Tubal Ligation & Permanent Sterilizations – Things to Consider

November 27, 2014

Birth control runs the gamut from the rhythm method (which, btw, we don’t consider to be birth control at all since we’ve delivered many a baby as a result of this method!) to hormone-based pills and injections. You can use condoms, sponges and diaphragms or hope your spermicidal lubricant will do the trick. However, there is only one way a woman can enjoy permanent birth control and that is through tubal ligation.

Considering a Tubal Ligation? Here are Some FAQs and Answers

Yes, hysterectomies are also a form of permanent birth control but, these days, they are rarely used as such. Most women only have a hysterectomy if there is a medical reason for it, rather than as an elective form of birth control, so we’re not including it here.

What is tubal ligation?

Tubal ligation (also called “having your tubes tied”) is an invasive surgical procedure that results in the cutting, tying and/or blocking of a woman’s fallopian tubes. It prevents eggs from being able to be fertilized; when they are released, the eggs are simply blocked and are absorbed by the body.

A tubal ligation is typically done one of three ways:

• Laparoscopy. With this approach, the fallopian tubes are accessed through two small incisions in the abdomen, sometimes even through the belly button to minimize scarring.
• Minilaparotomy. With this procedure, the surgeon will make a small incision right above the pubic hair-line.
• During a C-Section. If it has been discussed beforehand, and the doctor has cleared the patient for a tubal ligation (more on that later), the procedure can be done right after a C-section.

Why does my doctor have to give me permission to get my tubes tied?

Because the procedure is considered permanent, doctors want to be sure that the patient is 100% confident about her decision. Deciding to have a tubal ligation is not something that should be done on a bad-parenting day (which can last for the first three years or more of a child’s life…). In most cases, your doctor will want you to be 25-years old or older and have at least two children of your own before she will be willing to perform the surgery on you.

Why is it called “permanent” when a tubal ligation can be reversed?

While it’s true that tubal ligations can be reversed, the data shows that – when all factors are taken into consideration – only about 50% of tubal reversals are successful. The older you are and the longer it has been after your initial surgery, the less likely it is that you will get pregnant after a tubal reversal. If you are 99.9% sure that you want permanent birth control, consider that vasectomies have a higher reversal success rate.

What are the complications associated with tubal ligations?

Typically, a tubal ligation procedure goes smoothly and there aren’t any serious complications to speak of. However, it is a surgical procedure and there are risks involved. The most common risks include:

• Typical surgical complications. Any time your body is under anesthesia you are at risk. There can be allergies and complications that have serious consequences. You will also be at risk for infection or wound separation that can lead to heavier bleeding or scarring.
• Scarring. There is always a risk of scarring, most commonly noted are “pucker-like” scars that appear at the incision site(s) and never fully recede.
• Injury to surrounding organs. While this complication is rare, there is a chance that surrounding organs – like the bladder or bowels – will be nicked when the laparoscopy instrument is used. This can cause lifelong complications and side effects.
• Long-term discomfort. We mentioned above that “blocking” is a form of tubal ligation and this is done using a fallopian tube implant. Tubal implants can cause physical pain and/or discomfort and sometimes have to be removed. Women with tubal implants are also more susceptible to infection.

The most popular alternative to permanent sterilization of the female is, of course, permanent sterilization of the male half of the partnership. Vasectomies are done during a short, out-patient procedure that has very minimal risks and almost zero complications so keep that in mind. Also, if your insurance doesn’t cover 100% of your permanent sterilization costs, vasectomies are significantly more affordable.

Have questions about whether or not tubal ligation is the right answer for you? Schedule an appointment with Women’s Health Associates and we’ll be happy to listen to your concerns and provide personalized recommendations.