When you’re making family planning decisions, you might be wondering what permanent birth control or female sterilization methods are available to you. Women are often curious about having their “tubes tied” once they’re finished having children. A postpartum tubal ligation or tubal sterilization might be a good choice for women who are currently pregnant with their last child.
What is a Tubal Ligation?
Postpartum tubal ligation is a female sterilization procedure that is performed in the first few hours or days after childbirth. This is a procedure that will permanently prevent pregnancy by blocking the path between eggs and sperm.
In a tubal ligation, the surgeon will make a small incision below the woman’s bellybutton. The surgeon either cuts the fallopian tubes and closes them with thread or cauterization, or clamps them with special clips. This blocks the eggs from traveling through the fallopian tubes into the uterus, as well as preventing the sperm from accessing the eggs.
Tubal ligation can be done at any time, including after childbirth or in combination with another abdominal surgery, such as a C-section. The woman’s swollen uterus is pressing the fallopian tubes close to the abdominal wall, making them readily accessible through a small surgical incision in the woman’s belly.
If the baby was delivered by Cesarean section, then the surgeon can easily perform a tubal ligation through the same incisions that were made to retrieve the baby.
Tubal ligation is typically performed under local, regional, or general anesthesia to make the process comfortable and painless. The type of anesthesia required depends on the woman and whether she had a vaginal or Cesarean birth.
Even though tubal ligation is a safe and effective form of birth control method, about 1 out of 200 women may still become pregnant after the procedure.
There are a few different types of tubal ligation. Some use an incision (a cut in your skin) in your belly to block your fallopian tubes. Essure sterilization is done through your vagina and cervix and doesn’t require an incision.
Why Tubal Ligation?
Tubal ligation is one of the most commonly used surgical sterilization procedures for women. Tubal ligation is a permanent method of birth control, so you no longer need any type of birth control. However, it does not protect against sexually transmitted infections.
Tubal ligation may also decrease your risk of ovarian cancer, especially if the fallopian tubes are removed.
Tubal ligation isn’t right for everyone, however. Your doctor or health care provider will make sure you fully understand the risks and benefits of the procedure.
Your doctor may also talk to you about other options, including long-acting reversible contraceptives such as an intrauterine device (IUD) or a birth control device that’s implanted in your arm. An alternative permanent option is hysteroscopic sterilization, in which your doctor places a small coil or other inserts into the fallopian tubes. The insert causes scar tissue to form and seal off the tubes.
Side Effects of a Tubal Ligation
Postpartum tubal ligation is a very safe surgical procedure with a low risk of complications relating to the surgery itself. A tubal ligation won’t affect your menstrual cycle since it has no effect on your ovaries and uterus.
Most risks and side effects are due to the effects of anesthesia. During recovery, you might experience pain at the site of incision and feel drowsy until the anesthesia wears off. You might also experience:
- Bloating and gas
- Shoulder pain
- Sore throat – this is a typical side effect of having a breathing tube that used with general anesthesia
If you develop a fever, if your pain is severe, or if the pain lasts longer than 3 days, call your doctor right away. This might indicate an infection.
After Tubal Ligation
If you do conceive after having a tubal ligation, there’s a risk of having an ectopic pregnancy. This means the fertilized egg implants outside the uterus, usually in a fallopian tube. An ectopic pregnancy requires immediate medical treatment. The pregnancy cannot continue to birth. If you think you’re pregnant at any time after a tubal ligation, contact your health care provider immediately.
Tubal Ligation Reversal
We recommend that you think carefully about the decision to undergo tubal ligation. There are many forms of birth control available that have virtually the same effectiveness as tubal ligation, without the permanence of surgical sterilization.
Most tubal ligation procedures cannot be reversed. If a reversal is attempted, it requires major surgery and isn’t always effective.
However, some tubal ligations are reversible. If the surgeon used clips to block the fallopian tubes, then the reversal procedure is more likely to be successful than if the tubes were cut and resealed. Reversal is not always recommended. Your tubes may be scarred from the procedure, and you may have difficulty becoming pregnant.
Keep in mind that although tubal ligation reversal is possible, the reversal procedure is complicated and may not work.
Family planning is a very personal decision, and you have many factors to consider. Talk with your OB-GYN, and make sure you thoroughly understand all of the options available to you.