Female Sterilization (Tubal Ligation)

Key Facts
  • Individuals who are assigned female at birth may participate in female sterilization as a permanent contraceptive. It’s more than 98% effective as a form of birth control.
  • It does not protect you against sexually transmitted infections (STIs).
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  • Young men's version of this guide

tubal ligation
Tubal ligation

Female sterilization, also called “tubal sterilization” is a huge decision because it’s a permanent type of contraceptive. This means that it protects against pregnancy forever. Individuals who choose this option usually do not want any children, or do not want any more, or cannot carry a pregnancy because of a medical condition. Another option for permanent birth control is male sterilization (vasectomy).

Out of 100 individuals using female sterilization
Typical use: 1 or fewer people become pregnant icon representing less than 1 pregnant woman
Perfect use: 1 or fewer people become pregnant icon representing less than 1 pregnant woman

What is tubal ligation?

“Tubal” refers to the fallopian tubes. Ligation means to tie off, cut, or close. Tubal ligation involves having minor surgery.

Why are the “fallopian tubes” sterilized?

The fallopian tubes (see picture above) is where an egg and sperm meet, and where the egg becomes fertilized before it moves to the uterus. By closing off the tubes, sperm can’t get to the egg which means that pregnancy can’t happen.

How is female sterilization done?

Female sterilization can be done in an operating room or in a medical office depending on the type of procedure. It can be done while you are sleeping or while you are awake. If awake, you will be given numbing medicine so you don’t feel too uncomfortable. Depending on the type of method you choose to have, you could either have a small incision or cut in your abdomen (belly) or the procedure can be done vaginally (without any incisions or cuts).

  1. Laparoscopic sterilization: This procedure is done in an operating room under general anesthesia (while sleeping). A small cut is made in the abdomen (belly) and then an instrument with a tiny camera (called a laparoscope) is placed inside the belly near the navel (belly button). The fallopian tubes (the tubes that carry eggs from the ovaries to the uterus) are then closed shut with another instrument. It can be done at any time during a person’s cycle except immediately after they deliver a baby. It works immediately so using additional kinds of birth control to prevent pregnancy isn’t necessary. However, you should continue to use condoms to prevent STIs.

The fallopian tubes are cut and tied, removed, stitched with suture material, or burned. The fallopian tubes can also be entirely removed; this is called salpingectomy (sal·​pin·​gec·​to·​my)

  • Sterilization using electrical current: An electrical current is used to burn and destroy the fallopian tubes after they have been cut. Sterilization done with an electrical current cannot be reversed.
  • Silicone band (tubal ring): Through the laparoscope, the surgeon will insert a special tool that stretches a plastic band, picks up a small loop of the fallopian tube, and places the plastic band over the loop. The tube is then clamped shut.
  • Spring clips: There are two types of clips that are used to clamp off the tubes. One, shaped like a clothespin, is placed over the fallopian tube and is held closed by its spring clip. The other type is a rounded clamp, which is closed over the fallopian tubes. The clamp’s plastic liner gets bigger to keep the tube closed as the tube flattens.
  1. Minilaparotomy (mini·​lap·​a·​rot·​o·​my): This procedure is also done in an operating room with general or local anesthesia (numbing medicine) usually within 1-2 days after an individual gives birth.

Are there any risks or complications with female sterilization?

Complications are rare and are usually from general anesthesia or surgery. Individuals who have other medical conditions that make surgery risky should have a thoughtful discussion with their health care provider about the procedure. There is a low risk of hurting the bowel, bladder or major blood vessel. If an electric current is used to destroy the fallopian tubes, there is a low risk of burning the skin and/or bowel or other internal organs. Other complications include bleeding and infection. The chance of becoming pregnant after being sterilized is rare. However, if pregnancy occurs, an individual is more likely to have a tubal or ectopic pregnancy (this means that the pregnancy is in their fallopian tube instead of in their uterus, which can be dangerous).

What should I expect after the laparoscopic surgery?

You may have symptoms after the laparoscopic surgery including:

  • Dizziness
  • Shoulder pain
  • Cramps
  • Bloated or gassy feeling

After your laparoscopic procedure, you will stay in the recovery room until you are wide awake and able to eat and drink light foods such as crackers and ginger ale. Most individuals go home within 2-4 hours on the same day. You’ll need someone to bring you to the hospital and take you home. Some people may have mild discomfort for a few days. If any of the symptoms below last longer than a couple of days, call your health care provider. Most individuals can go back to school or work within 1 week of having the procedure, but everyone is different so be sure to listen to what your health care provider tells you.

Does female sterilization work?

Female sterilization is one of the best methods of birth control available. It’s close to 100% effective. This means that out of 100 individuals who have a sterilization procedure, less than 1 would expect to become pregnant each year.

Does female sterilization protect against sexually transmitted infections (STIs)?

Female sterilization does not protect against sexually transmitted infections. Using condoms every time you have sex is recommended and greatly lowers the risk of getting an STI.

Will female sterilization affect my sex life?

No. Female sterilization will not change anything such as your sexual performance or your ability to have orgasms. In fact, some women feel more relaxed during sex because they’re not worried about becoming pregnant. Neither you nor your partner will be able to feel the clips or rings that may have been used to seal off your tubes.

Will my periods be the same after female sterilization?

Your periods will likely be the same. Medical studies have shown that individuals who are sterilized may in fact have fewer days of bleeding with their menstrual cycle, have a lighter flow and less menstrual cramps. A very small number of individuals may complain of irregular periods and menstrual cramping after sterilization.

If you have any of the following symptoms, call your health care provider:

  • Late or missed menstrual period
  • Severe lower abdominal (belly) pain
  • Nausea – feeling like you want to throw up
  • Breast tenderness

What if I decide I want to get pregnant after I am sterilized?

Tubal ligation should be considered a permanent procedure. The majority of people who choose sterilization are happy with the decision, but some people (14%) will ask about reversing the procedure. Reversal of tubal sterilization is frequently not feasible and can be expensive as it is not routinely covered by insurance.

Female sterilization is safe and a good option for some individuals such as young adults who have a very serious medical condition, individuals who know they definitely don’t want any children, and for those who can’t use other types of contraception. It’s also a good method for those who are absolutely sure they do not want any more children. Becoming sterilized is a serious decision that should be considered permanent. Talk to your health care provider or gynecologist if you’re considering female sterilization. It’s important to think about the benefits and risks and have all of your questions answered before making your final decision. If you chose to be sterilized the type of procedure will be based on your medical needs and when you want to have it done. Some individuals are sterilized right after they have a baby or an abortion, while many others choose another time.