Fourteen Years’ Experience in Voluntary
Female Sterilization Through
Minilaparotomy in Jos, Nigeria
A.O. Aisien,* I.A.O. Ujah,* J.T. Mutihir,* and F. Guful*
Between January 1985 and December 1998, 2913 female
sterilizations through minilaparotomy were performed.
The mean (ϮSD) age was 36.4 Ϯ 4.2 years and 68% of the
women were between the ages of 30 and 39 years. The
mean (ϮSD) parity distribution was 8.0 Ϯ 2.0; 59.5% of the
patients were para Ն8, and the mean (ϮSD) number of
living children was 6.8 Ϯ 1.6. Only 32.9% had the equiv-
alent Ն8 number of living children at the time of the
procedure. Completed desired family size was the indica-
tion for the tubal occlusion in 95% of the patients. The
predominant surgical technique was Pomeroy’s method in
97%. Tubal ligation as an interval procedure was per-
formed in 93.6% and local anesthesia was used in 83.7%.
The study showed a yearly increase in the growth of
voluntary surgical contraception at the institution, made
possible by trained personnel. C
249–252 © 1999 Elsevier Science Inc. All rights reserved.
minilaparotomy, female sterilization, Pomeroy’s
emale surgical contraception is today an estab-
lished component of many family planning pro-
grams. It is growing fast and an estimated 138
million women of reproductive age use this method.
The rapid spread of voluntary female sterilization has
been made possible by the surgical methods of mini-
laparotomy and laparoscopy, which are quick, highly
effective, and safe.
Though the prevalence of steril-
ization is high in developed countries, ranging from
30% to 40% in Canada, the United States, and Europe,
the incidence in Africa is the lowest in the world, Ͻ1%
in most African countries.
In Nigeria the percentage of
contraceptors who rely on female sterilization was
found to be Ͻ0.5%.
This is probably because of the
great desire for a large family, poor understanding of
the overall benefit, misconceptions, and the limited
availability of this method of contraception.
At Jos University Teaching Hospital, female steril-
ization has been done mainly for medical indications
but has not been readily available to clients for
limitation of family size, because of financial con-
The Association for Voluntary Surgical
Contraception assisted our department in establish-
ing this service in May 1985—including the training
of counselors and personnel in minilaparotomy fe-
male sterilization under local anesthesia—thus mak-
ing this procedure readily available and affordable to
clients. We present in this report our 14 years’ expe-
rience with the minilaparotomy approach to female
Materials and Methods
During the period between January 1985 and Decem-
ber 1998, the case notes of 2913 clients who had
surgical contraception through minilaparotomy were
analyzed retrospectively with regards to their socio-
demographic characteristics; the timing and tech-
niques of sterilization; the type of anesthesia used;
and the yearly trend in the number of those sterilized.
Characteristics of Subjects
The mean (ϮSD) age at sterilization was 36.4 Ϯ 4.2
years. Most of the clients (68%) were between 30 and 39
years of age; only 3.4% were 30 years of age (Table 1).
The mean (ϮSD) parity was 8.0 Ϯ 2.0, with 59.5%
of the patients being para Ն8. Only 3.5% were para
Յ4 (Table 2).
Most of the clients did not have any formal educa-
tion (74.9%), and only 8.5% had either a secondary or
higher education (Table 3).
Most of the women were married and in a stable
relationship (98.4%); only 1.6% were widowed (Table 4).
*Department of Obstetrics and Gynaecology, Jos University Teaching Hospital,
Jos, Plateau State, Nigeria
Name and address for correspondence: Dr. A. O. Aisien, Department of
Obstetrics and Gynaecology, University of Benin Teaching Hospital, PMB 1111,
Benin City, Edo State, Nigeria; Fax: 234-52-250668
Submitted for publication April 1, 1999
Revised September 8, 1999
Accepted for publication September 14, 1999
© 1999 Elsevier Science Inc. All rights reserved. ISSN 0010-7824/99/$20.00
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