What does it involve
The aim is to prevent the sperm from reaching the eggs so that fertilization and conception cannot take place. This is achieved by a surgical procedure that involves cutting, tying or removing all or part of the Fallopian tubes. Consequently, the passage of the eggs from the ovaries to the uterus is blocked, and the sperm will not be able to reach the eggs. This blocking or division of the tubes is known as a "tubal ligation."
Laparoscopic tubal ligation
(Band-aid or Bellybutton surgery)
This procedure is done under general anaesthesia. The surgeon makes a small incision (about 1 1/2 inches) just inside the navel. An instrument called a laparoscope (a fine tube that conducts light and is connected to a telescope) is inserted through the opening. This is used to light up and inspect the Fallopian tubes. Next, a "sealer" instrument is inserted. This instrument will be used to block the tubes either through electrical or nonelectrical means. Electrocoagulation seals the tubes through an electric current. The tubes can also be constricted using a metal clip or rubber band. After the surgery is over, the surgeon closes the incision with a single suture and covers it with a Band-Aid.
This is usually an outpatient procedure. It has the shortest recovery period and it leaves only a tiny scar just inside the navel. This method should be avoided for women who are obese, have serious heart disease, or have chronic respiratory illness.
This procedure, done under general anaesthesia, involves making a small incision just above the pubic hairline. The surgeon then lifts the tubes through the incision and blocks them either using electrocoagulation or using clips or bands. This method differs from a laparoscopy in that no visualizing instrument is inserted. The recovery period is around two to three days.
A laparotomy is usually advised for women for whom laparoscopy is not an option because they have had previous abdominal surgery, or serious heart or respiratory illness. However, if you are overweight or have a tubal infection or endometriosis, the doctor may recommend another method of sterilization.
Vaginal tubal ligation (colpotomy)
This procedure is usually done in cases where a woman cannot have a laparoscopy or laparotomy. It involves making a small incision in the vaginal opening through which the surgeon can draw the tubes and ligate them using suture material. The advantage of this method is that it can be performed under local anaesthesia and there will be no visible scar. However, the patient is more susceptible to infection because of the high bacterial count in the vagina. In addition, some women find intercourse painful for several months after undergoing this surgery.
Abdominal tubal ligation
This method is recommended for women who need abdominal surgery for other reasons or who have had recent or chronic tubal infections or endometriosis. These conditions cause scarring or adhesions that make it difficult to perform the other methods of sterilization. In this laparotomy, an abdominal incision is made either vertically below the navel or horizontally just at the pubic hairline. Women generally do not go in for this technique of sterilization because of the greater risk, hospital stay for three to five days and the prolonged recovery period.
Postpartum tubal ligation
This is basically a mini-laparotomy done following childbirth. The surgeon makes an incision just below the navel, draws part of each tube through the incision and sutures them shut. The operation may be performed any time within the first three days of childbirth.
This surgery involves the complete removal of the uterus. In the past, this was considered a fairly common sterilization procedure. Today, while women have to undergo this surgical procedure for other reasons, it is not recommended for birth control purposes.
How will sterilization change my life
Other than the fact that you cannot have children, your life will go on as before, may be even better than before. Your sex drive will remain undiminished and your menstrual cycle will be unaffected. You will probably enjoy sex more as the fear of getting pregnant will not bother you any more.