Understanding Sterilization for a Woman

You may be thinking about sterilization as your method of birth control. If so, this booklet will offer some useful information. You should read this whole booklet before making up your mind about sterilization.

Either a man or a woman can be sterilized.

Sterilization is a simple operation that prevents you from becoming pregnant. This operation is intended to be a permanent method of birth control.

There are several reasons why people consider sterilization:

  • They never want to have any more children
  • They do not want to ever have children
  • People may have an inherited medical condition which could affect their children.
  • Pregnancy may be a danger to a womanís health.

It is your decision whether to be sterilized or not. Donít let anyone make that decision for you.

If you do not want to be sterilized, you will not lose public benefits or medical services. If you decide to be sterilized, you can still change your mind at any time before the operation.

How will sterilization change a woman's body?
How will sterilization affect you?
How effective is sterilization?
Can a sterilization be undone?
What is anesthesia?
Which one of the four sterilization operations would be best for you?
How long does it take to recover?
What kinds of health problems can occur with these operations?
When can you have a sterilization operation?
What is a hysterectomy?
Is being sterile the right decision for you?

How will sterilization change a womanís body?

The fallopian tubes are where the manís sperm meet with the womanís egg. This joining of the egg and sperm may result in pregnancy.

After a successful sterilization operation, both tubes are blocked and the manís sperm canít reach the egg. The uterus, ovaries and hormones will remain the same as before the operation. A woman will still have her monthly period.

How will sterilization affect you?
If the operation is successful you will be immediately sterile. You will not need to use any kind of birth control. You will still have your menstrual periods. However, a few women report irregular or heavier periods. Sterilization will not change your ability to have sex, but it may change your feelings about sex. Most women feel better because they arenít afraid of becoming pregnant.

How effective is sterilization?

Sterilization almost always prevents pregnancy. Less than 1% of women get pregnant after the operation.

Sterilization is the most effective method of birth control, but it is not guaranteed. Occasionally it fails because:

Can a sterilization be undone?

Any sterilization operation should be considered permanent because it is very difficult to reverse. Even though the tubes can sometimes be reconnected, it is difficult, very expensive, and pregnancy may still not be possible.

There a four kinds of operations which block the tubes:

  1. Laparoscopy
  2. Mini-laparotomy
  3. Vaginal Sterilization
  4. Post Partum sterilization (after childbirth)


These operations are done under anesthesia and are done in either a hospital or a ďsurgi-centerĒ.

What is anesthesia?

Anesthesia keeps you from feeling pain during an operation. There are three kinds of anesthesia used for sterilization operations: general, local, and spinal area. If you have a sterilization operation, a doctor will help you decide which you anesthesia is best for you.
TypeHow It WorksPossible Problems
General AnesthesiaYou are put into a deep sleep. Your whole body is numb.Occasionally it causes heart and breathing problems. Very rarely, a person may die.
Local AnesthesiaThe area being operated on is made numb by injecting under the skin. A tranquilizer may be given to make you sleepy.Sometimes it doesnít relieve all the pain. It is not likely to cause serious health problems.
Spinal or Epidural AnesthesiaSome anesthesic is injected into the spinal area which makes your body numb from the waist down. It is most often used with sterilization after childbirth.Rarely, nerve damage or breathing problems may occur.

Which one of the four sterilization operations would be best for you?

If you decide to be sterilized, a doctor or counselor will help you decide which operation to have. Sometimes, a doctor may only do one kind of operation. Your body type (fat or thin) may also determine the type of operation you can have. It may also depend on what kind of anesthesia is used.

Laparoscopy

The doctor looks through a laparoscope (like a telescope) to see the fallopian tubes and close them off.

Hereís how it is done:

After general or local anesthesia, the doctor makes a small cut (about 1 to 1 Ĺ inches) just below your navel. Through this small cut, a gas such as carbon dioxide gas (CO2) is put into your abdomen. Your head will be slanted down so the gas pushes the intestines out of the way.

The doctor puts a laparoscope through this small cut. A laparoscope is a thin metal tube with a light in it which helps the doctor see your uterus and tubes. A second small cut is made right at the pubic hair line so an instrument can be used to reach in and close off the fallopian tubes. The tubes are clamped shut with either clips or rings, or closed with heat (hot cautery). A couple of stitches will close the one or two small cuts. This operation usually takes about 15 to 30 minutes.

How long does it take to recover?

If there are no problems, you will stay in the hospital about 4 to 6 hours. You should be back to normal in a couple of days. You are now safe from pregnancy and can have sex as soon as you like.

Mini-laparotomy

The doctor reaches the fallopian tubes through a small cut on the abdomen and cuts the tubes in half or closes them off.

Hereís how it is done:

After a general or local anesthesia is given, the doctor makes a small cut 1 to 3 inches long right above the pubic hair. Through this cut the doctor can grasp the tubes. The tubes are often tied off and cut in half with a little piece removed from each one. Or the tubes may be closed with clips or rings.

The cut is closed with a few stitches. This operation usually takes about 15 to 30 minutes.

How long does it take to recover?

If there are no problems, you will stay in the hospital about 4 to 6 hours. You should be back to normal in a couple of days. You wonít be able to have sex for a couple of weeks due to the cut in the vagina, but you are safe from pregnancy right after this operation.

Post Partum Sterilization

Right after childbirth, the fallopian tubes can be reached through a small cut below the navel.

Hereís how it is done:

After the baby is delivered, you will be given either epidural or general anesthesia. The doctor makes a small cut below your navel. When you have just had a baby, the uterus and tubes are just under the skin. Through this small cut, the doctor can tie off the tubes and cut them in half. A little piece of each may be removed.

A couple of stitches will close the cut. The operation usually takes about 15 to 20 minutes. If you are having a C-section (an operation on the uterus to take out the baby), the doctor can tie off and cut your tubes at the same time.

How long does it take to recover?

It you decide to be sterilized right after your baby is born, you might stay in the hospital an extra day. The small cit, or the C-section cut, will heal in several days. When you feel ready to have sex again, you will be safe from pregnancy.

What kinds of health problems can occur with these operations?

Any kind of surgical operation can cause health problems Ė some minor and some serious.

Minor problems (discomforts) are common after an operation, but usually go away in a few days without any treatment. Some of the possible discomforts after a sterilization operation are:

Serious health problems do not happen very often, but you should know about them. With laparoscopy and mini-lap, about 1 to 2 women out of 100 have serious problems after the operation. The same is true for post partum sterilization. Vaginal sterilization causes problems in 1 to 6 women out of 100 due to the higher possibility of infection.

Some of the possible health problems due to a sterilization operation are:

  • bleeding
  • fever and infection
  • injury to the intestines and bladder
  • heart and breathing problems (with laparoscopy)
  • accidental burning (with hot cautery)
  • painful sexual intercourse (with vaginal sterilization)
Rarely, there may be heart and breathing problems if general anesthesia is used. Very rarely a person may die.

When can you have a sterilization operation?

If you want to be sterilized, you should think about when to have it done. First talk to a doctor or counselor. Then, make up your own mind.

A sterilization operation can be done at different times:

What is a hysterectomy?

Hysterectomy is different from tubal sterilization. Instead of just blocking the tubes, the whole uterus is taken out. A hysterectomy should be done only when there is a disease of the uterus or some other problem that can be treated only by removing the uterus. Hysterectomy should not be done just for birth control.

A hysterectomy is much more serious than a tubal sterilization. A hysterectomy takes longer to do, and the woman is in the hospital longer. There are more discomforts, and there is a greater chance of serious health problems.

If your doctor recommends a hysterectomy, make sure you know why. You should consider getting a second opinion from another doctor.

Is being sterile the right decision for you?

You should think carefully about whether you want to be sterilized. The positive side of being sterile is: You never have to use birth control. You never have to worry about getting pregnant.

The negative side of being sterile is: You may change you mind and want to get pregnant after all.

Think carefully about your decision to be sterilized!

If you are deciding, think about these things:

Some women may be sorry they were sterilized, especially if it was somebody elseís idea (like a doctor, husband, or friend). Young people under 30 years old who have been sterilized are more likely to be sorry than others. You should think carefully about sterilization, especially if you are young, or if you have no children. If in doubt, postpone your decision.



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