June 16, 2011
FIGO, the International Federation of Gynecology and Obstetrics, has released new guidelines on sterilisation of women.
FIGO is an international organisation that brings together professional societies of obstetricians and gynecologists on a global basis. Currently member societies in 124 countries or territories.
The guidelines were approved by the FIGO Executive Board at its meeting in June 2011.
Surgical sterilisation is a widely used method of contraception. An ethical requirement is that it is preceded by the patient’s informed and freely given consent. The guidelines acknowledge however that there is ample evidence of a long history of forced and otherwise non-consensual sterilisations of women, including Roma women in Europe and women with disabilities. Reports have documented the coerced sterilization of women living with HIV in Africa and Latin America. “Fears remain that ethnic and racial minority, HIV-positive, low-income and drug-using women, women with disabilities and other vulnerable women around the world, are still being sterilized without their own freely-given, adequately informed consent.”
The recommendations (summarised here) include:
1. No woman may be sterilised without her own, previously-given informed consent, with no coercion, pressure or undue inducement by healthcare providers or institutions.
2. Women considering sterilisation must be given information of their options in the language in which they communicate and understand.
3. Sterilisation for prevention of future pregnancy is not an emergency procedure. It does not justify departure from the general principles of free and informed consent.
4. Consent to sterilisation must not be made a condition of receipt of any other medical care, such as HIV/AIDS treatment, assistance in natural or cesarean delivery, medical termination of pregnancy, or of any benefit such as employment, release from an institution, public or private medical insurance, or social assistance.
5. Forced sterilisation constitutes an act of violence, whether committed by individual practitioners or under institutional or governmental policies. Healthcare providers have an ethical response in accordance with the guideline on Violence Against Women (2007).
6. It is ethically inappropriate for healthcare providers to initiate judicial proceedings for sterilisation of their patients, or to be witnesses in such proceedings inconsistently with Article 23(1) of the Convention on the Rights of Persons with Disabilities.
7. At a public policy level, the medical profession has a duty to be a voice of reason and compassion, pointing out when legislative, regulatory or legal measures interfere with personal choice and appropriate medical care.
Download FIGO guidelines (English)
Download FIGO guidelines (Russian)