2%) additional cases applications for Sterilization were made by state medical officers. The Genetic Health Courts rejected applications for Sterilization in 42 (32.3%) cases. In one case a newborn baby affected with cheilognathopalatoschisis was renounced to the so-called “Reich Committee for Scientific Research of Serious Illness of Hereditary and Endogenetic Origin” for admission to a “Childrens Expert Department”. As a rule inmates in “Childrens Expert Departments” were murdered by euthanasia. Auf der Grundlage des Gesetzes zur Verhütung erbkranken Nachwuchses (GzVeN) vom 14. Juli 1933 wurden im Dritten Reich ca. 350.000 bis 400.000 Menschen zwangssterilisiert. Unter den Opfern befanden sich auch Menschen mit Lippen-Kiefer-Gaumen-Spalten. Die genaue Zahl der betroffenen Spaltträger ist nicht bekannt. Im ersten Teil dieser Studie wird der Unrechtscharakter des GzVeN und dessen soziale Folgen für die Spaltträger dargestellt. Anhand einer exemplarischen Literaturrecherche über 130 Kasuistiken und aktenkundige Verfahren gegen Spaltträger an Erbgesundheits- und Erbgesundheitsobergerichten in den Jahren 1934 bis 1940 wird die konkrete Politik der rassenhygienischen „Ausmerze“ gegenüber dieser Opfergruppe verdeutlicht. In ihren Ergebnissen waren diese Verfahren durch Willkür, Uneinheitlichkeit und Widersprüchlichkeit gekennzeichnet. Bei 71 Verfahren (54,6%) wurde die Sterilisation durchgeführt bzw. angeordnet. In weiteren 12 (9,2%) Fällen lag ein Antrag des Amtsarztes auf Sterilisation vor. In 42 (32,3%) Beschwerdeverfahren wurde die Sterilisation abgelehnt. In einem Fall ist die Meldung eines Neugeborenen an den „Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden“ zur Aufnahme in einer „Kinderfachabteilung“ dokumentiert. Dies hatte in der Regel den Mord im Rahmen der nationalsozialistischen Euthanasie zur Folge.
Debra B Stulberg - One of the best experts on this subject based on the ideXlab platform.
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tubal ligation in catholic hospitals a qualitative study of ob gyns experiences
Contraception, 2014Co-Authors: Debra B Stulberg, Yael Hoffman, Irma Dahlquist, Lori FreedmanAbstract:Abstract Objective Tubal Sterilization remains one of the most commonly requested contraceptive methods in the United States. Catholic hospital policy prohibits all Sterilizations, but this ban is not uniformly enforced. We conducted this study to assess obstetrician–gynecologists' beliefs and experiences with tubal ligation in Catholic hospitals. Study design We interviewed 31 obstetrician–gynecologists geographically dispersed throughout the US who responded to a national survey and agreed to be contacted for a follow-up interview or who were referred by colleagues from the survey sample. Twenty-seven had experienced working in a Catholic hospital. Interviews were open ended and guided by a semistructured instrument. Transcripts were thematically analyzed. Results Obstetrician–gynecologists disagreed with strict prohibition of Sterilizations, especially when denying a tubal ligation placed the patient at increased medical risk. Cesarean delivery in Catholic hospitals raised frustration for obstetrician–gynecologists when the hospital prohibited a simultaneous tubal ligation and, thus, sent the patient for an unnecessary subsequent surgery. Obstetrician–gynecologists described some hospitals allowing tubal ligations in limited circumstances, but these workarounds were vulnerable to changes in enforcement. Some obstetrician–gynecologists reported that Catholic policy posed greater barriers for low-income patients and those with insurance restrictions. Conclusion Obstetrician–gynecologists working in Catholic hospitals in this study did not share the Church's beliefs on Sterilization. Research to understand patients' experiences and knowledge of their Sterilization options is warranted in order to promote women's autonomy and minimize risk of harm. Implications statement Tubal Sterilization, even when medically indicated or in conjunction with cesarean delivery, is severely restricted for women delivering in Catholic hospitals. For women whose only access to hospital care is at a Catholic institution, religious policies can prevent them from receiving a desired Sterilization and place them at risk for future undesired pregnancy.
Lolita M Chan - One of the best experts on this subject based on the ideXlab platform.
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tubal Sterilization trends in the united states
Fertility and Sterility, 2010Co-Authors: Lolita M Chan, Carolyn WesthoffAbstract:Objective To review the rate, setting, and demographic characteristics of tubal Sterilization and its current trend within contraceptive practice in the United States. Design Review of U.S. health care statistics, NCHS publications, English-language literature searched using MEDLINE and PubMed, and bibliographies of key references. Result(s) Total annual cases of tubal Sterilization have declined from 687,000 in 1995 to 643,000 in 2006, despite a 4% population growth. Interval Sterilizations decreased by 12%. Postpartum Sterilizations remained stable and follow 8%–9% of all live births. Tubal Sterilizations remain more common in black and Hispanic women; women with lower income, lower education, and higher parity; and among women living in the South. From 1981 to 1995, inpatient interval Sterilizations fully migrated to ambulatory surgery care. Conclusion(s) After two decades of stable rates, there is a recent decline in Sterilization. Improved access to a wide range of highly effective reversible contraceptives gives women flexibility when deciding how to manage their reproductive ability.
Polly A. Marchbanks - One of the best experts on this subject based on the ideXlab platform.
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postpartum intrauterine device insertion and postpartum tubal Sterilization in the united states
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Maura K. Whiteman, Naomi K Tepper, Ana Penmanaguilar, Denise J. Jamieson, Kathryn M. Curtis, Polly A. MarchbanksAbstract:Objective The purpose of this study was to estimate US rates of postpartum intrauterine device (IUD) insertion and postpartum tubal Sterilization. Study Design Data from the 2001-2008 Nationwide Inpatient Sample were used to identify delivery hospitalizations with IUD insertion or tubal Sterilization procedure codes. Results Estimated rates of postpartum IUD insertion and postpartum tubal Sterilization were 0.27 and 770.67 per 10,000 deliveries, respectively. Although the rate of IUD insertion was similar across age groups, the rate of tubal Sterilization increased with age. Nonetheless, 15% of tubal Sterilizations occurred among women who were ≤24 years old. IUD insertion was more likely among women who delivered at teaching hospitals (odds ratio, 3.02; 95% confidence interval, 1.43–6.37); tubal Sterilization was more likely among women without private insurance (odds ratio, 2.04; 95% confidence interval, 1.97–2.11). Conclusion Among US postpartum women, IUD insertion occurs considerably less frequently than tubal Sterilization, even among younger women for whom postSterilization regret is a concern.
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postSterilization regret findings from the united states collaborative review of Sterilization
Obstetrics & Gynecology, 1999Co-Authors: Susan D. Hillis, Lisa Ratliff Tylor, Polly A. Marchbanks, Herbert B. PetersonAbstract:Abstract Objective: To evaluate the cumulative probability of regret after tubal Sterilization, and to identify risk factors for regret that are identifiable before Sterilization. Methods: We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal Sterilization. Participants included 11,232 women aged 18–44 years who had tubal Sterilizations between 1978 and 1987. Actuarial life tables and Cox proportional hazards models were used to identify those groups at greatest risk of experiencing regret. Results: The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal Sterilization was 20.3% for women aged 30 or younger at the time of Sterilization and 5.9% for women over age 30 at Sterilization (adjusted relative risk [RR] 1.9; 95% confidence interval [CI] 1.6, 2.3). For the former group, the cumulative probability of regret was similar for women sterilized during the postpartum period (after cesarean, 20.3%, 95% CI 14.5, 26.0; after vaginal delivery, 23.7%, 95% CI 17.6, 29.8) and for women sterilized within 1 year after the birth of their youngest child (22.3%, 95% CI 16.4, 28.2). For women aged 30 or younger at Sterilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased (2–3 years, 16.2%, 95% CI 11.4, 21.0; 4–7 years, 11.3%, 95% CI 7.8, 14.8; 8 or more years, 8.3%, 95% CI 5.1, 11.4) and was lowest among women who had no previous births (6.3%, 95% CI 3.1, 9.4). Conclusion: Although most women expressed no regret after tubal Sterilization, women 30 years of age and younger at the time of Sterilization had an increased probability of expressing regret during follow-up interviews within 14 years after the procedure. (Obstet Gynecol 1999;93:889–95.)
