What is Tubal Ligation?

Do you remember learning about sex in middle school? I was fortunate enough to learn how to use a condom with the help of a banana, and after we all practiced protecting a phallic-shaped fruit from pregnancy and STIs, my teacher quickly went over birth control options for people with vaginas. A powerpoint featuring contraceptive pills, the depo shot and a diaphragm was quickly covered, but some options were excluded from this not quite comprehensive deck. One of those was any mention of tubal ligation. If your sexual health education was anything like mine, then keep reading to learn more about tubal ligation as a form of permanent birth control, and decide if it’s right for you.

What is Tubal Ligation? 

Tubal ligation, commonly known as getting your tubes tied or tubal sterilization, is a form of permanent birth control for people with vaginas. During a tubal ligation procedure, the fallopian tubes are cut, tied or blocked. This prevents pregnancy by blocking an egg's ability to travel from the ovaries through the fallopian tubes, and by blocking sperm from traveling through the fallopian tube to reach the egg. The procedure is done by making a small incision into your abdomen and anesthesia is necessary. 

The Procedure

You can receive tubal ligation at any time, including after childbirth or during a C-section. If you receive tubal ligation as a stand alone, outpatient procedure your abdomen is inflated with gas through a needle or incision through your belly button. This allows a laparoscope to be inserted in your abdomen. It is common for additional special instruments to be inserted through a second incision in your abdominal wall. These instruments destroy or block the tubes with rings or clips in order to seal the fallopian tubes.  If you plan to have a tubal ligation after childbirth the doctor will make a small incision under your belly button to access your uterus and fallopian tubes if you have a vaginal childbirth. If you have a C-section, the doctor will use the same incision used to have the baby to complete the tubal ligation. 

Fewer than 1 out of 100 people will become pregnant in the year following tubal ligation but it is more likely to fail if you undergo the procedure when you are younger. If you do become pregnant after a tubal ligation, you may be at risk of an ectopic pregnancy. This demands immediate medical treatment and termination of the pregnancy. If you think you have conceived at any point after a tubal ligation you must reach out to your medical provider as soon as possible. 

Is Tubal Ligation Right for Me? 

While it may be desirable to be done with birth control pills, rings or condoms, it’s important to note two things. First of all, tubal ligation doesn’t prevent STIs, so it’s important to consider using other protective measures with your partners. Additionally, if you do decide to have children, reversing tubal ligation requires major surgery and it may not be effective. Make sure you review all options with your doctor, who may suggest other control measures. 

If you’re thinking tubal ligation may be right for you, be sure to prepare appropriately. This preparation consists mostly of having a candid conversation with your doctor about your reason for seeking sterilization, the risks and benefits of tubal ligation, details of the procedures and ways to prevent STIs. It is also recommended to begin or continue another form of birth control for a month leading up to the procedure to ensure you prevent pregnancy if you plan for an outpatient procedure.

You may feel pain or discomfort in different parts of your body, fatigue, dizziness or gas and bloating following a tubal ligation. It is important to avoid straining or irritating the incision area in the days after the procedure. This means no heavy lifting or sex. You may bathe 48 hours after the procedure, but make sure to try the area carefully and to avoid any extraneous rubbing while getting clean. 

Deciding to forgo having a child, and the different ways to prevent pregnancy is a personal choice. While our middle school sex education may not have given us all the information about ways to avoid conception, options to decide your reproductive future exist. For those interested in permanent birth control, talk to your healthcare provider about tubal ligation.