Tubal ligation

Also called 'female sterilisation'

Tubal ligation is a permanent form of contraception, to prevent pregnancy. It involves a small operation in which a woman's fallopian tubes are cut or blocked; this stops sperm from reaching an egg to fertilise it.

Key points

  1. Tubal ligation is a permanent form of contraception that should only be considered when you are sure that you do not want to have a child in the future.
  2. It is a very reliable and in most cases will prevent pregnancy but it is not 100% effective. About 1 in 200 women who have a tubal ligation may become pregnant.
  3. Tubal ligation may be performed under general anaesthetic either by a simple laproscopic procedure that takes about 30 minutes or a more complex surgical procedure that will require a stay in hospital for one or two days.
  4. Having a tubal ligation does not affect your sexuality or sex drive. 

How well does tubal ligation prevent pregnancy?

Tubal ligation is very reliable and in most cases will prevent pregnancy, but it is not 100% effective. About 1 in 200 women who have a tubal ligation may become pregnant. This may happen if:

  • the fallopian tubes are not cut or blocked properly
  • the cut ends grow back together
  • the clips on the tubes slip.

If pregnancy does occur after a tubal ligation, there is a greater chance that it will be ectopic. This means that the pregnancy occurs outside the uterus, usually in the fallopian tubes where the foetus can not survive.

What are the advantages and disadvantages of tubal ligation?

Advantages

  • You do not have to remember to take a pill every day.
  • After the procedure is complete, it is a private form of birth control.
  • Tubal ligation does not interfere with intercourse.
  • There are no significant long-term side effects.

Disadvantages

  • As tubal ligation is permanent, and difficult to reverse, some people regret having it – especially if their circumstances change. 
  • Tubal ligation does not protect against sexually transmitted infections (STIs), including infection with the human immunodeficiency virus (HIV). Condoms are the most effective method for preventing STIs. 
  • There are possible short-term surgery-related complications such as discomfort, infection, bruising or bleeding at the operation site, and possible reaction to anesthesia.

How is tubal ligation done

During tubal ligation, the fallopian tubes are closed either by:

  • cutting and tying the tubes, or
  • placing a clip, ring or band around the tubes.

There are two types of surgery by which tubal ligation may be performed: laparoscopic tubal ligation and mini-laparotomy. Your doctor will discuss the best option for you.

Laparoscopic tubal ligation

This is the most common procedure by which tubal ligation is performed. In this procedure:

  • Two small incisions are made in the abdomen. A laparoscope (a long thin tube with a camera and light source at its tip) is inserted through one incision and surgical instruments are inserted through the other incision.
  • The fallopian tubes are then able to be located and the tubal ligation performed.
  • The incisions in the abdomen are closed with steristrips (small paper tapes) or small stitches.

Laparoscopic tubal ligation is usually performed under a general anaesthetic. The procedure takes approximately 30 minutes and won't normally require an overnight stay in hospital.

Mini-laparotomy

Sometimes an “open” surgical approach known as mini-laparotomy may be required if the laparoscopic approach is unsuitable such as:

  • if there is scarring in the pelvis from previous surgery
  • medical conditions such as endometriosis.

With this approach:

  • A single incisio approximately 4 to 5 cm long is made, just above the pubic hair line.
  • The fallopian tubes are located and the tubal ligation performed.
  • The incision is closed with dissolvable stitches.

This type of tubal ligation usually requires a hospital stay of one to two days. 

Possible complications

For the most part tubal ligation is a safe procedure with very few complications. Most women have no problems after a tubal ligation, however their is a small risk of:

  • Infection, bruising or bleeding at the operation site.
  • Pelvic pain or pain in the abdomen.
  • A possible reaction to anesthesia.
  • Rarely, damage to organs, including the bowel, bladder, uterus, ovaries, blood vessels and nerves can occur.

Learn more

Tubal ligation NZ Family Planning