Getting Your Tubes Tied: Pros, Cons, what to Know

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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 the procedure and 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, you’ll have surgery to cut or block your fallopian tubes. That way, the eggs released by your ovary each cycle can't meet up and be fertilized by sperm.

The Pros of Tubal Ligation

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 one 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 to avoid pregnancy. 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.

If pregnancy would be a health risk for you, or if you or your partner has a genetic disorder that would be risky to pass on to a child, tubal ligation may be right for you.

The Cons of Tubal Ligation

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.

Pregnancy. It’s rare, but tubal ligation can fail. If your tubes aren’t completely closed, you can get pregnant.

It may lead to an ectopic pregnancy. If you do get pregnant, you’re more likely to have this type of pregnancy, occurs in someplace other than the uterus, usually in one of your fallopian tubes. Ectopic pregnancy may cause the tube to burst. This can lead to severe bleeding. You’ll need surgery right away to fix it.

There are risks to surgery. Problems are very rare, but this type of surgery can cause bleeding or damage your bowel, bladder, or major blood vessels.

After tubal ligation, you might have a rapid decline in the hormones estrogen and progesterone. Whether this may occur is often debated but it is referred to as post-tubal ligation syndrome (PTLS). Symptoms are a lot like menopause: hot flashes, night sweats, a dry vagina, mood swings, trouble sleeping, a lower sex drive, and irregular periods. Or you could have heavy, painful periods.

The cut made from your surgery 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.

Burns to your bowel or skin are also possible if your surgeon uses electric current to seal off your fallopian tubes.

What Happens During Tubal Ligation?

You’ll get your tubal ligation in a hospital or at an outpatient surgical clinic. The doctor will give you medicine to make you “sleep” so you won’t feel anything during the surgery.

The surgeon will make one or two small cuts in your belly, then inflate it with gas. They’ll put a long, thin device similar to a telescope (it’s called a laparoscope) into one cut to look into your belly. They’ll put tools into the other to cut, seal, band, clamp, or tie your fallopian tubes shut.

Your surgeon will then stitch up the cuts on your belly. You can go home a few hours later to rest.

Tubal Ligation Recovery

You can probably go home a few hours after your procedure.

Your incision sites (where you got the cuts) may be a little uncomfortable afterward. You might also have pain or cramps in your belly, fatigue, mild vaginal bleeding, dizziness, or a sore throat from the anesthesia.

If the surgeon used gas to blow up your abdomen to do the tubal ligation, you may have some bloating. It could cause belly or shoulder pain. This should go away in a couple of days.

Wait 48 hours after your tubal ligation to bathe or take a shower. Don’t rub or scrub your incision sites for at least a week. Pat your skin dry carefully after your bath or shower.

You should be able to get back to your normal routine a few days after your tubal ligation. But don’t lift anything heavy until your doctor says it’s safe to do so.

How Soon Can I Have Sex After a Tubal Ligation?

You should be able to have sex a week after your tubal ligation.

You don’t need to use a backup form of birth control after the procedure, but it won’t protect you from sexually transmitted diseases (STDs). Using a condom during sex will help prevent STDs.

Tubal Ligation Cost

The cost of your tubal ligation may vary based on where you live, your doctor, and your insurance coverage. Average costs range from $1,500 to $6,000.

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.

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