Birth control measures that are permanent in nature are preferred among couples who do not wish to have more children. This option allows the couples to dispense with the need for contraceptives or birth control pills to prevent unplanned pregnancies. This option is generally chosen by married couples and is usually not considered an option by unmarried women. However, the choice to opt for permanent, temporary, or reversible birth control measures is entirely a decision of the individual. Tubal ligation is one of the various permanent birth control measures that are effective. The following subsections will offer in-depth information about the procedure including tubal ligation side effects. This will help couples and women take a fully informed decision about the sterilization method.

Overview of tubal ligation

The method, also known as tubal sterilization involves a process of tying up the fallopian tubes, and this could also involve cutting the tubes or blocking the tubes to prevent conception.  The outcome of the procedure results in the prevention of the egg from traveling through the tubes and stops the penetrating sperm from moving up the tubes towards the egg. The highlight of the procedure is the absence of any impact on menstruation among women. The procedure offers women the option of choosing the method along with a cesarean delivery or could also be opted after childbirth. Families often opt to combine cesarean delivery with tubal ligation to avoid the need for another procedure at a later date. Another highlight of the procedure is the fact that removal of the fallopian tubes reduces the risk of exposure to ovarian cancer among women.

What is not to be expected from the procedure?

It is important for women and couples to be aware that though women are known to sometimes request a reversal procedure, tubal ligation is medically not considered reversible. The process is complex and is classified as a major surgical procedure, and in most instances, is not effective to offer women the opportunity to conceive again. It also does not offer any kind of protection from sexually transmitted diseases including HIV. While the effectiveness of the procedure is really high, it is also possible that in rare instances, or in exceptional circumstances, women may end up pregnant even after tubal ligation. This is attributed to the procedure or rather improper procedures performed during sterilization.

Tubal ligation and generally associated risks

The process is not a very simple procedure and involves anesthesia. This is precisely the reason for many women opting for the procedure along with childbirth. Incisions are made in the abdomen during the procedure, and while there is generally no risk of scarring on the outside, it cannot be entirely ruled out in all instances. Depending on the actual process used, for instance, if an electric current is used in the sealing procedure, the patient is exposed to the risk of burn injury to the fallopian tubes on the inside. Other risks include possible damage to the bowel, blood vessels, or the bladder. There is also the likelihood of women experiencing undesirable effects of anesthesia.

In the event that the wound caused during the procedure has not healed fully, the chances of infection are high. There are instances of women reporting pain in the abdomen or the pelvic area long after the procedure. This could be attributed to the incisions on the skin and the resultant bleeding, or possible infections.

Women are considered at high risk of possible complications from the procedure

Certain women are more at risk of experiencing complications from the procedure. This is linked to existing conditions that may aggravate the risks or expose patients to the risk of complications. For instance, women with a history of some pelvic condition, or abdominal issue, are likely to experience some effects. Women who have undergone some surgery on the abdomen or pelvis are also likely to be at risk of experiencing issues. Other categories of women who are at risk from the procedure include those who are classified as obese or diabetic. It is important for women to undergo a full assessment before opting for the procedure. This includes patients who have had problems with anesthesia in the past. In certain circumstances, the procedure may not be suitable due to existing conditions or reactions.

How is the procedure performed?

The procedure depends on when the method is chosen. For instance, if it is performed along with childbirth, there is a particular protocol or method that is typically followed. If it is performed after childbirth, then a different process is followed.

During childbirth – In the event, women choose the tubal ligation procedure during childbirth and if the delivery was a normal vaginal delivery, a small incision is made below the navel. The incision allows the instruments to reach the uterus and the fallopian tubes. The procedure involves the sealing of the tubes either by cutting or blocking.  In the event the woman has a cesarean delivery, the incision made for the delivery will be used for accessing the uterus and the tubes, which are then sealed in a similar fashion. In other words, during cesarean section, no additional incisions are made for tubal ligation.

After childbirth – In the event women choose the procedure sometimes after childbirth, then it is necessary to leave a gap of at least one month before opting for the procedure. Tubal ligation can be performed anytime, but there needs to be a clear gap of at least one month after delivery. The procedure involves a small incision below the navel and is performed with anesthesia. Prior to the actual procedure, the woman needs to undergo a pregnancy test to confirm or determine that she is not pregnant at the time of performing the procedure. The process involves the insertion of a needle or an incision below the navel to enable inflation of the abdomen with carbon dioxide or nitrous oxide. Following this inflation, a laparoscope is inserted and the fallopian tubes are sealed either by cutting, or blocking with clips, or rings. This may also require a second minor incision to permit the insertion of instruments required for the sealing.

Actions and experiences post-procedure

Tubal ligation is also performed on an outpatient basis, and depending on the procedure, women are typically allowed to go back home, hours after concluding the procedure. The gas inserted during the procedure is removed, and women who opt for this sterilization method along with childbirth, generally do not have to extend hospitalization.  As the sterilization involves incisions and sealing of the tubes on the inside, there is a likelihood of experiencing discomfort and pain at the site of the incision and the cutting.

Precautions to be followed after the procedure

Some of the commonly reported tubal ligation side effects are mainly attributed to women ignoring recommendations about actions after the sterilization. It is necessary for the instructions to be diligently followed, to avoid the possibility of undesirable effects. For instance, bathing is to be avoided for a full two days after the sterilization. During bathing, the area around the incision is not to be cleaned vigorously or with excessive pressure, or rubbing motions. The incision and the area around it are to be carefully dabbed, gently to avoid pressure.

Women are not to lift heavy objects for a certain period after the procedure, and this will be communicated by the specialist after an assessment or after a specified period. During this period, couples are to avoid sexual intercourse or any actions that could stimulate or cause discomfort. Resumption of routines will be as per the advice of the doctor, and it is advisable to ascertain beforehand if any follow-up consultation is necessary.

Situations that warrant medical attention

While it may not always be necessary to seek intervention medically, if all precautions are followed, there may be a need in the event of special circumstances. For instance, if there is a spike in temperature, if women are experiencing fainting repeatedly, or if certain outcomes are persistent. This includes pain in the abdomen or bleeding from the bandage that does not appear to stop. Other conditions that warrant medical attention include a foul-smelling odor from the wound that may indicate infection.

Commonly reported tubal ligation side effects

The procedure comes with the possibility of undesirable effects after the sterilization. This includes cramps or abdominal pain, and women are known to end up feeling extremely tired or drained of energy after the procedure. Feelings of dizziness are relatively common, and this is attributed to the effects of anesthesia. As a result of the use of gas for inflation, women may feel an abnormal bloated or gas-filled feeling. Pain in the shoulder has also been reported in certain circumstances. The possibility of ectopic pregnancies cannot be ruled out, in the event conception occurs even after the procedure. Ectopic pregnancy refers to the fertilization of an egg in the fallopian tubes, instead of the uterus where it should occur. These pregnancies warrant urgent medical attention, and it is important to stop them from progressing to childbirth.

When are additional tests required to determine efficacy?

Many women are typically under the impression that additional tests are required always to determine if the procedure was successful. However, additional tests are not required in all circumstances. For instance, in the event of a laparoscopic method being performed, additional tests are not required to confirm if the procedure was effective. The need for additional tests arises when the hysteroscopic tubal occlusion method is performed. In the event women choose this option, it is necessary for couples to choose contraceptives or birth control methods for a period of three months after the procedure, following which a hysterosalpingogram test is to be performed to check the effectiveness of the sterilization procedure.

Overall benefits and tubal ligation side effects

The sterilization process is relatively safe and permanent in nature offering couples the option of preventing unplanned pregnancies. The reduced risk of ovarian cancer makes the procedure a good choice. However, due to its irreversible nature unlike IUD devices, it is not a suitable option for couples looking at non-permanent options. Additionally, the single biggest risk is the possibility of ecotopian pregnancies, apart from the risk of wounds and infection.

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