Patient education: Tubal ligation (The Basics)

What is tubal ligation? — This is a form of birth control that prevents pregnancy permanently. It is also called "having your tubes tied." For this procedure, a doctor cuts, blocks, clamps, or seals the fallopian tubes (figure 1).

How do I prepare for tubal ligation? — The doctor or nurse will tell you if you need to do anything special to prepare. Before your procedure, your doctor will do an exam. They might send you to get lab tests.

The doctor will talk with you about tubal ligation and the best time to do it.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during tubal ligation? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●This surgery can be done in 2 ways:

•Minimally invasive surgery – This lets the doctor make smaller cuts (incisions) in the skin. They insert long, thin tools through the incisions. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

•Open surgery – The doctor makes an incision that lets them see directly inside the body when they do the surgery. In some cases, an open surgery for tubal ligation is done after a vaginal birth. If you are having a tubal ligation at the same time as a cesarean birth ("c-section"), this can be done through the same incision.

●The doctor can use heat to seal the fallopian tubes shut or use rings or clips to close the tubes. In some cases, they remove all or parts of the tubes.

●They will close your incisions and cover them with clean bandages.

What happens after tubal ligation? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Most people can go home the same day.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

What are the risks of tubal ligation? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Blood clots

●Damage to other internal organs

●Regretting your decision to have permanent birth control

●Becoming pregnant later (but this is rare)

What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Tubal ligation – Discharge instructions (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Choosing birth control (The Basics)

Patient education: Permanent birth control for females (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)