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Internal Medicine => Surgery => Tubal Ligation
Tubal Ligation
Tubal Ligation, also known as female sterilization, a surgical operation in which the fallopian tubes, tubes that extend from the ovaries to the uterus, are closed off. The operation permanently prevents pregnancy by making it impossible for the sperm to reach the egg. Tubal ligation is almost 100 percent effective in preventing pregnancy and is the most popular form of birth control in the United States. About 30 percent of American women 15 to 44 years old who use contraceptives choose it. It is most popular among women from 30 to 44 years old, women who have been previously married, and black and Hispanic women.
In a woman's body, an egg is released from one of the ovaries every month. The egg travels down one of the fallopian tubes to the uterus. If a sperm meets with and fertilizes this egg, the fertilized egg implants in the wall of the uterus, beginning a pregnancy. In tubal ligation the fallopian tubes are tied, sealed, blocked with a ring or a clip, or heated with an electric current to form a scar so that the tube is closed. The egg is prevented from traveling down the fallopian tube and egg and sperm cannot meet. However, the woman continues to have a monthly menstrual period.
Two surgical procedures are currently used for tubal ligation. In a laparoscopy, a doctor makes a small incision near the belly button and inserts a laparoscope (a long, thin, lighted viewing instrument). A gas such as carbon dioxide or nitrous oxide is then pumped into the abdomen to inflate it slightly so that the reproductive organs are easier to locate. The doctor uses the laparoscope to view the fallopian tubes and inserts another device either through the laparoscope or another incision to seal the tubes. In a minilaparotomy, an incision is made above the pubic bone and the tubes are sealed. In this case the incision is sometimes only one to two inches long.
Either procedure can be performed using local or general anesthesia as an outpatient procedure or in the hospital with an overnight stay. A woman may feel sore, tired, gassy, or bloated for the first few days after the operation. Possible complications of tubal ligation include infection, bleeding, injury to the intestines, and complications caused by general anesthesia. Major complications are rare, occurring in only about 1 out of 1000 cases.
Tubal ligation is a permanent form of birth control. Although new surgical techniques may be able to reverse a tubal ligation in some cases, no woman should undergo this procedure with the expectation that it can be reversed. Tubal ligations do not protect against sexually transmitted diseases (STDs).
In rare cases some women who undergo the procedure later become pregnant, usually with the fertilized egg growing outside the uterus, often in the fallopian tubes. This condition is known as an ectopic pregnancy and is potentially life-threatening. An ectopic pregnancy in a fallopian tube can cause the tube to burst, a situation that requires emergency surgery.
In the United States, female sterilization has provoked controversy since at least the 19th century. Eugenicists, people who believe that certain segments of the population contribute significantly to social problems like crime, advocate the sterilization of certain groups of society. As a result, disadvantaged or minority women have been sterilized during childbirth without knowing it or fully understanding the consequences. In addition, some physicians and legislators have attempted to implement sterilization of welfare recipients-that is, women who currently receive welfare must allow themselves to be sterilized to continue receiving welfare benefits. In other cases, physicians have refused to sterilize well-informed, white, middle-class women who have no children.
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