Tubal ligation or female sterilisation

This article on Tubal Ligation or Female Sterilisation explains how it works, who it is suitable for and the advantages and disadvantages of Tubal Ligation.

What is ‘tubal ligation’ or female sterilisation?

Sterilisation is permanent contraception. It is commonly referred to as ‘having your tubes tied’.

Every month an egg is released from one of the woman’s ovaries and travels along the fallopian tubes to the womb, or uterus. Here it will implant to form a new pregnancy, if it has been fertilised by the male sperm.

Female sterilisation involves an operation called tubal ligation, where the fallopian tubes are closed by one of the following methods –

• electro coagulation – the tubes are cauterised
• clips
• rings
• cut and tied.

There are two methods of doing the procedure

• Using a laparoscope (a tiny camera), which is inserted near the navel, via a small cut to the skin and muscle. A small incision is also made near the pubic hair line to attach the clips onto the fallopian tubes.
• Alternatively a larger abdominal incision will need to be made near the pubic hair line, if the laparoscopy is unsuitable, due to medical reasons.

Where and when can you get sterilised?

This method of contraception is suitable for women who do not want children, or who do not want any more children, or who are unable to have more children for financial or personal reasons.

It is advisable to consider whether you are ever likely to want any more children, for example if you had a new partner, or one of your existing children died.

It is also advisable to discuss this with your partner, although it is not legally necessary for them to give consent for you to have a permanent sterilisation.

If a woman decides that she wants to have this operation, in order to have permanent contraception, she will need to go to hospital for the procedure.

Occasionally this can be done at the same time as an elective Caesarean section, if discussed before hand with the obstetrician.

How does sterilisation work?

As a result of the fallopian tubes being cut or closed the sperm can no longer reach the egg – and the egg can no longer reach the womb. Pregnancy can therefore no longer take place.

How much does sterilisation cost?

Check with your own District Health Board for the current length of time on the public waiting list.

Tubal ligation costs about $3,500 – $5,000 when performed by a private surgeon. Most health insurance plans potentially cover treatment costs, but check the details in your own policy for inclusions, exclusions, and coverage maximums.

What is the success rate of sterilisation?

Sterilisation is very effective in preventing unwanted pregnancy. The failure rate is 1 in 200 – if 200 women use sterilisation for one year, one will fall pregnant.

Sterilisation does NOT prevent sexually transmitted infections or STIs. It is necessary to use a condom also to prevent infection.

What are the risks of sterilisation?

This is a permanent method of contraception; although some women have a successful reversal of a tubal ligation, this is not guaranteed.

Tubal ligation is done under general anaesthetic (you are ‘put to sleep’) or spinal anaesthetic (which blocks pain and sensation to your lower body) which both carry a small risk. Your anaesthetist will talk you through any particular risks for you (for example, smoking, medical conditions, previous anaesthetics) prior to the operation.

All operations carry a risk of infection. This can be minimised by –

• a healthy diet of fruit and vegetables
• avoiding smoking
• resting to allow the wound to heal well
• keeping the wound clean

All operations carry a risk of internal bleeding and risk of damage to other organs. These risks are minimal.

If a woman falls pregnant after a tubal ligation, she is at an increased risk of an ectopic pregnancy (where the fertilised egg implants outside of the womb).

What are the pros of female sterilisation?

• Female sterilisation is immediately effective.
• Sometimes women can go home the same day – particularly if the laparoscope has been used, as the cut will be smaller.
• Your normal menstrual cycle is unaffected by the operation and normal periods continue.

What are the cons of female sterilisation?

• Some women have to stay in hospital for 1-2 days, may have implications for childcare, work and life in general!
• Women need to avoid any lifting or straining for at least a week.
• This operation is not always reversible – and there is a cost to this whether a reversal is successful or not. It is advisable to think carefully before undertaking permanent contraception.

Check out the following articles to compare this option with the Combined Pill or Progesterone Only / Mini Pill, go here for additional information on Condoms. Or check out our full contraception section for more expert advice.