In the second half of the twentieth century, sterilization has become a very popular method of contraception. Worldwide in excess of 60 million women have been sterilized (Elias, 1991), and it is reported from the USA that 640000 tubal sterilizations were undertaken there in 1987 alone (Schwartz, Wingo, Antarsh et al., 1991). In the UK in 1980, one in three couples chose this method of contraception, and in 1983 it is reported that 90000 women and equal numbers of men were sterilized, at least a fifth of the women being under 30 years old. It seems likely that the forecast made in 1974, that in time one in three couples would rely on sterilization by the age of 35, will come true (Wellings, 1986).
At present, sterilization is undertaken once a family is complete, although previously the procedure was used for eugenic reasons. Even now, it is a very potent method of population control and is used as such in some parts of the world. At first the number of female sterilizations rose more quickly than those for vasectomy because of the legal doubts over vasectomy, but the numbers of operations are now more equal. The UK government has given financial support to a policy of sterilization in suitable cases, and the success of this policy has obvious long-term implications for the provision of contraceptive services (Allen, 1981). The popularity of the programme is such that it may become necessary to move resources from GP and community provision of family planning to the provision of sterilization and vasectomy.
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