Sterilization

Variations in Sterilization Prevalence

According to a 2008 report by the U.S.-based Population Reference Bureau (PRB), female sterilization has the highest prevalence (21 percent) among married women of reproductive age around the world, significantly more than the intrauterine device (IUD, 14 percent) or the pill (8 percent). Demographer John A. Ross offers explanations for the high prevalence of female sterilization in developing countries, which could also be applied to the world as a whole. First, female sterilization has an excellent continuation rate. Second, the age distribution of its adopters is quite broad. Third, the longer sterilization has been available in a country, the higher its national prevalence.

However, details of the PRB report also reveal striking regional and national variations. Developed regions generally have lower rates of female sterilization (less than 10 percent) than developing nations, where 20 percent of married women of reproductive age choose sterilization. But countries in North America, northern Europe, and Oceania have much higher rates.

Among them, the United States has a female sterilization rate exceeding 20 percent, and Canada's vasectomy rate is even higher. In addition to personal preference, the effect of national family planning programs on shaping the trends and prevalence of sterilization remains unclear. Nevertheless, from the 1920s to the 1970s, these countries also had strong eugenics movements and compulsory sterilization policies that targeted minority groups, a historical link that should be acknowledged.

Some less-developed countries share similar trends regarding policy influences. Asia (eastern and southern Asia in particular) and Latin America have the highest female sterilization prevalence, both around 30 percent. Many countries in these regions, such as China, South Korea, India, Brazil, Puerto Rico, and [Page 1171]the Dominican Republic, experienced intense, if not harsh, population control policies during the 1960s and the 1980s. In some countries, China and India, for example, such policies have continued into the 21st century. By contrast, virtually all African and Middle Eastern countries have the lowest levels of sterilization use, less than 5 percent. Studies suggest that this low rate reflects cultural, economic, and medical barriers to sterilization in these areas.

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