What is tubal ligation?
Tubal ligation, also known as sterilisation or ‘having your tubes tied’, is a permanent method of contraception that you can choose if you are sure that you do not want to have children in the future. Using keyhole surgery, clips are put on the fallopian tubes to block the sperm and egg from meeting.
How does tubal ligation prevent pregnancy?
When ovulation occurs, an ovum (egg) is released from the ovary and moves down the fallopian tube. If the ovum meets a sperm, conception may happen. Tubal ligation blocks the path of the sperm through the fallopian tube. Eggs are still released by the ovaries, but are broken down and safely absorbed by the body.
As the ovaries are not affected by sterilisation, your periods will keep happening as usual, with the ovaries continuing to release the same hormones. Sterilisation does not cause menopause or affect sex drive or enjoyment of sex.
Even though tubal ligation can often be reversed, it is considered to be a permanent method of contraception.
Tubal ligation – issues to consider
If you are thinking about sterilisation, issues to talk about with your doctor include the following:
- your reasons for wanting to be sterilised
- whether tubal ligation is the best option for you
- whether tubal ligation is recommended for women of your age
- whether other methods of contraception might be more suitable
- any side effects, risks and complications of the procedure.
Women with a disability who are incapable of giving their own consent
Under the Guardianship and Administration Act 1986, sterilisation is defined as a ‘special medical procedure’.
A person is considered incapable of consenting to a special medical procedure if they:
- are incapable of understanding the general nature and effect of the procedure
- are incapable of indicating whether or not they consent to the procedure.
Where a woman with a disability does not have the capacity to consent to special medical procedures, a guardian cannot provide the consent for sterilisation on her behalf. However, the Victorian Civil and Administrative Tribunal can consider an application for sterilisation and provide the consent where agreed.
Tubal ligation – operation procedure
Tubal ligation is an operation that is usually done under general anaesthetic using a procedure called laparoscopy. Between one and three small cuts are made around the navel (belly button). A telescopic device called a laparoscope is put in through one of the cuts.
A small camera at the tip of the laparoscope sends an image to a screen for the surgeon to see the internal organs. The surgeon works through these small holes to put clips on the tubes.
After tubal ligation
After having the operation, you can expect to:
- have some pain and nausea in the first four to eight hours (you may need pain medication for a short time)
- have some abdominal pain and cramps for 24 to 36 hours
- go home the same day
- have no changes to your periods
- have the stitches taken out after seven to 10 days
- see your surgeon for a check-up in six weeks.
Risks and complications of tubal ligation
Possible risks and complications from the tubal ligation operation include:
- an allergic reaction to the anaesthetic
- damage to nearby organs, such as the bowel or ureters
- infection, inflammation and ongoing pain
- haemorrhage (very heavy bleeding)
- infection of the wound or one of the fallopian tubes.
Longer-term possible risks and complications of tubal ligation include:
- pregnancy (the method is more than 99 per cent effective, but there is a very small chance of the tubes getting unblocked, which would mean a pregnancy could happen)
- ectopic pregnancy, where a pregnancy develops outside the womb (usually in the fallopian tubes) rather than in the uterus (womb).
Caring for yourself after tubal ligation
It is important to follow the advice of your doctor or surgeon. Suggestions for caring for yourself after having surgery include:
- Avoid intense exercise for seven days.
- You can take pain medication to manage the pain, but see your doctor if the pain is very strong.
- You can usually go back to work within a few days.
- You can start having sex again as soon as you feel ready. This is because the procedure starts working straight away.
Reversing tubal ligation
A person usually chooses sterilisation if they are sure that they do not want to have children in the future, but circumstances can change.
Tubal ligation can be reversed, but this is not always successful. Success rates depend on the age of the person having the reversal, and the way in which the tubal ligation was performed.
To reverse the procedure, the fallopian tubes are reached through a cut in the abdomen and the surgeon re-joins the cut tubes using very small stitches.
Generally, the chance of getting pregnant after reversal of a tubal ligation is about 60 per cent, with about 50 per cent having a baby after a reversal procedure. The partner’s age also impacts a woman’s ability to get pregnant.
The risk of ectopic pregnancy after a successful reversal is quite high. This is because scar tissue can stop the fertilised ovum from moving down the fallopian tube.
Tubal occlusion is a sterilisation procedure that, since 2017, is no longer available in Australia.
The procedure involves putting a tiny, flexible device called a micro-insert (EssureTM) into each fallopian tube. After having the procedure, the body grows scar tissue around the micro inserts, which blocks the fallopian tubes.
Other methods of contraception
Alternatives to tubal ligation include:
- hormonal injections, rings and implants
- hormonal and copper intrauterine devices (IUDs)
- oral contraceptive pills, such as the combined pill and the mini pill
- barrier methods, such as condoms
- vasectomy, which is a relatively simple method of permanent contraception for men.
Protection from sexually transmissible infections
Sterilisation does not give protection from sexually transmissible infections (STIs). It is important to practise safer sex, as well as to prevent an unintended pregnancy.
The best way to lessen the risk of STIs is to use barrier methods such as condoms with all new sexual partners. Condoms can be used for oral, vaginal and anal sex to help stop infections from spreading.
Where to get help
This page has been produced in consultation with and approved by:
Family Planning Victoria
Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.