THERE HAS been a marked decrease in the number of female sterilisation operations in the Republic, with some hospitals now rarely carrying out the procedure, new research has found.
According to data from the Hospital Inpatient Enquiry Scheme (HIPE), the number of tubal ligations - a procedure whereby clips are placed on a woman's Fallopian tubes rendering her sterile - fell from 2,566 in 1999 to 910 in 2004, representing a 65 per cent decrease.
Meanwhile, annual sales of a hormone-containing intrauterine device, Mirena, have increased by 350 per cent during the same period. And sales of a long acting contraceptive implant, Implanon, have also increased significantly.
Dr Richard Horgan, Prof John Higgins and Dr Gerry Burke of the Department of Obstetrics at Cork University Hospital and the Mid Western Regional Hospital in Limerick, who carried out the research, said the practice of surgical female sterilisation in their units has "almost disappeared completely".
Writing in the current issue of the Irish Medical Journal, they say that some of the newer long-acting contraceptive methods are as effective as tubal ligation. " preserve reversibility and have the huge advantage of being office procedures, requiring relatively little training and with a very small risk of procedure-related injury."
Tubal ligation became widely available here in the 1980s amid considerable controversy. Until then, it had not been available in certain hospitals for religious and ethical reasons.
But the procedure, which requires a general anaesthetic and involves keyhole surgery through the umbilicus, can cause serious complications.
The bowel, bladder and blood vessels may be injured - it is estimated that about two in 1,000 women who have a tubal ligation subsequently need open abdominal surgery to repair the damage.
The Mirena device, which can be inserted into the womb by GPs or gynaecologists, contains a long-acting form of progestogen. It and Implanon, a device implanted under the skin, are reversible methods of contraception.
Commenting on their findings, Dr Horgan and his colleagues say the swift change in medical practice suggests the decline in tubal ligation is doctor-led. "It would seem that a procedure that was introduced in Ireland to considerable furore is becoming rapidly obsolete. Many will have no regrets about its passing," they conclude.