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Birth Control Permanent Methods

What are Permanent Methods of Birth Control?

  • Sterilization is considered a permanent method of birth control that a man or woman may choose.
  • Although sterilization, or a tubal ligation, for women and vasectomy for men can sometimes be reversed, the surgery is much more complicated than the original procedure and may not be successful.
  • Thus, when choosing a sterilization method, you should be certain you do not desire future pregnancies.

Female Sterilization, Tubal Ligation

About 700,000 American women each year elect to have surgery for sterilization, referred to as tying the Fallopian tubes or tubal ligation. Some women have a hysterectomy (removal of the uterus and sometimes also the tubes and ovaries) each year but, but this is usually not performed only for birth control.

Most US women who have undergone sterilization experience either a postpartum minilaparotomy procedure or an interval (timing of the procedure does not coincide with a recent pregnancy) procedure. A postpartum tubal ligation is usually performed through a small incision made through the navel immediately following vaginal delivery of an infant, or it may be performed through an open incision at the time of cesarean section. An interval tubal sterilization is usually done with the use of small instruments inserted into a woman's abdomen following laparoscopy wherein the a scope is inserted through the umbilicus. Interval minilaparotomy - a small abdominal incision in bikini area - is usually the procedure of choice when distortion of the abdominal contents or adhesions are anticipated, which might compromise the ability to complete the procedure laparoscopically.The majority of cases of surgical sterilization for women are performed under general anesthesia.

The Fallopian tubes (through which the egg passes from the ovaries and where the egg is fertilized by the sperm) may be blocked with silastic rings, clips, bands, segmental destruction with electrocoagulation, or suture ligation with partial salpingectomy (removal of a segment in each of the fallopian tubes). Female sterilization prevents fertilization by interrupting the passage of sperm upward through the Fallopian tube.

  • How effective: Sometimes this method does not provide permanent birth control (i.e. tubal ligation failure). The United States Collaborative Review of Sterilization has examined the failure rate of female sterilization. Rates vary according to the procedure performed. Overall, about 5 women out of 1,000 women who have the procedure become pregnant within one year. This is likely caused by an incomplete closure of the tubes. If pregnancy does occur after the procedure, there is an increased risk for an ectopic pregnancy pregnancy in a location other than the anticipated position within the uterus).
  • Advantages: Female sterilization does not involve hormones. It is a permanent form of birth control. There are no changes in libido (sexual desire), menstrual cycle, or breastfeeding ability. The procedure is usually performed as a same-day procedure done in an outpatient surgical facility.
  • Disadvantages: The procedure involves general or regional anesthesia. It is permanent form of birth control, and some women may regret their decision at a later date. The two most common factors associated with regret are young age and unpredictable life events, such as change in marital status or death of a child. Regret also has been shown to correlate with external pressure by the clinician, spouse, relatives, or significant others.

Regret is difficult to measure because it encompasses a complex spectrum of feelings that can change over time. This helps to explain that while some studies have shown "regret" on the part of 26% of women, fewer than 20% seek reversal and fewer than 10% actually undergo the reversal procedure.

Female sterilization does not protect a woman from sexually transmitted diseases, and it involves all of the risks of surgery. Occasionally, sterilization cannot be done laparoscopically, and an abdominal incision may be necessary to reach the Fallopian tubes. There may be some short-term discomfort.

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