Contraception: female sterilisation
What is female sterilisation?
Female sterilisation is a form of surgical contraception that involves sealing off the fallopian tubes. It is sometimes referred to as tubal ligation, tubal occlusion, or ‘having your tubes tied’.
Hysterectomy (surgical removal of the womb or uterus) is also sometimes used as a female sterilisation technique, particularly if there are other problems associated with the uterus.
How does it work?
Tubal ligation works by preventing the sperm from reaching the egg. After ejaculation, sperm normally swim up the fallopian tubes and fertilisation can occur of an egg that has been released by one of the ovaries (ovulation) and is on its way down the tubes. The fallopian tubes, which carry the egg down to the uterus, are blocked either by cutting and tying or by applying clips, clamps or rings. Alternatively, the tubes may be sealed off by being cauterised using an electric current.
How effective is it?
Tubal ligation is around 99 per cent effective at preventing pregnancy. It can be reversed via an operation called reanastamosis but the success rate of fertility returning is only between 50 and 80 per cent, so sterilisation should always be thought of as a permanent measure.
What are the advantages?
Some of the advantages of female sterilisation are that:
- it is effective immediately;
- there are rarely any long-term health consequences;
- it does not affect sex drive;
- it does not interfere with spontaneity of sexual intercourse; and
- it does not affect intercourse, normal hormonal rhythms or periods.
What are the disadvantages?
Some of the disadvantages of female sterilisation include the following.
- It requires surgery, usually under a general anaesthetic.
- It is more complicated than vasectomy (male sterilisation).
- There is a risk, albeit low, of surgical complications such as internal bleeding, infection or damage to other organs.
- If a pregnancy should occur, there is an increased risk that it will be in the fallopian tubes (ectopic pregnancy).
- It is very difficult to reverse the process, and so should be undertaken by women who are absolutely certain that they do not want any more children.
How is it done?
Usually a surgeon performs minor surgery through a small incision below the navel — a procedure called a laparoscopy. With the aid of a laparoscope (a thin tube that allows a view into the abdominal cavity) the surgeon cuts and ties, cauterises or clips both fallopian tubes. The procedure can be done immediately after childbirth, at the same time as a Caesarean section or shortly after childbirth. Alternatively, it can be planned in advance as an elective surgical procedure.
Last Reviewed: 01 May 2002
