Hospital Variation in Postpartum Tubal Sterilization Rates in California and Texas

Joseph E. Potter, University of Texas at Austin
Amanda Stevenson, University of Texas at Austin
Kari White, University of Alabama at Birmingham
Kristine Hopkins, University of Texas at Austin

Postpartum sterilization is among the most commonly used methods of contraception in the United States. However, recent scholarship is divided as to whether postpartum sterilization is accessible and over-utilized, or there exist significant barriers to getting a postpartum tubal, especially for Medicaid patients and minorities. We use complete hospital discharge records for Texas and California in 2009 to describe variation in the hospital level rate of postpartum tubal sterilization and find that rates vary substantially between hospitals, between insurance statuses, and by type of delivery. There is also a noticeable difference in the level and pattern of variation between California and Texas. We argue that variation in barriers to access must explain at least part of the hospital level variability in rates of postpartum tubal sterilization.