This research will elucidate the decision making of poor women and their partners concerning voluntary female sterilization and examine the psychosocial sequelae to the operation in light of the perceptions and information available prior to the procedure. The research design is a prospective, longitudinal study of (a) 1,200 poor women and their spouses seeking sterilization information, and (b) a control group of 600 women and their spouses not planning to be sterilized and matched to the sterilization group on age, parity, economic status and the desire for no additional children. Those seeking sterilization information initially will be interviewed prior to their procedures and again six months subsequent to the time when the operation did or would have occurred. The control group will be interviewed at the same interval. The sample will come from hospitals in Pittsburgh, Atlanta and New York and thus will include black, Hispanic and white women from these different regions. Data analysis will focus on testing the utility of an expectancy-value model for predicting the sterilization decision, comparisons of those who go through with the operation and those who do not, the relationship of pre-operative expectations to post-operative sequelae, comparisons of satisfaction among those who did and did not elect sterilization, and analysis of these issues among subgroups. The projects will yield important guidelines for those providing sterilization and family planning services, especially to poor and minority women.