Pathways to Caesarian Section and Sterilization in Kerala, India: Associations and Attributes

Sabu S. Padmadas, University of Groningen
Inge Hutter, University of Groningen
Albert Mantingh, University of Groningen

Little is known about the associations between caesarean section and sterilization. Evidence from few countries, for example in India and Brazil, indicates a high prevalence of both caesarean section and sterilization. This paper examines the association between timing of caesarean section and that of female sterilization in Kerala and correlate these with demographic, health care, spatial and social variables. We used the cross-sectional data from the National Family Health Survey conducted in Kerala during 1992-93. The study was limited to 1550 women who had a birth since January 1988. Women who had a last birth delivered through caesarean are considerably more likely to have sterilization within the same month of the last birth (OR: 1.90, p<0.001). The effects persisted with statistical significance even after controlling for women's characteristics. Further research (panel and in-depth) is needed to understand the decison roles of both the physicians and the women.