Psychosocial implications of tubal ligation in a rural health district: A phenomenological study

Lutala, Hugo, Luhiriri

Description

Tubal ligation is the most popular family planning method worldwide. While its benefits, such as effectiveness in protecting against pregnancies, minimal need for long-term follow-up and low side-effects profile are well documented, it has many reported complications. However, to date, these complications have not been described by residents in Congo. Therefore, the study aimed at exploring the experience of women who had undergone tubal ligation, focusing on perceptions of physical, psychological and contextual experiences of participants. Methods This qualitative study used a semi-structured questionnaire in a phenomenological paradigm to collect data. Fifteen participants were purposefully selected among sterilized women who had a ligation procedure performed, were aged between 30 and 40 years, and were living within the catchment area of the district hospital. Data were collected by two registered nurses, tape-recorded, and transcribed verbatim. Reading and re-reading cut and paste techniques, and integration were used to establish codes, categories, themes, and description. Results Diverse and sometimes opposite changes in somatic symptoms, psychological symptoms, productivity, ecological relationships, doctor-client relationships, ethical issues, and change of life style were the major problem domains. Conclusions Clients reported conflicting experiences in several areas of their lives after tubal sterilization. Management, including awareness of the particular features of the client, is needed to decrease the likelihood of psychosocial morbidity and/or to select clients in need of sterilization.

Sujets

• Tubal ligation
• Congo
• Rural district
• Contraception

Informations

• Publié par: biomed
• Publié le: 01 janvier 2011
• Nombre de lectures: 10
• Langue: English

Extrait

Lutalaet al.Reproductive Health2011,8:38 http://www.reproductivehealthjournal.com/content/8/1/38

R E S E A R C H

Open Access

Psychosocial implications of tubal ligation in a rural health district: A phenomenological study 1* 2 3 Prosper M Lutala , Jannie F Hugo and Levi N Luhiriri

Abstract Background:Tubal ligation is the most popular family planning method worldwide. While its benefits, such as effectiveness in protecting against pregnancies, minimal need for longterm followup and low sideeffects profile are well documented, it has many reported complications. However, to date, these complications have not been described by residents in Congo. Therefore, the study aimed at exploring the experience of women who had undergone tubal ligation, focusing on perceptions of physical, psychological and contextual experiences of participants. Methods:This qualitative study used a semistructured questionnaire in a phenomenological paradigm to collect data. Fifteen participants were purposefully selected among sterilized women who had a ligation procedure performed, were aged between 30 and 40 years, and were living within the catchment area of the district hospital. Data were collected by two registered nurses, taperecorded, and transcribed verbatim. Reading and rereading cut and paste techniques, and integration were used to establish codes, categories, themes, and description. Results:Diverse and sometimes opposite changes in somatic symptoms, psychological symptoms, productivity, ecological relationships, doctorclient relationships, ethical issues, and change of life style were the major problem domains. Conclusions:Clients reported conflicting experiences in several areas of their lives after tubal sterilization. Management, including awareness of the particular features of the client, is needed to decrease the likelihood of psychosocial morbidity and/or to select clients in need of sterilization. Keywords:psychosocial implications, tubal sterilization, Congo, tubal sterilization, rural district, mini laparotomy, contraception

Background Tubal sterilization is the most practiced method of contra ception globally [13]. It has been estimated that the pro cedure has been performed on 190 million women worldwide [4]. Among other advantages, tubal sterilization is a balanced contraceptive method [1]. It offers effective protection against pregnancy, eliminates the need for longterm contraceptive supplies, and has a low risk of exposing women to complications when carried out according to standards. Surgical sterilization is a safe, con venient, easy, and highly effective birth control method for the long term [4]. Furthermore, female sterilization is the

* Correspondence: [e-mail] 1 Department of Family Médecine, Université de Goma, Goma, 2 Avenue Himbi, Congo P.O. Box 204 Goma, Congo Full list of author information is available at the end of the article

best option for countries in the SubSaharan region as it can be performed during hospitalization for either normal delivery or caesarean section, saving a return visit and allowing a single recovery period for the surgical proce dure and the delivery [5]. Although doing so is not in compliance with the required 40 days postpartum for the procedure, this helps to prevent losing touch with these women in the community, which would then increase the likelihood of an additional highrisk pregnancy that could lead to complications. In Congo, this contraception method seems most appropriate due to the difficult struc tural, social, and economic conditions prevailing in the health system. Demographically, Congo is populated by 71,712,867 inhabitants [6]. The total fertility rate is 5.24 children born per woman, and the maternal mortality rate is

© 2011 Lutala et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.