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Community Womens Services

Permanent birth control

Tubal ligation (often referred to as “having your tubes tied”) and tubal implants are surgical options available to women desiring a permanent form of birth control. Both procedures prevent the egg from traveling from the ovaries into the fallopian tubes, which is where fertilization normally takes place. These procedures are not meant to be reversed and should only be considered by women who are finished having children and do not want to become pregnant in the future.

Women who may wish to become pregnant in the future should discuss other birth control options with their doctor.

Tubal ligation

In a tubal ligation, the fallopian tubes are cut or closed so the egg cannot travel from the ovaries into the uterus, and sperm cannot pass through the fallopian tube to the egg. The surgical technique used will depend upon your personal health situation.

  • Mini-laparatomy – this is done with a small abdominal incision, about two inches in length.
  • Laparascopy – a viewing instrument and surgical tools are inserted through small incisions in the abdomen to perform the procedure.
  • Postpartum tubal ligation – this is performed 30 minutes to 36 hours after vaginal delivery through a small incision under the belly button.

Patients typically go home the same day of surgery and can resume all normal activities within a week. No backup form of birth control is needed following the surgery; however, tubal ligation is not 100 percent effective at preventing pregnancy. Over time, the fallopian tubes may grow back together, leading to pregnancy in a small percentage of women.

Patients should discuss with their doctor the benefits and risks of this procedure, including which tubal ligation methods are most effective at preventing future pregnancy.

Tubal implants (Essure)

Essure is a minimally-invasive alternative to tubal ligation. A lighted telescopic instrument, called a hysteroscope, is inserted into the vagina, through the cervix and into the uterus. A coiled implant is then inserted through the hysteroscope and into each fallopian tube. Once the implants are placed, the hysteroscope is removed through the vagina. Over time scar tissue develops around each implant, creating a barrier between the fallopian tube and the uterus.

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