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Description
Although tubal ligation is often referred to as "tying the tubes," actually, the fallopian tubes may be tied, cut, clamped or blocked, permanently preventing eggs from leaving the fallopian tubes. In no-incision sterilization, coils are inserted through the vagina, cervix and uterus, and then placed in the fallopian tubes.

How It Works
Tubal ligation is a surgical procedure that requires anesthesia. Depending on the type of procedure performed, a woman may go home the same day or may be hospitalized. If you are considering undergoing this irreversible procedure, first see your doctor or clinician and make sure you understand the risks.

With the no-incision method of sterilization, called Essure ® , the coils in the fallopian tubes cause tissue to grow, blocking the tubes and preventing eggs from getting through. It takes about three months for sterilization to become completely permanent, so another method of birth control should be used until sterilization is confirmed by your health care provider.

Should You Use It?
Women are sometimes pressured into getting sterilized, especially if they have just experienced a trying pregnancy or abortion. Many people are under the impression that sterilization is easily undone; however, sterilization should be considered permanent -- reversals can cost over $10,000 and may not be successful. One in three sterilized women regret their decision at some point in their lives, mostly due to a change in marital status, the death of a child, or a renewed desire to have children. For this reason, sterilization is not recommended unless you have a medical condition that would make pregnancy difficult or dangerous.

Effectiveness
Surgical sterilization has a failure rate of only 0.4%. The Essure ® method has been shown to be 99.8% effective.

STI Protection
Tubal ligation does not prevent the transmission of sexually transmitted infections (STIs), including HIV.

Advantages

• Tubal ligation is the safest, most effective form of birth control other than abstinence.
• It can reduce menstrual cramping and bleeding.
• The no-incision method requires no cutting or punctures to the body.

Disadvantages

• Irreversible.
• Can be expensive, costing between $1,000 and $3,000.
• Tubal ligation requires exacting abdominal surgery and anesthesia, both of which carry health risks.
• Surgical complications can include infection and uterine perforation.
• Long-term health risks of sterilization can include ectopic pregnancy, cervical cancer, menstrual cycle disturbances, increased bleeding and pain, and gynecological problems necessitating hysterectomy.
• Does not protect you from STIs, including HIV.
• Dispenses with the need for planning or forethought, sometimes enabling risky sexual behavior.

Where to Buy It
Your primary care provider, health department, family planning clinic or local medical society can refer you to a physician who can perform a tubal ligation.

Follow Up
If you experience any complications after your surgery, be sure to contact your doctor.

Contraception Overview