Permanent contraception is the most used method of contraception among women aged 15-49 years and is one of the most straightforward surgical procedures an obstetrician-gynecologist can perform. At the same time, this therapeutic option is enormously complex when considered from a historical, sociological, or ethical perspective. This Committee Statement reviews ethical issues related to permanent contraception using a reproductive justice framework. Ethical counseling and shared decision making for permanent contraception should adopt a nonjudgmental, patient-centered approach, using up-to-date information about permanent contraception procedures and alternatives. Obstetrician-gynecologists should strive to avoid bringing into the clinical encounter biases around gender, race, age, and class that affect thoughts on who should or should not become a parent. Obstetrician-gynecologists should also ensure that permanent contraception requests reflect each patient's wishes, come from a desire to permanently end childbearing, and come from a preference for permanent contraception over all reversible methods as well as permanent contraception for the male partner. When difficulties in meeting a postpartum permanent contraception request are anticipated and permanent contraception is desired by the patient, transfer of care for the remainder of pregnancy should be offered. ACOG recognizes the right of all patients to unimpeded access to permanent contraception as a way of ensuring health equity, but it is unclear how to craft policies that protect from coercion but also do not create barriers to autonomously desired care. Determining the ethical balance between access and safeguards will require a collaborative interdisciplinary approach that involves a variety of stakeholders with varying perspectives.

中文翻译：

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永久避孕：道德问题和考虑因素：ACOG 委员会声明第 8 号。

永久避孕是 15-49 岁女性最常用的避孕方法，也是妇产科医生可以进行的最简单的外科手术之一。与此同时，从历史、社会学或伦理的角度考虑，这种治疗选择非常复杂。本委员会声明利用生殖正义框架审查与永久避孕相关的伦理问题。永久避孕的道德咨询和共同决策应采用非评判性、以患者为中心的方法，并使用有关永久避孕程序和替代方案的最新信息。妇产科医生应努力避免在临床中引入性别、种族、年龄和阶级方面的偏见，这些偏见会影响人们对谁应该或不应该成为父母的看法。妇产科医生还应确保永久避孕请求反映每个患者的意愿，来自永久终止生育的愿望，并且来自对所有可逆方法的永久避孕的偏好以及对男性伴侣的永久避孕。当预计满足产后永久避孕要求有困难并且患者希望永久避孕时，应提供剩余妊娠期间的护理转移。ACOG 承认所有患者都有权不受阻碍地获得永久避孕措施，以此作为确保健康公平的一种方式，但目前尚不清楚如何制定政策，既能保护患者免受胁迫，又不会对自主所需的护理造成障碍。确定准入和保障之间的道德平衡需要采用跨学科协作方法，涉及具有不同观点的各种利益相关者。