Skip to main content Accessibility help


  • Kermyt G. Anderson (a1)


Tubal ligation is the modal form of family planning among American women aged 30 and older. As the preference for tubal ligation over cheaper, lower risk and more reliable methods, such as vasectomy, has puzzled experts, a theoretical approach that explains this preference would be useful. The present study investigates the high prevalence of voluntary sterilization among American women from the perspective of life history theory, arguing that the trade-offs between investing in current and future offspring will favour tubal ligation when women cannot obtain reliable male commitment to future parental investment. Data came from the National Survey of Fertility Barriers (NSFB), a nationally representative survey of 4712 American women aged 25–45 conducted between 2004 and 2007. Four novel predictions of the prevalence of tubal ligation, drawn from life history theory, were developed and tested: 1) it is most common among unpartnered women with children, and least common among married women with children; 2) it is negatively correlated with age at first birth; 3) it is least common among highly educated women without children, and most common among less educated women with children; and 4) among women with two or more children, it is positively correlated with lifetime number of long-term partners. These predictions were tested using multivariate regression analysis. The first prediction was not supported: women with children were more likely to be sterilized, regardless of their marital status. The other three predictions were all supported by the data. The results suggest that trade-offs influence women’s decisions to undergo voluntary sterilization. Women are most likely to opt for tubal ligation when the costs of an additional child will impinge on their ability to invest in existing offspring, especially in the context of reduced male commitment.


Corresponding author

1 Email:


Hide All
Alexander, R. D. (1974) The evolution of social behavior. Annual Review of Ecological Systems 5, 325383.
Amin, V. & Behrman, J. R. (2014) Do more-schooled women have fewer children and delay childbearing? Evidence from a sample of US twins. Journal of Population Economics 27, 131.
Anderson, J. E., Jamieson, D. J., Warner, L., Kissin, D. M., Nangia, A. K. & Macaluso, M. (2012) Contraceptive sterilization among married adults: national data on who chooses vasectomy and tubal sterilization. Contraception 85, 552557.
Anderson, J. E., Warner, L., Jamieson, D. J., Kissin, D. M., Nangia, A. K. & Macaluso, M. (2010) Contraceptive sterilization use among married men in the United States: results from the male sample of the National Survey of Family Growth. Contraception 82(3), 230235.
Anderson, K. G. (2006) How well does paternity confidence match actual paternity? Results from worldwide nonpaternity rates. Current Anthropology 48(3), 511518.
Anderson, K. G. (2011) Does paying child support reduce men’s subsequent marriage and fertility? Evolution and Human Behavior 32, 9096.
Anderson, K. G. (2017) Establishment of legal paternity in unmarried American women: tradeoffs in male commitment to paternal investment. Human Nature 28(2), 168200.
Anderson, K. G., Kaplan, H. & Lancaster, J. B. (1999) Paternal care by genetic fathers and stepfathers I: reports from Albuquerque Men. Evolution and Human Behavior 20, 405431.
Anderson, K. G., Kaplan, H. & Lancaster, J. B. (2007) Confidence of paternity, divorce, and investment in children by Albuquerque men. Evolution and Human Behavior 28(1), 110.
Anderson, K. G. & Low, B. S. (2003) Nonmarital first births and women’s life histories. In Rodgers, J. & Kohler, H. P. (eds) The Biodemography of Human Reproduction and Fertility. Kluwer Academic Publishers, Boston, pp. 5786.
Anderson, K. G. & Starkweather, K. E. (2017) Parenting strategies in modern and emerging economies. Human Nature 28(2), 133137.
Arendell, T. (1995) Fathers and Divorce. Sage, Thousand Oaks, CA.
Barone, M. A., Johnson, C. H., Luick, M. A., Teutonico, D. L. & Magnani, R. J. (2004) Characteristics of men receiving vasectomies in the United States, 1998–1999. Perspectives on Sexual and Reproductive Health 36(1), 2733.
Bass, L. E. & Warehime, M. N. (2009) Do health insurance and residence pattern the likelihood of tubal sterilization among American women? Population Research and Policy Review 28, 237249.
Becker, G. S. (1991) A Treatise on the Family (Enlarged Edition). Harvard University Press, Cambridge, MA.
Borgerhoff Mulder, M. (1992) Reproductive decisions. In Smith E. A. & Winterhalder, B. (eds) Evolutionary Ecology and Human Behavior. Aldine de Gruyter, New York, pp. 339374.
Borrero, S., Abebe, K., Dehlendorf, C., Schwarz, E. B., Creinin, M. D., Nikolajski, D. & Ibrahim, S. (2011) Racial variation in tubal sterilization rates: the role of patient-level factors. Fertility and Sterility 95(1), 1722.
Borrero, S., Moore, C. G., Creinin, M. D. & Ibrahim, S. A. (2010) Low rates of vasectomy among minorities: a result of differential receipt of counseling? American Journal of Men’s Health 4(3), 243249.
Borrero, S., Moore, C. G., Qin, L., Schwarz, E. B., Akers, A., Creinin, M. D. & Ibrahim, S. A. (2009a) Unintended pregnancy influences racial disparity in tubal sterilization rates. Journal of General Internal Medicine 25(2), 122128.
Borrero, S., Schwarz, E. B., Reeves, M. F., Bost, J. E., Creinin, M. D. & Ibrahim, S. A. (2009b) Does vasectomy explain the difference in tubal sterilization rates between black and white women? Fertility and Sterility 91(5), 16421645.
Brechin, S. & Bigrigg, A. (2006) Male and female sterilisation. Current Obstetrics & Gynaecology 16, 3946.
Bumpass, L., Thomson, E. & Godecker, A. L. (2000) Women, men, and contraceptive sterilization. Fertility and Sterility 73(5), 937946.
Cancian, M., Meyer, D. R. & Cook, S. T. (2011) The evolution of family complexity from the perspective of nonmarital children. Demography 48, 957982.
Chan, L. M. & Westhoff, C. L. (2010) Tubal sterilization trends in the United States. Fertility and Sterility 94(1), 16.
Chandra, A., Martinez, G. M., Mosher, W. D., Abma, J. C. & Jones, J. (2005) Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth. Vital and Health Statistics 23(25), 1160.
Chase, I. D. (1980) Cooperative and noncooperative behavior in animals. American Naturalist 115, 827857.
Cherlin, A. (2004) The deinstitutionalization of American marriage. Journal of Marriage and Family 66, 848861.
Cherlin, A. (2010) Demographic trends in the United States: a review of research in the 2000s. Journal of Marriage and Family 72, 403419.
Clutton-Brock, T. (1991) The Evolution of Parental Care. Princeton University Press, Princeton.
Coall, D., Tickner, M., McAllister, L. & Sheppard, P. (2016) Developmental influences on human fertility decisions: an evolutionary perspective. Philosophical Transactions of the Royal Society of London Series B 371(1692), 20150146.
Cohen, P. N. (2016) Maternal age and infant mortality for white, black, and Mexican mothers in the United States. Sociological Science 3, 3238.
Dassow, P. & Bennett, J. M. (2006) Vasectomy: an update. American Family Physician 74(12), 20692074.
Dehlendorf, C., Rodriguez, M. I., Levy, K., Borrero, S. & Steinauer, J. (2010) Disparities in family planning. American Journal of Obstetrics & Gynecology 202(3), 214220.
Dudgeon, M. R. & Inhorn, M. C. (2004) Men’s influences on women’s reproductive health: medical anthropological perspectives. Social Science & Medicine 59, 13791395.
Eeckhaut, M. C. W. (2015) Marital status and female and male contraceptive sterilization in the United States. Fertility and Sterility 103(6), 15091515.
Eisenberg, M. L., Henderson, J. T., Amory, J. K., Smith, J. F. & Walsh, T. J. (2009) Racial differences in vasectomy utilization in the United States: data from the National Survey of Family Growth. Urology 74(5), 10201024.
Finer, L. B., Jerman, J. & Kavanaugh, M. L. (2012) Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertility and Sterility 98(4), 893897.
Forste, R., Tanfer, K. & Tedrow, L. (1995) Sterilization among currently married men in the United States, 1991. Family Planning Perspectives 27(3), 100107, 122.
Geronimus, A. T. (1996a) Black/White differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis. Social Science & Medicine 42(4), 589597.
Gibson-Davis, C. (2014) Magic moment? Maternal marriage for children born out of wedlock. Demography 51(4), 13451356.
Godecker, A., Thomson, E. & Bumpass, L. L. (2001) Union status, marital history and female contraceptive sterilization in the United States. Family Planning Perspectives 33(1), 3541, 49.
Gray, P. & Anderson, K. G. (2010) Fatherhood: Evolution and Human Paternal Behavior. Harvard University Press, Cambridge, MA.
Guzzo, K. B. (2014a) New partners, more kids: multiple-partner fertility in the United States. Annals of the American Academy of Political and Social Science 654, 6686.
Guzzo, K. B. (2014b) Trends in cohabitation outcomes: compositional changes and engagement among never-married young adults. Journal of Marriage and Family 76, 826842.
Guzzo, K. B. & Hayford, S. (2011) Fertility following an unintended first birth. Demography 48, 14931516.
Guzzo, K. B. & Hayford, S. R. (2010) Single mothers, single fathers: gender differences in fertility after a nonmarital birth. Journal of Family Issues 31(7), 906933.
Harknett, K. & Knab, J. T. (2007) More kin, less support: multipartnered fertility and kin support among new mothers. Journal of Marriage and the Family 69, 237253.
Hawkes, K., O’Connell, J. F. & Blurton Jones, N. G. (1997) Hadza women’s time allocation, offspring provisioning, and the evolution of long postmenopausal life spans. Current Anthropology 38, 551577.
Hendrix, N. W., Chauhan, S. P. & Morrison, J. C. (1999) Sterilization and its consequences. Obstetrical and Gynecological Survey 54(12), 766777.
Hill, E. M. & Low, B. S. (1992) Contemporary abortion patterns: a life history approach. Ethology and Sociobiology 13, 3548.
Huber, S., Bookstein, F. L. & Fieder, M. (2010) Socioeconomic status, education, and reproduction in modern women: an evolutionary perspective. American Journal of Human Biology 22(5), 578587.
Johnson, D. R., McQuillan, J., Jacob, M. C., Greil, A. L., Lacy, N., Scheuble, L. K. et al. (2009) National Survey of Fertility Barriers: Methodology Report for Wave 1. National Survey of Fertility Barriers, Working Papers Series Paper 1, University of Nebraska.
Jones, J., Mosher, W. & Daniels, K. (2012) Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since (1995). National Health Statistics Reports; No. 60. National Center for Health Statistics, Hyattsville, MD.
Kaplan, H. (1996) A theory of fertility and parental investment in traditional and modern human societies. Yearbook of Physical Anthropology 39, 91135.
Kaplan, H., Hill, K., Lancaster, J. & Hurtado, A. M. (2000) A theory of human life history evolution: diet, intelligence, and longevity. Evolutionary Anthropology 9, 156185.
Kaplan, H., Lancaster, J. B., Johnson, S. E. & Bock, J. A. (1995) Does observed fertility maximize fitness among New Mexican men? A test of an optimality model and a new theory of parental investment in the embodied capital of offspring. Human Nature 6, 325360.
Kaplan, H., Lancaster, J., Tucker, W. T. & Anderson, K. G. (2002) Evolutionary approach to below replacement fertility. American Journal of Human Biology 14, 233256.
Kramer, K. L. (2010) Cooperative breeding and its significance to the demographic success of humans. Annual Review of Anthropology 39, 417436.
Lam, D. (2011) How the world survived the population bomb: lessons from 50 years of extraordinary demographic history. Demography 48, 12311262.
Lawson, D. W. & Mace, R. (2011) Parental investment and the optimization of human family size. Philosophical Transactions of the Royal Society B 366, 333343.
Leidy, L. E. (1999) Effect of exclusion: rates of hysterectomy and comparisons of age at natural menopause. American Journal of Human Biology 11, 687693.
Lichter, D. T., Qian, Z. & Mellott, L. M. (2006) Marriage or dissolution? Union transitions among poor cohabiting women. Demography 43(2), 223240.
Low, B. S. (1978) Environmental uncertainty and the parental strategies of marsupials and placentals. American Naturalist 112, 197213.
Low, B. S., Simon, C. P. & Anderson, K. G. (2002) An evolutionary ecological perspective on demographic transitions: modeling multiple currencies. American Journal of Human Biology 14, 149167.
Lycett, J. E. & Dunbar, R. I. M. (1999) Abortion rates reflect the optimization of parental investment strategies. Proceedings of the Royal Society of London Series B 266, 23552358.
Manlove, J., Logan, C., Ikramullah, E. & Holcombe, E. (2008) Factors associated with multiple-partner fertility among fathers. Journal of Marriage and Family 70, 536548.
Martin, S. P. & Parashar, S. (2006) Women’s changing attitudes toward divorce, 1974–2002: evidence for an educational crossover. Journal of Marriage and Family 68, 2940.
Martinez, G. M., Kimberly, D. & Anjani, C. (2012) Fertility of men and women aged 15–44 years in the United States: National Survey of Family Growth, 2006–2010. National Health Statistics Reports, No. 51. National Center for Health Statistics. Hyattsville, MD.
Maynard Smith, J. (1977) Parental investment: a prospective analysis. Animal Behavior 25, 19.
Melville, C. & Bigrigg, A. (2008) Male and female sterilization. Obstetrics, Gynaecology and Reproductive Medicine 18(12), 330334.
Meyer, D. R. & Cancian, M. (2012) “I’m not supporting his kids”: nonresident fathers’ contributions given mothers’ new fertility. Journal of Marriage and Family 74, 132151.
Monte, L. M. (2017) Multiple partner fertility research brief. Current Population Reports, P70BR-146. US Census Bureau.
Mosher, W. D. & Jones, J. (2010) Use of contraception in the United States: 1982–2008. National Center for Health Statistics. Vital Health Statistics 23(29), 144.
Mosher, W. D., Martinez, G. M., Chandra, A., Abma, J. C. & Willson, S. J. (2004) Use of contraception and use of family planning services in the United States, 1982–2002. Advance Data from Vital and Health Statistics, No. 350. National Center for Health Statistics, Hyattsville, MD.
Peccei, J. S. (2001) A critique of the grandmother hypotheses: old and new. American Journal of Human Biology 13, 434452.
Penn, D. J. & Smith, K. R. (2007) Differential fitness costs of reproduction between sexes. Proceedings of the National Academy of Sciences 104(2), 553558.
Roff, D. A. (1992) The Evolution of Life Histories. Chapman and Hall, New York.
Schwingl, P. J. & Guess, H. A. (2000) Safety and effectiveness of vasectomy. Fertility and Sterility 73(5), 923936.
Scott-Phillips, T. C., Dickins, T. E. & West, S. A. (2011) Evolutionary theory and the ultimate–proximate distinction in the human behavioral sciences. Perspectives on Psychological Science 6(1), 3847.
Sear, R. (2015) Evolutionary contributions to the study of human fertility. Population Studies 69(supplement 1), S39S55.
Sear, R. & Coall, D. (2011) How much does family matter? Cooperative breeding and the demographic transition. Population and Development Review 37(s1), 81112.
Shapiro, T. M., Fisher, W. & Diana, A. (1983) Family planning and female sterilization in the United States. Social Science & Medicine 17(23), 18471855.
Sharma, V., Le, B. V., Sheth, K. R., Zargaroff, S., Dupree, J. M., Cashy, J. & Brannigan, R. E. (2013) Vasectomy demographics and postvasectomy desire for future children: results from a contemporary national survey. Fertility and Sterility 99(7), 18801885.
Shih, G., Dubé, K. & Dehlendorf, C. (2013) “We never thought of a vasectomy”: a qualitative study of men and women’s counseling around sterilization. Contraception 88, 376381.
Shih, G., Turok, D. K. & Parker, W. J. (2011) Vasectomy: the other (better) form of sterilization. Contraception 83(4), 310315.
Shreffler, K. M., McQuillan, J., Greil, A. L. & Johnson, D. R. (2015) Surgical sterilization, regret, and race: contemporary patterns. Social Science Research 50, 3145.
StataCorp. (2015) Stata Statistical Software: Release 14. StataCorp LP, College Station, TX.
Stearns, S. C. (1992) The Evolution of Life Histories. Oxford University Press, New York.
Trivers, R. L. (1972) Parental investment and sexual selection. In Campbell, B. (ed.) Sexual Selection and the Descent of Man 1871–1971. Aldine, Chicago, pp. 136179.
Tullberg, B. S. & Lummaa, V. (2001) Induced abortion ratio in modern Sweden falls with age, but rises again before menopause. Evolution and Human Behavior 22(1), 110.
Vining, D. R. (1986) Social versus reproductive success: the central theoretical problem of human sociobiology. Behavioral and Brain Sciences 9, 167216.
Weiss, Y. & Willis, R. J. (1985) Children as collective goods and divorce settlements. Journal of Labor Economics 3, 268292.
Weiss, Y. & Willis, R. J. (1993) Transfers among divorced couples: evidence and interpretation. Journal of Labor Economics 11, 629679.
Westhoff, C. & Davis, A. (2000) Tubal sterilization: focus on the U.S. experience. Fertility and Sterility 73(5), 913922.
White, K. & Potter, J. E. (2014) Reconsidering racial/ethnic differences in sterilization in the United States. Contraception 89(6), 550556.

Related content

Powered by UNSILO


  • Kermyt G. Anderson (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.