
Tubal ligation is the process of having the fallopian tubes tied. It is a way to prevent pregnancy. The outpatient procedure involves cutting or blocking the tubes to prevent an egg from traveling from the ovary, where it might be fertilized by a sperm.
Your doctor may cut or tie the fallopian tubes, or may place small metal springs in each fallopian tube without cutting or tying them. Scar tissue will grow on the implants, permanently blocking the tubes.
The process is effective in preventing pregnancy, but it's not entirely reliable. An estimated 1 in every 200 women will get pregnant after tubal ligation.
The procedure doesn't affect your periods or your sex life. You may even feel more at ease because you will not have to worry about pregnancy.
Why you might need tubal ligation
Tubal ligation may be a good choice for birth control if you have completed your family planning or:
- You are in a stable relationship, and both of you have agreed to use a permanent form of birth control
- You and/or your partner have a genetic disorder you don’t want to pass to your child
- You are an adult woman and have decided against having children or more children
- Getting pregnant would be a health risk for you
This birth control method is not ideal if you might still want to become pregnant later in life. It’s also not good if you might get a new partner who would want you to have children.
How to get ready for a tubal ligation
In the days before your tubal ligation surgery, talk to your doctor about any medication you might be taking, including herbal supplements and over-the-counter medications. You may have to discontinue their use, as some may increase bleeding or cause blood thinning. You should also tell the doctor if:
- Someone in your family has ever reacted to any anesthesia
- You smoke
- You wish to have an inpatient or outpatient procedure
It’s also essential to:
- Receive instructions from your doctor about when to stop eating and drinking before the procedure
- Ask your surgeon if you take your medications with small sips of water before the procedure.
- Wear comfortable clothing during the procedure
- Arrange for someone to drive you home after the surgery
Risks of tubal ligation
While tubal ligation is generally a safe contraception method, it comes with some risks, just like all surgeries. However, serious complications are rare. Before you undergo the procedure, you need to sign a consent form that explains the benefits and risks. Discuss them with your surgeon to help you make an informed decision. Potential risks include:
- Infection
- Bleeding from the incision
- Unusual vaginal odor or discharge
- Difficulty breathing
- Rash or fever
- Damage to other organs in the abdomen
- Incomplete closure of the fallopian tubes, which could result in pregnancy
- Side effects from anesthesia
You are also at risk of getting an ectopic pregnancy if the tubes rejoin after cutting, sealing, and tying. The risk is higher when you are younger. You may discover you had previously started a pregnancy after tubal ligation. A fertilized egg may already have been implanted before undergoing the procedure.
For this reason, you may want to have a tubal ligation done after giving birth or after a menstrual period, when your risk of pregnancy is lower.
Symptoms of ectopic pregnancy
Tubal ligation increases the risk of having an ectopic pregnancy, which may also happen if you use an intrauterine device as a birth control method. The symptoms of such a pregnancy can initially look like a normal pregnancy. For example, a pregnancy test will come back positive, even though the egg is implanted where it can't grow. As a result, the baby can’t grow.
Symptoms include:
- Abdominal pain
- Light vaginal bleeding
- Pelvic pain
- Pelvic pressure, especially during a bowel movement
An ectopic pregnancy may lead to the rupture of the fallopian tube, causing fainting and shock. Go to the doctor if you experience:
- Shoulder pain
- Severe vaginal bleeding
- Severe pain in the pelvis or stomach
- Feeling extremely lightheaded and passing out
If the pregnancy is at an early stage, the doctor may give you a medication called methotrexate to stop further growth of the egg and bleeding. They will also monitor the level of your human chorionic gonadotropin hormone, which is an essential hormone in pregnancy.
If the medication is ineffective, surgery will be necessary to remove the growing tissue and repair the fallopian tube. If the pregnancy is too progressed, the surgeon will remove the affected fallopian tube.

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Critical Care Obstetrics and Gynecology: "Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital."
Current Opinion in Obstetrics and Gynecology: "Update on permanent contraception options for women."
Department of Health: "Ectopic Pregnancy."
INTERNATIONAL JOURNAL OF FERTILITY AND STERILITY: "Menstrual Pattern following Tubal Ligation: A Historical Cohort Study."
John Hopkins Medicine: "Tubal Ligation."
Journal of Reproductive Health and Contraception: "Tubal Ligation."
NHS: Treatment: "Ectopic Pregnancy."
Planned Parenthood: "How Effective is tubal ligation," "How safe is tubal ligation," "Sterilization," "What can I expect if I get a tubal ligation?"
Reproductive Facts: "What Do I Need to Know About Conceiving After Tubal Surgery?"
REVIEWS IN OBSTETRICS & GYNECOLOGY: "Hysteroscopic Sterilization: History and Current Methods."
The American College of Obstetricians and Gynecologists: "Ectopic Pregnancy."
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