title: Female sterilisation: The view from a general practice
Creators: name: Wright, Alastair F.
Publisher: name: University of Glasgow
Year: 1981
Subjects: subject: Medicine, obstetrics, women's studies, sterilisation (birth control).

description: The aim of this work is to present a descriptive survey of female sterilisation as seen in one general medical practice. Introduction (Chapter 1). The introductory chapter describes the New Town of Glenrothes and the author's practice. The practice population is defined in terms of age/sex distribution and the proportion of adult females contrasted with that in Glenrothes town and in Scotland. Literature Review (Chapter 2). The review of the literature is preceded by a list of papers surveyed, classified under the following subject headings (a) General and psychiatric studies from the 1960s. (b) Laparoscopic sterilisation. (c) General and psychiatric studies from the 1970's. (d) The timing of sterilisation. (e) Subsequent pelvic disease. (f) Menstruation after sterilisation. (g) Sterilisation failure and tubal pregnancy. (h) Sterilisation reversal. An indication of the content of each paper is given with the list. A separate summary, or overview, of the literature review is also provided and follows the review of individual papers. After reviewing the literature, the plan for the study is outlined and the author's reasons for undertaking the investigation are discussed. THE PRACTICE STUDIES. (Chapters 3-7) These are research probjects within the practice aimed at identifying cases, enumerating and classifying the operations done and studying the indications. Outcome is assessed by interviewing patients. The clinical impression that sterilised women complain more frequently of gynaecological symptoms (in particular, menstrual problems) is also explored. Record Search (Chapter 3). The preliminary search, of the records of 2,123 women, both married and single, identified 272 patients (12.8%) noted to have had elective sterilisation and nine patients who were on the waiting list for operation. No single women were found among the sterilised women identified. Random Sample (Chapter 4). A one in ten random sample of married women was drawn from the practice age/sex register to provide a more accurate estimate of the prevalence of female sterilisation and to determine rates for some of the variables to be examined in the main study. Follow-up of 375 Sterilised Women (Chapter 5). In chapter 5, a group of 375 identified sterilised women are examined from the demographic viewpoint of a general practice population. Comparison with Matches (Chapter 6). A comparison of 347 sterilised patients with randomly determined matches is detailed in chapter 6. The sterilised women appear to marry (mean 20.6 years) and have their first child (22.6 years) earlier than their matches (21.4 years and 23.4 years respectively) and to be more often responsible for the couple's family planning. Interviews (Chapter 7), The outcome of sterilisation is examined in chapter 7 and is discussed broadly tinder the headings (1) Regrets (2) Changes after Sterilisation. Three hundred and sixty-eight of the sterilised women were interviewed to assess how they felt about the choice they had made and in particular to examine the circumstances of those regretting the operation, with a view to improving the future management of patients coming for advice about sterilisation. Conclusions (Chapter 8). The final chapter comprises (a) Critical review of the methods used with particular emphasis on the problems of validation and the choice of matches. (b) Commentary on the results in the context of other published work. This is followed by a suggestion how the work of the thesis might point the way to a prospective Investigation of the possible association between tubal occlusion and menstrual disturbances. (c) Comment and suggestions on sterilisation counselling, (d) Clinical conclusions. (e) Personal conclusions. (Abstract shortened by ProQuest.).