Tubal Ligation: Benefits and Risks to Know Before Surgery

Each month an egg is released from the ovary and travels along the fallopian tube towards the womb, and fertilisation by sperm usually happens inside this tube. In tubal ligation the tubes are tied, cut, closed with clips, or partly or completely removed. As a result, the egg and sperm can no longer meet. The operation can be done by laparoscopy (keyhole surgery), through a small cut in the abdomen, or at the same time as a caesarean section. It is usually done under anaesthesia, and many women go home within a short time.

• Highly effective: it is one of the most reliable ways to prevent pregnancy.
• Permanent: no daily pills or regular injections are needed.
• No hormonal change: the ovaries keep working as before, so periods usually do not change and it does not bring on an early menopause.
• It does not interfere with your normal sexual life.
• Research shows that blocking or removing the tubes may slightly lower the risk of ovarian cancer.

• It is permanent: if you want another child later, an operation to rejoin the tubes is not always successful, and IVF may often be needed.
• General surgical risks: reaction to anaesthesia, bleeding, infection and, rarely, injury to the bowel, bladder or blood vessels.
• Failure is rare but possible: if pregnancy does occur after ligation, there is a higher chance that it is outside the womb, an ectopic pregnancy.
• It does not protect against sexually transmitted infections (STIs).
• For a few days after surgery you may have abdominal pain, shoulder-tip pain or tiredness, which usually settles on its own.

Tubal ligation is suitable when you are certain you do not want any more children in the future. Decisions made at a young age, immediately after a birth or miscarriage, or at a time of family pressure or emotional distress are more likely to be regretted later. Remember that the decision is yours, though it helps to discuss it with your partner.

There are also long-acting but reversible methods, such as the copper or hormonal intrauterine device (IUD) and the implant, which are almost as effective and can be removed when you wish. For the husband, vasectomy is a simpler permanent option. Talk openly with your doctor and take time to decide if you need it.