Tubal Ligation: What You Need to Know

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Tubal ligation is a surgical procedure that provides permanent birth control for women. It is also known as "having your tubes tied" or tubal sterilisation.

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What is Tubal Ligation?

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Tubal ligation is a surgery that closes or blocks the fallopian tubes, which are the tubes that connect the ovaries to the uterus. The fallopian tubes are where the eggs and sperm meet and fertilisation occurs. By closing or blocking the tubes, tubal ligation prevents pregnancy by stopping the eggs and sperm from meeting.

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There are different methods of tubal ligation, such as:

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• Cutting and tying the tubes with a special thread (suture).
• Clamping, clipping or banding the tubes with a metal or plastic device.
• Sealing the tubes with an electric current (electrocoagulation) or a chemical substance.
• Removing a small portion of the tubes (partial salpingectomy).
• Removing the entire tubes (salpingectomy).

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The method of tubal ligation may depend on your preference, your health condition, your doctor's recommendation, and the availability of equipment and facilities.

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How Effective is Tubal Ligation?

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Tubal ligation is one of the most effective forms of birth control. It has a failure rate of less than 1% per year, which means that less than one out of 100 women who have tubal ligation will get pregnant in a year. However, tubal ligation is not 100% foolproof. There is a very small chance of pregnancy after tubal ligation, especially if the surgery was not done correctly or if the tubes grow back together or form a new connection (recanalization).

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Tubal ligation does not protect against sexually transmitted infections (STIs). You still need to use condoms or other barrier methods to prevent STIs.

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What are the Benefits of Tubal Ligation?

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Some of the benefits of tubal ligation are:

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• It provides permanent and reliable birth control. You do not need to worry about getting pregnant or using other forms of contraception.
• It does not affect your hormones, menstrual cycle, sexual function or breast milk production.
• It may reduce your risk of ovarian cancer, especially if you have your tubes removed completely.
• It can be done at any time, including right after childbirth or during another abdominal surgery, such as a C-section.

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What are the Risks of Tubal Ligation?

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Some of the risks of tubal ligation are:

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• Damage to the bowel, bladder or major blood vessels during surgery.
• Reaction to anaesthesia or infection after surgery.
• Improper wound healing or scarring.
• Continued pelvic or abdominal pain.
• Ectopic pregnancy (a rare but life-threatening condition where a fertilised egg implants outside the uterus) if pregnancy occurs after tubal ligation.
• Regret or dissatisfaction with the decision to have permanent sterilisation.

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What to Expect Before, During and After Tubal Ligation?

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Before you have tubal ligation, you should discuss with your doctor or health care provider about your reasons for wanting sterilisation, your alternatives, your expectations and your concerns. You should also have a physical exam, a pregnancy test and some blood tests to make sure you are healthy and not pregnant. You may need to sign a consent form that states that you understand the procedure and its implications. You may also need to wait for a certain period of time (usually 30 days) between signing the consent form and having the surgery. This is to ensure that you have enough time to think about your decision and change your mind if you want to.

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Tubal ligation can be done in a hospital or an outpatient clinic. Depending on the method of tubal ligation and your health condition, you may have general anaesthesia (where you are asleep) or local anaesthesia (where you are awake but numb). The surgery usually takes about 30 minutes. The surgeon will make one or more small incisions in your abdomen and use a special instrument called a laparoscope (a thin tube with a light and a camera) to see inside your abdomen and access your fallopian tubes. The surgeon will then close or block your tubes using one of the methods described above. The incisions will be closed with stitches or glue.

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After tubal ligation, you will be monitored for a few hours in a recovery room. You may have some pain, bleeding, bruising or swelling in your abdomen. You may also feel nauseous or dizzy from the anaesthesia. You will be given some painkillers and antibiotics to prevent infection. You will be able to go home the same day or the next day. You will need someone to drive you home and help you with your daily activities for a few days. You should avoid heavy lifting, strenuous exercise, sexual intercourse and tampon use for about two weeks or until your doctor tells you otherwise. You should also keep your incisions clean and dry and watch for any signs of infection, such as fever, redness, swelling or pus. You should follow up with your doctor in a week or two to check your healing and remove any stitches.

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You should have a normal menstrual cycle and be able to resume your normal activities within a month after tubal ligation. You may need to use another form of birth control until your doctor confirms that your tubes are completely closed or blocked. This may require a special test called a hysterosalpingogram (HSG), where a dye is injected into your uterus and an X-ray is taken to see if the dye flows through your tubes. If the dye does not flow through your tubes, it means that they are successfully blocked and you do not need any other contraception.

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Conclusion

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Tubal ligation is a permanent and effective form of birth control that involves closing or blocking the fallopian tubes. It has many benefits, such as preventing pregnancy, reducing ovarian cancer risk and not affecting hormones. It also has some risks, such as surgical complications, ectopic pregnancy and regret. Tubal ligation can be done at any time, but it requires careful consideration and informed consent. Tubal ligation does not protect against STIs, so you still need to practise safe sex.

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Sources

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- Debbo Africa: https://debbo.africa

- Tubal ligation - Mayo Clinic 

- Tubal Ligation: Procedure, Recovery & Side Effects - Cleveland Clinic 

- Tubal ligation - Wikipedia 

- Tubal Ligation | Tubes Tied | MedlinePlus