Access to reproductive health services is limited by numerous factors. For tubal ligations, federal regulations mandate a set of policies that include a 30-day interval between signing the consent and obtaining the sterilization (Institute of Medicine, 1995). While the policy’s intent is to protect women by timely and informed consent, in practice it may limit access for low-income women. Welfare reform could compound this access issue. We examined the impact of the mandatory waiting period for Michigan women covered by Medicaid, who requested and consented to a tubal ligation, but did not receive one. Fifty-two women who had received their prenatal care at a university-based clinic, who were enrolled in Medicaid, and who had signed a consent for a tubal ligation to be performed following the delivery of their infant were enrolled in the study. The survey instrument addressed possible barriers to receiving a tubal ligation including: mandatory 30-day waiting period; hospital or clinic issues; problems with Medicaid; health problems; and issues in their personal life. Among the women interviewed, 26 received and 26 did not receive a tubal ligation. Related to the waiting period, 17.6% (9/52) of the women reported issues such as not being informed of the waiting period, having less than 30 days between signing consent and delivery, learning about the waiting period too late after changing hospitals. Our presentation will address our specific findings in the context of welfare reform and discuss how the waiting period may interact with other system factors to limit access.
Learning Objectives: 1. Increase awareness of federal policies surrounding tubal ligations 2. Identify factors affecting access to tubal ligations
Keywords: Access to Care, Reproductive Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.