Prophylactic Salpingectomy Use at the Time of Postpartum Sterilization

Postpartum female sterilization is a contraceptive option for women who have completed childbearing and desire permanent contraception. It is performed for women soon after giving birth and occurs in 8-9% of childbirth hospitalizations in the United States. Recent advances in scientific evidence suggest that replacing the conventional sterilization approach of tubal ligation with salpingectomy (removal of fallopian tubes) at these procedures offers the dual benefit of contraception and ovarian cancer risk reduction. This is because latest research suggests that most ovarian cancer originates from the fallopian tubes (rather than from the ovaries). Therefore, adopting prophylactic salpingectomy has great potential for improving long-term health outcome of mothers undergoing postpartum sterilization. The goal of this project is to understand the trajectory of prophylactic salpingectomy use at the time of postpartum sterilization and identify influencing factors. This goal will be achieved via the following specific aims: 1) to examine temporal trend in the adoption of prophylactic salpingectomy in postpartum sterilizations; and 2) to examine physician variation in their trajectory of adopting prophylactic salpingectomy at the time of postpartum sterilization. Data analysis will be performed using the New Jersey Hospital Discharge Data which provide longitudinal record of health care encounters that can be linked by patients and physicians over time allowing for a thorough assessment of patient and physician factors that may influence the uptake of prophylactic salpingectomy. By elucidating barriers to utilization, this study seeks to improve quality of care for the large number of women undergoing postpartum sterilization each year.