Voluntary Sterilization in Serbia: Unmet Need?

Abstract

Is voluntary sterilization as a birth control method accepted in Serbia? This is certainly a question that is being imposed for research, regardless of the fact that voluntary sterilization is neither accessible nor promoted. Most importantly because there is no understanding in the social nor political sphere for legalization of voluntary sterilization as a form of birth control, apart from the clear necessity for this, first, step. They are: the recognition that voluntary sterilization is an efficient and safe birth control method, respectability of basic human as well as sexual and reproductive rights, spreading of sterilization as a form of birth control among population of both developed and developing countries and an epidemic diffusion of repeated induced abortions in Serbia. Thus individual recognition of the advantages of relying on voluntary sterilization, in a non-encouraging atmosphere, certainly represents one more argument to enable couples to prevent conception by sterilization.

Since it was impossible to carry out a representative research among the population of men and women who are at risk for conception, an attempt was made to obtain a reply to the set question among women who decided to induce abortion. It was done out of at least two reasons. The first being that women with induced abortion in their reproductive history were the target group for voluntary sterilization. The second reason was based on the assumption that bringing a decision on induced abortion is preceded by the reconsideration of an earlier adopted strategy regarding children, giving birth and contraception and thus its rational component is revealed more and therefore more easily measurable. The research was carried out in the University Clinic of Obstetrics and Gynaecology "Narodni front" in Belgrade from January 21^st o March 1^st 2002, and included 296 women. By comparing the social and demographic characteristics of the female respondents, as well as important events in their reproductive history with structural traits of the total population of women of same age and parity who induce abortion, the representativeness of samples was confirmed and thus generalization of results. 

The results indicate that a target group is clearly distinct which would decide on sterilization as a contraceptive method. Not only do more than half of the surveyed women who induce abortion believe that voluntary sterilization as a method of contraception should be available in Serbia, but also a large number of surveyed women, almost a half, would subject themselves to voluntary sterilization after having given birth to the desired number of children and when they would be convinced that sterilization does not influence health, sex potency, nor quality of sex life. Younger women, respondents with secondary education, those who gave birth to the desired number of children, as well as those who have a good relationship with their partner, and confronted themselves with a large number of induced abortions, namely those who wish to use contraception in future, are more open to voluntary sterilization. The reasons for individual nonacceptance, namely undetermined standpoint towards sterilization as a contraception method, indicate that many of the registered ambivalent or negative opinions could be changed by knowledge spreading on the characteristics of voluntary sterilization.