Everything You Need to Know Before Getting Your Tubes Tied
Requests for female sterilization have quadrupled in the last few months since the draft decision to overturn Roe v. Wade was made public, and this trend is likely to continue now that the right to legal abortion has been abolished. by the Supreme Court . Given that Supreme Court Justice Clarence Thomas stated in his opinion his desire to review previous court decisions, including the right to access contraceptives, you may wonder if sterilization, which is a permanent form of birth control, might be the right decision for you.
If you are still of childbearing age and are 100% sure that you don’t want any more children, sterilization may be the best option to prevent an unwanted pregnancy. The procedure is more invasive and requires a longer recovery time than your partner’s vasectomy , but the benefit is that the person who can get pregnant directly eliminates the risk.
Two types of tubal sterilization
To begin with, there are two types of tubal sterilization procedures , which differ depending on how the fallopian tubes are blocked. To take a refresher course in reproductive anatomy, each month an egg will be released from one of your ovaries and travel through the fallopian tube where it can be fertilized. If the egg is fertilized, it can implant in your uterus.
Sterilization surgeries work by blocking or removing the fallopian tubes, which prevents sperm from reaching the egg. There are two types of surgeries that do this: tubal ligation or bilateral salpingectomy. Tubal ligation involves closing, cutting, or removing a small portion of the fallopian tube. Bilateral salpingectomy works by completely removing the fallopian tubes.
Bilateral salpingectomy used to be relatively rare compared to tubal ligation, but has been on the rise in previous years as studies have shown them to be more effective in reducing the risk of ovarian cancer.
Is sterilization right for me?
Planned Parenthood does not recommend sterilization for people who have doubts about whether they want children in the future; people who are pressured by friends, family or partner; or people who think sterilization will solve temporary problems such as family or money problems. It also won’t protect against STDs.
In terms of how well it works, sterilization is over 99% effective in preventing pregnancy . If you want a contraceptive option that is reversible but has a similar level of effectiveness, IUDs and implants are also over 99% effective at preventing pregnancy.
What if I end up regretting my decision?
Given that sterilization is irreversible, there is always a risk that you will end up regretting your decision. According to a study published in March this year, approximately 10% of women who have undergone sterilization regret it.
Although reversal is technically possible with tubal ligation, it is not a practical option because the operation is expensive and insurance often does not cover it. Pregnancy success rates after reversal range from 40% to 85%, and that’s only if you’re a candidate for surgery.
Another option to get pregnant after sterilization is in vitro fertilization, in which your eggs are fertilized in a laboratory and then implanted in your uterus. However, this comes at a high price, $15,000 to $30,000 per cycle, which is not guaranteed to work.
How to go through the sterilization procedure?
If sterilization is the right option for you, you need to discuss this with your doctor. When it comes to the procedure, many women often have to overcome many (very sexist) hurdles. Women report being denied the procedure because they are too young, do not have children, or do not have enough children. Some doctors require the husband’s approval of the procedure. For women on Medicaid, there is a 30-day waiting period.
If your doctor is giving you trouble, it might be worth referring him to the opinion on ethical sterilization practices published by the Ethics Committee of the American College of Obstetricians and Gynecologists. This statement, which was developed in 2007 and validated in 2020, outlines best practices for evaluating the appropriateness of sterilization as an option.
In line with its opinion, ACOG recommends that “respect for the reproductive autonomy of the individual woman be a primary concern”, “the practice of coercive or forced sterilization is unethical and should never be performed” and that “OB/GYNs should provide pre-sterilization counseling”. it includes discussion of a woman’s reproductive desires and puts her desires at the center of care.”
The ACOG also considers it ethically acceptable to sterilize women without children if they so desire, and advises that a request from a young woman without children should not be considered grounds for mental health counseling. As they note, “While physicians are understandably reluctant to cause sterilization to be regretted in women, they must also avoid paternalism.”
Unfortunately, paternalism is still alive and well in medicine, as elsewhere, so if your doctor refuses, you will have to find another – preferably one that will respect the woman’s right to bodily autonomy. Some child protection organizations have created crowdsourced lists of doctors willing to perform sterilizations without undue hurdles.
What to expect during the procedure
If you decide to have the procedure, it will most likely be a laparoscopic procedure , in which the surgeon makes several small incisions through which a camera and surgical instruments are inserted. This reduces the amount of cutting required, which speeds up recovery time.
In laparoscopic sterilization , the surgeon makes a small incision near the navel to insert the laparoscope and a second small incision to cover or remove the fallopian tubes.
Recovery time will depend on your general health, but the worst should pass within a few days, although you should refrain from lifting anything heavy for at least a week. As far as sterilization is concerned, the operation is effective immediately, although you should talk to your doctor about when it is safe to have sex again.