Our Summary

This research paper looks at how certain policies during the COVID-19 pandemic affected patients’ access to a specific type of birth control surgery called postpartum bilateral tubal ligations (ppBTLs). The study was conducted at a medical center in New Jersey, and it found that out of 110 patients who wanted this procedure, 24 were not able to get it because they had COVID-19 and the policy didn’t allow “elective” surgeries for these patients.

Out of these 24 patients, 10 didn’t have any health insurance, 13 were on Medicaid, and almost all of them were Hispanic or Latinx. After giving birth, five of them were able to get the surgery at a later date, seven never got any form of birth control, and one got pregnant again. The study concludes that this policy had a negative impact on uninsured patients by denying them access to this permanent form of birth control.

FAQs

  1. What was the impact of the policy prohibiting “elective” procedures for COVID-positive patients on those seeking postpartum bilateral tubal ligations?
  2. What percentage of patients were unable to obtain postpartum bilateral tubal ligations due to COVID infection?
  3. How did this policy affect uninsured patients in particular?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bilateral tubal ligation is to discuss their options with their healthcare provider and make sure they understand the procedure, risks, and benefits before making a decision. It’s also important to consider factors such as future fertility desires and alternative contraceptive options. Additionally, patients should be aware of any potential barriers to accessing the procedure, such as insurance coverage or hospital policies.

Suitable For

Patients who are typically recommended bilateral tubal ligation include those who are seeking a permanent form of contraception, have completed their desired family size, and do not wish to have any more children in the future. Additionally, patients who have medical conditions that make pregnancy dangerous or who have a high risk of complications during pregnancy may also be recommended for bilateral tubal ligation.

Timeline

Before bilateral tubal ligation:

  • Patient requests postpartum bilateral tubal ligation (ppBTL)
  • Policy prohibiting “elective” procedures for COVID-positive patients at the medical center
  • Patient is identified as COVID-positive
  • 22% of ppBTL requests are canceled due to COVID infection

After bilateral tubal ligation:

  • 21% of patients obtain interval tubal ligation
  • 37% of patients never receive contraception
  • 1 patient has a future pregnancy
  • Uninsured patients are disproportionately affected by the policy, with 42% being uninsured and 92% being Hispanic/Latinx.

What to Ask Your Doctor

  1. Can I still undergo a bilateral tubal ligation if I test positive for COVID-19?
  2. Are there any alternative contraception options available to me if I am unable to undergo a bilateral tubal ligation due to COVID-19 restrictions?
  3. How long do I need to wait after recovering from COVID-19 before I can undergo a bilateral tubal ligation?
  4. Are there any specific risks or complications associated with undergoing a bilateral tubal ligation during the COVID-19 pandemic?
  5. Will my insurance coverage or financial situation impact my ability to undergo a bilateral tubal ligation during this time?
  6. Are there any special precautions or measures that will be taken to ensure my safety during the procedure in light of COVID-19?

Reference

Authors: DiCenzo N, Shah N, Glassman D, Singla A. Journal: Contraception. 2023 Jul;123:110051. doi: 10.1016/j.contraception.2023.110051. Epub 2023 Apr 19. PMID: 37085093