Reconsidering Racial/Ethnic Differences in Sterilization in the United States
Kari White, University of Alabama at Birmingham
Cross-sectional analyses of women’s current contraceptive use demonstrate that low-income and racial/ethnic minority women are more likely to use female sterilization and less likely to rely on a partner’s vasectomy than women with higher incomes and whites. This has prompted concern that providers may be promoting sterilization in these groups. Using the 2006-2010 National Survey of Family Growth, we fit Cox models to estimate women’s risk of getting sterilized following delivery. African Americans and Latinas were less likely to use female sterilization and vasectomy than whites. Women with Medicaid-paid deliveries had a somewhat higher risk of using female sterilization than women with private insurance. However, among women with Medicaid, whites were more likely to use female sterilization than African Americans and Latinas. These results suggest that low-income minority women face unique barriers to obtaining permanent contraception, and that cross-sectional results are biased by differences in exposure to repeated unintended pregnancies.