Every year, around 700,000 women are sterilized, or get their “tubes tied.” This is surgery that blocks the fallopian tubes to prevent pregnancy. For women, this method is more popular than birth control pills: 12.6% of women use the pill, while 18.6% get their tubes tied.
This is because it’s a safe, convenient, and effective form of birth control. It’s also considered permanent, but there are exceptions. Pregnancy -- intended and unintended -- is still possible. Sometimes, it can happen many years after you’ve had the operation. In some cases, it can be a medical emergency.
How Well Does It Work?
Tubal ligation is an extremely reliable way to prevent pregnancy. Fewer than 1 out of 100 women will get pregnant within a year of surgery. But different things play a role in your chances of getting pregnant later.
One is the surgical method your doctor uses. Your tubes may be:
- Cut and tied with special thread
- Closed with bands or clips
- Cauterized, which means they’re sealed shut with an electric current
- Blocked with scar tissue that forms when your doctor inserts small implants
While all work well to prevent pregnancy, not all are equally effective. Methods that cause the most damage to the tubes are most likely to be permanent.
Age also plays a role in the chance that you could get pregnant after the procedure. The younger you are when you have it, the more likely it is to fail at some point.
Rarely, an ectopic pregnancy can happen after tubal ligation. This isn’t like a normal pregnancy, when a fertilized egg attaches and grows inside the uterus. Instead, the fertilized egg implants and starts to grow somewhere else, usually in a fallopian tube. The fertilized egg can’t survive. You could also have serious internal bleeding.
Remember, there’s almost no chance you’ll get pregnant after the surgery. But you should still be aware that there’s a small chance of having an ectopic pregnancy. One study found that a third of unintended post-tubal ligation pregnancies were ectopic.
You need to see a doctor right away if you think you have an ectopic pregnancy. Warning signs include:
Reversing Your Tubal Ligation
Just because you were anti-pregnancy when you had your operation doesn’t mean you’ll always feel that way. More than 14% of women who had their tubes tied have later asked for information about how to reverse it.
If you want to get pregnant, you may able to reverse your tubal ligation. In a best-case scenario, the pregnancy rate after this procedure is 75%-80%. Success depends on several things, such as:
- Length and health of fallopian tubes
- The type of surgery used
- Presence of scar tissue: In general, you can’t reverse Essure, the method that causes scar tissue to form via tiny implants.
If you’re not a candidate for reversal surgery, you may still be able to get pregnant through in-vitro fertilization. This is when a fertilized egg is placed directly into your womb. This may be the best option for women over 40 who want to get pregnant. Women this age are less likely to have good results from the reversal.