Contraceptive Sterilization in Puerto Rico
For twenty years Puerto Rico has had the world's highest prevalence of sterilization. From the 1982 Puerto Rico Fertility and Family Planning Assessment we examine whether the probability of obtaining sterilization is changing and what impact sterilization has on fertility, finding that the use of contraceptive sterilization has not declined and will probably continue to increase in Puerto Rico. Nonuse rather than temporary methods of contraception is the second most likely circumstance after sterilization. We also find that sterilization has reduced the total marital fertility rate by over 33 percent, thus having a significant effect on reducing the rate of natural increase; by all indications, it will have a greater effect in the future
Warren, C. W., Westoff, C. F., Herold, J. M., Rochat, R. W., & Smith, J. C. (1986). Contraceptive Sterilization in Puerto Rico. Demography, 23(3), 351-365.