Standards for Female and Male Sterilization Services - STATE ...
Standards for Female and Male Sterilization Services - STATE ...
Standards for Female and Male Sterilization Services - STATE ...
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42<strong>St<strong>and</strong>ards</strong> <strong>for</strong> female <strong>and</strong> male <strong>Sterilization</strong> servicesAnnexure 2Medical Eligibility Criteria <strong>for</strong> <strong>Female</strong> Surgical<strong>Sterilization</strong>(Source: Medical Eligibility Criteria <strong>for</strong> Contraceptive Use, Third Edition, WHO, 2004)There are no absolute contraindications <strong>for</strong> per<strong>for</strong>ming a sterilization operation.However, there are certain relative contraindications where one needs to apply thecriteria of “C”, “D”, <strong>and</strong> “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 preparation<strong>and</strong> precautions.D Delay The procedure is delayed until the condition is evaluated <strong>and</strong>/or corrected. Alternativetemporary methods of contraception should be provided.S Special The procedure should be undertaken in a setting with an experienced surgeon <strong>and</strong> staff,the equipment needed <strong>for</strong> providing general anaesthesia, <strong>and</strong> 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 <strong>and</strong> reproductive historyPregnancyDYoung age* C Clarification: Young women, like all women, should be counselledabout the permanency of sterilization <strong>and</strong> 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, <strong>and</strong> that young age is one of the strongestpredictors of regret (including requests <strong>for</strong> reversal in<strong>for</strong>mation <strong>and</strong>obtaining reversal) that can be identified be<strong>for</strong>e sterilization.Parity*a) Nulliparousb) ParousBreastfeedingAAA