Female sterilization
Female
sterilisation is achieved by closing off the fallopian tubes
It
should only be used if the woman does not wish to have any more children, as it
is a permanent form of birth control
It
is usually carried out using low-risk surgical techniques
There is a small failure rate of two
to four pregnancies per 1000 operations
Complications
are rare
Which
women may consider sterilisation?
Sterilisation is a permanent form of birth control and is used by
women who have decided that they either do not wish to have children at all, or
who have decided that their family is complete. Obviously this choice should be
discussed with your partner.
Sterilisation can also be used when pregnancy would be a serious health risk.
All
other methods of birth control should be considered before choosing
sterilisation, since it must be regarded as permanent.
What
methods are available?
Sterilisations are carried out in hospitals or clinics with surgical
units. They can be done under local anaesthetic or general anaesthesia.
The
principle behind female sterilisation is to close off the fallopian tubes – the
tubes that run from the ovaries to the uterus – preventing an egg from meeting
sperm and being fertilised. There are several ways to do this:
Cutting
or tying the tubes – tubal ligation
Sealing
the tubes using an electric current which produces heat – cautery
Applying clips, clamps or rings
Removing a small piece of
tube and tying off the cut ends
A
woman’s general health may indicate which procedure is best. Previous surgery
and body weight are factors to be considered.
More
than half the sterilisations performed are done shortly after childbirth or
termination of pregnancy. The decision to combine sterilisation with other
procedures must be made in advance.
Sterilisation is a low-risk surgical procedure and is usually carried out using
one of the following techniques:
Laparoscopy
– this is one of the most common methods. A harmless gas (carbon dioxide) is
injected into the abdominal cavity. This inflates it, allowing the organs to be
seen more clearly. The surgeon then makes a small incision near the navel and
inserts a laparascope – a rod-like instrument with a light and a viewing lens –
into the abdomen.
The surgeon may also insert an instrument used for closing the tubes,
usually through a second small opening.
The procedure can be performed at outpatient surgical clinics. It
takes 20 to 30 minutes, and women generally go home the same day. There is very
little scarring afterwards.
Mini-laparotomy
– this is also a common method, often used after childbirth. No gas or
visualising instruments are used.
A small incision is made in the lower abdomen, just above the pubic
hair. The surgeon locates the tubes and then closes them using one of the
methods described above.
Laparotomy
– this is major surgery and is less common than either of the above methods. The
surgeon makes a larger incision in the abdomen, then locates and closes off the
tubes. The operation requires spinal or general anaesthesia. The woman may be
hospitalised for two to four days and may need a few weeks to recover at home.
What
complications can occur after sterilisation?
Complications are unusual, but can happen after any kind of surgery.
These
include:
Bleeding
Infection
Reaction to the anaesthetic
Complications occur in one to four percent of sterilisations.
How
effective is sterilisation?
There is a small failure rate – two to four pregnancies per 1000
sterilisations.
Frequently asked questions
Will sterilisation affect an existing pregnancy?
No,
sterilisation will not be performed if you are pregnant.
Will sterilisation affect menopause?
Sterilisation will not cause menopause because you are still
producing hormones from your ovaries. It will not prevent you from entering
menopause.
Will I still have a period?
Yes, most menstrual cycles are the same after sterilisation. However,
some women who have their tubes blocked using cautery find their menstrual cycle
is disturbed for a while. This may also happen if you stop using the
contraceptive pill.
Will I be as feminine after sterilisation?
Yes, your hormones are not affected since your ovaries are still
working.
How soon after the procedure can I have sexual intercourse?
Ask your doctor’s advice and do not have intercourse until you feel
comfortable. Recovery usually takes about a week, unless you were sterilised
after childbirth, in which case most doctors advise waiting four weeks.
The
procedure does not affect the ability to experience sexual pleasure.
Can sterilisation be reversed?
If you are thinking about reversal, do not consider sterilisation.
Reversal procedures require complicated surgery and cost a lot of money. Even
though the tubes can be rejoined in some cases, pregnancy is not guaranteed.
When to
see the doctor
Discomfort after the operation depends on your general health, the
type of operation you had and your pain tolerance.
You may
feel tired and have slight abdominal pain. However, you should contact your
doctor immediately if you:
Develop
a fever
Bleed from an incision
Have
severe, continuous abdominal pain
Have
fainting spells
