Postpartum Tubal Ligation – Procedure, Benefits, and Risks

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Dr. Sabiha Anjum (Obstetrician and Gynaecologist )
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Postpartum Tubal Ligation - Procedure, Benefits, and Risks

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A couple who has recently had a baby and don’t wish to add to their family may look for a permanent form of birth control to prevent pregnancies in the future. While there are many options in birth control available today, tubal ligation offers a permanent solution. When a couple decides to go ahead with it after having a baby, it can be called as postpartum tubal ligation. Read on to know more about postpartum tubal ligation, how and when it’s done, its benefits, risks, and side effects.

What Is Postpartum Tubal Ligation?

The procedure carried out to prevent a woman from conceiving a baby permanently is known as postpartum tubal ligation. This method is an effective contraceptive option which can be performed at the time of caesarean delivery or immediately after a vaginal delivery. Since the fallopian tubes are closed or removed in this procedure, the egg is prevented from travelling into the uterus through the fallopian tubes and the sperm does not reach the egg.

When Is It Performed?

Postpartum tubal ligation is carried out immediately after the baby is delivered through vaginal delivery. It is usually done before the enlarged uterus returns to its normal position and size. It does not extend your stay in the hospital in any way. If a caesarean section is carried out, the procedure will be done at the same time if you request so. This is a permanent form of birth control and doctors generally recommend it under the following conditions:

  • if a woman is unable to use any other birth control methods
  • if another pregnancy can be life-threatening to a woman
  • if a woman has a serious genetic disease which could be passed on to the baby
  • if a woman doesn’t want any more children

Benefits of Tubal Ligation After Childbirth

  • Tubal ligation is considered to be a reliable form of birth control since the fallopian tubes are closed leading to lifetime sterilization.
  • Sexual intercourse is not affected in any way due to a birth control device or spermicide. One also does not need to take pills before or after intercourse to avoid pregnancy.
  • Serious infections like Pelvic Inflammatory Disease (PID) can be avoided due to the blocking of fallopian tubes.

Preparing for Postpartum Sterilization Procedure

A woman needs to prepare herself before she decides to go ahead with the postpartum sterilization procedure. If you want to go through this procedure, you will have to ensure that there are people at home to take care of your baby and you as you will take some time to recover after the operation. If you have a family to take care of, ask for help from relatives or friends. Smoking and consuming tobacco should be avoided during pregnancy (or otherwise), and your doctor will ask you to stop smoking before and after the procedure (if you choose to smoke after delivery). Smokers are more likely to suffer from breathing-related issues during surgery and heal slower than non-smokers post-surgery. If you are a smoker, you are advised to quit smoking at least a couple of weeks before the procedure.

What Happens During the Procedure?

During the postpartum sterilization procedure, you will be given a local or regional anaesthetic so that it numbs specific parts of your body while you remain conscious. However, it keeps you from feeling the pain of surgery. The general anaesthetic is given to relax the muscles, which can help you fall asleep and keep you from feeling pain.

During the procedure, the doctor makes an incision just below the navel or the belly button. This is done because during pregnancy, the uterus is enlarged and the fallopian tubes are situated in the abdomen. In this manner, the doctor is able to reach the tubes for clamping, sewing or tying them up as desired. After this closing process, the incision is covered with dissolving stitches and bandages and left to heal.

What Happens During the Procedure?

What Happens After the Procedure?

The procedure does not add any kind of discomfort to that of childbirth birth itself nor will you have to stay in the hospital for long due to it. Make sure you speak to your doctor about the actual period of recovery, the kind of activities you should avoid and how you should take care of yourself while at home. Ask for the next check-up appointment date before you leave the hospital.

How Long Can Postpartum Sterilization Take?

The postpartum sterilization procedure takes about 30 minutes to be completed. Also since it is usually carried out immediately after or during childbirth, it does not extend your stay at the hospital in any way.

When Should You Avoid Postpartum Sterilization?

It is best to avoid postpartum sterilization when you are going through difficult times or period of extreme emotional stress like a divorce or the death of a person you were close to. Especially avoid it if you are being pressurized by a partner to do this or another family member. Women who are below the age of 30 should think before committing to this procedure as they are more likely to regret it later. If you have had serious complications with the baby, it is best to postpone postpartum sterilization.

Risks and Side Effects of This procedure

Every medical procedure has its own set of risks and side effects. Check out those associated with postpartum sterilization:

Risks

  • During the process, intestines, glands, blood vessels and abdominal organs could be damaged and abdominal surgery to repair them may be required. This, however, is a rare event.
  • Anaesthesia has to be administered professionally and could carry some risks if not done correctly. It is best to discuss this with the doctor before the process is undertaken.
  • Pelvic organs could get permanent scar tissues or adhesions.
  • During this procedure, a blood clot could break off, enter the bloodstream and block arteries in the legs, pelvis or lung. In rare cases, a blood clot could clog a brain or heart artery which could lead to a stroke or a heart attack.
  • The procedure could also lead to bleeding or infection.
  • Although, it is a lifetime permanent sterilization process, there are slight chances of the woman becoming pregnant despite tubal ligation. In this case, this will be a pregnancy outside the uterus which can be dangerous for the woman. Further surgery will be needed to terminate the pregnancy.

Side Effects

Depending upon the kind of anaesthesia used and the manner in which the surgery is performed, you could face certain side effects after postpartum tubal ligation procedure. There will be a general feeling of tiredness and you could also expect pain in the abdominal area. The following side effects can occur too:

  • If general anaesthesia was used during this surgery, you could have a sore throat due to the breathing tube inserted
  • Inflammation of the abdominal wall lining
  • A bloated feeling
  • Nausea
  • Dizziness
  • Abdominal cramps
  • Shoulder pain

Speak to your doctor if the abdominal pain refuses to let go and increases in severity or if you have a fever.

FAQs

1. What Kind of Anaesthesia Is Used?

During a postpartum tubal ligation, two types of anaesthesia—general and spinal—can be used to eliminate any pain that will be caused.

For spinal anaesthesia, the specialist will inject your lower back with the medicine. This will cause the portion from below the rib cage to become numb and immune to pain. You may still feel some movement and pressure during the actual procedure.

For general anaesthesia, an oxygen mask will be placed on your mouth and nose and an IV will be used to help the medicines to enter your veins. You will feel sleepy and relaxed. A breathing tube will be inserted through the windpipe to help you breathe with ease.

2. Are There Any Alternatives to Postpartum Sterilization?

It is necessary to consider a few alternatives before opting for this procedure. The alternatives include condoms, vasectomy, birth control pills and intrauterine devices. Speak to your doctor about your needs before making a selection.

3. What If You Decide to Become Pregnant After Postpartum Sterilization?

There is a possibility of a change of mind about becoming a mother after the postpartum sterilization is carried out. However, attempts to reverse this process do not meet with much success. The chances of pregnancy after the reversal of tubal ligation are very less. Even is a woman gets pregnant, it could be an ectopic pregnancy which could be risky for the mother.

Postpartum tubal ligation is a permanent method of contraception and the decision to go ahead with it should be a well-thought one. The couple should considered every scenario before taking this step as the reversal is difficult. If you have second thoughts, you can also consider its alternatives, which though do not offer a permanent solution, are very effective.

Also Read: Natural Family Planning – Fertility Awareness Methods

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