Tubal ligation, often referred to as “tying the tubes,” is one of the most popular methods of fertility control in the United States. This is the most commonly used method of contraception among married or previously married women. The procedure involves ligating, or surgically interrupting the fallopian tubes. This prevents the egg (ovum) from being transported to the uterus, and also blocks the passage of sperm through the tubes.
There are several methods of tubal ligation. It is generally performed laparoscopically as an outpatient procedure under general anesthesia. A laparoscope is a narrow telescope which is inserted through the belly button after the abdomen is filled with gas. Another small incision is usually made above the pubic bone, and the tubes can be ligated with rings or bands, or cauterized (burned). Alternatively, at the time of cesarean section, the tubes may be ligated. After a vaginal delivery, a surgical procedure called a “mini-laparotomy” can be performed under epidural, spinal, or general anesthesia. This involves making a small incision below the umbilicus and locating and ligating the tubes through the incision. This does not normally increase a woman’s hospital stay.
There are some risks to this surgical procedure. A very small percentage of women will have serious complications related to general anesthesia. Another potentially serious complication is injury to the bladder, bowel, or blood vessels during the operation.
Occasionally, tubal ligation fails, and the woman becomes pregnant. The pregnancy rate after tubal liga-tion is about 1 in 200, and is higher for younger women.
Another serious problem after tubal ligation is regret, which is more common in younger women, and in women who remarry. Tubal ligation may be reversed, but this requires a major surgical procedure. Following a tubal ligation reversal, approximately 50-80% of women will become pregnant, depending upon the type of tubal ligation that was performed.
Most providers will also counsel women about other alternatives prior to performing a tubal ligation. Tubal ligation is often a good choice for women who are positive in not desiring future pregnancy.
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