• Southern medical journal · Nov 2021

    Investigating Barriers to Completion of Postpartum Tubal Ligation: A Retrospective Chart Review.

    • June Ng, Diana Ho, Jharna M Patel, Cybill Esguerra, Meike Schuster, and Jennifer Amico.
    • From the Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, the Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, the Department of Obstetrics and Gynecology, Johns Hopkins Medicine, Baltimore, Maryland, and the Department of Family Medicine and Community Health Rutgers - Robert Wood Johnson Medical School, New Brunswick, New Jersey.
    • South. Med. J. 2021 Nov 1; 114 (11): 675-679.

    ObjectivesTo identify the completion rate for postpartum tubal ligation (PPTL) and predictors of noncompletion of PPTL in a central New Jersey population.MethodsWe conducted a retrospective chart review at a tertiary care center in New Jersey for patients delivering during an 18-month period. We used the electronic medical record to identify all of the patients who had documented desire for a PPTL at the time of admission. We calculated the rate of PPTL completion and identified predictors of completion and risk factors for noncompletion. We recorded any documented reasons for cancellation and choice of contraception after noncompletion.ResultsOf 626 women who requested PPTL on admission, 508 (81.2%) procedures were performed. The most common reasons for noncompletion were patient changing her mind (38.1%) and unknown/not documented (22.9%). Cesarean delivery was the strongest predictor of completion, with 93.4% completion among cesarean deliveries compared with 65.6% among vaginal deliveries (P < 0.01). Lack of insurance also was associated with noncompletion (P < 0.01). There was no difference in body mass index (P = 0.75), gravidity (P = 0.99), parity (P = 0.72), or high-risk status (P = 0.47) between completed and noncompleted PPTL.ConclusionsCesarean delivery is a strong predictor of PPTL completion, most likely because of easier availability of the operating room, anesthesia, and ancillary staff. Body mass index, gravidity, and parity are not associated with PPTL completion. Future research should focus on exploring whether this association is system, provider, or patient dependent.

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