Alternatives to female sterilization.

With national policies aimed at reaching zero population growth in the shortest possible time, many countries have introduced restrictive legislation and disincentive programs in an attempt to decrease family size norms to 2 or 3 children. As a result, younger women of lower parity are being sterilized, with consequences that will be seen in the years to come. Although female sterilization is usually associated with minimal complications and side effects and is highly effective without continuing motivation or promotion, it has the disadvantage of causing permanent, essentially irreversible sterility. Therefore, it will not be readily acceptable to a large portion of the population. For many women, alternatives must be sought. Reversible methods of female or male sterilization, longacting systemic contraceptives, longacting implants, and immunization against implantation or sperm antigens are potential alternatives, but all are still in experimental stages of development. Intrauterine devices and injectables are the 2 most effective alternatives now available. The use of intrauterine devices with abortion as a backup in case of contraceptive failure ranks high as an alternative to female sterilization.