Does healthcare coverage affect the decision to undergo female sterilization in a tertiary hospital setting?

Background: Postpartum sterilization in Thailand has relatively few barriers and is partially covered by different healthcare plans. We aim to determine if healthcare plans or other demographic factors affect sterilization rate in a tertiary urban hospital. Methods: We conducted a secondary analysis of a cohort of 4,482 postpartum women from previous data comparing contraception during and before the COVID-19 pandemic. Results: Overall immediate postpartum sterilization rate was 17.8%. Those whose healthcare covered the procedure trended toward postpartum sterilization (OR = 1.11; 95%CI = 0.94–1.31). Women aged 40–44 years were 8.53 times as likely to choose sterilization than those aged 20–24 years (aOR = 2.74; 95%CI = 1.63–4.60). Women who delivered via cesarean section were more likely to undergo sterilization at the time of delivery (aOR = 5.78; 95%CI = 4.69–7.12). Women having their second or third child were more likely to undergo postpartum sterilization than those having their first child. Conclusions: In conclusion, we found that age, parity, and route of delivery were associated with higher sterilization rates. Healthcare coverage was not associated with increased immediate postpartum sterilization in our setting.