What is a postpartum tubal ligation?
Postpartum indicates that it is going to be performed after childbirth. Tubal ligation is the destruction of a portion of the fallopian tubes to prevent pregnancy. The tubes carry the egg from the ovary to the womb.
When is it done?
This operation is done approximately 6-24 hours after giving birth, while you are still in the hospital. If you deliver during the day, your doctor will arrange to have the tubal ligation performed that day. If you deliver at night, your doctor will probably wait until the next morning to arrange your tubal ligation.
How do I prepare for the surgery?
Since this is a permanent procedure, your doctor will want you to be sure that you no longer wish to have more children. Some insurance plans require that you sign a special permission form 30 days prior to having the tubal ligation performed. Your doctor will want to make sure this form has been signed at least 30 days before your due date.
After you deliver the baby, you cannot eat or drink anything if the procedure is to be performed that day. If you are going to have the procedure the next day, you may be able to eat and drink until midnight, but nothing after midnight. This is very important because the medicines given to you to make you sleep during the surgery can cause vomiting. Vomiting while you are asleep can cause you to breathe in the material and severely injure your lungs. If you eat before your surgery, it may have to be canceled or delayed.
How is the surgery done?
You will be given medicine to make you sleep and you will be kept asleep with gas given to you through a mask or a tube in your throat. While you are asleep, a cut will be made right under your belly button measuring about 2 to 3 inches. After giving birth, the tubes are on either side of the belly button. They will be pulled up through the incision, clamped, and a large portion of each tube will be removed. The ends will then be sewn closed. The incision will then be closed in several layers and a bandage will be placed over the incision.
What are the risks and benefits?
It is very important that you understand the risks as well as your alternatives to the procedure. This should be considered a permanent procedure. It is unlikely that anyone will be able to connect your tubes and make them work again. You must be sure that you do not want any more children. Even though this should be considered a permanent procedure, it is not perfect. For every 1,000 women who have a tubal ligation, 4 to 7 of those women will get pregnant up to 10 years after their tubal ligation. This is sometimes due to the tubes reopening or growing back together. If you ever feel pregnant, you should get tested.
The risks of the tubal ligation include, but are not limited to:
- Bleeding
- Infection
- Injury to other organs
- Pain
- Anesthesia complications
- Failure of the procedure in 4 - 7 out of 1,000 women over 10 years
- Ectopic pregnancy (pregnancy outside the womb)
Most of these risks are rare, but every patient that has a tubal ligation can possibly have one or more of these occur. If you have any questions or concerns about these risks, please ask your doctor.
What are the alternatives?
It is very important that you are aware of alternatives to tubal ligation. There are many other methods to prevent pregnancy besides having your tubes cut. Possible alternatives include:
- Birth control pills
- Depo Provera shot
- Intrauterine device
- Norplant
- Vasectomy (having the man’s tubes cut)
- Condoms
- If you have any questions about these other methods, please speak to your doctor.
- If you are less than 25 years of age, it has been found that you are at increased risk to have a failure of your tubal ligation, or to regret having the tubal ligation performed. If you are less than 25 years of age, you may want to consider another form of birth control or to speak to your doctor about other choices available.
How will you feel after the procedure?
- When you wake up from the procedure, you may feel a little sick to your stomach and you may have some soreness or pain around your belly button.
- You will be given pain medicine during the procedure, as you wake up and after the procedure.
- You will be given some fluids to drink and if that does not make you feel sick to you stomach, you will slowly be allowed to eat regular food.
- After an hour or two, you will be able to sit up in bed and after three or four hours, you may be allowed to take short walks.
- You should expect to rest in bed for the remainder of the first day and may require pain medicine quite regularly. On the second day, the soreness should be improved.
- You can expect the soreness to last anywhere from 3 to 7 days.
- You should be able to go home either the evening of the tubal ligation or the following day.
When should I call the doctor?
You should call the doctor immediately if:
- You develop a fever.
- You develop nausea and vomiting and are unable to drink fluids for more than 6 hours.
- You have pain that is not getting better with the pain medication.
- Your incision opens, drains pus, or begins to bleed.
- You should make an appointment to see your doctor approximately 1-2 weeks after the procedure to have your incision checked.