Tubal Ligation (Female Sterilization)

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KEY POINTS

• Tubal ligation is a way to prevent pregnancy by surgically closing a woman's fallopian tubes. People often call this procedure "having your tubes tied." It is best to think of tubal ligation as a permanent method of birth control.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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What is tubal ligation?

Tubal ligation is a way to prevent pregnancy by surgically closing a woman's fallopian tubes. People often call this procedure "having your tubes tied."

Normally, the fallopian tubes carry the eggs from the ovaries to the uterus (the muscular organ where babies grow). Tubal ligation closes the tubes. It prevents pregnancy because it stops sperm from reaching and fertilizing eggs when you have sex. It also prevents eggs from reaching the inside of the uterus.

Although tubal ligation protects you against pregnancy, it does not protect you from sexually transmitted diseases such as syphilis, gonorrhea, herpes, and HIV. Following safe sex practices by using condoms can protect you against infection.

When is it used?

You may choose to have this procedure if you are sure you do not want to become pregnant. If you change your mind and later want to get pregnant, it may not be possible to unblock your tubes. It is best to think of tubal ligation as a permanent method of birth control. Healthcare providers may also recommend tubal ligation if:

• Being pregnant might be dangerous for you
• You have a high risk of passing on a serious disease
• You cannot use other birth control methods

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
• Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

Laparoscopy is the procedure most often used to close the tubes. The surgery may be done in a clinic, healthcare provider's office, hospital, or surgical center.

Before the surgery, you are given a regional or general anesthetic to keep you from feeling pain. Regional anesthesia numbs part of your body while you stay awake. If you have regional anesthesia, you may also be given medicine to help you relax. The medicine can make you drowsy or you may fall asleep before the procedure. General anesthesia relaxes your muscles and puts you into a deep sleep.

A laparoscope is a lighted tube put into the belly through a small cut to look at the organs and tissues inside the belly. For a laparoscopy, your belly is first inflated with carbon dioxide gas. This helps your healthcare provider see your organs. Your provider then makes 1 or more small cuts in your belly. The fallopian tubes may be closed by tying them, sealing them with an electric current, or using clamps, clips, or rings. Your provider then removes most of the gas through the tube of the laparoscope and sews up the small cuts in your belly.

If you have just had a normal vaginal delivery of a baby, your healthcare provider makes a cut in your lower belly. Your provider then is able to reach your fallopian tubes so that they can be cut, tied, burned, or clamped. The cut in your belly is then sewn closed.

If you have a baby by C-section, the tubal ligation can be done during the same surgery.

What happens after the procedure?

After the procedure, you may stay in the hospital for a few hours. Usually you can go home the day you have the surgery. You may have some shoulder pain, feel bloated, or have a mild change in bowel habits for a few days.

Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• You may have problems with anesthesia.
• You may have infection or bleeding.
• Other parts of your body may be injured during the procedure.
• Scar tissue may form on the organs in your belly.
• There is a very slight chance that you could get pregnant after the procedure. If you have had a tubal ligation and you get pregnant, there is a high risk that the baby will grow in the tubes instead of your uterus. A tubal pregnancy can cause serious problems and be life-threatening.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.