Unintended Pregnancy Prevention:
Sterilization: Summary of Surgical Sterilization
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Summary of Surgical Sterilization in the United States: Prevalence and
The complete report may be printed by downloading the
Vital and Health Statistics Series 23/No.20 PDF
This report presents national data on the prevalence of surgical
sterilization from 1965 to 1995 among women 15–44 years of age. Data are
shown by type of sterilizing operation and demographic characteristics of
the women. For the 1995 survey data, reasons for the three most common
sterilizing operations (tubal ligation, vasectomy, and hysterectomy) are
shown, as well as the desire for reversal among those with potentially
Data are based on nationally representative samples of women 15–44
years of age: the 1965 National Fertility Study (NFS), and the 1973, 1982,
1988, and 1995 cycles of the National Survey of Family Growth (NSFG).
After rising from 16 to 42 percent between 1965 and 1988, the
prevalence of surgical sterilization among married women 15–44 years old
remained stable at 41 percent in 1995. Age, parity, religious affiliation,
and education continued to be strongly associated with overall surgical
sterilization levels. Tubal ligation and vasectomy were equally prevalent
in the 1965 and 1973 surveys, but since 1982, tubal ligation has been more
prevalent than vasectomy.
Several factors contributed to the rise in reliance upon surgical
sterilization among women 15–44 years old over the last 3 decades: (a)
aging of the post-World War II Baby Boom women (and their partners)
through the primary reproductive years; (b) relatively high contraceptive
failure rates, particularly among socioeconomically less advantaged women;
and (c) higher expectations for contraceptive effectiveness, safety, and
convenience. Overall sterilization prevalence may be leveling off among
women 15–44 years old, in part due to greater delay of first and
subsequent births, thus making sterilization less of a concern while women
are in this age range.
- Between the 1965 and 1988 surveys, the prevalence of surgical
sterilization rose dramatically among married women 15–44 years of age in
the United States from 16 to 42 percent. In 1995, the prevalence remained
about the same at 41 percent.
- In the 1965 and 1973 surveys, tubal ligation and vasectomy were
equally common among currently married and ever-married women aged 15–44
(and their partners). Since the 1982 survey, tubal ligation has become
more prevalent than vasectomy, occurring 1½ to 2 times as often. Among
married women in 1995, 24 percent reported a tubal ligation, compared with
15 percent reporting that their husbands had a vasectomy.
- The profile of the typical ever-married woman with a tubal ligation
has changed over time, as has the profile of the typical woman who
reported that her husband or partner had a vasectomy. From 1973 to 1995,
an increasing proportion of tubal ligations occurred among ever-married
women aged 35–44 years with 1 or 2 births (as opposed to 3 or more births)
and with education beyond high school. Over the same period, a similar
shift toward older age, lower parity, and higher education occurred for
vasectomies. In addition, vasectomies reported by Catholic women
represented a greater proportion of all vasectomies reported in the 1995
survey than in the 1973 survey. Some of these shifts reflect similar
changes among the general population of ever-married women between the
- Age, parity, religious affiliation, and education continued to be
strongly associated with overall surgical sterilization rates. Marital
status, race and Hispanic origin, and socioeconomic factors such as
education and income were also strongly associated with particular types
of sterilizing operations.
- Among ever-married women aged 15–44 years in 1995, 41 percent were
surgically sterile (15.3 million women), 26 percent reported having a
tubal ligation, 7 percent had a hysterectomy, and 12 percent were
currently living with a husband or partner who had a vasectomy.
- The most frequently cited reasons for tubal ligation and vasectomy
among women who had any births were that one or both partners wanted no
more children. Among nulliparous women with tubal ligation, medical
reasons and problems with their birth control method were cited most
often. As expected, medical problems were the most frequent reason given
for hysterectomy, cited by 90 percent.
- Nearly 25 percent of women with an unreversed tubal ligation in 1995
expressed a desire for reversal of the operation, on the part of herself,
her husband or partner, or both. About 11 percent of married or cohabiting
women whose partner had a vasectomy reported some desire for reversal.
Higher levels of desire for tubal ligation reversal were seen among
younger women, Hispanic women, and women with lower levels of education
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Page last reviewed: 5/7/09
Page last modified: 4/4/07
Division of Reproductive Health,
National Center for Chronic
Disease Prevention and Health Promotion