tubal ligation

If you’ve been looking into long-term birth control methods, you have almost certainly heard about tubal ligation, or “getting your tubes tied.”

With all the different family planning tools available to men and women these days, all of the choices may be overwhelming. However, many of the options are intended for short to mid-term contraception and are not considered permanent solutions. This is especially true of hormonal birth control methods, like the birth control pill or the birth control patch, which are typically not suitable for women over 35. 

Having your tubes tied, on the other hand, is a permanent and effective birth control option. The most typical candidate is a woman who has already had the number of children she wants, who has one sexual partner, and who doesn’t want to have to worry about birth control methods all the way up to menopause. If you would like to know more about tubal ligation, keep reading.

Tubal ligation: Dam it up

How can birth control be permanent? Well, the name tubal ligation actually refers to a set of surgical procedures that either remove a part of the female reproductive system or, more commonly, create an impassable barrier between your eggs and your uterus (and the visiting sperm!). More specifically, it closes the fallopian tubes through cutting, burning, or cinching with a device. The body continues releasing eggs as before, but they can never reach the uterus. Similarly, the sperm can’t travel up to meet them. The barrier acts like a dam that keeps the sperm and egg separated; instead, the egg biodegrades inside the fallopian tube and is reabsorbed by your body.

It’s as easy as that! You simply have the procedure and go about your daily life. You and your partner will be free to enjoy spontaneous lovemaking without worrying about an accidental pregnancy. Most women even still have periods just like before because the body continues to release eggs just like it always has. However, the specific post-op experience will be different for each woman and will also depend a lot on which specific procedure is done.

Tubal ligation: Choose carefully 

There are many different ways to getting your tubes tied, with very few of the modern methods actually involving tying. Typically the procedures can be done within an hour, using either local or generalised anaesthesia. Some require incisions, whereas others can be performed vaginally. Also, some have much greater risk of complications and side effects than others, so you should talk over all the options thoroughly with your doctor before deciding which procedure to have. Here is a quick list and explanations of some of the most common tubal ligation surgeries:

  • Laparoscopy – They fill the abdomen with carbon dioxide to inflate the abdominal wall and push it away from the fallopian tubes and uterus. The doctor will make a small incision just under the belly button and use a laparoscope (a tool that works a bit like a telescope) to see inside. He will make another cut a few inches lower than that to insert the tool that will seal the fallopian tubes. Your doctor may choose to physically tie them, burn them sealed, or pinch them closed with a device.

  • Mini-laparotomies – This is essentially the same procedure as the laparoscopy, but in some cases they are able to do all the work through only one incision.

  • Tubal implant – The doctor will have to dilate your cervix, and then he will use a catheter to place implants inside the fallopian tubes. During the few weeks following the procedure, scar tissue will be developing around the implants, which will form the barrier. With this method, you have to use an alternate form of contraception for the first 90 days while the scar tissue grows.

  • Hysterectomy – In some cases, this more extreme method may be the best option. It is the removal of the uterus, fallopian tubes, ovaries, or cervix—all, some, or one of these may be removed.

After the surgery, you will need to take it easy for a few days. You can begin having sex again when you feel comfortable, unless the surgery was performed vaginally, in which case you need to wait 2 weeks to prevent infections.

Tubal ligation: Weighing the good and the bad 

Most women who opt to have tubal ligation surgery do so because it is an extremely effective—99.5%--and permanent birth control solution. Also, most of the procedures are immediately effective. Furthermore, they require no attention after the surgery and allow for sexual spontaneity, unlike many other birth control methods.

On the other hand, there are some drawbacks to getting your tubes tied. Primarily, it requires surgery, which can make some feel nervous or uncomfortable. And although the procedures are relatively easy and safe, there are always some associated risks or potential complications. For example, in the rare event that you do get pregnant after tubal ligation, you will be much more likely to suffer from an ectopic pregnancy. There are also increased risks for bladder infections as well as irregular bleeding. Furthermore, there may be a condition called post-tubal sterilization syndrome that includes very painful menstruation, or even no menstruation at all, but its existence is debated within the medical community. An additional drawback is that it cannot protect against STIs or HIV.

Tubal ligation: Varying cost

Because tubal ligation is a surgical procedure, where you live and what kind of healthcare you have will determine the price. Within the UK, almost all contraceptive procedures are offered to all free of charge.


Tubal ligation: What if you change your mind?

Even though tubal ligation is meant to be a permanent form of birth control, some of the procedures can be reversed. If you think it’s possible that you could regret your decision or change your mind in the future, you may want to talk to your doctor about which procedure would be best for you. However, there are a number of factors, complications, and risks to consider before having a reversal. First, depending on where you live and your healthcare provider, it could be very difficult. Also, tubal ligation reversal surgeries can be more difficult than the initial procedure, made easier or harder depending on which type of procedure you’ve had. They are not always successful, though, and the chances of having an ectopic or risky pregnancy after reversal are much higher.

There is a lot to think about when considering getting your tubes tied. Family planning methods are always something that you should think about carefully and discuss with your doctor and partner, but this is even truer for permanent options like tubal ligation. If you decide to go with this option, it will most likely turn out well without complications, but surgery is a serious step. Never let anyone pressure you into making such an important decision because it may not be reversible. Instead, think hard about what you want for yourself and what you are comfortable with—and follow your heart!