Female sterilization, or tubal sterilization (also referred to as getting one’s “tubes tied”), is the most widely used method of birth control in the world (Church & Geller, 1990). Between 1994 and 1996, over 2 million tubal sterilizations were performed, half of which were done directly following childbirth (MacKay et al., 2001). In a tubal sterilization, a physician may sever or block both Fallopian tubes so that the ovum and sperm can not meet. Blocking the tubes can be done with cauterization, a ring, band, or clamp (which pinches the tube together), or ligation. The procedure is often done under general anes­thesia. Recently, some of these procedures have been done using clips or silicone plugs instead of severing the tubes, which may enable physicians to reverse the operation in the future. However, at the present time, female sterilization is considered irreversible. The majority of women who undergo sterilization are happy with their decision, except for women aged 30 or younger. These women are more likely to regret the decision later in their lives (Alan Guttmacher Institute, 1999a).

Sterilization procedures can be done during outpatient surgery or directly following childbirth in a hospital. The sterilization procedure is generally done with the use of a laparoscope through a small incision either under the navel or lower in the abdomen. After this is done, a woman continues to ovulate, but the ovum does not enter the uterus. The costs for female sterilization vary, but generally range from $2,000 to $5,000.

As with any other surgery, potential risks exist. A woman may feel side effects from the anesthesia or experience bleeding, infection, or possible injury to other organs dur­ing the procedure. In a few cases, the surgery is unsuccessful and must be repeated. On the positive side, however, tubal sterilization has been found to substantially reduce the

 

sterilization

Surgical contraceptive method that causes permanent infertility.

 

tubal sterilization

A surgical procedure in which the Fallopian tubes are cut, tied, or cauterized, for perma­nent contraception.

 

cauterization

A sterilization procedure that involves burning or searing the Fallopian tubes or vas deferens for permanent sterilization.

 

I ligation

A sterilization procedure that involves the tying or binding of the Fallopian tubes or vas deferens.

 

outpatient surgery

Surgery performed in the hospital or doctor’s office, after which a patient is allowed to return home; inpatient surgery requires hospitalization.

 

laparoscope

A tiny scope that can be inserted through the skin and allows for the viewing of the uterine cavity.

 

Body tissue grows into the Essure micro-insert, blocking the Fallopian tube

 

Figure 13.8

Essure is a permanent method of contraception.

 

Female Sterilization

risk of ovarian cancer (Pollack, Carignan, & Jacobstein, 2004). Overall, research has shown that women who undergo tubal sterilization maintain their levels of sexual inter­est and desire and have more positive than negative sexual effects (Costello et al., 2002).

In 2003, the FDA approved Essure, a nonincision, permanent birth control method for women. Essure is a tiny, springlike device that is threaded into the Fallopian tubes. This creates tissue growth around the device, which blocks fertilization. This process generally takes 3 months from the time Essure is placed in the tubes, so it doesn’t offer immediate birth control. A woman using this method must undergo testing to make sure that the Fallopian tubes are fully blocked.