Permanent Contraception in the childfree population: an exploratory study

Objective: To describe the childfree population seeking permanent contraception, identify barriers to receiving care, and characterize the incidence of regret.

Study design: We conducted a cross-sectional survey of people in the US, 18 years and older, without biological children, and who are seeking or have previously sought a permanent contraception procedure. Participants completed an online REDCap survey distributed over social media platforms, including Reddit, TikTok, and Facebook.

Results: 400 respondents completed the survey, of whom a151 (38%) underwent a permanent contraception procedure, 44 (11%) had found a doctor to perform a procedure, but not yet undergone it, 32 (8%) had been unable to find a doctor to do the procedure, 83 (21%) were seeking a doctor, and 90 (22%) had not yet sought a doctor. Respondents were predominantly white (88%), identified as women (83%), and were diverse in sexual orientation (heterosexual 42%, bisexual 41%). Reasons for seeking permanent contraception included not wanting children (96%), fear of pregnancy/childbirth (70%), the current state of the world (68%), environmental reasons (59%), and medical reasons (32%). Barriers to care included cost of the procedure (30%) and inability to find a doctor who would perform the procedure (42%). Of the 151 respondents who had undergone a permanent contraception procedure, 70 (46%) asked more than one doctor for the procedure. Of those with permanent contraception, 97% answered "yes" to "Do you think sterilization as a permanent method of birth control was a good choice for you?"

Conclusion: Childfree individuals have a variety of reasons for seeking sterilization and may be at a lower risk of regret than reported in the literature for parous people with permanent contraception.

Implications: Clinicians should be aware of the barriers to permanent contraception for patients who do not desire to have children. Providing patient-centered, individualized care to patients seeking permanent contraception can ensure that patients do not face unnecessary barriers to care and feel heard and empowered to enact their reproductive preferences.