What is a tubal ligation?

Tubal ligation, or “having your tubes tied,” is a surgical procedure that provides permanent birth control for women. A tubal ligation involves surgically cutting or blocking both fallopian tubes so a man’s sperm cannot reach a woman’s egg and fertilize it to begin a pregnancy.

The fallopian tubes are located in the lower abdominal (pelvic) area. They connect the ovaries to the uterus and provide a passage for sperm to move to a woman’s egg and for a fertilized egg to move into the uterus. When the fallopian tubes are blocked, sperm cannot reach the egg and fertilize it to begin a pregnancy.

Tubal ligation is a common but significant surgery with risks and potential complications. Other methods of birth control are less invasive than a tubal ligation and are not permanent. Ask your doctor about all of your options to understand which are best for you before having a tubal ligation. 

Types of tubal ligations

Methods of blocking or disconnecting fallopian tubes during a tubal ligation include:

  • Clamping or banding involves applying a small clamp, clip, or band to each fallopian tube to shut it.
  • Cutting and tying involves making one cut in each fallopian tube so that they are no longer connected and tying shut the open ends.
  • Sealing with electrical current involves making one cut in each fallopian tube so that they are no longer connected then using a small amount of electrical current to seal the open ends. 

Why is a tubal ligation performed? 

Your doctor may recommend a tubal ligation for permanent sterilization and birth control.  You should not consider a tubal ligation until you are finished having children or you are sure that you never want to have children. 

A tubal ligation is sometimes reversible, but it carries risks and is not successful for many women. Talk with your doctor about all permanent and temporary birth control options, such as an intrauterine device (IUD), condoms, the birth control pill, hysteroscopic sterilization, and vasectomy. 

Who performs a tubal ligation?

An obstetrician-gynecologist (Ob/Gyn) performs tubal ligation. An Ob/Gyn is a doctor who specializes in women’s health and pregnancy. An Ob/Gyn is trained in medical and surgical treatments.

How is a tubal ligation performed?

Your tubal ligation will be performed in a hospital or surgical center. It is performed as an open procedure requiring a five-to-seven-inch incision in your lower abdomen, or as a minimally invasive laparoscopy or minilaparotomy procedure. Laparoscopy and minilaparotomy, as compared to an open procedure, generally entail a faster recovery time, less pain, and a lower risk of some complications, such as infection.   

Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital or surgical center based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different tubal ligation procedures and ask why your doctor will use a particular type for you. 

Surgical approaches to a tubal ligation

A tubal ligation may be performed using one of the following approaches: 

  • Laparoscopy is a minimally invasive method of tubal ligation that involves making a few small incisions in your abdomen. A small tube, fitted with a special camera and other surgical instruments, is inserted through the incisions to cut, tie or clip your fallopian tubes.
  • Laparotomy (open tubal ligation) involves making a five-to-seven-inch incision in the lower part of your belly. The incision may be vertical or horizontal. A horizontal incision (bikini cut) is placed very low on the abdomen so it is not easily visible.
  • Mini-laparotomy involves making one small incision in the lower abdomen, pulling the fallopian tubes through the incision, and cutting, tying or clipping them shut.

Types of anesthesia that may be used

A tubal ligation may be performed using either general anesthesia or regional anesthesia. 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. 
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.