Reproductive Factors and the Likelihood of Hysterectomy in India: Evidence from the National Family Health Survey, 2019-21

Jesty Varghese, University of Queensland-IIT Delhi Academy of Research, IIT-Delhi
Sisir Debnath, Indian Institute of Technology Delhi
Sapna Desai, Population Council
Sourabh Paul, Indian Institute of Technology Delhi
Gita Mishra, The University of Queensland

Research on the reproductive factors associated with hysterectomy remains limited in the Indian context. Considering the higher proportion of women in India undergoing hysterectomy at younger ages and its long-term adverse health consequences, it becomes imperative to identify the factors across the life course that may be associated with an increased likelihood of hysterectomy. Thus, we examined the association between usage of hormonal contraceptives, history of terminated pregnancy, age at first birth, and hysterectomy. The analysis included 724,115 women from the National Family Health Survey, 2019-21, and multivariable binary logistic regression analysis was used. The results show that women who have ever used intrauterine devices, oral contraceptive pills, or injectable contraceptives have lower odds of hysterectomy. Also, the likelihood of hysterectomy was higher among women who have ever had a terminated pregnancy and an earlier age at first birth. Our findings highlight the significance of life course research, which can help in the early identification of women at increased risk of hysterectomy. The results also highlight the need to promote awareness on the non-contraceptive benefits of hormonal contraceptives as a treatment for heavy menstrual bleeding.

Keywords: Sexual and Reproductive Health and Rights, Health and Morbidity, Family Planning and Contraception

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