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Surgical fertility regulation among women on the Navajo Indian reservation, 1972-1978.

H Temkin-Greener, S J Kunitz, D Broudy and M Haffner

Changes in the rates of induced abortions, bilateral tubal ligations, and hysterectomies on the Navajo Indian Reservation have been examined for the years 1972-1978. While the incidence of abortions and tubal sterilizations is still considerably lower among Navajo women than among the total United States population of women, it has risen, especially among those in the prime of the reproductive cycle, i.e., ages 20-34. The rate of hysterectomy has not changed substantially. Regression analyses performed on the data indicate that the utilization of surgery for fertility regulation in women on the Navajo Reservation, unlike other surgical procedures, is not affected by access to hospitals which provide surgery. Rather measures of involvement in the wage work economy are of primary importance. Those areas of the Reservation having the highest levels of such involvement exhibit the highest rates of such surgery.