Tubal ligation, or getting your tubes tied, is an effective permanent form of birth control. But it's not the only option out there. Here's everything parents should know, including how the procedure works, what it costs, and side effects.

By Erica Jackson Curran
December 03, 2020
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When it comes to birth control, we're fortunate to have more options for preventing pregnancy than we ever have before. But for women seeking permanent, nearly foolproof contraception, sterilization is the only option. Whether you call it tubal ligation or "getting your tubes tied," it's a fairly simple procedure—and significantly more common than its male sterilization counterpart, vasectomies. (We'll get into that more later.)

tubal ligation illustration
Credit: Illustration by Caitlin-Marie Miner Ong

Doctors like Diana Sunday, M.D., an OB-GYN at MedStar Montgomery Medical Center in Columbia, Maryland, typically view tubal ligation as a safe and effective form of permanent birth control. "Less than 1 percent of women get pregnant following tubal ligation—about one in 200 women," says Dr. Sunday. The odds don't get much better than that.

But beyond its effectiveness for preventing pregnancy, there's lots to consider when it comes to getting your tubes tied, from side effects to cost. Here's everything you need to know.

How Tubal Ligation Surgery Works

So exactly which tubes are getting tied in this procedure—and how do they tie them? We're talking about your fallopian tubes, which connect the ovaries to the uterus. Cutting off that important passageway makes it extremely unlikely that pregnancy will occur. "This prevents her egg from traveling outside the ovaries into the fallopian tubes and blocks sperm from traveling up the fallopian tubes to the egg," says Dr. Sunday.

There are two ways that sterilization can be performed on women, according to the American College of Obstetricians and Gynecologists: minilaparotomy and laparoscopy.

  • With a minilaparotomy, a procedure that's often used postpartum, a small incision in made in the abdomen to access the fallopian tubes. Then either a small section of each tube is removed, or both tubes are removed completely. Clips may also be used to close off the tubes.
  • With a laparoscopy, a laparoscope is inserted into an incision in or near the belly button, and the tubes are closed off internally.

While it has permanent effects, tubal ligation is generally viewed as a quick, minor surgical procedure. "It typically can be performed at the time of a patient's C-section, sometimes after a vaginal delivery," says Dr. Sunday. "If a woman isn't pregnant, it can be done laparoscopically via one to three small incisions."

Tubal Ligation Side Effects

The side effects of getting your tubes tied are typically mild, and recovery time tends to be short—though that does depend on your general health, lifestyle, and the type of procedure you've undergone. Common side effects include feeling tired, dizzy, nauseous, and cramping for a short time following the tubes tied surgery.

And there is one positive, longer term side effect of the tubes tied procedure to consider: Evidence has shown that tubal ligation may also greatly decrease the risk of ovarian cancer. "This is when the entire fallopian tube is removed, rather than just removing a small portion or placing a clip in the middle of the fallopian tube," says Dr. Sunday. "Women who have undergone a bilateral tubal ligation and especially with removal of the entire fallopian tube have been shown to have a lower risk for ovarian cancer."

Something the surgery won't change? Your menstrual cycle. "Because tubal ligation doesn't use hormones to prevent pregnancy, it doesn't change your natural hormones or change a woman's period or cause menopause," says Dr. Sunday. "Unlike hormonal birth control, like birth control pills or IUDs, it does not have the same side effects like headaches, weight gain, cramps, or mood swings."

The Cost of Tubal Ligation

How much does it cost to get your tubes tied? According to Planned Parenthood, the procedure may cost anywhere from $0 to $6000. If you have health insurance or Medicaid, it may not cost you a penny to get your tubes tied. Cost may also vary based on the type of procedure you choose and where you get the procedure done. Out of pocket, tubal ligation usually costs much more than vasectomies.

Tubal Ligation vs. Vasectomies

Of course, female sterilization isn't the only permanent option — though it is by far the most popular. For men, vasectomies are quicker, less expensive, and generally considered lower risk than tubal ligation. Ngozi Wexler, M.D., an OB-GYN at Medstar Montgomery Medical Center, confirms that women across the country get sterilized at higher rates. "Women notoriously are often the driver of their own, their family, and their partner's medical care," she explains.

Many times vasectomies can be performed in a doctor's office with a local anesthetic in less than 30 minutes, while tubal ligation is more invasive and often conducted under general anesthesia, Dr. Wexler explains. "Vasectomies can be an effective procedure that can also be reversed, while tubal ligation largely cannot be reversed."

When deciding between tubal ligation and vasectomy, you and your partner should both speak with your doctors to understand the recovery time, cost, and risks associated with each option. "If a woman or her partner are not absolutely certain they no longer want to conceive a child, I advise them to explore alternative birth control options," Dr. Sunday adds. "Women have a lot of choices, and should be empowered to make the one that is best for her health and her wishes around pregnancy."

The Bottom Line

Before committing to a tubal ligation, consider all of your birth control options to make an informed decision about what's right for you. Your physician can help you understand all of your options, what the risks are, and how they will affect you. "This is a very personal decision for a woman, and one no one should make for her," says Dr. Sunday.

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