Publication:

Study of the incidence of tubal ligation and long-acting reversible contraceptives in tertiary care centre: a population-based study

Background Tubal ligation and long-acting reversible contraceptives (LARC) provide reliable long-term contraception; however, women’s choices are influenced by factors such as age, parity, previous deliveries, and counselling. This study aimed to assess and compare the acceptance of tubal ligation versus LARC among reproductive-aged women at a tertiary care centre, with the primary objective of identifying the demographic, obstetric, and socioeconomic factors affecting their choice of contraception.

Methods A prospective cross-sectional study was conducted from April 2023 to December 2024 at a tertiary care obstetrics and gynecology centre. Sexually active women aged 19-49 years seeking post-partum family planning were recruited via purposive sampling if opting for tubal ligation or LARC. Sociodemographic, obstetric, and contraceptive data were collected and analysed using SPSS.

Results Most participants were aged 26-32 years (79, 46.47%) and 18-25 years (75, 44.12%). FTND was the most common previous pregnancy (105, 61.76%). The uterus was anteverted in 165 (97.06%). Contraception choices included tubectomy (99, 58.23%), PPIUCD (28, 16.47%), and DMPA (34, 20%). LARC use was higher in P1L1 (28, 100%) and P1L1A2 (4, 100%), while tubectomy was associated with higher parity and previous LSCS (p<0.001). Delivery mode also influenced method (LSCS 37, 56.92%; FTND 62, 59.05%; p=0.0069).

Conclusions Tubal ligation was the main contraceptive choice, especially among multiparous women and those with prior cesarean sections. LARC was preferred by younger or lower-parity women but remained underutilised. Choices were influenced by obstetric history and delivery mode, underscoring the need for better counselling, awareness, and access.