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 all 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, your fallopian tubes are cut or blocked. That way, the eggs released by your ovaries each cycle can’t make their way to your uterus, where they might be fertilized by sperm.
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 1 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. That may make you feel more relaxed about sex.
It may lower your chances of ovarian cancer. Scientists aren’t sure exactly why this happens, but research has shown that tubal ligation can greatly lower a woman’s odds of this type of cancer.
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.
It doesn’t protect against STDs. You’ll need to use condoms to prevent sexually transmitted diseases, including HIV.
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.
It has risks like any surgery. Problems are very rare, but this type of surgery can cause bleeding or damage your bowel, bladder, or major blood vessels. Your incision can get infected, or you might react to the anesthesia. There’s also a small chance of lingering belly pain.
Your risk for these types of issues is higher if you’re overweight, have had surgery in the same area before, or have diabetes, lung disease, or pelvic inflammatory disease.
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.
IUD. Your doctor puts this small T-shaped plastic device into your uterus. It can stay in place anywhere from 3 to 10 years. IUDs are more than 99% effective in preventing pregnancy.
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.