Tubal ligation or Female Sterilization is a permanent birth control method. In tubal ligation, the fallopian tubes are cut, tied or blocked to prevent pregnancy permanently.
Tubal ligation prevents the egg from passing from the ovaries through the fallopian tubes and prevents the sperm from moving through the fallopian tubes to the egg. This procedure does not affect the menstrual cycle.
Tubal ligation can be done at any time, including after the baby is born or with other abdominal surgery, such as cesarean delivery. Most tubal ligation procedures cannot be reversed. If a reversal is attempted, it requires major surgery and is not always effective.
Tubal ligation is one of the most common surgical sterilization procedures for women. Tubal sterilization prevents pregnancy permanently, so you will not need any form of contraception later. However, it does not protect against sexually transmitted infections.
Tubal ligation can also reduce your risk of ovarian cancer, especially if the fallopian tubes are removed.
However, tubal ligation is not suitable for any woman. Your doctor will ensure that you fully understand the risks and benefits of this procedure. Your doctor can also talk to you about other options, including long-term reverse contraceptives such as IUD, or a contraceptive implanted in your arm. Another permanent option is hysteroscopy, in which your doctor places a small device inside your fallopian tubes. This device causes scar tissue to form and close off the tubes.
Tubal ligation is a surgical procedure that involves making abdominal incisions and it is done under anesthesia. The risks associated with tubal ligation include:
- Major bowel, bladder or blood vessel damage
- Anesthesia reaction
- Infection or improper wounds recovery
- Persistent abdominal or pelvic pain
- Procedure failure, which leads to unwanted pregnancy in the future
Things that make you more likely to have complications from tubal ligation include:
- History of abdominal or pelvic surgery
How to prepare
Before undergoing tubal ligation, your doctor will talk to you about the reason for wanting sterilization. Together, you will discuss factors that may make you regret the decision, such as young age or changing your marital status.
Your doctor will also review the following:
- The risks and benefits of permanent and reversible contraceptives
- Procedure details
- The cause and probability of sterilization failure
- Methods to prevent sexually transmitted diseases
- The best time to do the procedure – for example, soon after birth or along with other abdominal surgery, such as a cesarean delivery
What to expect
Tubal ligation can be done in the following cases:
- After vaginal delivery through a small incision under the belly button (mini-abdominal incision)
- During a cesarean delivery
- At any time as an outpatient procedure using a laparoscope and short-acting general anesthesia.
During the procedure
If the tubal ligation is performed as an outpatient procedure, either an incision is made, or a needle is inserted through the navel so that your stomach can be inflated with gas (carbon dioxide or nitrous oxide). The laparoscope is then inserted into the abdomen.
In most cases, the doctor will make a second small incision to insert special tools through the abdominal wall. The doctor uses these tools to seal the fallopian tubes by destroying the tips of the tubes or plugging them with rings or plastic clamps.
If the tubal ligation is performed after a vaginal delivery, the doctor will likely make a small incision below the navel, providing easy access to the uterus and fallopian tubes. If the tubal ligation is going to be done during cesarean delivery, the doctor will use the incision made to deliver the baby.
After the procedure
If the gas is used during tubal ligation, it will be removed upon completion of the procedure. You may be allowed to go home several hours after undergoing the procedure. Undergoing tubal ligation immediately after birth does not usually require staying in the hospital for a longer period.
You will feel uncomfortable in the place of the incision. You may also experience:
- Abdominal pain and cramps
- Gas or bloating
- Shoulder pain
Your doctor will discuss pain management with you after the procedure, before leaving the hospital and going home.
You can shower 48 hours after the procedure but avoid rubbing the incision. Carefully dry the incision after a shower.
Avoid lifting heavy objects and having sex until your doctor tells you it’s safe to do so. You can gradually resume your normal activities when you start to feel better. The stitches will fade and will not need to be removed. Consult with your health care provider to see if you need to set up a follow-up appointment.
If you have concerns that you are not recovering properly, contact your doctor. Contact your doctor right away if you have any of the following symptoms:
- Temperature of 100.4 ° F (38 ° C) or higher
- Fainting spells
- Severe abdominal pain that persists or worsens after 12 hours
- Bleeding from the wound passes through the bandage
- Smelly discharge from the wound
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