Female Sterilization (Bilateral Tubal Ligation) at the Rivers State University Teaching Hospital: A Five-Year Review

Background: Female sterilization also known as bilateral tubal ligation (BTL) is the most common method of permanent contraception in women. This study aimed to determine the rate, trend, indications, sources of information, and the association between BTL indications and sociodemographic factors for improved permanent contraceptive services.

Methodology: This was a cross-sectional study of all cases of BTL performed at the RSUTH from 1st January 2016 to 31st December 2020. Data were analysed using IBM, SPSS, version 25.0 (Armonk, NY). The test of association was done using Chi-square at a significance level of p≥0.05.

Results: Over the period reviewed, there were 12,406 deliveries and 153 cases of BTL; giving the prevalence of BTL as 1.23% or 12.3 / 1000 deliveries with a decreasing trend. The mean ±SD age and gestational age of the women at delivery were 35.0 ± 3.6 years, 95% CI: 34.8, 35.6, and 37.4 ± 1.5 (95% CI: 37.2, 37.6) respectively. The commonest indication and source of information on BTL were completed family size [133(86.9%)] and hospital [139 (90.8%)] respectively. Most of the cases were performed during caesarean section by ‘modified’ Pomeroy’s technique. Majority were booked [145(94.8%)], multipara [138(90.2%)], Christians [147(96.1)] and had tertiary level education [84(54.9)]. Parity was significantly associated with BTL [X2 =11.203, p =0.004, (95%CI:0.044,0.052)] while other variables did not attain significance.

Conclusion: Uptake of BTL at the RSUTH is low; demonstrating a decreasing trend. The procedure was performed mostly during caesarean section. Mini-laparotomy and laparoscopic surgery should be encouraged for improved uptake of this permanent contraceptive method.