Female sterilization, also known as a tubal ligation or “getting your tubes tied”, is a permanent method of contraception. This means that once you’ve undergone the procedure, you won’t be able to get pregnant naturally anymore for the rest of your life.
This article is part of our Contraception Series!
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Note: the information below was sourced from references (1-5), unless stated otherwise.
What is it?
Female sterilization, also known as a tubal ligation or “getting your tubes tied”, is a permanent method of contraception. This means that once you’ve undergone the procedure, you won’t be able to get pregnant naturally anymore for the rest of your life. Because this is, in principle, irreversible, you need to be sure that you won’t want biological children in the future. Be aware that there’s a small chance that you’ll regret your decision, especially if you’re young (6-8). This does not mean you shouldn’t do it; it just means you have to think about it very well – as you should about having children.
You should also discuss this option with your partner, if you have one, so that you’re on the same page about the consequences of permanent contraception. Your doctor will also have a thorough conversation with you before they’ll perform this procedure on you.
Note that sterilization is illegal in some countries; check your national and local laws to know if this applies to your country.
While it’s the most used method of contraception worldwide (9), it is unfortunately quite common in different parts of the world that a doctor refuses to perform sterilization on women and people with a uterus, even if sterilization is permitted by law. They might think that you’re too young, that you’ll regret your decision, or they require permission from a husband or partner. If this is the case, you can always try to find a different doctor, or you can contact your hospital’s or clinic’s patient support to discuss this matter. A medical professional has no reason to refuse treatment if you’ve made a well-considered decision, you’ve considered other options seriously, and there are no medical or legal reasons that you shouldn’t undergo this procedure. But they are allowed to refuse if they don’t think it’s in your best interest. (10, 11)
How does it work?
In a tubal ligation, the fallopian tubes that carry eggs from the ovaries toward the uterus are typically tied or cut (“ligation” means tying off). This prevents the release of an egg, and so it can’t be fertilized. This requires surgery, often under general anesthesia but sometimes with regional anesthesia. If you’re pregnant and want to have tubal ligation after pregnancy, you can often get the procedure done during your delivery.
How effective is it?
Sterilization is about 99.5% effective, which means that out of 1000 people* who get sterilized, only 5 become pregnant within a year. However, if you’re still young, there’s a higher chance your sterilization fails. The exact effectivity of the procedure also depends on which technique your surgeon uses. Ask your doctor what the chances are sterilization won’t work for you.
What are possible side-effects?
After tubal ligation, blood flow and pain during menstruation may be decreased, but you might experience more irregular cycles. If your tubal ligation fails and you do get pregnant, there’s a higher chance you'll have an ectopic pregnancy, which can be very dangerous. The procedure itself can also be dangerous, especially if you’re under general anesthesia for it, but these are risks that exist with any surgery.
Tubal ligation might reduce the risk of ovarian cancer.
Note that only a portion of people experience (some of) these side-effects, and some people will experience side-effects not listed here. Whether you will, depends on many different factors.
When can't I use it?
There are few situations in which you can’t undergo sterilization. These situations are typically those in which it’s dangerous to undergo any surgery, or if you’re allergic to materials used in the procedure. Your doctor will indicate if your current situation is not a good fit for sterilization.
Does it work immediately?
This depends on the method your surgeon used for the procedure. In most cases, tubal ligation is effective immediately. However, some methods require a test a few months after the procedure to check that it’s been successful, and you need to use another method of contraception during this time. Ask your doctor which situation applies to you if they haven’t explicitly told you.
What happens to my fertility if I stop using it?
Tubal ligation is intended to be irreversible, meaning you’ll be permanently infertile. While your doctor can try to reverse it, there’s no guarantee that it’ll be successful. Generally, the chance of a successful reversal is higher if less time has passed since you got your tubal ligation. Evidence suggests that between 30% to 80% of reversals are successful (12), but the chance of ectopic pregnancy is also increased after a reversal. If reversal isn’t successful, you can try assisted reproductive technologies like IVF – but these are often expensive and also aren’t guaranteed to work.
Does it protect against sexually transmitted diseases (STDs)?
No. If you’re having sex with someone new or untested, use a condom as well.
*People, here, means anyone who is able to become pregnant, including girls, women, and non-binary people and transgender men who still have their uterus, vagina, and ovaries.
Are you curious about other methods to protect yourself from an unwanted pregnancy? Read about other birth control options here!
This article is pending medical review.
Contributors
Written by Juliëtte Gossens
Reviewed by Sophie Oppelt and Selina Voßen
Edited by Juliëtte Gossens
References
McFarlane I (ed.). Seeing the unseen: The case for action in the neglected crisis of unintended pregnancy. United Nations Population Fund. 2022. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf
Hacker NF, Gambone JC, Hobel CJ (eds.). Hacker & Moore’s Essentials of Obstetrics & Gynecology. 6th ed. Philadelphia: Elsevier; 2016.
Hoffman BL, Schorge JO, Halvorson LM, Hamid CA, Corton MM, Schaffer JI (eds.). William’s Gynecology. 4th ed. New York: McGraw-Hill Education; 2020.
Centers for Disease Control and Prevention. The United States Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html
Centers for Disease Control and Prevention. 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html
Danvers A, Evans TA. Risk of Sterilization Regret and Age. Obstetrics & Gynecology. 2022;139(3):433-439. DOI: 10.1097/AOG.0000000000004692
Bansal A, Dwivedi LK. Sterilization regret in India: Is quality of care a matter of concern? Contraception and Reproductive Medicine. 2020;5:13. DOI: 10.1186/s40834-020-00115-8
Curtis KM, Mohllajee AP, Peterson HB. Regret following female sterilization at a young age: a systematic review. Contraception. 2006;73:205-210. DOI: 10.1016/j.contraception.2005.08.006
United Nations. Contraceptive Use by Method. 2019. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf [Accessed September 12th, 2022]
McGowan E. Can Doctors Refuse Tubal Ligation? Here’s Why It’s Hard To Get One. Available from: https://www.bustle.com/life/can-i-get-my-tubes-tied-process-for-tubal-ligation [Accessed September 14th, 2022]
Lalonde D. Sexist barriers block women’s choice to be sterilized. The Conversation. August 14th, 2018. https://theconversation.com/sexist-barriers-block-womens-choice-to-be-sterilized-99754 [Accessed September 16th, 2022]
Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.
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