Tubal ligation is a surgical form of sterilization. It is a permanent form of birth control. During the surgery, the fallopian tubes are blocked; this can be done by tying, sealing, or attaching a ring or clip to them. This procedure can be performed postpartum (at time of cesarean section or within 48 hours after vaginal delivery) or as an interval procedure (performed six weeks after delivery or at any time not related to pregnancy). Postpartum tubal ligation is performed through a small incision under the navel. Interval tubal ligation can be performed through a small bikini type incision or by a technique called laparoscopy. During laparoscopy, the doctor uses an instrument-like telescope, called a laparoscope, to look at the pelvic organs and to block the fallopian tubes.
Tubal ligation permanently blocks the fallopian tubes so the egg cannot move down the tube and the sperm cannot reach the egg, therefore pregnancy cannot occur.
Tubal ligation is 99.20 effective. If a woman does get pregnant after sterilization, there is a greater chance that it is a tubal pregnancy. Failure of the procedure is more likely if a woman is relatively young, because younger woman are more fertile than older women.
Tubal ligation is ideal for those women who are certain they wish no further children and need a reliable contraceptive method. If you are considering tubal ligation, you and your partner should discuss vasectomy, a sterilization procedure performed on men. Compared to female sterilization, vasectomy is simpler, safer, less expensive, and more (99.9%) effective. It is performed under local anesthesia by a urologist.
Tubal ligation is a permanent procedure. You and your partner should be absolutely sure that you do not want anymore children-now or in the future. If there is any chance that you might want to have children in the future, you should think about using another method of birth control. There may be a greater chance that you will regret your decision if:
you are unhappy with other reversible methods of birth control performed in the immediate postpartum period; it should be delayed if there is any issue with your baby’s health.
* The final decision is between you and your doctor.
The operation takes place in an outpatient surgical suite. Consent for the surgical procedure will be obtained by your doctor. When you sign this you are stating that you understand the risks and benefits of the operation itself, understand that the procedure is NOT 100% effective for birth control, and that you are aware of appropriate alternatives.
An intravenous line will be started to give you fluids during the operation. General anesthesia is necessary for the laparoscopic procedure, so you will be asleep during the operation. After anesthesia is given, a small incision about half an inch long is made in the skin just below the navel. Carbon dioxide is used to swell the abdomen so the pelvic reproductive organs can be seen more clearly. The laparoscope is inserted into the abdomen through the incision. This instrument has a bright light and lens like a tiny telescope that allows the surgeon to see into the abdomen. A second instrument is inserted either through the laparoscope or through a small second incision made near the pubic hairline. The fallopian tubes are grasped and sealed by using bands, clips, or electrocoagulation (electricity). With electrocoagulation, an electric current is used to burn and block the tubes. After the procedure, the instruments are removed and the gas is released. The incisions are then closed. You will be observed for a short time to be sure that everything is all right. Most women are ready to go home 2-4 hours after the procedure.
What should I expect after the surgery?
The incision should be treated as an ordinary skin cut and kept dry for a few days to promote good healing. A bruise around the incision, if present, will soon fade away. If the incision appears infected or if the tenderness lasts longer than a few days, your doctor should check to make sure there is no infection. After the incision has healed, a slight scar will remain. A postoperative check-up will be scheduled for two weeks after the operation.
Call your doctor if you have any of the following problems: