Family PACT

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Sterilization for women

Birth Control
for Women

California Department of Health Services 

There are two kinds of birth control, reversible and
permanent. Permanent birth control for women is
called tubal sterilization or a "tubal." Permanent birth     
control for men is called vasectomy. This pamphlet
is about tubal sterilization. For more information
about vasectomy, ask for the pamphlet, "Permanent

Birth Control for Men."

The information about tubal sterilization in this
pamphlet will help you decide if permanent birth
control is right for you. Don't let anybody else make
the decision for you. It is your choice.

You may want permanent birth control if:

  • You are sure you do not want children in the
    future, even if your partner does.
  • Pregnancy would be dangerous to you-or your
    baby's health.
  • You can't use or do not want to sue other birth
    control methods.
  • You have a medical problem that you could
    pass on to your children.

How does tubal sterilization work?

Woman in a business suit  Every month, a woman's
ovaries release an
egg that moves down the
fallopian tubes to the
uterus. If a man's sperm
meets the woman's egg
in the fallopian tubes, the
woman may get pregnant.
After the tubal sterilization,      
both tubes are blocked so
that the sperm cannot
reach the egg. This
prevents pregnancy.

What happens to the egg?

An egg is still released from the ovary each month,
but your body absorbs it.  

How is tubal sterilization done? 

The operation is done under anesthesia in an
office, surgery center, or hospital. The choices for
anesthesia include:

  • General anesthesia - You are in a deep sleep
    and you do not feel anything.
  • Local anesthesia - You are awake and medicine
    is used to numb the area where the operation
    will be done.
  • Spinal or epidural anesthesia - Medicine is
    used to make your body numb from your waist

After you get the anesthesia, there are several ways
a doctor can reach your fallopian tubes:

  • Laparoscopy - One or more small cuts are
    made in the skin on your belly. The doctor uses
    a laparoscope (a thin metal tube with a light) to
    see inside your abdomen and reach your fallopian
  • Mini-laparotomy - The doctor reaches the
    fallopian tubes through a small cut in the skin on
    your belly.
  • During C-section - (operation on the uterus to
    deliver the baby)
    The doctor reaches the fallopian tubes through the
    same cut that was used to deliver the baby.
  • Through the cervix - A hysteroscope (a thin
    metal tube with a light) is placed through the
    cervix (opening to the uterus) into the uterus. After
    the doctor reaches your tubes, there are several
    ways to block or close them.
Types of tubal sterilization

Which type of tubal would be best for me?

Talk with your doctor about the different types of
operations and anesthesia. Then you and your doctor
can decide which would be best for you.

What are the risks? 

Any operation can cause health problems - some
minor and some serious. Minor problems just after
the operation may include soreness near the skin
cut, cramps, nausea, vomiting, and sore shoulders,
neck, or throat. Some women notice later changes in
their menstrual periods, but these changes are not
related to the sterilization. 

Serious health problems are rare. Serious health
problems may include bleeding, infection, injury to
the intestines or bladder, and heart or breathing
problems from the anesthesia. 

When can I have the tubal? 

The operation can be done: 

  • While you are in the hospital after having a baby.
  • At the same time you have a baby by C-section.
  • At any time if you are not pregnant.

What should I expect after the operation?

Most women will go home on the same day of the
operation. You will want to take it easy for a few
days. Your doctor will give you instructions for follow-
up care.

After the tubal, when can I start having sex again?

You can start having sex as soon as you feel

When can I stop using my current birth control

That depends on how your doctor closes the tubes.
Your doctor will tell you when you are no longer at
risk for pregnancy and can stop using other types of
birth control.

How effective is tubal sterilization?

Tubal sterilization is a very effective and permanent
way to prevent pregnancy. However, there is a
small chance that you would get pregnant after the
operation, even though the tubal was done right.
A pregnancy after tubal sterilization may not be in
the uterus. This serious problem is called ectopic
pregnancy. If you think you might be pregnant after
having a tubal, contact your doctor immediately.

How will having a tubal affect me?

Tubal sterilization will NOT:

  • Change female hormones.
  • Make a woman go through the change of life
  • Cause weight gain.
  • Lower a woman's sex drive.
  • Cause skin or breast changes.
  • Protect against sexually transmitted infections
    (STIs) and HIV.
  • Fix sexual, emotional or relationship problems.

Many women enjoy sex more after having a tubal
because they no longer have to worry about
getting pregnant.

A small percentage of women later regret having
had a tubal sterilization. You should think carefully
before having a tubal, especially if you are young
or do not have children.

Will a tubal sterilization protect me from STIs
and HIV?

No. Tubal sterilization will not protect you from
sexually transmitted infections like chlamydia,
gonorrhea, genital warts, herpes, syphilis, or HIV.
If you are at risk for STIs or HIV, you should use a
condom every time you have sex, even it you have
had a tubal.

Can tubal sterilization be undone? 

Tubal sterilization should be considered
permanent. In some cases, a later operation can
be done to reconnect your tubes, but you still may
not be able to get pregnant. Pregnancy also may
be possible through "in vitro fertilization (IVF)" or
similar procedures, but they are expensive, may
not be covered by insurance, and may not work. 

Are there any forms I need to fill out? 

You will need to sign a consent form before your
operation. If you have Medi-Cal, you must sign
the consent at least 30 days before your operation.
you do not need permission from your partner or
anyone else. After signing the
consent, you can still change A woman thinking about sterilization
your mind at any time before
the operation.

Is a tubal the same as a

No. During a tubal, none of a
woman's female organs are

Are there other ways to prevent pregnancy? 

Before you make up your mind about tubal
sterilization, you might also want to think about
vasectomy, permanent birth control for men.
Vasectomy is safer, simpler and less expensive
than tubal sterilization.

If you think you might want children in the future,
you or your partner should use a reversible
method of birth control. Some of the reversible
methods are as effective as sterilization but
when you stop using them you are still able to
get pregnant. Your options for reversible birth
control are listed in the table at the end of this

Tubal sterilization may be a good choice for
you if: 

  • You are sure you do not want children in the
    future, even if your partner does.
  • Pregnancy would be dangerous to you or your
    baby's health.
  • You cannot use or do not want to use other
    reversible birth control methods.
  • You have a medical problem that you could
    pass onto your children.

Think carefully about your decision to use
permanent birth control! Tubal sterilization
and vasectomy are safe, effective and provide
permanent protection from pregnancy. Talk
with your clinician and make sure all of your
questions have been answered.

Make up your own mind about what is right
for you.


Pregnancies in
100 couples in
the first year of       
typical use
Vasectomy Less than one 
Tubal sterilization Less than one 
Intrauterine contraception Less than one 
Contraceptive injection  Less than one 
Birth control pills  5
Contraceptive patch or ring  2
Male condoms  14
Diaphragm, cervical cap  20
Periodic abstinence  25
Withdrawal  19
Spermicides  26
No method  85

Additional copies of this brochure
may be obtained from the
Department of Health Care Services web site.