What is tubal ligation and how does it work? Doctors explain.

Knots tied to represent tubal ligation
Tubal ligation, sometimes known as female sterilization or "getting your tubes tied," is a permanent form of birth control. (Getty Images)

The overturning of Roe v. Wade, the Supreme Court case that guaranteed the right to an abortion on a federal level, has caused many women across the country to take a closer look at their birth control options. Tubal ligation, aka female sterilization, is getting plenty of attention as a method to consider.

Tubal ligation’s popularity isn't new, it turns out: Data from the Centers for Disease Control and Prevention shows that female sterilization is the most common contraceptive method used, with 18.6% of women aged 15 to 49 relying on it to prevent an unintended pregnancy. The most popular methods after that are the oral contraceptive pill (12.6%), long-acting reversible contraceptives (10.3%), and the male condom (8.7%).

If you're done having children or don't want them at all, you may be interested tubal ligation. Here's what you need to know.

How does tubal ligation work?

Tubal ligation is a permanent form of birth control, according to the American College of Obstetricians and Gynecologists (ACOG). With a tubal sterilization, the fallopian tubes are removed or cut and tied with special thread, closed shut with bands or clips, or sealed with an electric current, the ACOG explains.

“These procedures can be performed at two distinct times — right after delivery of a baby, while still in the hospital, or separate from pregnancy/delivery,” Dr. Jessica Kiley, chief of general obstetrics and gynecology at Northwestern Medicine, tells Yahoo Life. “In the U.S., the latter are typically performed via laparoscopy, which is a minimally invasive surgical procedure using small incisions.”

Tubal ligation can be done via a minilaparotomy, a small abdominal cut used for a surgery in which the fallopian tubes are closed off, or laparoscopy, a surgical procedure in which a thin, lighted telescope called a laparoscope is inserted through a small incision in the abdomen.

The goal of the procedure is to prevent sperm from reaching the egg, women's health expert Dr. Jennifer Wider, tells Yahoo Life.

What is the recovery from tubal ligation like?

In general, “recovery is pretty rapid and straightforward,” Kiley says. “Patients go home the same day after a laparoscopic procedure and recover from the effects of anesthesia quickly,” she continues. “There may be soreness in the belly or at the incisions, but it’s usually not much and can be controlled with common pain medications.”

In fact, the ACOG says that most women can go home two to four hours after the procedure (although you'll need someone to drive you home because of the lingering effects of the anesthesia).

The ACOG says you may have the following symptoms after a tubal ligation:

  • Dizziness

  • Nausea

  • Shoulder pain

  • Abdominal cramps

  • Gassy or bloated feeling

  • Sore throat (from the breathing tube if general anesthesia was used)

“After a laparoscopic procedure, patients typically recover within a week or two,” Kiley says. That said, if you had a tubal ligation after giving birth, you may be in the hospital a little longer than someone who didn't give birth, simply because of normal postpartum care. Keep in mind, though, that “recovery from a postpartum procedure does not extend the hospital stay or affect normal postpartum recovery,” says Kiley.

After the procedure, “patients are told to avoid heavy lifting and sex until cleared by their health care provider,” Wider says.

How effective is tubal ligation?

Tubal ligation is considered a highly effective method of birth control: Fewer than 1 out of 100 people who have a tubal ligation will get pregnant each year, according to Planned Parenthood.

Worth noting, however, is that tubal ligation may be less effective in younger women. “Since the likelihood of failure continues over time — we call this the ‘cumulative failure rate’ — younger individuals have a higher likelihood of failure in their lifetimes,” Kiley says.

What are some of the reasons why women choose tubal ligation?

Kiley cites the main reasons why someone may opt for female sterilization:

  • It's permanent, so there's no need to worry about contraception in the future

  • Control over your own fertility

  • To avoid other methods of birth control, like IUDs and implants

  • To avoid having more children, or if you know you never want children

  • To have an effective form of contraception without hormones

Can tubal ligation ever be reversed?

If you're considering the possibility of having children, Wider says it's best to find a different form of birth control. “Most health care providers will warn patients that the procedure is permanent and should only be chosen if they no longer want to have a family,” she says. “Having said that, it can be reversed, depending on the procedure, but it isn’t a guarantee and reversal doesn't work for everyone.”

Kiley agrees. “Often, patients who seek pregnancy after having had a permanent contraception procedure will undergo in vitro fertilization.”

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