Health consequences of sterilizations

One-third of married women are sterilized in India. This is largely due to family planning programs that put a strong emphasis on 'permanent' contraceptive methods rather than temporary ones. However, little is known about potential adverse effects on women's wellbeing. We analyse the consequences of sterilization on maternal health. To do so, we take advantage of datasets that record information on various symptoms in the reproductive sphere or anthropometric and biological measurements. In order to deal with endogeneity issues, we exploit two features of the sterilization decision. First, households have a son preference and women are more likely to be sterilized when their first-born is male. Second, Indian households face different malaria prevalence. Being sterilized involves taking the risk of losing one child in infancy and not being able to replace him or her. As a consequence, women tend to postpone sterilization in areas with more malaria. We exploit the fact that the increase in sterilization associated with a male first-born decreases with malaria prevalence. We show that sterilization strongly increases the prevalence of various symptoms in the reproductive sphere (from +50 per cent for vaginal discharge to more than 100 per cent for pain or problems during sexual intercourse, for instance). However, we also find that sterilization leads to improvements in BMI and haemoglobin levels, likely from the avoidance of pregnancies.