Women must Know this before Deciding Female Sterilization: Tubal Ligation

Female sterilization, also called “tubal sterilization” is a huge decision because it’s a permanent type of contraceptive. This means that it protects against pregnancy forever. Only adult women who do not want any children, or do not want any more, or cannot carry a pregnancy because of a medical condition should use this method of contraception. Another option for permanent birth control is male sterilization (vasectomy).

Out of 100 women using female sterilization

  • Typical use: 1 or less women become pregnant
  • Perfect use: 1 or less women become pregnant

Here’s What is tubal ligation

Tubal” refers to a woman’s fallopian tubes. Ligation means to tie off, cut or close. Tubal ligation involves having minor surgery.

Here’s How is female sterilization done

Female sterilization can be done in an operating room or in a medical office depending on the type of procedure. It can be done while you are sleeping or while you are awake. If awake, you will be given numbing medicine so you don’t feel too uncomfortable.

Depending on the type of method you choose to have, you could either have a small incision or cut in your abdomen (belly) or the procedure can be done vaginally (without any incisions or cuts).

A. Laparoscopic sterilization:

  • A small cut is made in the abdomen (belly) and then an instrument with a tiny camera (called a laparoscope) is placed inside the belly near the navel (belly button). The fallopian tubes (the tubes that carry eggs from the ovaries to the uterus) are then closed shut with another instrument. This procedure is done in an operating room under general anesthesia (while sleeping) at any time during a woman’s cycle except immediately after she delivers a baby.

The fallopian tubes are cut and tied, removed, stitched with suture material, or burned. The fallopian tubes can also be entirely removed

  • Sterilization using electrical current: An electrical current is used to burn and destroy the fallopian tubes after they have been cut. Sterilization done with an electrical current cannot be reversed.
  • Silicone band (tubal ring): Through the laparoscope, the surgeon will insert a special tool that stretches a plastic band, picks up a small loop of the fallopian tube, and places the plastic band over the loop. The tube is then clamped shut.
  • Spring clips: There are two types of clips that are used to clamp off the tubes. One, shaped like a clothespin, is placed over the fallopian tube and is held closed by its spring clip. The other type is a rounded clamp, which is closed over the fallopian tubes. The clamp’s plastic liner gets bigger to keep the tube closed as the tube flattens.

B. Minilaparotomy:

  • This procedure is also done in an operating room with general or local anesthesia (numbing medicine) usually within 1-2 days after a woman has a baby.

C. Hysteroscopic sterilization:

  • This procedure is called the “Essure” method and is done in an operating or office setting using local anesthesia (numbing medicine) about 7-10 days after a woman’s period. While the patient is awake, the doctor inserts a thin instrument with a camera at the end, into the vagina, which is then passed through the cervix, uterus and finally to the fallopian tube where a tiny coil is placed. Scar tissue then grows which seals the tube shut. Since this takes time to happen, another form of birth control must be used for the first 3 months

A follow-up test called the Essure Confirmation Test is done within 3 months after the procedure. This is similar to an x-ray which allows your doctor to see that your tubes are closed off. If the tubes are tightly sealed at this point, your health care provider will likely tell you that you can stop other forms of birth control. However, you should always use condoms to prevent STIs. Essure can usually be done anytime except immediately after a woman gives birth

What if I decide I want to get pregnant after I am sterilized

If you change your mind after your tubes have been closed off you may be able to have your tubes rejoined, however reversing sterilization is a major operation and only about 70% successful. Less than 1% of women get their tubes rejoined, because they are almost always sure that they do not want any more children at the time of the procedure. Medical insurance does not pay to have a woman’s tubes “untied” or reversed.

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