Use of matched pairs in evaluation of a birth control program.
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A multicenter data set was analyzed to compare incidences of poststerilization pregnancies between women who were not pregnant and those who were pregnant at admission of laparoscopic sterilization. The 12-month life-table poststerilization pregnancy rate was 6.0 per 1,000 procedures for the 7,696 nongravid and 32.8 for the 1,703 gravid women, for a fivefold difference. The crude pregnancy rates were consistently higher for the gravid women when data were classified by tubal occlusion technique and by patients' sociodemographic characteristics. The difference in pregnancy rates between the two groups was reduced to 2.4-fold when analysis was limited to data sets from centers that admitted both groups of women and that performed sterilization by the same technique. Results of this analysis support previous studies suggesting that gravid women, especially postpartum patients, carry a higher pregnancy risk following sterilization.
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The relationship between contraceptive failure and selected characteristics of users is examined using data collected in the 1970 and 1975 rounds of the National Fertility Study. Intention regarding future childbearing and choice of contraceptive method are found to be the most important considerations. Within categories of intention, choice of method appears to have an important influence on differentials by age and other characteristics. The longitudinal aspect of the study design permitted the inclusion in the analyis of certainty of intention, coital frequency, and women's perceptions of their own ability to control fertility.