Sterilization and its reversal--the Singapore experience

Autor: K, Singh, Y K, Fong, S S, Ratnam
Rok vydání: 1990
Předmět:
Zdroj: Biology and society : the journal of the Eugenics Society. 7(1)
ISSN: 0266-3880
Popis: The incidence of sexual sterilization reached a peak of over 10,000 procedures in 1976--the year Singapore removed virtually all restrictions on eligibility and introduced social incentives promoting the procedure. 90% of sterilizations are performed on females and are increasingly performed in private sector facilities. Over 60% of female procedures take place in the postpartum period. As a result of this increased access to sterilization and other family planning services and liberalization of abortion laws, Singapore's gross reproduction rate has fallen from 3.19 in 1957 to 1.01 in 1975 and, in 1983, was 0.765--well below the replacement level of 1.025. Before 1986, no sterilization reversals were authorized. In 1987, however, as a result of concern over the precipitous decline in fertility, the Singapore Government revised this policy to allow reversal in government hospitals in cases where a woman has 2 or fewer children. In 1986-87, a total of 30 macrosurgical and 56 microsurgical tubal reanastomoses and 20 vas deferens reanastomoses were performed in government and private hospitals. In government hospitals, those seeking sterilization reversal must be screened and undergo counseling from a medical social worker. There are no such requirements in private facilities. Reversal of female sterilization costs US$3400-5000 in a government hospital. Although the procedure is not subsidized by the government, the medisave insurance scheme can be used for part of the costs. Since sterilization reversal is a difficult and costly procedure, greater emphasis should be placed on counseling sterilization seekers and on the promotion of alternative forms of fertility control such as Norplant.
Databáze: OpenAIRE