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Tubal Ligation

There are dozens of different methods of birth control available today, giving women the freedom to choose the one that is right for them, depending on individual needs, lifestyle, and reproductive goals. One of the most effective and permanent of these is tubal ligation (otherwise known as "getting your tubes tied").

In order for conception to occur, the fallopian tubes must connect the ovaries to the uterus. In a tubal ligation, the fallopian tubes are cut (ligated) so that sperm cannot travel up the tubes to fertilize the egg and eggs cannot travel to the uterus. A tubal ligation virtually eliminates the chance of getting pregnant in the first year after the procedure, the chance of getting pregnant is less than 1 percent.

There are several ways to perform a tubal ligation. Laparoscopy is a popular technique in which a small telescope, called a laparoscope, is inserted into your abdomen through a small incision and the fallopian tubes are ligated with a cauterizing (heat) device, clamped with special clips, or blocked with tubal implants. A tubal ligation may also be performed through the vagina rather than the abdomen; however, this is less common. Many women choose to have a tubal ligation immediately after they give birth. If you had a Cesarean section and your abdomen is still open, your doctor can perform the tubal ligation in just a few extra minutes while you are still anesthetized (called an open tubal ligation, or laparotomy). After a vaginal delivery, your doctor may opt for a method known as minilaparotomy in which a small incision is made below the navel through which your doctor raises a portion of each fallopian tube.

Many doctors prefer to perform a tubal ligation shortly after delivery because you're already in the hospital, your abdominal wall is relaxed, and pregnancy has pushed the top of your uterus near your navel the entry point of the operation making direct access to the tubes easier. In most cases when this surgery is performed on an outpatient basis the procedure is considered same-day surgery (you go home the same day you have the surgery). Laparoscopy and mini-laparotomy are usually done with a regional or general anesthetic while laparotomy is usually done under general anesthesia. If you received general anesthesia, you will probably have to stay overnight.

If you choose to have a tubal ligation done immediately after you deliver, be sure to discuss this with your doctor during your prenatal appointments and arrange for it in advance. Inform your doctor of any circumstances under which you would not want him or her to proceed with the tubal ligation at the time of delivery.

Within eight hours after a tubal ligation, most women can resume relatively normal activity. After surgery, you may feel some discomfort that may last about a week, during which time you should abstain from sex and strenuous exercise. You may also experience dizziness, fatigue, nausea and bloating. If you have a laparoscopic procedure, you may feel discomfort in your shoulder or the side of your neck. This is normal and due to irritation of your diaphragm by the gas used to inflate your abdomen.

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