ABSTRACT
In the USA, voluntary surgical contraception is the single
most common modality of family planning. The reality is
that even though there is now a wide choice of satisfactory
modern methods of contraception, failure of the methods
and, more importantly, human errors in use, are sufficiently
common that over a fertile lifetime a significant number of
couples will have one or more unwanted pregnancies. Any
community which is striving to have a small family size
must either accept the limitations of reversible methods and
be prepared to back them up with safe abortion, or offer a
choice of voluntary surgical contraception. Wherever this
choice has been made available, it has become an increas-
ingly important part of the family planning choices. As
noted in Chapter 9, the failure rate of levonorgestrel-releas-
ing intrauterine devices (IUDs) overlaps with that of surgi-
cal sterilization, but underutilization of IUDs in the USA
and the high cost of these devices in developing countries
prevent the large-scale use of this alternative to surgery.
