Choosing a Birth Control Method.

Association of Reproduction Health Professionals

Abstinence/outercourse

Knot Female sterilization

Female sterilization is a procedure in which each of your fallopian tubes, the passageway from the ovary to the uterus, is blocked. This can be done by removing the tube, tying it off so an egg cannot get to the uterus, or placing an object in the tube that closes it.

Female sterilization does not affect your sexual desire or attractiveness. During this procedure, no glands or organs will be removed or changed. After this procedure, all of your hormones will still be produced, your ovaries will still release an egg every month, and your menstrual cycles will most likely follow their regular pattern.

Female sterilization is permanent; it is NOT reversible. You should consider possible changes in your life, such as divorce, remarriage, or death of children, in which case you may want to have children or more children.

Female sterilization is not intended to protect you from sexually transmitted diseases-called STDs for short-which are diseases, infections, or illnesses that can spread from one person to another through sexual contact. Some examples of STDs are chlamydia, herpes, HIV, gonorrhea, and syphilis.

Pros:

You do not have to do anything right before, during, or after sex.
There are no hormonal side effects.
With one type of sterilization, tubular occlusion or "blockage," you can have the procedure performed in your health care provider's office, without general anesthesia, and go home the same day.

Cons:

Some women do not want to have an invasive surgical procedure, which is involved in most methods of sterilization.
With one type of sterilization, tubal occlusion or "blockage," you must continue to use another type of birth control for three months to make sure the blockage is complete.

Effectiveness: Once a woman is sterilized, there is nothing she needs to do to prevent pregnancy in the future, and there is no chance for the method to be used incorrectly, so "typical" and "perfect" use rates are the same: If 100 women are sterilized, maybe 1 and probably no one out of that group of 100 will become pregnant in one year. There is a difference, however, based on the age at which a woman is sterilized and the type and timing of procedure she chooses.

Available sterilization options

Abdominal procedures

Laparoscopy Laparoscopy is one of the two most common methods of sterilization. First the abdomen is inflated with an injection of harmless gas (carbon dioxide). This allows the organs to be seen clearly. Then the surgeon makes a small incision near the navel and inserts a laparoscope (a thin tube with a light and a viewing lens) for locating the tubes. The surgeon locates the tubes and then ties, clips, or uses electrocautery (a small probe that has an electric current running through it, which cauterizes tissue) to block them off. Very little scarring occurs. The procedure takes 20 to 30 minutes and can be performed in outpatient surgical clinics. Women often go home the same day. They may have sexual intercourse as soon as they feel comfortable about it.

Mini-laparotomy is another common method of sterilization. It is often performed after childbirth. No gas or visualizing instrument is used. A small incision is made in the lower abdomen, just above the pubic hair. (If the operation takes place within 48 hours of delivery, the incision is made just below the navel.) The surgeon locates the tubes, then ties, clips, or uses electrocautery to block them off. The incision is then closed. Women usually recover in a few days. Your health care provider will advise you about when may start having sexual intercourse again.

Laparotomy is another common method of sterilization. It is often performed after childbirth. No gas or visualizing instrument is used. A small incision is made in the lower abdomen, just above the pubic hair. (If the operation takes place within 48 hours of delivery, the incision is made just below the navel.) The surgeon locates the tubes, then ties, clips, or uses electrocautery to block them off. The incision is then closed. Women usually recover in a few days. Your health care provider will advise you about when may start having sexual intercourse again.

Non-surgical procedures

Essure^® is a non-surgical procedure that involves placing a small flexible device, called a micro-insert, into each fallopian tube. Your doctor will insert a catheter through your vagina and insert the coil without ever having to make an incision. Once these micro-inserts are in place, over the next three months, your body tissues grow into the micro-inserts, making a blockage in your fallopian tubes. During the three months it takes for the tissues to grow into the coil, you must use another method of contraception. Three months after the procedure, you must visit your doctor to have a test called a hysterosalpingogram (HSG) to make sure your fallopian tubes are completely blocked. This procedure is similar to the micro-insert insertion.