Standards for Female and Male Sterilization Services - STATE ...

42Standards for female and male Sterilization servicesAnnexure 2Medical Eligibility Criteria for Female SurgicalSterilization(Source: Medical Eligibility Criteria for Contraceptive Use, Third Edition, WHO, 2004)There are no absolute contraindications for performing a sterilization operation.However, there are certain relative contraindications where one needs to apply thecriteria of “C”, “D”, and “S” as stated below.A Accept There is no medical reason to deny sterilization to a person with this condition.C Caution The procedure is normally conducted in a routine setting, but with extra preparationand precautions.D Delay The procedure is delayed until the condition is evaluated and/or corrected. Alternativetemporary methods of contraception should be provided.S Special The procedure should be undertaken in a setting with an experienced surgeon and staff,the equipment needed for providing general anaesthesia, and other back-up medicalsupport. To meet these conditions, the capacity to decide on the most appropriateanaesthesia regimen is also needed. Alternative temporary methods of contraceptionshould be provided if referral is required or if there is otherwise any delay.Condition Category Clarification/EvidencePersonal characteristics and reproductive historyPregnancyDYoung age* C Clarification: Young women, like all women, should be counselledabout the permanency of sterilization and the availability of alternative,long-term, highly effective methods.Evidence: Studies show that up to 20% of women sterilized at a youngage later regret this decision, and that young age is one of the strongestpredictors of regret (including requests for reversal information andobtaining reversal) that can be identified before sterilization.Parity*a) Nulliparousb) ParousBreastfeedingAAA