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What is female sterilization?

Female sterilization is a form of birth control in which a woman's fallopian tubes are surgically closed. Normally, the fallopian tubes carry the eggs to the uterus. Closing the tubes with surgery prevents pregnancy because it prevents sperm from reaching and fertilizing an egg.

It is important to realize that sterilization is usually permanent and may not be reversed through a second operation.

When is it used?

Doctors generally recommend sterilization only in the following situations:

In the U.S. nearly one in every four married women between the ages of 15 and 44 chooses sterilization as a means of birth control.

What happens during the procedure?

Laparoscopy and minilaparotomy are the most common procedures used to seal the tubes. These surgeries may require an overnight hospital stay, but often they are done at an outpatient clinic. Surgery is done under local or general anesthetic.

For a laparoscopy, the doctor makes one or two small cuts in the abdomen. One is made just below the navel and the other in the pubic hair area. The doctor inserts an instrument called a laparoscope through one of the cuts. Using the laparoscope to see inside the abdomen, the doctor inserts an operating instrument through the other small incision to cut, tie, burn, or clamp the fallopian tubes.

A minilaparotomy is most often done after delivery of a baby because the position of the uterus makes it easy for the doctor to reach the fallopian tubes. A minilaparotomy requires only one incision. The incision must be large enough for the surgeon to see inside the abdomen and to put an instrument through to cut, tie, clamp, or burn the fallopian tubes.

What happens after the surgical closing of the tubes?

You may feel some pain or discomfort for 24 to 48 hours after a laparoscopy or minilaparotomy. The doctor may suggest that you rest in bed for 24 to 48 hours and take acetaminophen for pain.

The doctor will want to see you again to be sure that you are healing properly.

If you were using birth control pills before the sterilization, you may notice menstrual changes after the procedure. These menstrual changes are not caused by the surgery. They occur because you are no longer taking the birth control pills.

What are the benefits of this procedure?

Sealing of the fallopian tubes almost always results in permanent sterilization and is a very reliable form of birth control.

What are the risks associated with this procedure?

Complications after sterilization are rare. In some cases, an ectopic pregnancy (pregnancy outside the uterus) may occur, particularly if the fallopian tubes were burned. Other risks include infection, possible bleeding, and scar tissue formation (adhesions).