The doing and undoing of surgical sterilization: a psychosocial profile of the tubal reimplantation patient.

A woman's decision to end her fertility surgically can be a well-founded decision with which she is satisfied, or it can be made for reasons that later lead to regret. What psychosocial factors distinguish the woman who will regret her sterilization and seek to have it reversed? Using a retrospective design, we compared 33 women who were satisfied with their ligations with 32 who chose to have the procedure reversed. We found that age, marital difficulties, emotional problems in the year prior to the ligation, and a history of unreliable contraceptive use differentiated the reversal patient from her satisfied counterpart. In addition, we found that the decision to be sterilized can occur in response to intrapsychic and interpersonal stresses that have little to do with fertility per se. In the reversal subjects, the decision to have and then reverse the ligation was part of the woman's characteristic use of fertility behavior to deal with conflicts about autonomy, dependency and self-esteem.