The pit-a-pat of little feet is not a sound that every woman wants to hear when she wakes up in the morning. While birth control is the leading form of birth control for young women, sterilization is the leading method of contraceptive for women over the age of 35. Blocking the egg from traveling through the fallopian tubes to the uterus, the site where fertilization occurs, sterilization is 99.5 percent effective at permanently preventing pregnancy. Over 150 million women worldwide and an estimated 10 million in the United States are undergoing sterilization a year. Unlike temporary contraceptives, it has no side effects, doesn’t require any follow-up doctor visits or inconvenient prescription refills, or daily pill popping. 

Is Sterilization Right for You?

There are a number of things to consider before choosing sterilization as your birth control method. Being that it’s permanent, you should try talking to a few people before making a decision, such as your gynecologist or a doctor you can trust and your partner. You might want to visit a healthcare provider besides your own that specializes in sterilization to get a second opinion. Another factor to take into account is the talk you have with your partner. Make sure you and your partner plan on being with each other well after your childbearing years, which may be hard to predict. Even though the procedure may be reversed in some cases, if your current partner is ok with it your next partner might not be and it may be damaging to your relationship. Now, if you have children already and are pretty sure that you don’t want any more children with your current partner or with any partner(s) in the future, and you don’t want to think about contraceptives or abortions, sterilization is the best choice.

Age is an important factor in deciding if sterilization is right for you. Younger women should really wait before using sterilization as a form of contraceptive.  Children may not be something a woman wants early on in her life, but with time feels can change and sterilization can wreck future family planning.

Sterilization shouldn’t be used as a quick fix for relationship problems or emotional issues. The right to choose has always been one of the greatest battles women had to fight, so you should never feel pressured into sterilization. 

Don’t look to sterilization if you still need protection against sexually transmitted diseases and infections. Condoms, both male and female or other latex and polyurethane barriers such as dental dams, are still the best method at protecting against STIs and HIV infection.

Health issues can also play an important role in making the decision to be sterilized. Conditions like heart disease, diabetes, anemia, and any bleeding disorders should be treated before the procedure is performed. On the other hand, if you’re suffering from any of the cancers of the reproductive organ, such as cervical or ovarian cancer, fibroids, endometriosis, prolapsed pelvic adhesions, heavy menstrual bleeding or pelvic pain, a sterilization procedure like hysterectomy may be your only option.

Laparoscopic Tubal Sterilization

Tubal sterilization, also known as “getting your tubes tied,” is one of the most commonly used surgical forms of sterilization. The procedure involves the fallopian tubes being either cut, burned, or blocked with rings, bands, or clips. The target="_blank"laparoscope is a small telescope-like surgical instrument which allows for a procedure with little tissue trauma and scarring. Tubal sterilization takes only about 30 minutes and recovery is one hour. The average patient has little to no complications or post-operative pain. There have been a few known cases of abnormal bleeding and bladder infection as a result of the procedure. Even with the procedure being 99.5 percent effective, there is a small chance of an ectopic pregnancy after having your tubes tied. 

Any women undergoing tubal sterilization will only need a few days to recover and can have sex whenever she is ready. There is no change in hormone levels because there is still a menstrual cycle and the ovaries continue to release eggs that are stopped in the fallopian tubes and absorbed into the body. Not having to worry about pregnancy can even improve sexual satisfaction.

Tubal Sterilization Reversal

If you choose tubal sterilization and down the line decide you want to become pregnant, tubal reversal surgery is the best option for women who want a second chance at pregnancy. In the reversal, the technique of microsurgery is used to open and reconnect the fallopian tube pieces that remain after the sterilization surgery. Most women want a reversal procedure because of remarriage or the change of mind with their current partner to have more children. A small percentage of women want to reverse sterilization due to the death of a child, to relieve symptoms of post-tubal ligation syndrome, or for religious reasons.

Essure

Essure is the first and only FDA-approved sterilization that doesn’t involve any cutting or surgical incisions. What makes Essure so different from tubal sterilization is the insertion of spring-like coils into the body through the vagina which then will go into the fallopian tubes.  The procedure can be performed right in the comfort of your healthcare provider’s office with any kind of anesthesia. 

Within the first three months after the procedure, the spring-like coils begin to come together to form a barrier preventing sperm from reaching the egg. It is during this timeframe you will need to use another form of birth control. Once the three months are over, a special x-ray will be taken to confirm that the fallopian tubes are totally blocked, in which case the secondary form of contraceptive is no longer needed.

During initial clinical trials, Essure resulted in no pregnancies. Just like tubal sterilization, there are no hormones to interfere with a woman’s period. There is no reversing Essure, so if you choose this method as your form of sterilization you have to make sure you don’t want children in the future.

Hysterectomy

Probably the only non-voluntary sterilization procedure, a hysterectomy is performed to remove the uterus. Some hysterectomies also involve the removal of the ovaries, reducing the production of essential female hormones. Once a hysterectomy is performed, a woman can no longer have children and her period stops. Hysterectomies are performed as treatment for a number of diseases and condition. In cases where there is cancer forming on any of the reproductive organs or hemorrhaging of the uterus, the operation can save your life.

There are a number of reasons a woman might need a hysterectomy. The main reasons are to save her life, to solve a major problem that interferes with normal bodily functions, and to improve the quality of life. In most cases, as mentioned earlier, hysterectomy is used as treatment for cancer, fibroids, endometriosis, prolapsed pelvic adhesions, heavy menstrual bleeding, or pelvic pain.

As with any major operation, there are some risks and side effects after having a hysterectomy. Some of the more serious complications are blood clots, severe infection, adhesions, hemorrhaging, bowel obstruction, and injury to the urinary tract. Some women may suffer from depression and loss of sexual pleasure.  If worried about the side effects, there are alternatives to having a hysterectomy.

A myomectomy, which doesn’t involve the removal of the uterus, can be performed. However, the operation is more severe than a hysterectomy and there is high risk of bleeding and infection. Laparoscopy tubal sterilization is also a hysterectomy alternative.  Some may opt to just bear with any pain or discomfort and not have a hysterectomy at all.

Abortion

Another form of surgical contraceptive and probably the most controversial procedure is an abortion. An abortion is the removal of an embryo from the uterus resulting in the end of an unwanted pregnancy. While most abortions are voluntary, there are some cases where the procedure is performed to save the life of the carrier or to avoid an extremely difficult birth defect.

The Right to Choose

Making the choice not to have children is a major life-changing decision and should not be taken lightly. With some of the sterilization procedures being permanent, you wouldn’t want to jump right into it without weighting all your options. Be sure to get a first and second opinion from a healthcare provider and talk to your partner about not having children. Don’t make the decision on your own, because it can be a permanent one that not only affects you.