Maybe you’ve already completed your family, and don’t want to add more children to your brood. Perhaps you’ve decided you don’t want to have kids at all. Or, you just don’t like the other birth control methods that are available. For women who are confident that they don’t want to have babies in the future, permanent sterilization through tubal ligation – aka “getting your tubes tied” – can be an attractive option.
Even more popular than implanted uterine devices, condoms, and birth control shots, tubal ligation surgery is becoming the birth control method of choice for an increasing number of women. A full 27 percent of American women currently using contraception go on to get their tubes tied.
And while tubal ligation used to be thought of as an option chosen by mostly older women, data shows that it’s the millennials who are lining up to get the surgery done. Because tubal ligation is considered permanent, it is important for younger women to understand how it works, and for them to be 100 percent certain they want to give up the ability to have children in the future.
Should you get your tubes tied? Here are five things to know before moving forward with it.
Tubal ligation is simple and effective
The procedure is straightforward enough: A surgeon makes a small incision in the abdomen and seals both ends of the Fallopian tubes by cutting, banding, or clamping them; this prevents sperm from meeting up with the woman’s eggs. The procedure can be performed during a Cesarean Section, after a vaginal delivery with a small incision near the belly button, or by laparoscopy with 2-3 very small incisions as an outpatient. These procedures are covered by most insurance policies. And besides abstaining from sex altogether, tubal ligation is one of the most effective methods of birth control out there, with a 99.5% success rate. This means there is still a very slight chance you could get pregnant.
Tubal ligation is safe, but there are risks
While tubal ligation is a safe procedure with little risk of complications, injury to arteries, bladder or large intestine can occur. Also, as with any surgery, there are risks of infection and with adverse reactions to anesthesia. Additionally, if a sperm meets an egg outside the womb, an ectopic pregnancy can result, which can be life-threatening. Or, the tubes can sometimes actually “grow back together,” allowing sperm back into the Fallopian tubes. And finally, unlike with the use of condoms, tubal ligation doesn’t protect you from sexually transmitted diseases.
You can’t change your mind later
Tubal ligations are not performed on women who may want a future pregnancy. It is very difficult to reverse the procedure, and very expensive. In addition, many physicians are recommending complete removal of the fallopian tubes instead of tying the tubes. Removal of the tubes increases the effectiveness of the procedure and may lower the risk of ovarian cancer.
Your period may change afterward
Even though you have gone through surgery that prevents pregnancy, your hormones are still working, so you’ll still ovulate and have a period every month. But many women notice changes in the duration and heaviness of their periods, and can even experience lengthy, painful cramping during ovulation. There are various theories as to why these things can happen – from stopping the use of birth control pills to fluctuating hormonal levels that would change with age anyway. This is another reason to have a long talk with your doctor about the options and benefits of various birth control methods. If birth control pills have been helping to control cramps, acne or weight gain, for example, you may want to keep taking them after sterilization.
Vasectomy is an easier procedure
If you and your partner have decided on permanent sterilization, you might consider vasectomy instead. Since a vasectomy is performed outside the abdomen and doesn’t require general anesthesia, it is regarded as a much less risky procedure. Also, vasectomy is even more effective at preventing pregnancy than tubal ligation. Finally, vasectomy is cheaper to do than tubal ligation. (If your partner has reservations about getting snipped, perhaps this appeal to his wallet can change his mind!)
If you are considering tubal ligation as your method of birth control, it’s important for you to be very confident in your decision. If you have any doubts or questions, it’s a good idea to talk it over with a physician. You can find a doctor who can help you in our provider directory.
Have you had an experience with tubal ligation or other long-term forms of contraception? Share your story below.