The essence of most definitions of the word ‘counselling’ is that the patient is helped to review their own situation and make their own decisions. Such an understanding is central to the idea of sterilization counselling, but there are other imperatives for doctors who are discussing sterilization with their patients. In the first place they must give clear, up-to-date information in a way the patient can understand. They must also share their medical knowledge about possible risks and benefits, trying to avoid passing on any personal prejudices. In addition, doctors with some psychosexual training will be able to help individuals to understand some of the less conscious feelings within themselves which may contribute to decisions that are not in their best long-term interests. An ability to concentrate on what is happening between the couple, and to interpret this in such a way as to free them to relate more honestly to each other, is invaluable. It may be possible to identify punishing or controlling attitudes, feelings of guilt and the need to make reparation, and the complicated effect of such joint interaction as mutual projection (Main, 1966).
In summary, the overall picture shows that sterilization is a good and acceptable method of contraception, widely used by both men and women. A few will have regrets about the operation, but this number is a very small proportion of the total. It should be possible to reduce the number of these unfortunate people by adequate discussion before the operation, and particularly if those people who are most likely to be at risk can be identified and offered help from a doctor with skills to help them to look at the less conscious aspects of their feelings and actions.