Is “Getting Your Tubes Tied” For You?
For years you’ve been shuffling between birth control options: setting alarms to pop a contraceptive pill at the same time every day, constantly checking the expiration dates on condoms and/or scheduling doctors’ appointments for injections or IUD insertions. It helped you time the births of your children to some degree. But now that chapter of your life is winding down, you might prefer a more permanent birth control method.
If your male spouse is willing, a vasectomy is considered by many doctors to be easier and less risky than a female sterilization. But if your spouse doesn’t want the procedure — or if you have other reasons for choosing to be the one who’s sterilized — you might be considering the surgery yourself.
You’ve probably heard the term “getting your tubes tied,” if not “tubal ligation” (or possibly “tubectomy”). But you might even hear the term ‘tubal sterilization’; even though ‘ligation” means “to tie” or “to bind” the fallopian tubes aren't actually tied together during the surgery. Whatever you call it, the procedure involves closing off a woman’s fallopian tubes, preventing eggs from traveling out of the ovaries and towards the uterus, ultimately preventing pregnancy. So is it right for you?
Who should consider This procedure?
Because it’s considered a permanent surgery, tubal sterilization is meant for you if you’re completely sure that you don’t want any more babies. Some women choose to have a tubal sterilization in conjunction with childbirth, since it can be done at the same time as a C-section or within about 48 hours after a vaginal delivery. (Many surgeons actually prefer to do this surgery after birth because you’re already in the hospital, and your abdominal wall is much more relaxed post-birth.) But you can also wait and have it done any time after that, too.
Who shouldn’t consider this procedure?
If you’re still on the fence about having more children, you might be a better fit for other forms of birth control. While you may have heard of people getting their tubal sterilizations reversed, definitely don’t get your tubes tied thinking you’ll just have the procedure reversed someday; that actually doesn’t work in all cases — plus it involves a second invasive surgery.
Since tubal sterilization involves surgery, if you’re obese, have chronic health conditions such as heart disease or if you’ve had complicated abdominal surgeries in the past, your doctor might recommend against the surgery.
What does tubal sterilization surgery entail?
What was once considered major abdominal surgery is happily now a much less invasive surgery that can be done in an outpatient setting. And since the 30-minute procedure will be performed under anesthesia (local, spinal or general), you won’t feel a thing. The surgery is typically performed by a gynecologist, general surgeon or laparoscopic surgeon. Thanks to the Affordable Care Act, insurance companies are required to completely cover the cost of the surgery.
In the days before your surgery, your practitioner may ask you to stop taking drugs that make it harder for your blood to clot (like aspirin and ibuprofen), and you’ll be asked to not eat or drink anything for the eight hours leading up to your surgery.
On the day of your tubectomy, your doctor will give you a pregnancy test just to be 100 percent sure that you’re not expecting. During the procedure itself, a small incision will be made in your abdomen — usually near your belly button — and the surgeon will pump a bit of gas into your belly and insert a light and a small tool through the incision so she can see your uterus and fallopian tubes. Then, depending what method your doctor prefers, she’ll block off your fallopian tubes by either adding a clip, by adding a ring that holds the tubes into a small kink, by making a cut in the tubes, or by burning a scar into the tubes (all of the approaches are effective).
What kind of recovery should you expect?
You’ll be able to go home from the hospital the same day you have the procedure (just make sure you have a ride home!). After all, these days tubal ligation is considered a low-risk operation.
As with any surgical procedure, mild side effects can occur. The follow symptoms should subside after a few days:
- Abdominal cramps
- Gassiness or bloating
- A swollen stomach or shoulder pain (from the gas inserted during the procedure)
- Sore throat (from the breathing tube if general anesthesia was used)
- Slight vaginal bleeding (though if you had the procedure after childbirth you’ll have the normal post-delivery bleeding which could go on for days to weeks)
Doctors usually recommend taking a day off of work to rest. Try not to touch the incision for at least one week post-surgery to help healing and avoid infection of the incision site. Your doctor will let you know when you can resume normal activities (usually within two to five days) and have intercourse (usually within a week).
When to call your doctor
If you experience any of the following more serious side effects, contact your doctor immediately:
- Fever higher than 101°F
- Fainting or feeling faint
- Bleeding at the incision site that persists or worsens after 12 hours
- Severe abdominal pain that persists or worsens after 12 hours
- Bloody or any other discharge from the incision that persists or worsens
Does it really work?
Good news: Tubal sterilizations are more than 99 percent effective. That means no more worrying about birth control. As an added bonus, according to the National Institutes of Health (NIH), tubal sterilization also significantly decreases your future risk of ovarian cancer.
Risks and complications
Now the bad news: If you notice a missed period or have a positive pregnancy test, make sure to let your doctor know right away. After the surgery, there’s still a very slight chance you could get pregnant (about 0.5 percent), and you’re at increased risk of an ectopic pregnancy, when an egg is fertilized and implanted outside your uterus (usually in one of the fallopian tubes) — a condition that can be dangerous. However the vast majority of women will have no problems and find that tubal ligation is a worry-free, permanent method of birth control.
There are also some risks associated with getting your tubes tied that generally apply to any abdominal surgery, like bladder infections, damage to blood vessels or internal bleeding after surgery. But they’re relatively minor and quite rare; less than 2 percent of women who have the surgery experience complications.