Tubal ligation -- also known as having your tubes tied -- is a kind of surgery that will keep you from ever getting pregnant. If you’re thinking about having it done, it's important to understand the procedure and the advantages and disadvantages before making a decision.
"Tubal" refers to your fallopian tubes, and "ligation" means to tie off. Fallopian tubes are thin tubes that connect each of your ovaries to your uterus -- they’re passageways for unfertilized eggs. In a tubal ligation, you’ll have surgery to cut or block your fallopian tubes. That way, the eggs released by your ovary each cycle can't meet up and be fertilized by sperm.
The Pros of Tubal Ligation
It’s permanent. This is a big plus if you don’t want to have children or you don’t wish to have any more.
It works. Only about one in 200 women get pregnant after a tubal ligation. That’s less than 1%.
It doesn’t affect your hormones. It won’t change your periods or bring on menopause. And it doesn't cause the side effects that birth control pills do, like mood swings, weight gain, or headaches, or the ones sometimes caused by IUDs, like cramps, heavier periods, or spotting.
You don't need to remember to do anything. You don’t have to put in a diaphragm, take a pill, use a condom, or count days on the calendar to avoid pregnancy. That may make you feel more relaxed about sex.
If pregnancy would be a health risk for you, or if you or your partner has a genetic disorder that would be risky to pass on to a child, tubal ligation may be right for you.
The Cons of Tubal Ligation
It’s permanent. While it can sometimes be reversed with surgery, that's not always possible. Only around half the women who have a reversal are able to get pregnant. Unless you're certain you'll never want to get pregnant, tubal ligation isn’t right for you.
Pregnancy. It’s rare, but tubal ligation can fail. If your tubes aren’t completely closed, you can get pregnant.
It may lead to an ectopic pregnancy. If you do get pregnant, you’re more likely to have this type of pregnancy, when the fetus grows in one of your fallopian tubes instead of in your uterus. Ectopic pregnancy may cause the tube to burst. This can lead to severe bleeding. You’ll need surgery right away to fix it.
After tubal ligation, you might have a rapid decline in the hormones estrogen and progesterone. This is called post-tubal ligation syndrome (PTLS). Symptoms are a lot like menopause: hot flashes, night sweats, a dry vagina, mood swings, trouble sleeping, a lower sex drive, and irregular periods. Or you could have heavy, painful periods.
The cut made from your surgery can get infected, or you might react to the anesthesia. There's also a small chance of lingering belly pain.
What Happens During Tubal Ligation?
You’ll get your tubal ligation in a hospital or at an outpatient surgical clinic. The doctor will give you medicine to make you “sleep” so you won’t feel anything during the surgery.
The surgeon will make one or two small cuts in your belly, then inflate it with gas. They’ll put a long, thin device similar to a telescope (it’s called a laparoscope) into one cut to look into your belly. They’ll put tools into the other to cut, seal, band, clamp, or tie your fallopian tubes shut.
Your surgeon will then stitch up the cuts on your belly. You can go home a few hours later to rest.
Tubal Ligation Recovery
You can probably go home a few hours after your procedure.
Your incision sites (where you got the cuts) may be a little uncomfortable afterward. You might also have pain or cramps in your belly, fatigue, mild vaginal bleeding, dizziness, or a sore throat from the anesthesia.
Wait 48 hours after your tubal ligation to bathe or take a shower. Don’t rub or scrub your incision sites for at least a week. Pat your skin dry carefully after your bath or shower.
You should be able to get back to your normal routine a few days after your tubal ligation. But don’t lift anything heavy until your doctor says it’s safe to do so.
How Soon Can I Have Sex After a Tubal Ligation?
You should be able to have sex a week after your tubal ligation.
Tubal Ligation Cost
The cost of your tubal ligation may vary based on where you live, your doctor, and your insurance coverage. Average costs range from $1,500 to $6,000.
Other Methods of Birth Control
Up to 20% of women who have tubal ligation eventually wish they hadn't, so it’s important to think about all the possibilities. Women younger than 30 are more likely to change their minds later.
If you’re not sure, you might think about these long-term options for birth control:
Vasectomy. If you’re in a committed relationship, your husband or partner might be willing to get this procedure that keeps sperm from getting into his semen. It’s a safer procedure than a tubal ligation, and it can be done while he's awake.
Implant. Your doctor puts a plastic rod about the size of a matchstick under the skin of your upper arm. It releases the hormone progestin and can stay in place for up to 3 years.