What is it?
Tubal ligation is an operation in which the fallopian tubes are closed off to prevent the ova from entering the uterus and encountering sperm. The fallopian tubes are cut and tied, cauterized, clamped shut, or blocked. Tubal ligation is known as female sterilization because it renders the female unable to conceive and is largely irreversible.
 
How it's done:
There are two major surgical procedures and two transcervical methods used for tubal sterilization used in the United States. The surgical methods are minilaparotomy and laparoscopy and the transcervical procedure is known as Essure.
Minilaparotomy:
In this method, a small incision is made just above the pubic hairline. The surgeon is then grasps the fallopian tubes, pulls them to the incision, and clamps them or ties and cuts them. This method is considered major surgery and is done under general anesthesia. Recovery generally lasts a few days.
 
Laparoscopy:
This method is considerably less invasive than the Mini-lap. The surgeon makes two tiny incisions in the abdomen and inserts a thin viewing tube called a laparoscope into one and a second operating device into the other. The surgeon locates the fallopian tubes using the laparoscope and uses the operating device clamp or cut the oviducts. Because of the smaller incision used in a laparoscopy, this method is generally less painful and can be done under either local or general anesthesia.
 
Essure:
This method involves passing a metal and plastic coil through the cervix and uterus until it reaches the fallopian tube. The metal coil holds the device in place while the plastic fibers cause a local reaction in the fallopian tube. This reaction causes the growth of tissue around the Essure device that eventually closes off the oviduct. This tissue growth takes approximately 3 months and thus the contraceptive efficacy of Essure is not immediate, as with the Mini-lap and the Laparoscopy. This method requires neither general anesthesia nor incisions and may be preferable to women who do not want to undergo surgery.
 
Things to consider:
Female Sterilization is generally an irreversible form of birth control. As with any permanent change to your body, it is important to consider the impact this will have on your life. Before finalizing your choice, consider whether or not there any circumstances in which you may want to have more children in the future. If you are unsure about female sterilization, consider what other forms of birth control might be a better alternative at this point in time. Finally, if in a committed relationship, be sure to discus female sterilization with your partner before going through with the procedure.
 
What if I regret my decision?
It cannot be stressed enough that tubal ligation is meant to be a PERMANENT procedure. It is technically possible to reverse the procedure but the surgery is very expensive and may not be effective.
 
Potential Problems:
There a very few risks inherent to female sterilization and almost no conclusive evidence for any major side effects other than those inherent to any major surgery.
 
Advantages:
Female sterilization is a permanent method of birth control requiring no action on the part of the woman. After undergoing the procedure, the woman will no longer have to worry about becoming pregnant. This fact alone can bring quite a bit of peace of mind to a woman. In addition, sterilization causes absolutely no hormonal changes to the body and thus can be considered more natural when compared to hormonal birth control methods.
 
Disadvantages:
Depending on one’s point of view, the irreversibility of female sterilization can be seen as a disadvantage. If the woman has a change of heart after the procedure it is very difficult or impossible to reverse the sterilization. In addition, sterilization does not protect against STI’s and thus barrier protection still must be used during intercourse. Another disadvantage is that some methods of female sterilization requires surgery.
 
Effectiveness:
Only about 0.5% of women become pregnant after surgical tubal ligation. Only .26% of women become pregnant after the Essure procedure.
 
Cost:
The cost varies from $1500 to $6000, depending on the type of procedure and where you live.
 
 
 
References:
“Sterilization for Women (Tubal Sterilization)” Planned Parenthood. Planned
Parenthood Federation of America, 2012. Web. 6 March 2012
Hurskainen, R. et al. (2010). "Hysteroscopic tubal sterilization: a systematic review of the
Essure system". Fertility and sterility 94 (1): 16–19.
 
Greenberg, Jerrold S., Clint E. Bruess, and Sarah C. Conklin. "Female Sterilization."
Exploring the Dimensions of Human Sexuality. 4th ed. Sudbury, MA: Jones and Bartlett, 2011. 204-07. Print.
 
LeVay, Simon, Janice Baldwin, and John Baldwin. "Chapter 9: Contraception and
Abortion". Discovering Human Sexuality. Sunderland: Sinaur Associates, Inc.,
2009.
 
Created April 6, 2003, last updated April 17, 2012