- Design
- Randomised controlled trial with attention control
- Population
- 350 US adults considering tubal sterilisation
- Primary outcome
- Perceived access to reproductive health services at 3 months
- Effect
- Perceived access 62% vs 58% (adjusted difference 3.24, 95% CI 1.81 to 4.67); knowledge 61% vs 52%
A US randomised trial published in AJOG on 8 October enrolled 350 people considering tubal sterilisation. One group reviewed a purpose-built educational website; the comparison group reviewed the federal sterilisation consent form and an existing clinic website.
At three months, knowledge scores were higher in the website group (61% vs 52% of questions correct; adjusted mean difference 2.00, 95% CI 0.21 to 3.79), and perceived access to contraception was modestly higher (62% vs 58%). Preference for sterilisation did not differ significantly (30% vs 25%), while preference for the implant rose (17% vs 9%, p=0.05).
The point is not that a website changes the decision; it is that people arrive at a permanent choice knowing little about the long-acting reversible alternatives, and structured information fixes some of that without steering them away from sterilisation. Outcomes were knowledge and perceived access, not regret, which is the outcome that matters most and was not measured.
- Check what a patient requesting sterilisation knows about implants and hormonal IUDs before booking the procedure.
- Offer a structured written or online decision aid rather than relying on the consent form alone.
- Record that reversible long-acting methods were discussed, and that the patient understands sterilisation as permanent.
- Mention vasectomy as an option where the patient has a partner.
Why it matters
Baseline knowledge was low in both groups, which suggests many people choose sterilisation without knowing the reversible options.
Don't overread it
The trial measured knowledge and perceived access, not regret or reversal requests.
The statistics, in plain English
The adjusted knowledge difference of 2.00 has an interval from 0.21 to 3.79 — it excludes zero, so the gain is real, though the lower end is small. The implant preference finding sits right at p=0.05 and should be treated as a hint, not a result.
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