Female Sterilisation
Learn about female sterilisation, commonly referred to as “getting your tubes tied” or tubal ligation. Discover how the procedure prevents pregnancy, the methods used to perform it, and what recovery entails following the surgery.
What is Female Sterilisation?
Female sterilisation is a permanent method of contraception that involves blocking or cutting the fallopian tubes to prevent sperm from reaching an egg. The fallopian tubes connect the ovaries to the womb. This procedure is often referred to as tubal ligation or "getting your tubes tied."
Effectiveness is over 99% in preventing pregnancy. Importantly, female sterilisation does not impact hormonal levels, and regular menstrual periods will continue. However, it is important to note that reversing female sterilisation is typically not available through the NHS. Success rates for reversal are also not high.
It is also essential to understand that female sterilisation does not protect against sexually transmitted infections (STIs). The use of condoms is strongly advised to safeguard against STIs, including HIV.
Understanding Female Sterilisation
Who is Eligible for Female Sterilisation?
Female sterilisation is a permanent method of contraception. It may be appropriate for individuals who:
Already have children and do not wish to have more
Do not intend to have children at all
Typically, other forms of long-term contraception are suggested first, as they do not involve permanent changes.
Effectiveness of Female Sterilisation
Female sterilisation is over 99% effective at preventing pregnancy, making it one of the most reliable contraception options. However, there is a rare chance that the procedure may not be successful.
How to Request Sterilisation
Contraception services, including female sterilisation, are available free of charge and are confidential through the NHS. If you are considering sterilisation, schedule an appointment at your GP surgery or a sexual health clinic.
During your appointment, a nurse or doctor will discuss the procedure, explain the different options, outline potential risks, and answer any questions. You will also be offered counselling to help you make an informed decision about whether sterilisation is right for you. Discussions with your partner may also be beneficial, if applicable.
Should you decide that female sterilisation suits your needs, you will be referred to a hospital for the operation.
Preparing for Female Sterilisation
How to Prepare for Sterilisation
Before the surgery, you will have a pre-assessment appointment at the hospital. This appointment is vital for checking your health and discussing the details of the procedure.
Continue using your regular contraception methods up until the day of your operation.
If you will be receiving a general anaesthetic, you will be provided with specific instructions regarding fasting – typically, you should not eat or drink before the procedure.
If You Are Pregnant
Sterilisation may be performed concurrently with a caesarean section or an abortion. However, it is generally advised to wait several weeks between these procedures.
What Happens During Female Sterilisation
How Female Sterilisation is Conducted
Female sterilisation is performed in a hospital setting, typically under general anaesthetic, ensuring you are unconscious throughout the procedure.
On the day of the operation, a pregnancy test will be conducted to confirm that you are not pregnant.
The procedure is generally carried out using keyhole surgery, known as laparoscopy, and takes between 20 to 30 minutes. The process involves the following steps:
The surgeon will make 2 or 3 small incisions in your abdomen, usually near the belly button.
Gas will be introduced into your abdomen to improve visibility of your organs.
A long, thin tube equipped with a camera, called a laparoscope, will be inserted to access your fallopian tubes.
The surgeon will either block your fallopian tubes or remove part of them and seal the ends.
The incisions in your abdomen will be closed using surgical glue or dissolvable stitches.
If laparoscopy is unsuitable, a slightly larger incision, termed a mini-laparotomy, may be made instead.
After the Operation
In most cases, you will be able to return home on the same day as the sterilisation procedure.
If you have received general anaesthetic, it is essential for a friend or family member to accompany you home from the hospital. It is also advisable to have someone stay with you overnight following the anaesthetic.
Healthcare professionals will provide guidance on how to care for the wound and stitches at home, along with advice on pain relief options.
Recovering After Female Sterilisation
Recovering at Home Following Sterilisation
After female sterilisation, it is common to experience abdominal discomfort and light vaginal bleeding for a few days.
Before your discharge from the hospital, a healthcare professional will provide specific instructions on how to care for your incision site, as well as guidance on suitable pain relief options.
You will also receive information on when you can resume your usual activities.
Recovery may take longer if you have undergone a mini-laparotomy compared to keyhole surgery (laparoscopy), as the former involves larger incisions in the abdomen.
Complications of Female Sterilisation
Potential Complications of Female Sterilisation
Female sterilisation is generally a very safe procedure; however, as with any surgical intervention, there are associated risks that your doctor will discuss with you.
The majority of individuals undergoing sterilisation experience no complications. When complications do occur, they are typically minor and manageable.
There exists a small risk of serious complications, which may include blood clots, infection, or ectopic pregnancy.
Blood Clots or Deep Vein Thrombosis (DVT)
Following surgery, alterations in blood flow may lead to the formation of blood clots or DVT. A clot that originates in the leg has the potential to travel to the lungs, resulting in a pulmonary embolism, which can be serious.
To mitigate this risk, your doctor may recommend the use of compression stockings or prescribe anticoagulant medications if they assess you as being susceptible to blood clots.
Wound Infection or Urinary Tract Infection (UTI)
There is a minor risk of infection at the surgical site or the development of a UTI post-operation. Typically, these infections are treated effectively with antibiotics.
Damage to Nerve, Artery, or Organ
During the procedure, there is a slight possibility of inadvertently damaging surrounding organs, such as the bowel or bladder, along with major blood vessels or nerves. The surgical team is trained to address and repair such issues during the operation.
Ectopic Pregnancy
In cases where the sterilisation procedure is not fully effective, pregnancy may occur. If this happens, there is an increased risk of an ectopic pregnancy.
Request an urgent appointment with your GP or seek assistance from NHS 111 if you’ve recently undergone sterilisation and experience any of the following symptoms:
A high temperature or shivering
A swollen, painful wound that is leaking blood or pus
A leg that is swollen, throbbing, and warm to the touch
Frequent urination accompanied by burning or stinging sensations
Abdominal pain along with vomiting or loss of appetite
Sudden difficulty breathing
Coughing up blood
You can contact 111 or access help from 111 online.
Immediate action is necessary: Call 999 or attend A&E if you experience:
Severe difficulty breathing
Pain in your chest or upper back
A very rapid heartbeat
These symptoms may indicate a pulmonary embolism or another serious condition.
Information based on current national NHS guidelines.