Birth control: Tubal ligation
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If this is to be your last pregnancy, you and your partner may be considering forms of permanent birth control. Learn about tubal ligation -- a method of female sterilization -- in this article, which covers how the surgical procedure is performed, and a look both the benefits and risks.
What it is
Tubal ligation (having your "tubes tied") is considered a permanent method of female sterilization. It is a surgical procedure during whith a piece of each of your two fallopian tubes are tied, blocked, cauterized, cut or clipped.
Tubal ligation closes the fallopian tibes so that sperm cannot reach the egg to fertilize it, causing a pregnancy.
Sterilization is the most common method of contraception in the US and has no proven long-term risks. It differs from other methods in that it is intended to provide permanent contraception. According to a study by Hatcher, Guest, Stewart, et al in Contraceptive Technology (16th rev ed. New York, 1994), the average failure rate is 0.4%. The complication rate from tubal ligation depends on the type of procedure (e.g., mini-laparotomy, laparoscopy, colpotomy), but is generally less than 1%.
How it is done and reversal information
Tubal sterilization must be performed by a doctor, under general or regional anesthesia. In the US, the majority of surgeries are performed through the abdomen, though some doctors have been trained in completing the procedure through the vagina.
No matter the surgical method of ligation chosen, the procedure is not easily reversed, and can also be expensive if you change your mind. It should be considered permanent birth control. Keep in mind that within two years of the procedure, up to 3% of American women reported regret over sterilization. Fertility reportedly can, however, be restored in up to 70% of women after reversal of tubal ligation.
Other considerations
While sterilization does not protect against sexually transmitted infections, tubal ligation is associated with lower risk of PID and ovarian cancer (Obstetrics and Gynecology, 1986; Journal of the American Medical Association, 1993).
There are some risks and side effects, however. Directly from the procedure, there are the risks associated with any surgery and use of anesthetic. There may also be bleeding, or even infection, at the incision site.
Afterward, there could be some disruption of your menstrual cycle, and, if the surgery fails, you are at a high risk of a ectopic (tubal) pregnancy.
Counseling is advisable before undergoing such a sterilization procedure. Be sure to take some time to decide whether or not tubal ligation is right for you and your family.
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