Maybe you've decided your family is perfect and you don't want to have any more (or any at all) children.  You can either continue using contraception until you or your partner goes through menopause or have surgery (vasectomy or tubal ligation) to make that decision permanent. While vasectomy is a less expensive, less invasive and less risky procedure than tubal ligation, it's not right for every couple or woman.  When you're absolutely sure there are no more babies in your future, tubal ligation might be for you.

What is tubal ligation?  Sometimes called female sterilization or "getting your tubes tied," tubal ligation is one of three surgical techniques that blocks the fallopian tubes and prevents sperm from reaching an egg.  Normally, an egg is released into one of the fallopian tubes (ovulation) during each menstrual cycle. If a woman has sex near the time of ovulation, sperm is released into the vagina and travels through the uterus and fallopian tubes where it can penetrate and fertilize the egg.  That fertilized egg then travels through the fallopian tube and implants into the uterus.  Nine months later, you're having a baby.   With tubal ligation however, the fallopian tubes are blocked, clipped or closed so sperm never reaches the egg.  While no birth control method is guaranteed to be 100 percent effective, tubal ligation is pretty close, at greater than 99 percent.

There are two options for performing tubal ligation: 

1) No-incision methods

2) Incision methods

No-incision methods involve inserting a small plug or coil into the fallopian tubes.  Over time, scar tissue forms around these plugs or coils and permanently blocks the tube. It takes a few months for scar tissue to form so backup birth control is required until doctors determine by special x-ray that the tubes are blocked. This procedure is often done in a doctor's office or a day surgery center.  Pain medication and local anesthesia are administered (not general anesthesia) as well as medication to dilate the cervix. Then, small tools and a special microscope are threaded into the uterus and fallopian tubes.  The whole procedure takes about 30 minutes and most patients can go about their normal business as soon as pain medication wears off.

Incision methods of tubal ligation are performed by one of three techniques:

1)  Laparoscopy - surgical tools and a customized microscope are inserted through mini-incisions in the abdomen which is inflated with gas so doctors can see and work. Fallopian tubes are then either clamped, cut and tied or cut and burned.  This procedure general anesthesia or an epidural.  It is effective immediately and most patients fully recover within a week.

2) Mini-laparoscopy is similar to a laparoscopy but is done through one small incision (usually less than 2 inches).  It's often done right after childbirth while the fallopian tubes are high in the abdomen.  No gas is required and most patients recover quickly.


3)    Laparotomy is major abdominal surgery, usually requiring general anesthesia and longer recovery time.  This procedure is sometimes performed with another abdominal surgery like a cesarean section or when laparoscopy is not possible. 

Tubal ligation is intended to be permanent. Tubal ligation reversals are possible but aren't very effective.  Talk to your gynecologist about whether this choice is right for you.



Planned Parenthood - Sterilization for Women