Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecovery
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
Tubal ligation surgery is an elective procedure that involves cutting, sealing, clipping, or tying off thefallopian tubes—which connect theovariesto theuterus—to prevent sperm from reaching an egg. Also known as getting your tubes tied or female sterilization, a tubal ligation is a permanent form of contraception that is effective in almost all cases.
Tubal ligation surgery can be done on its own, but it is also sometimes done in the hospital very soon after a person gives birth—particularly via cesarean section (C-section), as surgeons can use the same incision to reach the fallopian tubes.
What Is Tubal Ligation?
The procedure can be done either laparoscopically or as an open surgical procedure, as is the case when done after a C-section or amyomectomy. Once the tubes are closed or “tied,” sperm will not be able to reach an egg, so pregnancy cannot take place.
Tubal ligation ismore than 99% effective in preventing pregnancy.Failure can occur if the fallopian tubes reconnect themselves, which happens occasionally. If a pregnancy does occur after a tubal ligation, there is a 33% chance of it being a non-viableectopic pregnancy.
Types of Tubal Ligation Surgery
Tubal ligation is often performed within hours of childbirth (postpartum). But it can also be done on its own (interval).
Tubal ligations can be performed in a few different ways. In determining the right method for you, your healthcare provider will (in advance) consider factors such as your body weight, any previous abdominal surgery, and whether you will be having the procedure immediately following a vaginal birth, C-section, or other surgery.
Among the options your healthcare provider will consider:
An open procedure requires a much larger incision and, on its own, would be major surgery. As such, open tubal ligation is rarely done in the absence of another procedure also being performed.
Be sure you ask your healthcare provider why a particular technique is being recommended and get answers to any questions you may have.
Contraindications
The main contraindication for tubal ligation is the person’s desire to have children. The procedure is only recommended for women who are absolutely certain that they do not want to get pregnant in the future.
Every person is different, but according to 2012 study of people who got the procedure, subjects were more likely to regret having their tubes tied if:
For women who have a tubal ligation and change their minds later, a tubal reversal may be possible. However, it requires major surgery that isn’t always effective. Roughly 40% to 60% of women who have their tubal reversed become pregnant.
Additional contraindications apply to certain procedures. People with obesity, an adhesive disease, or medical comorbidities may not be good candidates for abdominal or laparoscopic surgery.
In people whose fallopian tubes are anatomically abnormal, procedures that use clips or rings to close off the tubes may not be appropriate.
What to Ask Yourself Before Choosing Birth Control
Potential Risks
As with any surgical procedure, a tubal ligation carries some risk. Possible problems can be broken down into three categories.
Risks related to the use of anesthesia:Thetype of anesthesiaused depends on the surgical approach chosen. Tubal ligation may be performed with eitherconscious sedation(a form of anesthesia where you are awake, but relaxed and drowsy) or deep sedation (ageneral anestheticis given and you are asleep).
Anesthesia can be local, regional (the body is numb from the navel down), or general (involving the entire body).
Risks of surgery in general: Generalrisks of any surgeryinclude infection and bleeding.
Possible Complications After a Tubal Ligation
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Purpose of Tubal Ligation
While the purpose of tubal ligation is to make it so that a person cannot get pregnant,whypeople seek this end result can differ and is highly personal.
For example, some people may not have children and may not want any in the future. Others may already have children but not want to add to their family for a variety of reasons. Still, others may be advised against future pregnancies due to serious health concerns.
The possible benefits of tubal ligation include:
Tubal ligation also has the added advantages of possibly reducing your risk of certain diseases.
Yet another benefit of tubal ligation is that having your tubes tied may lower your chances of developingpelvic inflammatory disease(PID).
While the risk of PID may be reduced, remember that tubal ligation does not provide any protection againstsexually transmitted diseases.
Preparation for tubal ligation always involves confirming that you are certain that you want the procedure performed. If you choose to proceed, your healthcare provider will then review technique options and logistics to help plan for your surgery.
Counseling and Consent
In the United States, sterilization procedures require informed consent. Prior to tubal ligation surgery, you will be provided with counseling to ensure you understand the procedure is permanent and not intended to be reversed.
The discussion will include alternative methods of long-acting contraception (such as anIUD) and the risks and benefits of the procedure.
Location
Tubal ligation surgery can be performed in a hospital or outpatient surgical clinic. If you are having a laparoscopic procedure that is not being performed immediately after giving birth, it can be performed as same-day surgery.
What to Wear
During the procedure, you will be wearing a hospital gown. Whether you are coming to the hospital for childbirth or for stand-alone/same-day tubal ligation, it is recommended you wear something comfortable that is easy to change out of.
You will not be allowed to wear jewelry during the procedure and you should leave anything of value at home.
Food and Drink
Your healthcare provider will instruct you on when you will need to stop eating and drinking prior to the procedure. It is typically recommended to consume anything for at least eight hours before any surgery.
Medications
Your healthcare provider will let you know what medications you can and cannot take in the days leading up to surgery. If you are pregnant and planning to have the procedure after giving birth, these directions may/may not differ from those you’ve been instructed to follow throughout gestation.
Certain drugs and supplements should not be taken prior to any surgery. Blood thinners, in particular, may cause problems with blood clotting during such a procedure. Tell your healthcare provider about all prescription and over-the-counter medications and supplements you use so you receive the proper guidance.
Don’t assume that your entire surgical team knows what medications you are taking. Repeat it to them on the day of your tubal ligation so they are aware of what you have been on and how much time has passed since you last took it.
What to Bring
Most interval tubal ligations will not require a hospital stay. You will not be allowed to drive after the procedure, so be sure to make arrangements in advance so you have a ride home. Do not forget to bring your insurance documents and identification.
Packing for a Hospital Stay
What to Expect on the Day of Surgery
If your tubal ligation is being done on its own or in conjunction with a planned C-section, you will know exactly when to report to the medical facility. If the surgery is planned to follow spontaneous childbirth, the exact date of your procedure will, obviously, not be known.
Given your circumstance, do all you can to arrive at your surgery having followed all of your healthcare provider’s pre-op instructions.
Before the Surgery
A member of the surgical team will review your medical history, ask questions about the last time you ate or drank, and take your vital statistics. You may also be given a pregnancy test to confirm you are not pregnant.
During the Surgery
What happens next depends on the type of tubal ligation procedure being done.
Laparoscopic
For a laparoscopic tubal ligation, the surgeon makes an incision in the navel and possibly another incision in the lower abdomen. A laparoscope (a small, telescope-like instrument with a light) is then inserted through the incision.
Mini-Lap
Within 24 hours after giving birth, you will be taken to an operating room for the procedure. Because your uterus is still enlarged from being pregnant, your fallopian tubes are right at the top of the uterus—which is located just under your belly button.
A small incision is made in or near the navel, the fallopian tubes are brought up through it, and a small section of each tube is removed. Alternately, both tubes can be removed completely, and sometimes clips are used to close off the tubes.
Open Laparotomy
An open laparotomy is performed immediately after a preceding surgery is complete. The surgeon will use the incision already made to remove or cut and seal both fallopian tubes before closing up your abdomen.
Regardless of the type of tubal ligation you have, the procedure takes about 15 minutes to complete.
After the Surgery
Once the procedure is complete, you will be taken to the recovery room and monitored closely until the anesthesia has worn off. If you came for a same-day procedure, it can take up to four hours before you are ready to be discharged.
For those who have a postpartum tubal ligation, the procedure will not add any additional recovery time than childbirth. The only difference is you will have a small incision on your abdomen that your healthcare provider will advise you on how to care for.
What to Expect With Postpartum Bleeding (Lochia)
The majority of people recover from this procedure with no problems. Unlike with male sterilization (vasectomy), no tests are required to check for sterility.
The ovaries are not removed during a tubal ligation. This means hormone levels will continue to fluctuate throughout the month and you will still get your period. A tubal ligation will not interfere with sexual function or desire.
Summary
Female sterilization is an effective and cost-effective form of birth control for people who are absolutely certain they do not want to become pregnant in the future. The decision to have a tubal ligation should not be taken lightly. While a tubal ligation is reversible, only about half of people who have the procedure reversed go on to become pregnant.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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