Desire for Sterilization Reversal Among U.S. Females: Increasing Inequalities by Educational Level.

Context: For decades, high reliance on female sterilization in the United States has been accompanied by a high level of desire for sterilization reversal, and less-educated women have been more likely than better educated women to use the method and desire a reversal. Little is known about how levels of and educational differentials in such desire have changed in recent decades.

Methods: Data from 4,147 women who reported being sterile from a tubal sterilization in the 1995, 2002 and 2006-2010 waves of the National Survey of Family Growth were analyzed using chi-square and Wald tests and binary logistic regression analyses. Predicted probabilities were calculated to determine the likelihood of desire for procedure reversal by wave and educational level.

Results: The prevalence of desire for sterilization reversal rose by 41%, from 18% in 1995 to 23% in 2002 and 25% in 2006-2010. Overall, women with a bachelor's degree were less likely than those who had not finished high school to desire a reversal (odds ratio, 0.2), and this educational differential was larger in 2006-2010 than in earlier waves. Predicted probabilities indicate that 9% of sterilized women with less than a high school education and 8% of those with a bachelor's degree expressed a desire for procedure reversal in 1995, as did 15% and 3%, respectively, in 2006-2010.

Conclusion: Future research should consider how insurance coverage of all methods under the Affordable Care Act may affect use of sterilization and desire for reversal.