Medical Eligibility Criteria for
Female Sterilization

All women can have female sterilization. No medical conditions prevent a woman from using female sterilization. This checklist asks the client about known medical conditions that may limit when, where, or how the female sterilization procedure should be performed. Ask the client the questions below. If she answers "no" to all of the questions, then the female sterilization procedure can be performed in a routine setting without delay. If she answers "yes" to a question, follow the instructions, which recommend caution, delay, or special arrangements.

In the checklist below:

• Caution means the procedure can be performed in a routine setting but with extra preparation and precautions, depending on the condition.
• Delay means postpone female sterilization. These conditions must be treated and resolved before female sterilization can be performed. Give the client another method to use until the procedure can be performed.
• Special means special arrangements should be made to perform the procedure in a setting with an experienced surgeon and staff, equipment to provide general anesthesia, and other backup medical support. For these conditions, the capacity to decide on the most appropriate procedure and anesthesia regimen also is needed. Give the client another method to use until the procedure can be performed.

1.    Do you have any current or past female conditions or problems (gynecologic or obstetric conditions or problems), such as infection or cancer? If so, what problems?

NO    YES If she has any of the following, use caution:

• Past pelvic inflammatory disease since last pregnancy
• Breast cancer
• Uterine fibroids
• Previous abdominal or pelvic surgery

If she has any of the following, delay female sterilization:

• Current pregnancy
• 7–42 days postpartum
• Postpartum after a pregnancy with severe pre-eclampsia or eclampsia
• Serious postpartum or postabortion complications (such as infection, hemorrhage, or trauma) except uterine rupture or perforation (special; see below)
• A large collection of blood in the uterus
• Unexplained vaginal bleeding that suggests an underlying medical condition
• Pelvic inflammatory disease
• Purulent cervicitis, chlamydia, or gonorrhea
• Pelvic cancers (treatment may make her sterile in any case)
• Malignant trophoblast disease

If she has any of the following, make special arrangements:

• AIDS (see Female Sterilization for Women With HIV)
• Fixed uterus due to previous surgery or infection
• Endometriosis
• Hernia (abdominal wall or umbilical)
• Postpartum or postabortion uterine rupture or perforation

2.    Do you have any cardiovascular conditions, such as heart problems, stroke, high blood pressure, or complications of diabetes? If so, what?

NO    YES If she has any of the following, use caution:

• Controlled high blood pressure
• Mild high blood pressure (140/90 to 159/99 mm Hg)
• Past stroke or heart disease without complications

If she has any of the following, delay female sterilization:

• Heart disease due to blocked or narrowed arteries
• Blood clots in deep veins of legs or lungs

If she has any of the following, make special arrangements:

• Several conditions together that increase chances of heart disease or stroke, such as older age, smoking, high blood pressure, or diabetes
• Moderately high or severely high blood pressure (160/100 mm Hg or higher)
• Diabetes for more than 20 years or damage to arteries, vision, kidneys, or nervous system caused by diabetes
• Complicated valvular heart disease

3.    Do you have any lingering, long-term diseases or any other conditions? If so, what?

NO    YES If she has any of the following, use caution:

• Epilepsy
• Diabetes without damage to arteries, vision, kidneys, or nervous system
• Hypothyroidism
• Mild cirrhosis of the liver, liver tumors (Are her eyes or skin unusually yellow?), or schistosomiasis with liver fibrosis
• Moderate iron-deficiency anemia (hemoglobin 7–10 g/dl)
• Sickle cell disease
• Inherited anemia (thalassemia)
• Kidney disease
• Diaphragmatic hernia
• Severe lack of nutrition (Is she extremely thin?)
• Obesity (Is she extremely overweight?)
• Elective abdominal surgery at time sterilization is desired
• Depression
• Young age
• Uncomplicated lupus

If she has any of the following, delay female sterilization:

• Gallbladder disease with symptoms
• Active viral hepatitis
• Severe iron-deficiency anemia (hemoglobin less than 7 g/dl)
• Lung disease (bronchitis or pneumonia)
• Systemic infection or significant gastroenteritis
• Abdominal skin infection
• Undergoing abdominal surgery for emergency or infection, or major surgery with prolonged immobilization

If she has any of the following, make special arrangements:

• Severe cirrhosis of the liver
• Hyperthyroidism
• Coagulation disorders (blood does not clot)
• Chronic lung disease (asthma, bronchitis, emphysema, lung infection)
• Pelvic tuberculosis
• Lupus with positive (or unknown) antiphospholipid antibodies, with severe thrombocytopenia, or on immunosuppressive treatment